No abstract
Background: In daily clinical practice, leukocyte count is the most common and simple inflammation parameter. Moreover, its role in predicting acute coronary syndrome (ACS) patients' clinical outcomes and prognosis is still conflicting. This study aimed to assess the role of leukocytosis as the predictor of mortality in ACS patients undergoing percutaneous coronary intervention (PCI). Method: This single-center retrospective cohort study used the STEMI registry data in Saiful Anwar General Hospital, Malang, Indonesia, from January to July 2019. The exposure was the leucocyte count during hospital admission and the outcome was the 30-day mortality following PCI procedure. The receiver-operating characteristic (ROC) curve was used to determine leucocyte count cut-off pint, sensitivity, and specificity. Result: The best leukocyte count cut-off value was 12300/µL, with the area under the curve (AUC) of 0.702 (95% CI 0.575 - 0.83), sensitivity of 71.4%, and specificity of 61.3%. Leukocytosis increased the risk of 30-day mortality (74.5% vs 42.4%; OR = 3.958; 95% CI = 1.518-10.25; p = 0.014). Survival rate within 30-day after PCI was lowered in leukocytosis group (the Log-Rank p = 0.002). The difference became apparent after day five post-PCI. Conclusion: Leukocytosis during hospital admission is associated with increased mortality in ACS patients undergoing PCI. Leucocytosis is a good predictor of mortality within 30 days after PCI in this population. Keywords: leukocytosis, acute coronary syndrome, percutaneous coronary intervention, mortality
Percutaneous coronary intervention can be associated with several complications such as periprocedural myocardial infarction (PPMI) that was defined as an elevation of CK-MB >3 times the upper limit of the normal range in at least two blood samples with a normal range of baseline value, prolonged ischemia as demonstrated by persistent chest pain (>20 min), or new pathological Q waves seen on the electrocardiogram. By epidemiology, periprocedural myocardial infarction was happen in about 6 – 7% patient underwent PCI and associated with adverse outcome. Therefore it is important to identify the possible factors to detect, prevent and manage this event.
Most of tourist will choose new unvisited tourism spot as their new tourism destination. However, limited information of the new tourism destination often becomes a barrier to plan and schedule their tourism activity. The purpose of this research is to create an application called IndoLista, to provide complete tourism spot information, create tourism planning and schedule with social media concept. The social media concept will facilitate communication and interaction between user to get updated information in effective way. Eachuser will be able to organize their tourism planning with application's feature provided, completed by detail information of tourism spot. Research methodology is divided into two parts; analysis method by book andjournals study literature, analyze similar application, user data collection with quisioner and and design method with UML tools. Quisioner evaluation conclude society opinion that the application as research result, give asolution to user in the interest of planning and schedulling online tourism trip by providing complete information of tourism spot and facilitating interaction and communication between user via social media concept.
Aims Despite the spike in COVID-19 hospitalizations, the number of acute coronary syndrome (ACS) admissions has declined significantly. It raises concerns about the long-term consequences of cardiovascular problems. This study aims to provide new insights into our awareness of the pandemic situation in ACS settings. Methods We performed a single centre retrospective analysis of 397 patients from iSTEMI Registry between March-October 2019 (Pre-COVID-19 pandemic) and March-October 2020 (COVID-19 pandemic) with ACS (i.e., unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and STEMI). We analyzed case fatality rate, delay to First Medical Contact (FMC), and troponin findings. Results The number of ACS patients admissions in March-October 2019 (254 patients) and 2020 (143 patients) had significantly reduced by 43.7%. Admission of ACS significantly dropped for STEMI (35.76%, p=0.048) and NSTEMI (65.70%, p=0.001), but not for UA (31.90%, p=0.262). There was non-significant case fatality rate between-group of STEMI (p = 0.168), NSTEMI (p = 0.388), or UA (p = 0.343). We found a significant delay to FMC during pandemic (39.8%, p=0.000) and correlated with the higher troponin I level (30,6%, p=0.001). Conclusion This study reveals that local conditions in our institution are similar to the other centers during the COVID-19 pandemic. In parallel to the COVID-19 burden, we will have to deal with the morbidity and mortality caused by delays in FMC and patients severity in the future. Further studies are needed to analyze the factors that decreased ACS patients' admission.
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