The Open Cardiovascular Medicine Journal最新文献

{"title":"Body Surface Mapping of T-wave Alternans Depends on the Distribution of Myocardial Scarring.","authors":"Amy Zeller,&nbsp;Behnaz Ghoraani","doi":"10.2174/1874192401509010026","DOIUrl":"https://doi.org/10.2174/1874192401509010026","url":null,"abstract":"<p><p>T-Wave alternans (TWA) testing using 12-lead electrocardiogram/Frank leads is emerging as an important non-invasive biomarker to identify patients at high risk of Sudden Cardiac Death (SCD). Cardiac scarring is very common among cardiomyopathy patients; however, its influence on the body surface distribution of TWA has not yet been defined. Our objective was to perform a simulation study in order to determine whether cardiac scarring affects the distribution of TWA on thorax such that the standard leads fail to detect TWA in some of cardiomyopathy patients; thereby producing a false-negative test. Developing such a novel lead configuration could improve TWA quantification and potentially optimize electrocardiogram (ECG) lead configuration and risk stratification of SCD in cardiomyopathy patients. The simulation was performed in a 1500-node heart model using ECGSIM. TWA was mimicked by simulating action potential duration alternans in the ventricles. Cardiac scarring with different sizes were simulated by manipulating the apparent velocity, transmembrane potential and transition zone at varied locations along the left ventricular posterior wall. Our simulation study showed that the location of maximum TWA depends on the location and size of the myocardium scarring in patients with cardiomyopathy, which can give rise to false-negative TWA signal detection using standard clinical leads. The TWA amplitude generally increased with the increment of scar size (P<0.00001). We found one specific location (a non-standard lead) that consistently appeared as the top five maximum TWA leads and could be considered as an additional lead to improve the outcome of the TWA testing in cardiomyopathy patients. </p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"9 ","pages":"26-34"},"PeriodicalIF":0.8,"publicationDate":"2015-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/c1/TOCMJ-9-26.PMC4378024.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33183090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local use of ankaferd blood clotter in emergent beating heart coronary artery bypass grafting.","authors":"Hakan Atalay,&nbsp;Atakan Atalay,&nbsp;Omer F Dogan","doi":"10.2174/1874192401509010018","DOIUrl":"https://doi.org/10.2174/1874192401509010018","url":null,"abstract":"<p><strong>Background: </strong>Severe beeding which requiring massive blood transfusion after emergent beating heart surgery is shown to be 1-3%. Therefore, complications and side effects of transfusion can be seen. The aim of this study was to investigate the effectiveness of Ankaferd blood clotter (ABC) as a new topical herbal blood clotter to decrease mediastinal bleeding in emergent beating heart CABG patients who medicated with clopidogrel and acetyl salisilic acite (ASA) prior to CABG surgery.</p><p><strong>Materials and methods: </strong>25 CABG patients received a high dose clopidogrel (600 mgr) and 300 mgr ASA have been included into the study (ABC group). 25 patients have also been included into the study for comparison (placebo group, PG). After the administration of protamine sulphate, a 10 ml of ABC solution has been sprayed to the surgical area including mediastinum and epicardial sac. We compared mediastinal drenaige, reoperation due to tamponade, and required blood and blood products in both groups.</p><p><strong>Results: </strong>The mean amount of bleeding after operation was 230 ml in ABC group, and 490 ml in CG (P=0.001). In ICU, bleeding in ABC group and CG was 410ml and 680ml, respectively (P=0.0022). The mean total bleeding from mediastinum was 530±280 mL and 990±440 mL In ABC and CG group, respectively (P=0.001). The amount of autotransfusion was as follows: 175 mL in ABC group, and 290 mL in CG (P=0.002). No patient needed the surgical revision in ABC group, but four patients (16%) from CG group because of cardiac tamponade. Seventeen patients from CG required blood transfusion due to low hematocrite level postoperatively. In CG, the mean hematocrite level was 17±2,3. Transfusion of fresh frozen plasma and platelets in ABC group and CG were as follows: 0.2 and 0 in ABC group, and 0.3and 0.4 in CG.