A. Magdás, Andreea Ciacâru, Z. Szász, C. Podoleanu
Abstract Introduction: In acute heart failure patients, the prothrombotic state is likely due to arterial and venous endothelial dysfunction. Decompensated heart failure appears to also be associated with increased levels of prothrombotic molecules, such as fibrinogen and von Willebrand factor, which also contribute to the prothrombotic state. Case presentation: We present the case of a 72-year-old male patient, admitted for signs of acute heart failure with bilateral ankle edema. Laboratory data showed D-dimer level >5 µg/mL, which raised the suspicion of pulmonary embolism secondary to deep vein thrombosis. Doppler ultrasound performed to exclude a deep vein thrombosis revealed a total occlusion of the superficial femoral artery on the lower left limb and an abdominal aorta with a lumen diameter of 35 mm and a true lumen of 18.6 mm with circular isoechoic material on the aortic wall. The computed tomography angiography described an aneurysm of the abdominal aorta with mural thrombosis extending to the bifurcation level. Conclusion: In patients with acute heart failure, a comprehensive vascular assessment is also needed. The therapeutic management of these patients varies from conservative to endovascular or surgical therapy, but revascularization therapy should be considered based on the patient’s medical condition.
{"title":"Arterial Embolic Complications in a Patient with Acute Heart Failure","authors":"A. Magdás, Andreea Ciacâru, Z. Szász, C. Podoleanu","doi":"10.2478/jce-2022-0015","DOIUrl":"https://doi.org/10.2478/jce-2022-0015","url":null,"abstract":"Abstract Introduction: In acute heart failure patients, the prothrombotic state is likely due to arterial and venous endothelial dysfunction. Decompensated heart failure appears to also be associated with increased levels of prothrombotic molecules, such as fibrinogen and von Willebrand factor, which also contribute to the prothrombotic state. Case presentation: We present the case of a 72-year-old male patient, admitted for signs of acute heart failure with bilateral ankle edema. Laboratory data showed D-dimer level >5 µg/mL, which raised the suspicion of pulmonary embolism secondary to deep vein thrombosis. Doppler ultrasound performed to exclude a deep vein thrombosis revealed a total occlusion of the superficial femoral artery on the lower left limb and an abdominal aorta with a lumen diameter of 35 mm and a true lumen of 18.6 mm with circular isoechoic material on the aortic wall. The computed tomography angiography described an aneurysm of the abdominal aorta with mural thrombosis extending to the bifurcation level. Conclusion: In patients with acute heart failure, a comprehensive vascular assessment is also needed. The therapeutic management of these patients varies from conservative to endovascular or surgical therapy, but revascularization therapy should be considered based on the patient’s medical condition.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"402 1","pages":"86 - 89"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77643602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Farnaz Eslamimehr, Z. Hosseini, T. Aghamolaei, M. Nikparvar, A. Ghanbarnezhad
Abstract Background: Hypertension is a crucial general health issue. Severe and acute hypertension needs urgent medical intervention. Self-care behaviors can help patients with hypertension in controlling blood pressure and preventing hypertensive emergencies. This study aimed to determine the perception of hypertension towards self-care behaviors using constructs of the theory of planned behavior (TPB) in critically ill patients with hypertension to prevent hypertensive emergencies. Material and Methods: This study was conducted based on the directed qualitative content analysis of 33 critically ill patients with hypertension who participated in semi-structured interviews and focus group discussions. Results: The data were analyzed based on the four main categories of TPB. The attitude category consisted of positive and negative subcategories. The subjective norms category consisted of authority of healthcare staff, family support and approval, and influence of friends subcategories. The perceived behavioral control category included discipline, self-control, receiving consultation, individual concerns, financial problems, access to medicine, food culture, and coronavirus limitations subcategories. The behavioral intention category had intention to perform the behavior and intention to continue a behavior subcategories. Conclusion: The results revealed the requirement for a multidimensional approach to improve attitude, subjective norms, and behavioral control for performing self-care behaviors to reduce the number of hypertensive emergencies in critically ill patients with hypertension. Factors affecting self-care included socioeconomic status, family support, governmental organizations, and participants’ health condition.
