Acute coronary syndrome among patients with chest pain: Prevalence, incidence and risk factors

Baccouche, Houda; Belguith, Asma Sriha; Boubaker, Hamdi; Grissa, Mohamed Habib; Bouida, Wahid; Beltaïef, Kaouthar; Sekma, Adel; Fredj, Nizar; Bzeouich, Nasri; Zina, Zied; Boukef, Riadh; Soltani, M.S.

doi:10.1016/j.ijcard.2015.11.065

Cited by 13 publications

(19 citation statements)

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“…The prevalence of ACS was similar to that described by Baccouche et al [ 9 ] in a monocentric study performed in the Monastir ED three years ago. This relatively low Tunisian ACS prevalence can be explained by lifestyle differences and local habits [ 14 ].…”

Section: Discussionsupporting

confidence: 89%

“…Patients were diagnosed with ST segment elevation myocardial infarction (STEMI) or unstable angina pectoris/negative ST segment elevation myocardial infarction or (UA/NSTEMI) using standardized criteria. Conventional classification of CVRFs was used [ 9 ]. The emergency output mode were exit at home after emergency supervision or transfer to other service (cardiology).…”

Section: Methodsmentioning

confidence: 99%

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Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

et al. 2018

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BackgroundWe aimed to describe diagnosed acute coronary syndrome (ACS) and its care management and outcomes in emergency departments (EDs) and to determine related cardiovascular risk factors (CVRFs).MethodsWe conducted a cross sectional multicenter study that included 1173 adults admitted to EDs for acute chest pain (ACP) in 2015 at 14 sites in Tunisia. Data included patients’ baseline characteristics, diagnosis, treatment and output.ResultsACS represented 49.7% of non-traumatic chest pain [95% CI: 46.7–52.6]; 74.2% of ACS cases were unstable angina/non-ST-segment-elevation myocardial infarction (UA/NSTEMI). Males represented 67.4% of patients with ACS (p < 0.001). The median age was 60 years (IQR 52–70). Emergency medical service transportation was used in 11.9% of cases. The median duration between chest pain onset and ED arrival was two hours (Inter quartile ranges (IQR) 2–4 h). The age-standardized prevalence rate was 69.9/100,000 PY; the rate was 96.24 in men and 43.7 in women. In the multivariable analysis, CVRFs related to ST segment elevation myocardial infarction were age correlated to sex and active smoking. CVRFs related to UA/NSTEMI were age correlated to sex, familial and personal vascular history and type 2 diabetes. We reported 27 cases of major adverse cardiovascular events (20.0%) in patients with STEMI and 36 in patients with UA/NSTEMI (9.1%).ConclusionHalf of the patients consulting EDs with ACP had ACS. Emergency medical service transportation calls were rare. Management delays were acceptable. The risk of developing an UA/NSTEMI was equal to the number of CVRFs + 1. To improve patient outcomes, it is necessary to increase adherence to international management guidelines.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

et al. 2018

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“…More than two thirds of sudden cardiac death resulting from acute thrombus occurs in smokers (3). Compared to nonsmokers the odds ratio (OR) for myocardial infarction is ~2.5, and for cardiovascular diseases overall the OR is ~2 (2,4). Smoking cessation in persons with known CHD reduces the risk of recurrent myocardial infarction or cardiovascular death from 30 to 50% (5) during the subsequent 3-7 years (6).…”

Section: Introductionmentioning

confidence: 99%

Acute coronary syndrome: factors predicting smoking cessation

Abroug

Hraïech

Mehrez

et al. 2020

East Mediterr Health J

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Background: Few randomized controlled trials have examined the efficacy time of smoking cessation in hospitalized patients with acute coronary syndrome, either during hospitalization or after discharge. Aims: To assess smoking cessation rates at 24 weeks among patients with acute coronary syndrome. Group A had begun nicotine replacement therapy during hospitalization, and Group B after discharge. We also determined factors predicting success. Methods: We conducted a randomized controlled trial in the . Participants were randomly assigned to the above 2 groups. The endpoint assessment was smoking abstinence at 24 weeks, defined as self-reported abstinence in the past week, confirmed by measured exhaled carbon monoxide (CO) ≤ 8 ppm. We analysed data by intention to treat. We used a binary logistic regression model to determine factors predicting abstinence. Results: All participants were male and mean (standard deviation) age was 55 (11) years. At 24 weeks there was no significant difference in smoking cessation rate between the 2 groups: 54.5% [95% confidence interval (CI): 44.7-64.3%] in Group A and 45.5% (95% CI: 35.7-55.3%) in Group B (P = 0.81). High level of nicotine dependence [odds ratio (OR): 0.72; 95% CI: 0.54-0.96) and good compliance during follow-up (OR: 6.56; 95% CI: 2.07-20.78) were predictive factors for abstinence. Conclusions:Smoking cessation rate after acute coronary syndrome was high regardless of the start date. Good compliance during follow-up was the key predictive factor for success.

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“…The odds of suicide were highest during the initial 6 months post‐ACS diagnosis (OR=3.05, 95% CI=2.55‐3.65) and remained high for at least 4 years after ACS diagnosis. Ischemic heart disease is a public health problem worldwide …”

Section: Discussionmentioning

confidence: 99%

Acute Coronary Syndrome and Suicide: A Case‐Referent Study

Liu¹,

Yeh

Wang

et al. 2016

JAHA

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BackgroundThe high prevalence of acute coronary syndrome (ACS) represents a significant burden on healthcare resources. A robust association exists between depression and increased morbidity and mortality after ACS. This study examined the relationship between suicide and ACS after adjusting for depression and other comorbidities.Methods and ResultsIn this case‐referent study conducted in Taiwan, the cases were people aged 35 years or older who died from suicide between 2000 and 2012 and 4 live referents, each matched by age, sex, and area of residence. The covariates adjusted for in the analysis were sociodemographic characteristics, physical comorbidities, and psychiatric disorders. We identified 41 050 persons who committed suicide and 164 200 referents. In the case and referent groups, 1027 (2.5%) and 2412 (1.5%) patients had ACS, respectively. After potential confounders were adjusted, ACS was significantly associated with increased odds of suicide (aOR=1.15, 95% confidence interval [CI]=1.05‐1.26). The odds of suicide were highest during the initial 6 months post‐ACS diagnosis (OR=3.05, 95% CI=2.55‐3.65) and remained high for at least 4 years after ACS diagnosis.Conclusions ACS patients are at an increased risk of suicide compared with otherwise healthy people. The risk of suicide is particularly high in the 6 months after ACS diagnosis. Our results suggest that we need to identify efficacious methods to recognize those at risk for suicide and to develop effective interventions to prevent such deaths.

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Acute coronary syndrome among patients with chest pain: Prevalence, incidence and risk factors

Cited by 13 publications

References 16 publications

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia)

Acute coronary syndrome: factors predicting smoking cessation

Acute Coronary Syndrome and Suicide: A Case‐Referent Study

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