</p><p><strong>Conclusion: </strong>Our study showed that the local use of 10 mL ABC reduces bleeding significantly. Therefore, transfusion requirements of PRBC, platelets, and total blood units in patients on clopidogrel and ASA undergoing emergent beating heart CABG. To provide cardiac tamponade because of excessive mediastinal bleeding and requirement of blood transfusion after emergent CABG patients who previously administered clopidogrel and ASA, we propose local use of ABC solution as a potent coagulant agent.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"9 ","pages":"18-25"},"PeriodicalIF":0.8,"publicationDate":"2015-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/92/TOCMJ-9-18.PMC4378067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33183088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid valve regurgitation following temporary or permanent endocardial lead insertion, and the impact of cardiac resynchronization therapy.","authors":"Masoud Sadreddini,&nbsp;Michelle J Haroun,&nbsp;Lisanne Buikema,&nbsp;Carlos Morillo,&nbsp;Sebastian Ribas,&nbsp;Syamkumar Divakaramenon,&nbsp;Stuart J Connolly,&nbsp;Robby Nieuwlaat,&nbsp;Eva M Lonn,&nbsp;Jeff S Healey,&nbsp;Hisham Dokainish","doi":"10.2174/1874192401408010113","DOIUrl":"https://doi.org/10.2174/1874192401408010113","url":null,"abstract":"<p><strong>Background: </strong>While some studies indicate that permanent pacemaker implantation is associated with development of tricuspid regurgitation (TR), other studies indicate no association.Little is known about the impact of temporary lead insertion during ablation procedures, or whether therapy (CRT) prevents TR post-device implantation.</p><p><strong>Hypothesis: </strong>We hypothesized that permanent, but nottemporary endocardial leads, are associated with development of TR, and that CRT would prevent (physiologic) TR.</p><p><strong>Methods: </strong>We performed a retrospective study of consecutive patients who underwent first device or radiofrequency catheter ablation over a 12-month period at a single, tertiary academic center who underwent pre- and post-procedure echocardiography.</p><p><strong>Results: </strong>In the 89 patients in the device group, the degree of TR significantly increased ≥ 1 grade post-permanent lead implantation: 9 had less TR, 46 were unchanged, and 34 had more TR(p=0.005). TR increased in the 62 patients who underwent device implantation without CRT (p=0.005), but did not increase in the 27 patients with CRT (p=0.47). In the 66 patients in the ablation group, there was no significant change in TR post-ablation: 8 had less TR, 48 were unchanged, and 10 had more TR (p=0.31).</p><p><strong>Conclusion: </strong>Permanent endocardial lead implantation was associated with an increase in TR; however, patients who underwent device implantation with CRT did not have an increase in TR.Temporary lead insertion during ablation was not associated with changes in the degree of TR. A large, prospective study is needed to accurately define the incidence and exact mechanisms of permanent endocardial lead-related TR.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"113-20"},"PeriodicalIF":0.8,"publicationDate":"2014-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/4b/TOCMJ-8-113.PMC4321203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33048868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HEALS Hypertension Control Program: Training Church Members as Program Leaders.","authors":"Sunita Dodani,&nbsp;Irmatine Beayler,&nbsp;Jennifer Lewis,&nbsp;Lindsey A Sowders","doi":"10.2174/1874192401408010121","DOIUrl":"https://doi.org/10.2174/1874192401408010121","url":null,"abstract":"<p><strong>Introduction: </strong>Health disparities related to cardiovascular diseases (CVDs) including stroke have remained higher in the African-Americans (AAs) than in other populations. HEALS is a faith-based hypertension (HTN) control program modified according to AA community needs, and delivered by the church-lay members called church health advisors (CHAs). This study examined the feasibility and acceptability of training CHAs as HEALS program leaders.</p><p><strong>Design: </strong>Four CHAs completed a 10-hour HEALS program training workshop at the Church, conducted by the nutrition experts. Workshop was evaluated by CHAs on their level of satisfaction, clarity of contents covered and comfort in delivery the program to the church congregation.</p><p><strong>Results: </strong>The overall six main HEALS curriculum components were completed. Workshop was highly evaluated by CHAs on length of training, balance between content and skills development, and level of satisfaction with program delivery.