{"title":"Self-Care Behaviors in Patients with Hypertension to Prevent Hypertensive Emergencies: a Qualitative Study Based on the Theory of Planned Behavior","authors":"Farnaz Eslamimehr, Z. Hosseini, T. Aghamolaei, M. Nikparvar, A. Ghanbarnezhad","doi":"10.2478/jce-2022-0016","DOIUrl":"https://doi.org/10.2478/jce-2022-0016","url":null,"abstract":"Abstract Background: Hypertension is a crucial general health issue. Severe and acute hypertension needs urgent medical intervention. Self-care behaviors can help patients with hypertension in controlling blood pressure and preventing hypertensive emergencies. This study aimed to determine the perception of hypertension towards self-care behaviors using constructs of the theory of planned behavior (TPB) in critically ill patients with hypertension to prevent hypertensive emergencies. Material and Methods: This study was conducted based on the directed qualitative content analysis of 33 critically ill patients with hypertension who participated in semi-structured interviews and focus group discussions. Results: The data were analyzed based on the four main categories of TPB. The attitude category consisted of positive and negative subcategories. The subjective norms category consisted of authority of healthcare staff, family support and approval, and influence of friends subcategories. The perceived behavioral control category included discipline, self-control, receiving consultation, individual concerns, financial problems, access to medicine, food culture, and coronavirus limitations subcategories. The behavioral intention category had intention to perform the behavior and intention to continue a behavior subcategories. Conclusion: The results revealed the requirement for a multidimensional approach to improve attitude, subjective norms, and behavioral control for performing self-care behaviors to reduce the number of hypertensive emergencies in critically ill patients with hypertension. Factors affecting self-care included socioeconomic status, family support, governmental organizations, and participants’ health condition.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"80 1","pages":"75 - 85"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75761081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hendrianus, Susetyo Atmojo, R. Soerarso, D. Hasanah
{"title":"Focal Atrial Tachycardia as Presenting Feature of Left Atrial Myxoma","authors":"Hendrianus, Susetyo Atmojo, R. Soerarso, D. Hasanah","doi":"10.2478/jce-2022-0014","DOIUrl":"https://doi.org/10.2478/jce-2022-0014","url":null,"abstract":"","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"23 1","pages":"90 - 91"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73357106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Derșidan, Claudiu Constantin Ciucanu, Agatha Maria Ilioniu, Ionela Georgiana Bodiu, Carina Diana Covalcic, Ludovic Alexandru Szanto, A. Mureṣan
Abstract Introduction: Severe ischemia occurring in the lower limbs represents the advanced stage of peripheral artery disease (PAD). Atherosclerosis and inflammatory markers have been intensively studied to identify prognostic tools with a role in the evolution of patients with PAD. The aim of this study is to demonstrate the predictive value of systemic inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and the systemic inflammation index (SII) in the prognosis of patients diagnosed with critical leg ischemia (CLI) undergoing infrainguinal surgical revascularization with remote endarterectomy. Materials and methods: This retrospective study included all patients admitted to the Vascular Surgery Clinic of the County Emergency Clinical Hospital of Târgu Mureș, Romania between January 2018 and December 2021, who had critical limb ischemia Leriche-Fontaine stage III and were treated with endarterectomy. Patients were divided into two groups based on the presence or absence of patency in the lower limbs at 12 months. Results: There was a higher baseline value of neutrophil count (p <0.0001), platelet count (p = 0.006), NLR and SII value (p <0.0001), as well as a lower value of lymphocyte count (p = 0.001) in the group without patency at 12 months. The ROC curve analysis showed that the NLR and SII were associated with the risk of major amputation and primary patency failure at 12 months, while multivariate analysis has shown that arterial hypertension (OR 3.63, p = 0.04), history of myocardial infarction (OR 2.93, p = 0.009), diabetes mellitus (OR 2.20; p = 0.04) and smoking (OR 3.48, p <0.0001) were also predictors of primary patency failure. Conclusions: The results of this study demonstrated the predictive role of NLR and SII regarding poor outcomes among patients with CLI Leriche-Fontaine stage III undergoing infrainguinal surgical revascularization with remote endarterectomy.
