The Association between Acute Coronary syndrome and Anti Helicobacter Pylori Antibody

Background: Coronary artery disease is the main cause of mortality in developing countries like Iran.recently Due to failure of classic risk factors to completely explain Cause of acute coronary syndrome other risk factors, for example infection diseases are under investigation. One of these infectious agents is Helicobacter pylori which have been investigated in numerous studies. This study was designed to study of Association between Acute Coronary syndrome and Anti Helicobacter Pylori Antibody. Materials and Methods: This case-control study was performed on 300 hospitalized patients with Acute Coronary syndrome include UA and MI who refered to emam khomaini hospital and 300 hospitalized patients in fatemi and alawi hospital without of history of coronary heart disease and then Anti Helicobacter Pylori Antibody was examined by ELISA. Using chi-square and t- test the results were analyzed and P value less then 0.05 was considered significant. Results: 79 patients (26/3%) were seropositive, and 122(40/6%) seronegative in case group, different between Helicobacter pylori seropositivity and risk factor of Acute Coronary syndrome.sigmificant Association was found between Helicobacter pylori is case and control group. Conclusion: This study showed that prevalence of Helicobacter pylori infection in patients with acute coronary syndrome was higher and Helicobacter pylori infection could be e risk factor for Acute Coronary syndrom

“EFFECTIVENESS OF AN EDUCATIONAL PROGRAM TO ENHANCE SELF-CARE SKILLS AFTER ACUTE CORONARY SYNDROME: A QUASI-EXPERIMENTAL STUDY”

The aim of this study is to determine the effectiveness of an educational program to enhance self-care skills in patients after an acute coronary syndrome. According to the findings of the study, a systematized and structured educational program, is effective in developing self-care skills in patients after an acute coronary syndrome.

Relationship of some risk factors and symptoms in patients with acute coronary syndrome

Acute coronary syndrome (ACS) is one of the major causes of death in the worldwide. Clinical manifestations are different. So it's necessary to have knowledge about the types of symptoms experienced by patients with ACS. This study was performed to assay the Relationship of some risk factors and symptoms in patients with acute coronary syndrome. This cross-sectional study, were studied 294 patients with acute coronary syndrome at least 24 hours after admission had survived. Data was collected by a questionnaire that included demographic data form and check list of some symptoms and history of risk factors. There was a significant relationship between STEMI with vomiting (OR=1.94) and anxiety (OR=1.83) and UA with vomiting (OR=0.42). Between sex with weakness (OR=2.29) and anxiety (OR=1.82), diabetes with dyspenea (OR=1.8), weakness (OR=1.02) and tinnitus (OR=2.06) and hyperlipidemia with weakness (OR=2.35) and tinnitus (OR=2.49) was available significant difference. The findings of this study indicate that the appearance of symptoms of acute coronary syndrome were different as for ECG changes and risk factors, and more focused on those symptoms that they are common with any other diseases. Since, many of the symptoms of acute coronary syndrome can be potentially dangerous and life threatening, accurate diagnosis and timely action is crucial for the patients

CT imaging of coronary artery disease

Cardiovascular disease is the most common cause of death in developed countries. Particularly with regard to coronary artery disease, approximately 19 million people yearly worldwide either have acute coronary syndrome or die of sudden cardiac death. Thus, early identification and an accurate risk assessment of atherosclerotic disease are mandatory for improvement in the early identification, management, and prevention of acute coronary syndrome.peer-reviewe

Takotsubo cardiomyopathy in a healthy twenty year old

Takotsubo cardiomyopathy, also known as Transient apical ballooning syndrome, stress-induced cardiomyopathy and broken-heartsyndrome, is a rare non-ischemic cardiomyopathy that presents as an acute coronary syndrome without evidence of obstructive atherosclerotic coronary disease. Its name is derived from the Japanese Takotsubo – an octopus trap, resembling the elliptical shape of the very typical akinetic left ventricular apex during systole on imaging studies. It is nowadays increasingly recognized as a new disease entity when faced with normal coronary arteries on angiography with the very typical left ventriculogram, often presenting with acute heart failure, arrhythmias or rarely ventricular rupturepeer-reviewe

Effect of air pollution on onset of acute coronary syndrome in susceptible subgroups

While long-term exposure to air pollutants is associated with an increase in heart diseases and mortality, little information is available about the short-term effects of air pollution. This case-crossover study assessed the relationship of particulate matter (PM10) and carbon monoxide (CO) levels with hospital admission for acute coronary syndrome in Tehran, Islamic Republic of Iran. We interviewed 250 patients with a first episode of acute coronary syndrome and obtained data from hospital records and Tehran Air Quality Control Company. The risk of acute coronary syndrome was significantly associated with elevated concentrations of CO the day before the event (OR 1.18; 95% CI: 1.03-1.34) but not significantly with PM10 (OR 1.00; 95% CI: 0.99-1.02). Stratification by age, sex, diabetes, hypertension and smoking status did not affect the results, but women were more susceptible than men to CO levels (OR for women/men 1.68; 95% CI: 1.25-2.26)

Acute coronary syndromes and acute heart failure:a diagnostic dilemma and high-risk combination. A statement from the Acute Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology

Acute coronary syndrome is a precipitant of acute heart failure in a substantial proportion of cases, and the presence of both conditions is associated with a higher risk of short-term mortality compared to acute coronary syndrome alone. The diagnosis of acute coronary syndrome in the setting of acute heart failure can be challenging. Patients may present with atypical or absent chest pain, electrocardiograms can be confounded by pre-existing abnormalities, and cardiac biomarkers are frequently elevated in patients with chronic or acute heart failure, independently of acute coronary syndrome. It is important to distinguish transient or limited myocardial injury from primary myocardial infarction due to vascular events in patients presenting with acute heart failure. This paper outlines various clinical scenarios to help differentiate between these conditions and aims to provide clinicians with tools to aid in the recognition of acute coronary syndrome as a cause of acute heart failure. Interpretation of electrocardiogram and biomarker findings, and imaging techniques that may be helpful in the diagnostic work-up are described. Guidelines recommend an immediate invasive strategy for patients with acute heart failure and acute coronary syndrome, regardless of electrocardiographic or biomarker findings. Pharmacological management of patients with acute coronary syndrome and acute heart failure should follow guidelines for each of these syndromes, with priority given to time-sensitive therapies for both. Studies conducted specifically in patients with the combination of acute coronary syndrome and acute heart failure are needed to better define the management of these patients

A Review of Neurogenic Stunned Myocardium.

Neurologic stunned myocardium (NSM) is a phenomenon where neurologic events give rise to cardiac abnormalities. Neurologic events like stroke and seizures cause sympathetic storm and autonomic dysregulation that result in myocardial injury. The clinical presentation can involve troponin elevation, left ventricular dysfunction, and ECG changes. These findings are similar to Takotsubo cardiomyopathy and acute coronary syndrome. It is difficult to distinguish NSM from acute coronary syndrome based on clinical presentation alone. Because of this difficulty, a patient with NSM who is at high risk for coronary heart disease may undergo cardiac catheterization to rule out coronary artery disease. The objective of this review of literature is to enhance physician\u27s awareness of NSM and its features to help tailor management according to the patient\u27s clinical profile

Kounis syndrome – Anaphylaxis-induced acute coronary syndrome

Kounis syndrome is an underdiagnosed condition in which anaphylaxis triggers vasospastic acute coronary syndrome, either with or without underlying coronary artery disease. The prevalence of this syndrome among hospitalized patients for allergic/hypersensitivity/anaphylactic reactions in the United States is 1.1%, with a 7% rate of all-cause inpatient mortality. This article presents an anaphylaxis-induced acute coronary syndrome case in a patient with underlying coronary artery disease. The pathophysiological mechanism of anaphylactic-induced acute coronary syndrome involves the inflammatory mediators of type I hypersensitivity reactions

Elevated Baseline Serum Fibrinogen: Effect on 2-Year Major Adverse Cardiovascular Events Following Percutaneous Coronary Intervention.

BackgroundElevated fibrinogen is associated with short-term major adverse cardiovascular events (MACE) after percutaneous coronary intervention, but the relation with late MACE is unknown.Methods and resultsBaseline demographics and 2-year MACE were recorded among subjects undergoing nonemergent percutaneous coronary intervention. A total of 332 subjects (66.6±19.5 years, 69.9% male, 25.3% acute coronary syndrome) were enrolled. Two-year MACE (periprocedural myocardial infarction 9.0%, rehospitalization 6.3%, revascularization 12.7%, non-periprocedural myocardial infarction 4.5%, stent thrombosis 0.9%, stroke 1.8%, and death 0.6%) were associated with higher fibrinogen (352.8±123.4 mg/dL versus 301.6±110.8 mg/dL; P<0.001), longer total stent length (40.1±25.3 mm versus 32.1±19.3 mm; P=0.004), acute coronary syndrome indication (38.7% versus 17.8%; P<0.001), number of bare-metal stents (0.5±1.1 versus 0.2±0.5; P=0.002), and stent diameter ≤2.5 mm (55.8% versus 38.4%, P=0.003). No relation between platelet reactivity and 2-year MACE was observed. Fibrinogen ≥280 mg/dL (odds ratio [OR] 3.0, confidence interval [CI], 1.6-5.4, P<0.001), total stent length ≥32 mm (OR 2.2, CI, 1.3-3.8, P<0.001), acute coronary syndrome indication (OR 4.1, CI, 2.3-7.5, P<0.001), any bare-metal stents (OR 3.2, CI, 1.6-6.1, P<0.001), and stent diameter ≤2.5 mm (OR 2.0, CI, 1.2-3.5, P=0.010) were independently associated with 2-year MACE. Following a landmark analysis excluding periprocedural myocardial infarction, fibrinogen ≥280 mg/dL remained strongly associated with 2-year MACE (37.0% versus 17.4%, log-rank P<0.001).ConclusionsElevated baseline fibrinogen level is associated with 2-year MACE after percutaneous coronary intervention. Acute coronary syndrome indication for percutaneous coronary intervention, total stent length implanted, and use of bare-metal stents or smaller-diameter stents are also independently associated with 2-year MACE, while measures of on-thienopyridine platelet reactivity are not