</p><p><strong>Conclusion: </strong>Church-based culturally modified health promotion interventions conducted by the community lay members may be a way to reduce health disparities in ethnic minorities.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"121-7"},"PeriodicalIF":0.8,"publicationDate":"2014-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/d4/TOCMJ-8-121.PMC4323768.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33057970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor encasement of the right coronary artery: role of anatomic and functional imaging in diagnosis and therapeutic management.","authors":"Yu-Hsiang Juan,&nbsp;Yiannis S Chatzizisis,&nbsp;Sachin S Saboo,&nbsp;Tatiana Rocha,&nbsp;Michael L Steigner","doi":"10.2174/1874192401408010110","DOIUrl":"https://doi.org/10.2174/1874192401408010110","url":null,"abstract":"<p><p>We presented two rare cases of mediastinal tumor encasing the right coronary artery (RCA), one with recurrent metastatic thymoma and another with primary poorly differentiated neoplasm. Different degrees and locations of RCA involvement were noted. The treatment approach varied from conservative to surgical. Coronary artery involvement by mediastinal tumors is important to be investigated with imaging as it may guide the surgical planning. </p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"110-2"},"PeriodicalIF":0.8,"publicationDate":"2014-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/fa/TOCMJ-8-110.PMC4241555.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32836826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in Medical and Device Therapy for Patients with Left Ventricular Systolic Dysfunction: The EchoGap Study.","authors":"Hisham Dokainish,&nbsp;Lauren Jewett,&nbsp;Robby Nieuwlaat,&nbsp;Joshua Coulson,&nbsp;Catherine Demers,&nbsp;Eva Lonn,&nbsp;Jeff Healey,&nbsp;Brian Haynes,&nbsp;Stuart Connolly","doi":"10.2174/1874192401408010094","DOIUrl":"https://doi.org/10.2174/1874192401408010094","url":null,"abstract":"<p><strong>Objectives: </strong>To assess gaps between guidelines and medicine prescription/dosing and referral for defibrillator therapy in patients with left ventricular systolic dysfunction (LVSD).</p><p><strong>Methods: </strong>Outpatient echocardiography reports at an academic hospital centre were screened and outpatients with LVEF<40% were included. A questionnaire was mailed to the patients' physician, querying prescription/dosing of ACE-inhibitors (ACEi), angiotensin receptor blockers (ARB) and beta-blockers (BB). Patients with LVEF<30% had additional questions on implantable cardiac defibrillator (ICD) referral.</p><p><strong>Results: </strong>Mean age was 69.6+/-12.2 years and mean LVEF was 29.7+/-6.5%. ACEi and/or ARB prescription rate was 260/309(84.1%) versus 256/308(83.1%) for BB (p=NS for comparison). Of patients on ACEi, 77/183(42.1%) were on target dose, compared to 7/45(15.5%) for ARB and 9/254(3.5%) for BB (p<0.01). Of 171/309 patients (55.3%) with LVEF<30%, 72/171(42.1%) had an ICD and 16/171(9.4%) were referred for one.</p><p><strong>Conclusion: </strong>Prescription rates of evidence-based HF medicines are relatively high in outpatients with LVSD referred for echocardiography at this Canadian academic medical centre; however, the proportion of patients at target doses was modest for ACEi and low for ARB and BB. Approximately half of patients who qualify for ICD by EF alone have one or were referred. Important reasons for patients with LVSD not on evidence-based therapy were identified.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"94-101"},"PeriodicalIF":0.8,"publicationDate":"2014-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/f3/TOCMJ-8-94.PMC4205776.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32770827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of 3 Common ABCA1 Gene Polymorphisms on Optimal vs Non-Optimal Lipid Profile in Greek Young Nurses.","authors":"Apostolia Marvaki,&nbsp;Vana Kolovou,&nbsp;Niki Katsiki,&nbsp;Maria Boutsikou,&nbsp;Anastasia Kotanidou,&nbsp;Stylianos Orfanos,&nbsp;Gerasimos Filippatos,&nbsp;Katerina Marvaki,&nbsp;Anastasios Koumoulidis,&nbsp;Sophie Mavrogeni,&nbsp;Genovefa Kolovou","doi":"10.2174/1874192401408010083","DOIUrl":"https://doi.org/10.2174/1874192401408010083","url":null,"abstract":"<p><strong>Objective: </strong>This study is in line with two previous ones from our group. They evaluated the influence of ATP-binding cassette transporter A1 (ABCA1) gene polymorphisms [such as rs2230806 (R219K), rs2230808 (R1587K) and rs4149313 (I883M)] on the human lipid profile (defined as Optimal and Non-Optimal).