Tag Archives: acute coronary syndrome

Risk Factors Associated with Acute Coronary Syndrome after Successful Percutaneous Coronary Intervention

Violeta Dinesch1, Mihail Dinesch2, Ileana Voichita Sirbu3, Cosmin Macarie3, Mircea Buruian4

1. University of Medicine and Pharmacy Tîrgu Mures, Romania
2. Department of Cardiology, Institute for Cardiovascular Disease and Heart Transplant, Tîrgu Mures, Romania
3. Department of Internal Medicine M3, University of Medicine and Pharmacy, Tîrgu Mures, Romania
4. Department of Morphologic Sciences M1, University of Medicine and Pharmacy Tîrgu Mures, Romania

DOI: 10.1515/amma-2017-0036

Objective: Admission for acute coronary syndrome after successful percutaneous coronary intervention is a delicate situation for the patient and doctor. Predictors of these cases are poorly described.
Methods: We retrospectively analysed the files of post-percutaneous coronary intervention patients admitted to the Department of Cardiology of the Institute for Cardiovascular Disease and Heart Transplant in Tirgu Mures between January 2012 and December 2015. Analyses using the t-test, chi-square test, and Fisher test were performed to compare demographics, clinical and angiographic characteristics of patients with acute coronary syndrome, patients with stable angina, and those without symptoms.
Results: One hundred eighty post-percutaneous coronary intervention patients were readmitted; 46 patients (25.55%) were readmitted for acute coronary syndrome. Histories of arterial hypertension and renal dysfunction at hospital admission were associated with acute coronary syndrome. Bare metal stent in-stent restenosis and localisation of bare metal stent in-stent restenosis of the left descendent coronary artery were angiographic predictors of acute coronary syndrome.
Conclusion: Several clinical and angiographic factors identify patients at high risk for acute coronary syndrome after successful percutaneous coronary intervention. Recognition and treatment of these factors may prevent readmission for such a dangerous condition and may improve outcomes.

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High-on-Aspirin Residual Platelet Reactivity Evaluated Using the Multiplate® Point-of-Care Device

Mărginean Alina1,2*, Moldovan Valeriu1, Mărginean Mihai1,2

1 University of Medicine and Pharmacy of Tîrgu Mures, Romania
2 Emergency Military Hospital “Dr. Constantin Papilian” Cluj-Napoca, Romania

DOI: 10.1515/amma-2015-0124

Objective: The aim of this study was to evaluate the prevalence of aspirin non-responsiveness using whole blood multiple electrode aggregometry and to investigate the role of different clinical and laboratory variables associated with the lack of response.
Methods: The present study included 116 aspirin treated patients presented with acute coronary syndromes or stroke. Response to aspirin was assessed by impedance aggregometry using arachidonic acid as agonist, in a final concentration of 0.5 mM (ASPI test).
Results: In our data set 81% (n=94) were responders and 19% (n=22) non-responders showing high-on-aspirin platelet reactivity. Correlation analysis showed that the ward of admittance, low-density lipoproteins (LDL), concomitant antibiotic treatment, beta-adrenergic receptor blockers, history of myocardial infarction as well as PCI performed on Cardiology patients have different degrees of association with aspirin response.
Conclusion: Concomitant treatment with beta-adrenergic receptor inhibitors, history of myocardial infarction and Cardiology ward admittance significantly increased the chance of responding to aspirin treatment whereas antibiotic therapy and low-density lipoproteins cholesterol seemed to increase the risk of high-on-aspirin residual platelet reactivity.

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Study on the Resuscitations Performed in the Emergency Department of the Clinical Emergency County Hospital from Târgu Mureș in 2009

Bratu Simona¹, Copotoiu Sanda-Maria2,3

1 UPU-SMURD, County Emergency Clinical Hospital, Tîrgu Mureş, Romania
2 University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Anesthesia and Intensive Care, County Emergency Clinical Hospital, Tîrgu Mureş, Romania

Objectives: The study assesses the results of the cardiac arrest resuscitations performed by the medical staff of the Emergency Department of The Clinical Emergency County Hospital from Târgu-Mureş in the year 2009.
Method: We conducted a prospective study between 01.01-31.12.2009, including the cardiac arrest cases occurred in the ED or brought with ongoing resuscitation from the pre-hospital setting. For the statistical study we used SPSS program, version 17; the χ2 tests and p values were determined to compare the data.
Results: We had a total of 186 cases of cardiac arrest, representing 0.47% of the total 39.074 patients assisted in the ED in 2009. The gender distribution of the cases showed a higher incidence in male (61%) and the most affected age groups ranged between 60–80 years. The patients with cardiac arrests presented various diagnosis: the highest incidence is acute coronary syndrome 32 patients (17%), followed by sepsis/MSOF 20 (11%), pneumonia/asthma 17 (9%), pulmonary embolism 17 (9%), stroke 13 (7%), etc. We have resuscitated successfully 42 patients, representing 22.58 % of the total 186 cases. All 42 patients were transferred to the hospitals departments. Out of the hospitalized patients, 25 died later on the wards and 17 (40.47%) survived and were discharged home, 6 from the Intensive Care Department and 11 from the Coronary Unit.
Conclusions: The results are comparable with the reported international data. The cases with cardiac arrest due to acute coronary syndrome, ventricular rhythms and those witnessed and treated early in the ED are having a better outcome.

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