摘要简介:下肢发生严重缺血是外周动脉疾病(PAD)的晚期。动脉粥样硬化和炎症标志物已被深入研究，以确定在PAD患者演变中起作用的预后工具。本研究的目的是证明全身炎症标志物如中性粒细胞与淋巴细胞比值(NLR)和全身炎症指数(SII)对诊断为严重腿缺血(CLI)的患者行腹股沟下手术重建术并远程动脉内膜切除术的预后的预测价值。材料和方法:本回顾性研究纳入了2018年1月至2021年12月在罗马尼亚t rgu mureau县急诊临床医院血管外科诊所收治的所有重症肢体缺血lerhie - fontaine III期并接受动脉内膜切除术治疗的患者。根据12个月时下肢通畅与否将患者分为两组。结果:无通畅组12个月中性粒细胞计数基线值(p <0.0001)、血小板计数基线值(p = 0.006)、NLR和SII值基线值(p <0.0001)较高，淋巴细胞计数基线值较低(p = 0.001)。ROC曲线分析显示NLR和SII与12个月时主要截肢和原发性通畅衰竭的风险相关，多因素分析显示动脉高血压(OR 3.63, p = 0.04)、心肌梗死史(OR 2.93, p = 0.009)、糖尿病(OR 2.20;p = 0.04)和吸烟(OR 3.48, p <0.0001)也是原发性通畅衰竭的预测因素。结论:本研究的结果表明NLR和SII对于行腹股沟下手术重建术并远程动脉内膜切除术的CLI III期患者预后不良的预测作用。
{"title":"Neutrophil-to-Lymphocyte Ratio and Systemic Inflammation Index as Predictors of Poor Outcome in Patients with Critical Limb Ischemia Treated with Remote Endarterectomy","authors":"A. Derșidan, Claudiu Constantin Ciucanu, Agatha Maria Ilioniu, Ionela Georgiana Bodiu, Carina Diana Covalcic, Ludovic Alexandru Szanto, A. Mureṣan","doi":"10.2478/jce-2022-0013","DOIUrl":"https://doi.org/10.2478/jce-2022-0013","url":null,"abstract":"Abstract Introduction: Severe ischemia occurring in the lower limbs represents the advanced stage of peripheral artery disease (PAD). Atherosclerosis and inflammatory markers have been intensively studied to identify prognostic tools with a role in the evolution of patients with PAD. The aim of this study is to demonstrate the predictive value of systemic inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and the systemic inflammation index (SII) in the prognosis of patients diagnosed with critical leg ischemia (CLI) undergoing infrainguinal surgical revascularization with remote endarterectomy. Materials and methods: This retrospective study included all patients admitted to the Vascular Surgery Clinic of the County Emergency Clinical Hospital of Târgu Mureș, Romania between January 2018 and December 2021, who had critical limb ischemia Leriche-Fontaine stage III and were treated with endarterectomy. Patients were divided into two groups based on the presence or absence of patency in the lower limbs at 12 months. Results: There was a higher baseline value of neutrophil count (p <0.0001), platelet count (p = 0.006), NLR and SII value (p <0.0001), as well as a lower value of lymphocyte count (p = 0.001) in the group without patency at 12 months. The ROC curve analysis showed that the NLR and SII were associated with the risk of major amputation and primary patency failure at 12 months, while multivariate analysis has shown that arterial hypertension (OR 3.63, p = 0.04), history of myocardial infarction (OR 2.93, p = 0.009), diabetes mellitus (OR 2.20; p = 0.04) and smoking (OR 3.48, p <0.0001) were also predictors of primary patency failure. Conclusions: The results of this study demonstrated the predictive role of NLR and SII regarding poor outcomes among patients with CLI Leriche-Fontaine stage III undergoing infrainguinal surgical revascularization with remote endarterectomy.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"30 1","pages":"67 - 74"},"PeriodicalIF":0.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75761565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Biological factors that characterize extrinsic plaque vulnerability include various pro- and anti-inflammatory cytokines that contribute to the development and progression of atherosclerosis. Adhesion molecules are among the initiators of the atherosclerotic process, by mediation of endothelial inflammation. The soluble forms of these adhesion molecules have been identified in the circulatory blood, with an increased level in case of subjects with atherosclerotic lesions and higher levels in patients with acute coronary syndromes or vulnerable plaques. In addition, several authors have found a significant predictive capacity of these molecules in case of patients presenting with acute coronary and cerebrovascular events. The aim of this manuscript is to provide a short description of the role of adhesion molecules in the development and progression of atherosclerotic lesions towards acute coronary syndromes, as well as their capacity for predicting major adverse cardiovascular events in vulnerable cardiovascular patients.