</p><p><strong>Methods: </strong>The present study included 447 unrelated young women and men self-reported as being healthy and that attended the University of Nursing of Technological and Educational Institution. All subjects were genotyped and the ABCA1 polymorphisms (R219K, R1587K and I883M) were recorded. According to lipid profile [total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C)] the subjects were separated into those with optimal lipid profile (Optimal Group, n=209) and Non-Optimal Group (n=238).</p><p><strong>Results: </strong>No statistical differences were observed in the distribution of R219K, R1587K and I883M polymorphisms according to the lipid profile (p>0.05 in all cases). No statistical differences were observed in the distribution of R219K, R1587K and I883M polymorphisms according to sex (p>0.05 in all cases). However, Logistic Regression revealed that subjects with RK (R1587K polymorphism) genotype had 69% increased risk on average of having LDL-C above normal limits as compared with those with RR genotype. Similarly, subjects with K allele (R1587K polymorphism) had 59% increased risk on average of having LDL-C above normal limits compared with those with R allele.</p><p><strong>Conclusion: </strong>These findings suggest that R1587K polymorphism of ABCA1 gene may influence the lipid profile. However, this needs to be confirmed by larger studies.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"83-7"},"PeriodicalIF":0.8,"publicationDate":"2014-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/a2/TOCMJ-8-83.PMC4181169.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32717138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Rationale of Gulf locals with Acute Coronary Syndrome Events (Gulf Coast) Registry.","authors":"Mohammad Zubaid,&nbsp;Khalid Bin Thani,&nbsp;Wafa Rashed,&nbsp;Alawi Alsheikh-Ali,&nbsp;Najib Alrawahi,&nbsp;Mustafa Ridha,&nbsp;Mousa Akbar,&nbsp;Fahad Alenezi,&nbsp;Rashed Alhamdan,&nbsp;Wael Almahmeed,&nbsp;Hussam Ouda,&nbsp;Arif Al-Mulla,&nbsp;Fahad Baslaib,&nbsp;Abdulla Shehab,&nbsp;Abdulla Alnuaimi,&nbsp;Haitham Amin,&nbsp;Harlan M Krumholz","doi":"10.2174/1874192401408010088","DOIUrl":"https://doi.org/10.2174/1874192401408010088","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the risk profile, management and one-year outcomes of patients hospitalized with acute coronary syndrome (ACS) in the Gulf region of the Middle East.</p><p><strong>Subjects and methods: </strong>The Gulf locals with acute coronary syndrome events (Gulf COAST) registry is a prospective, multinational, longitudinal, observational, cohort-based registry of consecutive citizens, from the Gulf region of the Middle East, admitted from January 2012 to January 2013 to 29 hospitals with a diagnosis of ACS. Data entered online included patient demographics, cardiovascular risk profiles, past medical history, physical findings on admission, in-hospital diagnostic tests and therapeutic management, as well as one year outcomes.</p><p><strong>Results: </strong>3188 patients were recruited. The mean age was 60.4 ± 12.6years (range: 22-112), 2104 (66%) were males and 1084 (34%) females. The discharge diagnosis was ST-segment elevation myocardial infarction (STEMI) in 741 (23.2%), new-onset left bundle branch block myocardial infarction (LBBBMI) in 30 (0.9%), non-ST-segment elevation myocardial infarction (NSTEMI) in 1486 (46.6%) and unstable angina in 931 (29.2%). At hospital presentation, 2105 (66%), 1779 (55.8%), 1703 (53.4%) and 740 (23.2%) had history of hypertension, dyslipidemia, diabetes mellitus and active smoking, respectively.</p><p><strong>Conclusion: </strong>Patients with ACS in our region are young with very high risk profile. The Gulf COAST registry is an example of successful regional collaboration and will provide information on contemporary management of ACS in the region.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"88-93"},"PeriodicalIF":0.8,"publicationDate":"2014-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/48/TOCMJ-8-88.PMC4197526.