Acute Coronary Syndrome Behavior: Results of a Brazilian Registry

Piegas, Leopoldo Soares; Avezum, Álvaro; Guimarães, Hélio Penna; Muniz, Antônio José; Reis, Helder José Lima; Santos, Elizabete Silva dos; Knobel, Marcos; Souza, Roberta de Castro

doi:10.5935/abc.20130101

Cited by 33 publications

(43 citation statements)

References 11 publications

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“…Thus, a follow-up study may indicate this association. Low levels of Hb were more prevalent among older patients (10), which can be due to nutritional deficiencies or chronic diseases (16), and among females probably because of iron deficiency due to menstruation, pregnancy, and childbirth (17).…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

Fazlinezhad¹,

Hami²,

Shakeri³

et al. 2015

Int Cardiovasc Res J

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A B S T R A C T Background: Studies have shown that Glomerular Filtration Rate (GFR) and Hemoglobin (Hb) concentrations are two predictive values for ST-elevation Myocardial Infarction (MI) mortality.Objectives: This study aimed to investigate the relationship between GFR and Hb concentrations and intra-hospital mortality and electrocardiographic (ECG) and echocardiographic abnormalities in ST-elevation MI patients admitted to a highly equipped hospital in Mashhad. The results will help define some factors to manage these patients more efficiently. Patients and Methods:This descriptive study aimed to assess the relationship between Hb and GFR concentrations and mortality and morbidity among 294 randomly selected patients with ST-elevation MI. Echocardiography, ECG, and routine laboratory tests, including Hb and creatinine, were performed for all the patients. Then, the data were entered into the SPSS statistical software, version 16 and were analyzed using chi-square, t-test, and ANOVA. P < 0.05 was considered as statistically significant. Results: Intra-hospital mortality rate was 10.5%. Besides, the results showed higher levels of serum blood sugar (P < 0.001), higher levels of creatinine (P < 0.001), lower levels of GFR (P < 0.001), lower ejection fraction (P < 0.001), higher grades of left ventricular diastolic dysfunction (P = 0.002), and lower mean Hb concentration (P = 0.022) in the dead compared to the alive cases. Besides, the patients with mechanical complications had lower Hb levels (P = 0.008). The results showed no significant relationship between creatinine level and mechanical and electrical complications (P = 0.430 and P = 0.095, respectively). However, ejection fraction was significantly associated with GFR (P = 0.016). Conclusions: According to the results, low levels of Hb and GFR could predict mortality caused by ST-elevation MI and ECG abnormalities could notify intra-hospital death. Moreover, lower Hb levels were associated with mechanical complications and could be used as a parameter for diagnosis of high-risk patients.

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Section: Discussionmentioning

confidence: 99%

The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

Fazlinezhad¹,

Hami²,

Shakeri³

et al. 2015

Int Cardiovasc Res J

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“…According to the Brazilian Unified Health System’s Database, cardiovascular disease accounted for 10% of all hospitalizations and more than one-third of deaths in Brazil [1]. Acute coronary syndromes (ACS) represent a major cause of hospitalization and are the third leading cause of hospitalization in the Unified Health System [2]. …”

Section: Introductionmentioning

confidence: 99%

Symptoms awareness, emergency medical service utilization and hospital transfer delay in myocardial infarction

Mesas

Rodrigues

Mesas

et al. 2018

BMC Health Serv Res

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BackgroundThe length of time between symptom onset and reperfusion therapy in patients with ST-segment elevation acute myocardial infarction (STEMI) is a key determinant of mortality. Information on this delay is scarce, particularly for developing countries. The objective of the study is to prospectively evaluate the individual components of reperfusion time (RT) in patients with STEMI treated at a University Hospital in 2012.MethodsMedical records were reviewed to determine RT, its main (patient delay time [PDT] and system delay time [SDT]) and secondary components and hospital access variables. Cognitive responses were evaluated using a semi-structured questionnaire.ResultsA total of 50 patients with a mean age of 59 years (SD = 10.5) were included, 64% of whom were male. The median RT was 430 min, with an interquartile range of 315–750 min. Regarding the composition of RT in the sample, PDT corresponded to 18.9% and SDT to 81.1%. Emergency medical services were used in 23.5% of cases. Patients treated in intermediate care units showed a significant increase in SDT (p = 0.008). Regarding cognitive variables, PDT was approximately 40 min longer among those who answered “I didn’t think it was serious” (p = 0.024).ConclusionsIn a Brazilian tertiary public hospital, RT was higher than that recommended by international guidelines, mainly because of long SDT, which was negatively affected by time spent in intermediate care units. Emergency Medical Services underutilization was noted. A patient’s low perception of severity increased PDT.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3312-6) contains supplementary material, which is available to authorized users.

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“…In 2009, acute myocardial infarction (AMI) was the second major cause of death (96,386 individuals) 2 , representing an incidence of 48 deaths per 100,000 inhabitants 1 . In addition to the loss of lives, the social costs are worthy of note; for example, chest pain was the cause of approximately 100,000 visits to basic health care units 1 and more than 200,000 hospitalizations in 2010 3 . Those figures have increased over the years 4 .…”

Section: Introductionmentioning

confidence: 99%

Use of Evidence-Based Interventions in Acute Coronary Syndrome - Subanalysis of the ACCEPT Registry

Wang¹,

Neuenschwander²,

Filho³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundThe recommendations in guidelines are based on evidence; however, there is a gap between recommendations and clinical practice.ObjectiveTo describe the practice of prescribing evidence-based treatments for patients with acute coronary syndrome in Brazil.MethodsThis study carried out a subanalysis of the ACCEPT registry, assessing epidemiological data and the prescription rate of acetylsalicylic acid, p2y12 inhibitors, antithrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (IAT1RB), and statins. In addition, the quality of myocardial reperfusion in ST-segment elevation myocardial infarction was evaluated.ResultsThis study assessed 2,453 patients. The prescription rates of acetylsalicylic acid, p2y12 inhibitors, antithrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors/IAT1RB, and statins were as follows: in 24 hours - 97.6%, 89.5%, 89.1%, 80.2%, 67.9% and 90.6%; and at six months - 89.3%, 53.6%, 0%, 74.4%, 57.6% and 85.4%, respectively. Regarding ST-segment elevation myocardial infarction, only 35.9% and 25.3% of the patients underwent primary angioplasty and thrombolysis, respectively, within the recommended times.ConclusionThis registry showed high initial prescription rates of antiplatelet drugs, antithrombotic drugs, and statins, and lower prescription rates of beta-blockers and angiotensin-converting enzyme inhibitors/IAT1RB. Independently of the class, the use of all drugs decreased by six months. Most patients with ST-segment elevation myocardial infarction did not undergo myocardial reperfusion within the time recommended.

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Acute Coronary Syndrome Behavior: Results of a Brazilian Registry

Abstract: The Brazilian Registry of Acute Coronary Syndrome data do not differ from other data collected abroad. The understanding of their findings may help promote better planning and management of acute coronary syndrome care in public and private health services.

Cited by 33 publications

References 11 publications

The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

Symptoms awareness, emergency medical service utilization and hospital transfer delay in myocardial infarction

Use of Evidence-Based Interventions in Acute Coronary Syndrome - Subanalysis of the ACCEPT Registry

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