{"title":"Adhesion Molecules and Vulnerable Plaques – Promoters of Acute Coronary Syndromes","authors":"D. Opincariu, T. Benedek","doi":"10.2478/jce-2022-0009","DOIUrl":"https://doi.org/10.2478/jce-2022-0009","url":null,"abstract":"Abstract Biological factors that characterize extrinsic plaque vulnerability include various pro- and anti-inflammatory cytokines that contribute to the development and progression of atherosclerosis. Adhesion molecules are among the initiators of the atherosclerotic process, by mediation of endothelial inflammation. The soluble forms of these adhesion molecules have been identified in the circulatory blood, with an increased level in case of subjects with atherosclerotic lesions and higher levels in patients with acute coronary syndromes or vulnerable plaques. In addition, several authors have found a significant predictive capacity of these molecules in case of patients presenting with acute coronary and cerebrovascular events. The aim of this manuscript is to provide a short description of the role of adhesion molecules in the development and progression of atherosclerotic lesions towards acute coronary syndromes, as well as their capacity for predicting major adverse cardiovascular events in vulnerable cardiovascular patients.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"195 1","pages":"59 - 63"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79806129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evelin Szabó, L. Bordi, Teofana Mihaila, Cristian Tolescu, I. Benedek
Abstract Background: Cardiac arrest (CA) is the most severe complication of acute myocardial infarction (AMI). Besides the location and severity of coronary occlusion, different factors may have significant role in the pathogenesis of AMI-related cardiac arrest (CA), but their contribution is still under investigation. The aim of the study was to investigate the cardiac magnetic resonance (CMR) features of myocardial injury associated with a higher risk of CA accompanying an AMI. Methods: In total, 918 myocardial segments from 54 post-AMI patients undergoing CMR imaging with delayed gadolinium enhancement were enrolled in the study, of which 18.54% presented CA during the acute phase of AMI. In all patients, infarct mass, the proportion of high transmurality extent, and scar mass at different myocardial segments were calculated using QMap software (Medis BV). Results: Compared to patients without CA, those with CA had a significantly higher infarct size (p = 0.03) and a higher degree of transmurality (29.28% vs. 14.1%, p = 0.01). The risk of CA during the acute phase was significantly higher in patients in whom the location of myocardial injury was at the level of latero-apical, antero-lateral, and basal anterior segments. Group 1 presented a larger infarct size at the level of the latero-apical (33.9 ± 30.6 g vs. 13.6 ± 17.3 g, p = 0.02), anterolateral (26.5 ± 29.0 g vs. 8.9 ± 12.8 g, p = 0.02), and anterobasal segment (20.1 ± 21.5 g vs. 7.8 ± 14.7 g, p = 0.02). Conclusions: CMR imaging identified infarct mass, high transmurality degree, and large myocardial injury as features associated with an increased risk of CA in the acute phase of AMI, especially at the level of anterolateral segments.