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32758376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-blockers Associated with a Mortality Benefit in Patients with Systolic Dysfunction and Elevated Serum Bilirubin.","authors":"Christopher Labos,&nbsp;Vivian Nguyen,&nbsp;Nadia Giannetti,&nbsp;Thao Huynh","doi":"10.2174/1874192401408010076","DOIUrl":"https://doi.org/10.2174/1874192401408010076","url":null,"abstract":"<p><strong>Background: </strong>Hyperbilirubinemia is associated with increased mortality in heart failure (HF) patients. We evaluated the impact of evidence-based medical therapy, in particular beta-blocker on the survival of patients with HF and hyperbilirubinemia.</p><p><strong>Methods and results: </strong>We reviewed the charts of all patients followed at our tertiary care heart failure clinic. Hyperbilirubinemia was defined as total bilirubin >30 µmol/L (1.5 times the upper limit of our laboratory value). The primary endpoint was all-cause mortality. The secondary endpoint was a composite of death, cardiac transplant or ventricular assistance device implantation (VAD). Of 1035 HF patients, 121 patients (11.7%) had hyperbilirubinemia. Median follow-up was 556 days. Hyperbilirubinemia was associated with an eight-fold increase in all-cause mortality, hazard ratio (HR): 8.78[95% Confidence Intervals (CI): 5.89-13.06]. Beta-blocker use was associated with approximately 60% reduction in all-cause mortality (HR: 0.38, 95% CI:0.15-0.94) and 70% reduction in the composite secondary endpoint (HR:0.31, 95% CI:0.13-0.71) in patients with hyperbilirubinemia.</p><p><strong>Conclusion: </strong>HF patients with hyperbilirubinemia have increased early mortality, need for cardiac transplantation or VAD. Beta-blocker use was associated with early survival benefit in these patients. Bilirubin levels should be monitored in patients with HF and early initiation of beta-blockers in patients with hyperbilirubinemia should be considered.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"76-82"},"PeriodicalIF":0.8,"publicationDate":"2014-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/ef/TOCMJ-8-76.PMC4168649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32689652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute coronary syndrome in the young: clinical characteristics, risk factors and prognosis.","authors":"Marcos R Esteban,&nbsp;Sara M Montero,&nbsp;José J A Sánchez,&nbsp;Horacio P Hernández,&nbsp;José J G Pérez,&nbsp;Julio H Afonso,&nbsp;Del C R Pérez,&nbsp;Buenaventura B Díaz,&nbsp;Antonio C de León","doi":"10.2174/1874192401408010061","DOIUrl":"https://doi.org/10.2174/1874192401408010061","url":null,"abstract":"<p><strong>Background: </strong>To describe the characteristics of patients ≤40 years of age hospitalized for acute coronary syndrome, analyze the risk factors and identify the variables associated with prognosis.</p><p><strong>Methods: </strong>Case series of patients admitted between 2003 and 2012 inclusive in a tertiary hospital (123 consecutive cases admitted between 2003 and 2012), and case-control study (369 controls selected from the general population matched for sex and age with cases, at a ratio of 3:1).</p><p><strong>Outcome variables: </strong>Mortality, likelihood of survival without readmission for heart-related problems, extent of coronary disease as determined by coronary angiography and cardiovascular risk factors.</p><p><strong>Results: </strong>Mean age was 35.4±4.8 years and 83.7% of the participants were men. Myocardial infarction with abnormal Q wave (48%) and single-vessel involvement (44.7%) predominated. Intrahospital mortality was 1.6%. For the 108 patients eventually included in the follow-up, likelihood of readmission-free survival after 60 months was 69.3±4.8%. In the case group 36% of the patients admitted to using cocaine. Compared to controls, the prevalence in patients was higher for smoking (74.8 vs 33.1%, p<0001), diabetes (14.6% vs 5.1%, p=0.001), low HDL-cholesterol (82.9 vs 34.1%, p<0.001) and obesity (30.0 vs 20.3%, p=0.029). Decreased left ventricular ejection fraction (odds ratio=2.2, p=0.033) and smoking (odds ratio=7.8, p=0.045) were associated with readmission for coronary syndrome.</p><p><strong>Conclusion: </strong>Acute coronary syndrome in people younger than 40 years is associated with diabetes and unhealthy lifestyle: smoking, sedentary behavior (low HDL-cholesterol), cocaine use and obesity. The readmission rate is high, and readmission is associated with smoking and decreased ejection fraction.</p>","PeriodicalId":504447,"journal":{"name":"The Open Cardiovascular Medicine Journal","volume":"8 ","pages":"61-7"},"PeriodicalIF":0.8,"publicationDate":"2014-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874192401408010061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32610286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}