Systematic Review of Economic Evaluations of Units Dedicated to Acute Coronary Syndromes

Azeredo-da-Silva, André Luís Ferreira; Perini, Silvana; Soares, Pedro Henrique Rigotti; Polaczyk, Carisi Anne

doi:10.1016/j.jval.2015.11.015

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…In the present study, the mean±SD of age (63.9±12.11 years) was significantly higher in ACS patients compared with the control group (45.47±11.75 years) with p<0.05 (Table 1). The finding is supported by the study conducted by Zaky Doaa SE et al 3 where they found the mean±SD of age for the ACS cases was 56.28±10.66 years and for the controls it was 53.1±11.47 years. The elderly has the highest incidence of cardiovascular disease and frequently present with ACS.…”

Section: Discussionsupporting

confidence: 64%

“…2 Acute coronary syndrome or Ischemic heart disease (IHD) was the main cause of death globally during the last 15 years and continues to grow at exponential rates. 3 It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. 1 The common risk factors for the disease are smoking, hypertension, diabetes, hyperlipidaemia, male sex, physical inactivity, obesity, and poor nutritional practices.…”

Section: Introductionmentioning

confidence: 99%

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Lipid Profile in Patients with and Without Acute Coronary Syndrome

-¹,

-²,

-³

et al. 2023

IJFMR

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Background: Coronary heart disease (CHD) remains the major cause of mortality and morbidity in the entire world population despite therapeutic advances that control many risk factors. Lipid profile is regarded as an important factor in the development of coronary heart disease. There have been numerous studies showing the association of hyperlipidemias with coronary heart disease in most of the Western as well as Asian countries of the world. But we have very little data on the relation between CHD and lipid profile in this part of the globe. Objective: To evaluate the association between lipid profile and acute coronary syndrome (ACS). Methods: This cross-sectional study was done in the Department of Biochemistry in collaboration with the Department of Cardiology, Regional Institute of Medical Sciences, Imphal on diagnosed cases of acute coronary syndrome in between January 2021 to October 2022. Estimation of lipid profile was done by Randox Imola autoanalyzer. Data collected were entered in SPSS version 21.0 and analysed using descriptive measures, and statistical significances were set at p<0.05. Results: A total of 67 patients of acute coronary syndrome and 67 without acute coronary syndrome (total 134) were recruited in the study. It is seen that the mean±SD of age in cases was 63.69±12.11 years and in the controls, it was 45.47±11.75 years, and the difference observed was found to be statistically significant p<0.05. The majority of the cases were males comprising of 49 (73.3%) and females constitute only 18 (26.7%). 42 (62.2%) of the cases had history of HTN while 25 (37.8%) had no h/o HTN. In cases the mean±SD of SBP (112.67±17.35 mmHg) and DBP (73.38±11.63 mmHg) were found to be significantly lower than the controls. As regards the lipid profile, in the cases the mean±SD of total cholesterol was 208.75±31.25 mg/dl and in controls 144.02±19.57 mg/dl, triglycerides in cases was 162.51±39.81 mg/dl and 98.42±16.96 mg/dl in controls and LDL was 142.22±31.31 mg/dl in the cases and 71.40±21.24 mg/dl in controls showing that the values were higher in the cases as compared to the control group and the difference was found to be statistically significant with p<0.05. However, the mean±SD of HDL in the cases (34.78±6.44 mg/dl) was lower as compared to the controls (49.56±5.72 mg/dl) and the difference was statistically significant with p<0.05. Conclusion: In this study, it was found that the total cholesterol, triglycerides, and LDL cholesterol concentrations were significantly higher and HDL concentration was lower in acute coronary syndrome (ACSD) patients. The imbalance between TC and HDL levels plays a more important role in the pathophysiology of atherogenesis leading to ACS.

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Lipid Profile in Patients with and Without Acute Coronary Syndrome

-¹,

-²,

-³

et al. 2023

IJFMR

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“…Las UDT son un área dentro del servicio de urgencias encargada de la clasificación y el tratamiento de los pacientes que consultan por dolor en el pecho o síntomas sugestivos de síndrome coronario agudo, que busca disminuir las hospitalizaciones innecesarias y evitar el alta temprana de pacientes que podrían tener un síndrome coronario agudo en curso 7,8 . Las UDT han permitido la estratificación de pacientes con dolor de pecho con el fin de iniciar tratamientos oportunos en aquellos con síndrome coronario agudo y establecer la seguridad de un alta temprana en aquellos con condiciones de bajo riesgo [8][9][10] .…”

Section: Introductionunclassified

“…Diferentes estudios reportaron que las UDT implementadas en los servicios de urgencias de los centros hospitalarios son costo-efectivas 5,6,9 y disminuyen las hospitalizaciones innecesarias 5,6 , las reconsultas a urgencias 5,6 y la morbimortalidad 11 ; sin embargo, la información disponible correspondiente a países latinoamericanos es escasa 12,13 .…”