背景:心脏骤停(CA)是急性心肌梗死(AMI)最严重的并发症。除了冠状动脉闭塞的位置和严重程度外，不同的因素可能在ami相关性心脏骤停(CA)的发病机制中起重要作用，但它们的作用仍在研究中。本研究的目的是探讨心肌损伤的心脏磁共振(CMR)特征与CA合并AMI的高风险相关。方法:选取54例AMI后行延迟钆增强CMR显像的918段心肌，其中18.54%在AMI急性期出现CA。采用QMap软件(Medis BV)计算梗死块、高跨壁范围比例、不同心肌节段疤痕块。结果:与无CA患者相比，CA患者梗死面积明显增大(p = 0.03)，跨壁性程度明显增大(29.28% vs. 14.1%， p = 0.01)。心肌损伤部位位于前尖外侧、前外侧和基底段水平的患者，急性期CA发生的风险明显更高。1组在根尖外侧(33.9±30.6 g比13.6±17.3 g, p = 0.02)、前外侧(26.5±29.0 g比8.9±12.8 g, p = 0.02)和前基底段(20.1±21.5 g比7.8±14.7 g, p = 0.02)梗死面积较大。结论:CMR成像发现梗死块、高跨壁程度和大心肌损伤是AMI急性期CA风险增加的特征，特别是在前外侧段水平。
{"title":"Cardiac Magnetic Resonance Features Associated with the Risk of Cardiac Arrest in Patients with Acute Myocardial Infarction","authors":"Evelin Szabó, L. Bordi, Teofana Mihaila, Cristian Tolescu, I. Benedek","doi":"10.2478/jce-2022-0011","DOIUrl":"https://doi.org/10.2478/jce-2022-0011","url":null,"abstract":"Abstract Background: Cardiac arrest (CA) is the most severe complication of acute myocardial infarction (AMI). Besides the location and severity of coronary occlusion, different factors may have significant role in the pathogenesis of AMI-related cardiac arrest (CA), but their contribution is still under investigation. The aim of the study was to investigate the cardiac magnetic resonance (CMR) features of myocardial injury associated with a higher risk of CA accompanying an AMI. Methods: In total, 918 myocardial segments from 54 post-AMI patients undergoing CMR imaging with delayed gadolinium enhancement were enrolled in the study, of which 18.54% presented CA during the acute phase of AMI. In all patients, infarct mass, the proportion of high transmurality extent, and scar mass at different myocardial segments were calculated using QMap software (Medis BV). Results: Compared to patients without CA, those with CA had a significantly higher infarct size (p = 0.03) and a higher degree of transmurality (29.28% vs. 14.1%, p = 0.01). The risk of CA during the acute phase was significantly higher in patients in whom the location of myocardial injury was at the level of latero-apical, antero-lateral, and basal anterior segments. Group 1 presented a larger infarct size at the level of the latero-apical (33.9 ± 30.6 g vs. 13.6 ± 17.3 g, p = 0.02), anterolateral (26.5 ± 29.0 g vs. 8.9 ± 12.8 g, p = 0.02), and anterobasal segment (20.1 ± 21.5 g vs. 7.8 ± 14.7 g, p = 0.02). Conclusions: CMR imaging identified infarct mass, high transmurality degree, and large myocardial injury as features associated with an increased risk of CA in the acute phase of AMI, especially at the level of anterolateral segments.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"22 1","pages":"54 - 58"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84603553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The role of cardiac biomarkers in diagnosing acute myocardial infarction is undoubted. In the 2020 guidelines of the European Society of Cardiology, the measurement of cardiac peptides to gain prognostic information has a class IIa indication in all patients with ACS. In emergency care, ruling out a non-ST elevation myocardial infarction requires documentation of normal levels of cardiac biomarkers, which remain stable or have very small variations within several hours. This review aims to summarize the current knowledge and recent progresses in the field of cardiac biomarker discovery, from their routine use in emergency rooms to their prognostic roles in modern risk assessment tools. Integrated approaches combining cardiac troponin with other biomarkers of ventricular dysfunction or inflammation, or with modern cardiac imaging in emergency care are also presented, as well as the role of modern algorithms for serial troponin measurement in the modern management of emergency departments.
{"title":"Cardiac Biomarkers in 2022 – a Vital Tool for Emergency Care","authors":"T. Benedek, Monica Marton-Popovici","doi":"10.2478/jce-2022-0012","DOIUrl":"https://doi.org/10.2478/jce-2022-0012","url":null,"abstract":"Abstract The role of cardiac biomarkers in diagnosing acute myocardial infarction is undoubted. In the 2020 guidelines of the European Society of Cardiology, the measurement of cardiac peptides to gain prognostic information has a class IIa indication in all patients with ACS. In emergency care, ruling out a non-ST elevation myocardial infarction requires documentation of normal levels of cardiac biomarkers, which remain stable or have very small variations within several hours. This review aims to summarize the current knowledge and recent progresses in the field of cardiac biomarker discovery, from their routine use in emergency rooms to their prognostic roles in modern risk assessment tools. Integrated approaches combining cardiac troponin with other biomarkers of ventricular dysfunction or inflammation, or with modern cardiac imaging in emergency care are also presented, as well as the role of modern algorithms for serial troponin measurement in the modern management of emergency departments.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"36 1","pages":"43 - 53"},"PeriodicalIF":0.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90707742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Cardiovascular disorders have been described as relevant risk factor for severe COVID infection. Stent thrombosis is a life-threatening complication that may occur subacutely. We present an interesting case of a middle-aged woman who developed acute stent thrombosis while interrupting dual antiplatelet therapy (DAPT) ticagrelor, during an episode of coronavirus disease (COVID-19). In our case, the patient’s not-compliance to DAPT, associated with COVID-19 infection and a hyperinflammatory and hypercoagulable state associated with it played a major role in the development of stent thrombosis. The hypercoagulable and hyperinflammatory state associated with COVID-19 has important implications for cardiac patients, especially those undergoing complex coronary intervention, predisposing them to an increased risk of post-PCI complications.
