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1

White blood cells count and its populations in patients with acute coronary syndromes and co-morbidities

100%

Vakaliuk I., Alghzawi I.

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EN

INTRODUCTION: Acute coronary syndromes (ACS) and sudden death cause most ischemic heart disease (IHD)- related deaths, which represent 1.8 million deaths per year, with similar numbers of men and women dying from coronary artery disease (CAD). It’s known that inflammation plays crucial role in atherosclerotic plaque formation and its destabilization. The purpose of this study is to evaluate of white blood cells count in its subpopulation in patients with ACS and modifiable cardiovascular risk factors – arterial hypertension and 2 type Diabetes Mellitus (DM). MATERIAL AND METHODS: In this observational cohort trial we observed of 184 patients with ACS. All patients were randomized into four groups: 1st group - 42 patients with ACS without arterial hypertension (AH) or DM; 2nd group – 56 patients with ACS and previous AH; 3rd group – 42 patients with ACS and 2 type DM; and 4th group – 44 patients with ACS and AH and DM. We studied of leukocytes count and their subpopulations in blood. RESULTS: The mean white blood cells count was significant higher in patients with ASC, compared with control group: 8.23 [6.50; 9.40] vs 5.49 [5.20; 5.70] (p<0.001). Similarly, ACS caused increase of leukocytes subpopulation count in blood. The significant higher count of white blood cells was observed in patients with ACS and co-morbidities: 2 type DM and its association with AH. In patients with ACS and previous AH we observed significant lower neutrophils count (p<0.05), but increased quantity of lymphocytes, compared with patients with ACS without co-morbidities (p<0.001). DM and its association with AH was characterized of neutrophils, lymphocytes and monocytes counts growth. CONCLUSIONS:ACS is characterized of raised white blood cells count and its population, especially in cases of association with 2 type Diabetes Mellitus.

2

To determine the prognostic accuracy of the HEART score as a predictor for major adverse cardiac events in patients presenting with chest pain to emergency department in a tertiary care hospital

88%

Krishna P. P., Velavarthipati R. S., Srikanth M., Krishna B. S. G., Sriramula N., Goud D. P. K.

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EN

INTRODUCTION: One of the main causes of sudden cardiac death in the emergency department is myocardial infarction. Although there are several scores that helped predict an identified acute coronary incident, there was no quantitative tool available to risk stratifying patients with chest pain to support more decisions. The study is aimed to determine the prognostic accuracy of the HEART score as a predictor for major adverse cardiac events in patients presenting with chest pain to the emergency medicine department (ED). MATERIAL AND METHODS: Study included 83 adult patients presenting with Acute Myocardial Infarction who had chest pain attending to the ED were studied their HEART score to predict major adverse cardiac events. RESULTS: 60.24% of males and 39.76% of females with mean age of 57.83 ± 12.85 years were presented to ED. 44.56% had hypertension, 46.99% of diabetes mellitus, 21.69% of smoking, 16.87% of alcoholism, 4.82% of obesity, and 3.61% of patients with family history of cardiac diseases. 28.92% had non-specific repolarization, and 33.73% of patients had significant ST-Depression. According to Heart score, 26.51% of patients had low risk, 39.76% of patients had moderate risk, and 33.73% of patients had high risk. More percentage of male patient’s (67.9%) were in the high risk group of heart score than females (32.1%). ST-Depression cases were more in the high risk group (85.7%), and statistical significant association seen between ECG and the heart score (P<0.0001). among risk factors, Hypertension and Diabetes mellitus patients was more in the high risk groups with 48.6%, and 53.8% (P=0.001). 100% of high risk cases had ≥3 x normal limit of troponin, and there was a statistically association seen between troponin and heart score (P<0.0001). Diagnosis of HEART score of the low risk group showed that the risk factor had significantly higher AUC value (AUC = 0.801) than the age group (AUC = 0.778), history (AUC = 0.747), Troponin (AUC = 0.738), and ECG (AUC = 0.722). Out of 22 cases of the low risk group, 6 of Unstable angina (UA), 16 of NSTEMI, 4 of Percutaneous coronary intervention (PCI), 2 CABG, and 1 cardiovascular (CV) death. For moderate risk group (n=33), 13 of UA, 17 of NSTEMI, 3 of STEMI, 20 of PCI, 14 of CABG, and 12 of CV deaths. For high risk group (n=28), 10 UA, 14 of NSTEMI, 3 of STEMI, 9 of PCI, 6 of CABG, and 4 number of CV death. CONCLUSIONS: It was concluded that the HEART score should be used as the primary clinical decision tool for the risk stratification and a good predictor of major adverse cardiac events in patients presenting with chest pain to the emergency department to promote their safe and efficient nature in a community hospital setting.

3

An unusual cause of hypotension and abnormal electrocardiogram (ECG) - scombroid poisoning

75%

Lionte C.

Open Medicine

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2010

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vol. 5

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issue 3

292-297

EN

Scombroid fish or histamine food poisoning is an illness typically associated with fish consumption, rarely encountered and reported in Europe. Symptoms develop quickly and resemble an allergic reaction. This paper reports three cases of severe scombroid poisoning in previously healthy patients, which presented diffuse macular erythema, hypotension, palpitations, and abnormal electrocardiogram (ECG). All patients required intensive care, with a complete resolution of symptoms and ECG changes within 24 hours. This is the first Romanian report of scombroid poisoning, emphasizing that medical personnel should be aware of this condition, because symptoms and ECG changes often lead to confusion with other diseases.

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1 Lionte C.

1 Srikanth M.

1 Sriramula N.

1 Vakaliuk I.

1 Velavarthipati R. S.

White blood cells count and its populations in patients with acute coronary syndromes and co-morbidities

To determine the prognostic accuracy of the HEART score as a predictor for major adverse cardiac events in patients presenting with chest pain to emergency department in a tertiary care hospital

An unusual cause of hypotension and abnormal electrocardiogram (ECG) - scombroid poisoning