Section: Introductionunclassified

Efectividad de una unidad de dolor torácico en el primer nivel de atención en salud con telecardiología: un estudio cuasiexperimental de series de tiempo interrumpidas

Alzate-Gutiérrez¹,

Roldán-Toro²,

Gallo‐Villegas³

et al. 2022

RCCAR

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Introducción: Las unidades de dolor torácico disminuyen la morbimortalidad de los pacientes con síndrome coronario agudo. No obstante, se desconoce su efectividad en el primer nivel de atención con el apoyo de la telecardiología. Objetivo: Evaluar la efectividad de las unidades de dolor torácico sobre los tiempos de atención, la concordancia diagnóstica y la frecuencia de reconsultas a urgencias y hospitalización. Método: Estudio cuasiexperimental de series de tiempo interrumpidas, robusto, que incluyó 20,412 pacientes que consultaron al servicio de urgencias por dolor torácico, antes y después de implementar una unidad de dolor torácico. Se analizaron los cambios en la pendiente, el nivel, la autocorrelación y la varianza de los desenlaces estudiados entre ambos periodos (previo y posterior a las unidades de dolor torácico) a 30 días. Resultados: El promedio de edad fue de 44.9 ± 17.6 años y el 45.8% fueron hombres. La proporción global de pacientes remitidos para hospitalización fue del 9.0%. La pendiente de las tasas de reconsultas a urgencias disminuyó (diferencia: −1.23; intervalo de confianza del 95% [IC95%]: −2.46 a −0.01; p = 0.049) al comparar los dos periodos de observación. Igualmente, la proporción de pacientes remitidos sin síndrome coronario agudo y que finalmente tuvieron este diagnóstico en el tercer nivel de atención disminuyó en el periodo posterior a las unidades de dolor torácico con relación al previo p = 0.020). Conclusiones: Las unidades de dolor torácico incrementaron los egresos de forma segura, con disminución de las reconsultas a urgencias en los siguientes 30 días por la misma causa. Además, mejoró la concordancia diagnóstica del síndrome coronario agudo, sin modificar los tiempos de atención ni la frecuencia de rehospitalización por enfermedad cardiovascular en el seguimiento.Palabras clave: Dolor en el pecho. Síndrome coronario agudo. Servicios médicos de urgencia. Hospitalización. Estudios de series temporales.

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“…Low-to-intermediate risk chest pain is a common clinical issue in emergency departments (ED) [ 1 ]. Several noninvasive tests, including coronary computed tomographic angiography (CCTA), myocardial perfusion imaging (MPI), stress electrocardiogram (ECG), and stress echocardiography, have been performed for the patients with suspected coronary artery disease (CAD), however, there has been little consensus about which testing strategy is optimal [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Coronary computed tomographic angiography for patients with low-to-intermediate risk chest pain: A systematic review and meta-analysis

et al. 2016

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Coronary computed tomographic angiography (CCTA) can image the coronary vasculature rapidly and detect the presence and severity of luminal stenosis accurately. However, whether CCTA based care strategy could gain more benefits than conventional strategy with functional tests for patients with low-to-intermediate risk chest pain remains unknown. In this study we performed a meta-analysis to compare the clinical efficacy of CCTA versus conventional strategy. Eight randomized controlled trials with 14749 patients were finally included in this review after database searching. Compared with conventional strategy, CCTA significantly increased the rates of invasive coronary angiography (RR 1.44; 95% CI 1.28 to 1.63) and revascularization (RR 1.94; 95% CI 1.65 to 2.29), but did not change the rates of major adverse cardiovascular events (RR 1.10; 95% CI 0.92 to 1.30), death (RR 0.95; 95% CI 0.64 to 1.40) and hospital readmission (RR 0.96; 95% CI 0.66 to 1.40). Consequently, compared with conventional strategy, CCTA seemed not to improve clinical outcomes for patients with low-to-intermediate risk chest pain.

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Systematic Review of Economic Evaluations of Units Dedicated to Acute Coronary Syndromes

Abstract: Published economic evaluations indicate that more intensive care is likely to be cost-effective in comparison to routine hospital admission for patients with suspected ACS.

Cited by 5 publications

References 37 publications

Lipid Profile in Patients with and Without Acute Coronary Syndrome

Lipid Profile in Patients with and Without Acute Coronary Syndrome

Efectividad de una unidad de dolor torácico en el primer nivel de atención en salud con telecardiología: un estudio cuasiexperimental de series de tiempo interrumpidas

Coronary computed tomographic angiography for patients with low-to-intermediate risk chest pain: A systematic review and meta-analysis

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