{"title":"Double Trouble: Interrupting DAPT and COVID-19","authors":"T. Mihăilă, A. Roșca, B. Ion","doi":"10.2478/jce-2022-0007","DOIUrl":"https://doi.org/10.2478/jce-2022-0007","url":null,"abstract":"Abstract Cardiovascular disorders have been described as relevant risk factor for severe COVID infection. Stent thrombosis is a life-threatening complication that may occur subacutely. We present an interesting case of a middle-aged woman who developed acute stent thrombosis while interrupting dual antiplatelet therapy (DAPT) ticagrelor, during an episode of coronavirus disease (COVID-19). In our case, the patient’s not-compliance to DAPT, associated with COVID-19 infection and a hyperinflammatory and hypercoagulable state associated with it played a major role in the development of stent thrombosis. The hypercoagulable and hyperinflammatory state associated with COVID-19 has important implications for cardiac patients, especially those undergoing complex coronary intervention, predisposing them to an increased risk of post-PCI complications.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"38 1","pages":"39 - 42"},"PeriodicalIF":0.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90452071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emil-Marian Arbănași, A. Mureṣan, Eliza-Mihaela Arbănași, Réka Kaller, I. Cojocaru, Cătălin Mircea Coșarcă, E. Russu
Abstract Acute pulmonary embolism is a cardiovascular emergency with a significant morbidity and mortality. In the last decade, attempts have been made to find prognostic markers for pulmonary embolism. We conducted a systematic review of the literature for studies that assess the relationship between the neutrophil-to-lymphocyte ratio (NLR) and disease progression in patients with pulmonary embolism. We included a total of seven studies published between 2016 and 2021, reporting on a total of 4,272 patients. The mean NLR observed in these studies was 5.93, with values ranging from 5.12 to 7.3. Elevated NLR was significantly associated with an increased rate of mortality in all studies. Furthermore, the collected data revealed a 2-to-15 times higher mortality rate in the group with NLR values higher than the mean. Due to its accessibility and the simplicity with which it can be calculated, as well as the outcomes revealed in this review, we strongly emphasize that NLR should be used more in medical practice.
{"title":"The Neutrophil-to-Lymphocyte Ratio’s Predictive Utility in Acute Pulmonary Embolism: Systematic Review","authors":"Emil-Marian Arbănași, A. Mureṣan, Eliza-Mihaela Arbănași, Réka Kaller, I. Cojocaru, Cătălin Mircea Coșarcă, E. Russu","doi":"10.2478/jce-2022-0005","DOIUrl":"https://doi.org/10.2478/jce-2022-0005","url":null,"abstract":"Abstract Acute pulmonary embolism is a cardiovascular emergency with a significant morbidity and mortality. In the last decade, attempts have been made to find prognostic markers for pulmonary embolism. We conducted a systematic review of the literature for studies that assess the relationship between the neutrophil-to-lymphocyte ratio (NLR) and disease progression in patients with pulmonary embolism. We included a total of seven studies published between 2016 and 2021, reporting on a total of 4,272 patients. The mean NLR observed in these studies was 5.93, with values ranging from 5.12 to 7.3. Elevated NLR was significantly associated with an increased rate of mortality in all studies. Furthermore, the collected data revealed a 2-to-15 times higher mortality rate in the group with NLR values higher than the mean. Due to its accessibility and the simplicity with which it can be calculated, as well as the outcomes revealed in this review, we strongly emphasize that NLR should be used more in medical practice.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"82 1","pages":"25 - 30"},"PeriodicalIF":0.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76102490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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