Demographics, treatment and outcome of acute coronary syndromes: 17 years of experience in a specialized cardiac centre

Awaida, Jean-Pierre S.; Dupuis, Jocelyn; Théroux, Pierre; Pelletier, G.; Joyal, Michel; Guise, Pierre de; Doucet, Serge; Bilodeau, Luc; Thibault, Bernard; Tanguay, Jean‐François; Gallo, Richard; Grégoire, Jean; L’Allier, Philippe L.; Macle, Laurent; Nigam, Anil

doi:10.1016/s0828-282x(06)70250-1

Cited by 12 publications

(4 citation statements)

References 15 publications

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“…In recent decades, survival rates after acute coronary syndrome [ACS; ST-segment elevation myocardial infarction (STEMI), non–ST-segment elevation myocardial infarction (NSTEMI) or unstable angina (UA)] have steadily increased [1] , [2] . Thus, for the 1.4 million ACS patients discharged annually from US hospitals, as well as the 200,000 in Italy, 136,000 in France, and similar numbers of patients across Europe and throughout the world, quality of life after ACS has become vitally important.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder Prevalence and Risk of Recurrence in Acute Coronary Syndrome Patients: A Meta-analytic Review

et al. 2012

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BackgroundAcute coronary syndromes (ACS; myocardial infarction or unstable angina) can induce posttraumatic stress disorder (PTSD), and ACS-induced PTSD may increase patients’ risk for subsequent cardiac events and mortality. Objective: To determine the prevalence of PTSD induced by ACS and to quantify the association between ACS-induced PTSD and adverse clinical outcomes using systematic review and meta-analysis. Data Sources: Articles were identified by searching Ovid MEDLINE, PsycINFO, and Scopus, and through manual search of reference lists.Methodology/Principal FindingsObservational cohort studies that assessed PTSD with specific reference to an ACS event at least 1 month prior. We extracted estimates of the prevalence of ACS-induced PTSD and associations with clinical outcomes, as well as study characteristics. We identified 56 potentially relevant articles, 24 of which met our criteria (N = 2383). Meta-analysis yielded an aggregated prevalence estimate of 12% (95% confidence interval [CI], 9%–16%) for clinically significant symptoms of ACS-induced PTSD in a random effects model. Individual study prevalence estimates varied widely (0%–32%), with significant heterogeneity in estimates explained by the use of a screening instrument (prevalence estimate was 16% [95% CI, 13%–20%] in 16 studies) vs a clinical diagnostic interview (prevalence estimate was 4% [95% CI, 3%–5%] in 8 studies). The aggregated point estimate for the magnitude of the relationship between ACS-induced PTSD and clinical outcomes (ie, mortality and/or ACS recurrence) across the 3 studies that met our criteria (N = 609) suggested a doubling of risk (risk ratio, 2.00; 95% CI, 1.69–2.37) in ACS patients with clinically significant PTSD symptoms relative to patients without PTSD symptoms.Conclusions/SignificanceThis meta-analysis suggests that clinically significant PTSD symptoms induced by ACS are moderately prevalent and are associated with increased risk for recurrent cardiac events and mortality. Further tests of the association of ACS-induced PTSD and clinical outcomes are needed.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder Prevalence and Risk of Recurrence in Acute Coronary Syndrome Patients: A Meta-analytic Review

et al. 2012

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“…In Table 1 the changes that occurred in the coronary care unit at the Montreal Heart Institute between 1986 and 2003 are shown. 10 Despite an increase in the average age from 58.4 to 63.4 years, length of stay decreased from 7.5 to 3.5 days, and mortality decreased from 9% to 1.5%. More than 80% of patients received coronary angiography in 2003, compared with 50% in 1986, and the use of, or need for, cardiac pacing and a Swan Ganz catheter decreased markedly.…”

Section: The Changing Face Of Cardiovascular Diseasementioning

confidence: 96%

“…Data from Awaida et al 10 We should be training physicians not only to treat patients with cardiovascular disease, but also to manage an epidemic. Heart institutes with global programs have used different approaches.…”

Section: Future Role Of Heart Institutes: a Global Missionmentioning

confidence: 99%

The Past and Future of Heart Institutes: Having Moved Beyond the One-Trick Pony

Waters

2014

Canadian Journal of Cardiology

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“…In the United States alone, more than 1 million patients are hospitalized annually for acute coronary syndrome (ACS), which includes myocardial infarction and unstable angina (Bertoni et al, 2005; Saket, 2007). With the adoption of new technologies, interventions, and treatment guidelines over recent decades, survival rates after ACS have steadily improved, even as more patients are treated for ACS each year (Awaida et al, 2006; Theroux et al, 2000). These improvements in care, while of undeniable significance, result in a growing population of ACS survivors in whom the risk of 1-year ACS recurrence or mortality is substantial (Terkelsen et al, 2005).…”

mentioning

confidence: 99%

Enduring somatic threat perceptions and post-traumatic stress disorder symptoms in survivors of cardiac events

et al. 2017

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PTSD due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether PTSD at 1 month post-acute coronary syndrome (ACS) indeed required both high peritraumatic threat during the ACS and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department (ED) enrollment of 284 patients with a provisional ACS diagnosis, and cardiac threat perceptions and PTSD symptoms 1 month post-discharge. In a multiple regression model with adjustment for important covariates, ED threat perceptions were associated with higher 1-month PTSD symptoms only among those with high levels of ongoing cardiac threat.

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Demographics, treatment and outcome of acute coronary syndromes: 17 years of experience in a specialized cardiac centre

Cited by 12 publications

References 15 publications

Posttraumatic Stress Disorder Prevalence and Risk of Recurrence in Acute Coronary Syndrome Patients: A Meta-analytic Review

Posttraumatic Stress Disorder Prevalence and Risk of Recurrence in Acute Coronary Syndrome Patients: A Meta-analytic Review

The Past and Future of Heart Institutes: Having Moved Beyond the One-Trick Pony

Enduring somatic threat perceptions and post-traumatic stress disorder symptoms in survivors of cardiac events

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