Management of acute coronary syndrome: achievements and goals still to pursue. Novel developments in diagnosis and treatment

Boden, Helèn; Hoeven, Barend L. van der; Karalis, Ioannis; Schalij, Martin J.; Jukema, J. Wouter

doi:10.1111/j.1365-2796.2012.02533.x

Cited by 21 publications

(22 citation statements)

References 106 publications

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“…21,22 Treatment response, as well as outcomes are undeniably a function of timely treatment, which is essential in preventing complications. 23 Half of the patients who die of AMI do so before reaching a hospital. 1 De Luca noted that every delay of 30 minutes was associated with a relative risk for 1-year mortality in AMI patients.…”

Section: Discussionmentioning

confidence: 99%

Pre-hospital care in stable patients with acute coronary syndrome: Factors and predictors of pre-hospital delays in a tertiary public health institute

Bahall

Legall

2017

Int J Community Med Public Health

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Background: Incidences of pre-hospital delays (PHDs) remain high and affect the outcomes in acute coronary syndrome (ACS) patients. This study explored the factors associated with, and the predictors of PHD in ACS patients. Methods: Data were collected through interviews and the examination of the hospital records of 299 ACS patients admitted to a hospital between 1 December 2014 and 28 February 2015. Results: The patients were primarily female, and their mean age was 60.9±12.09 years. The mean PHD was 7.5±6.6 hours; this comprised mean delay from symptoms onset to departure, mean travel time from departure time to intermediate care facility, mean length of stay at intermediate care facility, and mean travel time from an intermediate care facility to hospital. The factors associated with delays were ignoring of symptoms (38.8%), indecisiveness and reluctance to seek treatment (16.7%), self-medication (35.5%), being unconvinced that the symptoms were serious (61.2%), and waiting for a worsening of pain (29.1%). The predictors of PHDs were ‘marital status’, ‘fear of having a heart attack’, ‘believing that the symptoms were self-limiting’, and ‘seeking intermediate care’. The predictors of hospital delays were ‘AM or PM occurrence of symptom’, ‘shortness of breath’, ‘having hypertension’, and ‘previous ischaemic heart disease’.Conclusions: Patient delays were high in the case of ACS, but utilization of an intermediate healthcare facility more than doubled the PHD. About two-thirds of the patients had a PHD that exceeded 2 hours.

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Section: Discussionmentioning

confidence: 99%

Pre-hospital care in stable patients with acute coronary syndrome: Factors and predictors of pre-hospital delays in a tertiary public health institute

Bahall

Legall

2017

Int J Community Med Public Health

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“…In acute MI cases, especially in ST-segment elevation MI (STEMI), it is important to applies pharmacological reperfusion therapy administration as soon as possible, either by percutaneous coronary intervention (PCI) or fibrinolytic medications, to reduce morbidity and mortality rates. 4,16,17 Patients with non-STsegment elevation MI (NSTEMI) or unstable angina pectoris (UAP) are also in indication for early catheterization, in addition to an intensive antiplatelet therapy. Revascularization of unstable coronary lesion is important to prevent future ischemic complications.…”

Section: Copeptin As a Myocardial Infarction Biomarkermentioning

confidence: 99%

The role of copeptin as a novel cardiovascular biomarker

Kristyagita

Siswanto

2015

Med J Indones

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Copeptin is a provasopressin-derived peptide, the precursor for arginine vasopressin (AVP), which is an antidiuretic hormone from the hypothalamus. Copeptin is secreted together with AVP equally as a response of AVP stimulation. While AVP’s main function is water and blood volume regulation and maintaining electrolyte homeostasis, copeptin’s function is still not fully understood. AVP, copeptin, and other vasopressinergic neuropeptides’ levels are elevated in acute stress caused by pathological conditions. Clinical use of AVP levels has many weaknesses. Copeptin can act as a replacement because of its molecular stability, easier testing methods, and faster results. For example, combination of copeptin and cardiac troponins can eliminate myocardial infarction (MI) diagnosis faster, while combined with brain-type natriuretic peptide (BNP) or its precursor can predict heart failure (HF) outcome. In cardiovascular shock, copeptin levels are elevated. As such, copeptin is a potential biomarker for MI diagnosis and predictor for HF mortality and morbidity.

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“…Adoption of evidence‐based recommendations has provided substantial reductions in ACS‐related morbidity and mortality, but mortality rates still vary widely across Asia and remain relatively poor . Registry‐based data demonstrate high variability across the region in overall use of invasive procedures and pharmacologic therapy, a situation compounded by poor patient education, limited healthcare resources, suboptimal risk stratification, economic barriers, and ethnic differences …”

Section: Introductionmentioning

confidence: 99%

Rationale, Design, and Baseline Characteristics of the EPICOR Asia Study (Long‐tErm follow‐uP of antithrombotic management patterns In Acute CORonary Syndrome patients in Asia)

Huo

Lee

Sawhney

et al. 2015

Clinical Cardiology

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Background: In-hospital and postdischarge mortality for acute coronary syndromes (ACS) vary across Asia and remain generally poorer than globally. The relationship between real-life antithrombotic management patterns (AMPs) and ACS-related outcomes in Asia is unclear. Methods: EPICOR Asia (Long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients in Asia) (NCT01361386) is a prospective, multinational, observational study of patients discharged after hospitalization for an ACS, with 2-year follow-up. The aim is to describe short-and long-term (up to 2 years post-index event) AMPs in patients hospitalized for ACS and to record clinical outcomes, healthcare resource use, and self-reported health status. Pre-and in-hospital management, AMPs, and associated outcomes, with particular focus on ischemic and bleeding events, will be recorded during the 2-year follow up. Results: Between June 2011 and May 2012, 13 005 patients were enrolled. From these, 12 922 patients surviving an ACS (6616 with STEMI, 2570 with NSTEMI, and 3736 with UA) were eligible for inclusion from 219 hospitals across 8 countries and regions in Asia: China (n = 8214), Hong Kong (n = 177), India (n = 2468), Malaysia (n = 100), Singapore (n = 93), South Korea (n = 705), Thailand (n = 957), and Vietnam (n = 208). Conclusions: EPICOR Asia will provide information regarding clinical management and AMPs for ACS patients in Asia. Impact of AMPs on clinical outcomes, healthcare resource use, and self-reported health status both during hospitalization and up to 2 years after discharge will also be described.

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Management of acute coronary syndrome: achievements and goals still to pursue. Novel developments in diagnosis and treatment

Cited by 21 publications

References 106 publications

Pre-hospital care in stable patients with acute coronary syndrome: Factors and predictors of pre-hospital delays in a tertiary public health institute

Pre-hospital care in stable patients with acute coronary syndrome: Factors and predictors of pre-hospital delays in a tertiary public health institute

The role of copeptin as a novel cardiovascular biomarker

Rationale, Design, and Baseline Characteristics of the EPICOR Asia Study (Long‐tErm follow‐uP of antithrombotic management patterns In Acute CORonary Syndrome patients in Asia)

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