Background : Coronary heart disease (CHD), a gradual chronic inflammatory disease, is influenced by the environmental, lifestyle, and genetic factors that can be seen from traditional risk factors, inflammatory biomarkers, and metabolic status.Inflammatory biomarkers that were currently being studied include high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα), and intercellular adhesion molecule-1 (ICAM-1). Increased hsCRP is an independent risk factor that is important for CHD and determines the prognosis in patients who have CHD. Cardiac rehabilitation has a role in improving risk factors and preventing a variety of advanced cardiovascular events. This study aims to find the relationship of cardiac rehabilitation programs to hsCRP values in patients with CHD who have undergone coronary artery bypass grafting (CABG).Methods :This study was conducted from April 2018 -September 2018 with a total sample of 67 patients underwent phase II cardiac rehabilitation programs following CABG that met the inclusion and exclusion criteria. The hsCRP laboratory examination was conducted by the Clinical Pathology Laboratory of Haji Adam Malik General Hospital in two measurement periods, before and after the phase II cardiac rehabilitation program. And then the data was analyzed to see the relationship between cardiac rehabilitation and hsCRP value.Results: The total subjects of this study were 67 people that can be classified into two groups, high risk group (hsCRP >3 mg/dL)15 people (22.38%) and medium risk group (hsCRP 1-3 mg/dL)52 people (77.61%). Statistically significant improvements were found with p <0.05 in various parameters such as: body weight, body mass index (BMI), waist circumference, six minutes walk distance (6MWD), functional capacity, hsCRP value, total cholesterol, LDL, HDL, and TG. Negative correlation was obtained between hsCRP value and functional capacity before the program with r -0.689 and p <0.05. A negative correlation was found between hsCRP value and functional capacity after the program with r -0.819 and p <0.05.Conclusion : There was a relationship between cardiac rehabilitation and hsCRP in patients undergoingCABG. A significant decrease of hsCRP value was found in this study. Cardiac rehabilitation program not only improved laboratory components such as hsCRP and lipid profile, but also improved other metabolic parameters such as weight, BMI, waist circumference, and also improved the 6MWD and exercise capacity of patients after CABG. There was a statistically significant negative correlation between hsCRP values and functional capacity both before and after the rehabilitation program.
Background: Non-ST segment elevation myocardial infarction (NSTEMI) has less frequent complications, but has worse long-term prognosis than ST segment elevation myocardial infarction (STEMI). Mortality rates of NSTEMI were lower than STEMI but after 6 months both mortality were similar. The purpose of this study was to determine the 2-year survival in patients with acute myocardial infarction (AMI). Method: This cohort retrospective study included 264 AMI patients treated from January-December 2015 in H. Adam Malik Medan General Hospital. The study sample was divided based on the diagnosis of STEMI and NSTEMI. Data were obtained from medical records. All patients were contacted by phone to determine their condition 2 years after experiencing AMI. Multivariate analysis was performed to assess the factors that affect the survival. The 2-year survival of STEMI and NSTEMI was compared using the Kaplan Meier plot.Result: From 264 patients, there were 216 (81.8%) men with median age of 56 years. We found 147 STEMI patients and 117 NSTEMI patients. NSTEMI group tended to have history of coronary artery disease, higher blood pressure, less revascularization, longer hospitalization days and less number of post AMI complications. Survival and mortality rates in 2 years were 58% and 28%. Multivariate analysis showed higher blood pressure (OR 1.023, CI 95%, 1.003-1.044) dan PCI during hospitalization (OR 8.604, CI 95%, 2.264-32.702) showed better 2-year survival. There were no significant 2-year survival differences between the two groups (log rank 0.136). Better 2-year survival was found in patients with single vessel disease (log rank 0.001), patients who received revascularization (log rank 0.001) and patients who did not experience heart failure or cardiogenic shock during hospitalization (log rank 0.001). Conclusion: There was no difference in 2-year survival between STEMI and NSTEMI patients who were admitted to H. Adam Malik Medan General Hospital in 2015. The 2-year survival appeared better in patients with single vessel disease, received revascularization and did not experience heart failure or cardiogenic shock during hospitalization.
As our population grows older, the rate of NSTEMI patients is rising. Risk stratification is an important process for patients with Non-ST Elevation Myocardial Infarction (NSTEMI). Global Registry of Acute Coronary Events (GRACE) scores in the best to predict mortality and myocardial infarction in NSTEMI Patients. On the other hand, NSTEMI Patients trends to be older with more co-morbidity. In this scenario, we need to predict the length of stay as it correlates with the patient's prognostic and cost. This study aims to analyze factors influencing the in-hospital length of stay in survivor NSTEMI Patients in four different hospitals
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