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      A Novel Index for Prompt Prediction of Severity in Patients with Unstable Angina Pectoris

      research-article
      1 , 2 ,
      Emergency Medicine International
      Hindawi

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          Abstract

          Objectives

          Rapid risk stratification by emergency department (ED) physicians to evaluate patients with chest pain for predicting the short-term occurrence of major adverse cardiac event (MACE) is crucial. The aim of this study was to investigate the predictive value of platelet-lymphocyte ratio (PLR) levels and compare with the modified heart score (m-HS) and stress testing to predict the severity of high-risk patients with unstable angina pectoris (UAP) in the ED.

          Methods

          This study is prospective which included 316 patients with UAP and 316 control healthy subjects. The study took place from 01 April 2016, until 01 April 2017, in Medipol University.

          Result

          The mean PLR levels in the UAP group were higher than those in the control group ( p < 0.001). The mean PLR of the m-HS ≥4 group was higher than that in the m-HS ≤3 group ( p < 0.001). The mean levels of PLR in the subgroups based on the stress testing positivity were higher than those in the stress testing negative subgroup ( p < 0.001). PLR levels were positively correlated with the m-HS, stress testing, and treatment decision in this study ( r = 0.559; p < 0.001; r = 0.582; p < 0.001; r = 0.789; p < 0.001, respectively).

          Conclusion

          A positive correlation was determined with an increase in m-HS, treatment decision, and positive exercise testing as the PLR levels increased, indicating the severity of high risk of UAP in the ED.

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          Most cited references25

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          ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines).

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            Bleeding in acute coronary syndromes and percutaneous coronary interventions: position paper by the Working Group on Thrombosis of the European Society of Cardiology.

            Bleeding has recently emerged as an important outcome in the management of acute coronary syndromes (ACS), which is relatively frequent compared with ischaemic outcomes and has important implications in terms of prognosis, outcomes, and costs. In particular, there is evidence that patients experiencing major bleeding in the acute phase are at higher risk for death in the following months, although the causal nature of this relation is still debated. This position paper aims to summarize current knowledge regarding the epidemiology of bleeding in ACS and percutaneous coronary intervention, including measurement and definitions of bleeding, with emphasis on the recent consensus Bleeding Academic Research Consortium (BARC) definitions. It also provides an European perspective on management strategies to minimize the rate, extent, and consequences of bleeding. Finally, the research implications of bleeding (measuring and reporting bleeding in trials, the importance of bleeding as an outcome measure, and bleeding as a subject for future research) are also discussed.
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              The Role of Hematological Indices in Patients with Acute Coronary Syndrome

              An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management. Their low-cost and consequent wide and easy availability in daily clinical practice have made them very popular in the laboratory testing. Furthermore, many studies have pointed at their effective prognostic value in all-cause mortality, major cardiovascular events, stent thrombosis, arrhythmias, and myocardial perfusion disorders in terms of acute myocardial infarction and unstable angina. The most recent research also emphasizes their significant value in the combined analysis with other markers, such as troponin, or with GRACE, SYNTAX, and TIMI scores, which improve risk stratification and diagnosis in ACS patients.
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                Author and article information

                Contributors
                Journal
                Emerg Med Int
                Emerg Med Int
                EMI
                Emergency Medicine International
                Hindawi
                2090-2840
                2090-2859
                2020
                3 January 2020
                : 2020
                : 7651610
                Affiliations
                1Medipol University Hospital, Department of Emergency Medicine, Istanbul, Turkey
                2Bozyaka Research and Training Hospital, Department of Emergency Medicine, Izmir, Turkey
                Author notes

                Academic Editor: Robert Derlet

                Author information
                https://orcid.org/0000-0001-6708-7946
                Article
                10.1155/2020/7651610
                7199558
                3ad3f805-55ed-4541-8453-75953203001e
                Copyright © 2020 Mustafa Bolatkale and Ahmet Cagdas Acara.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 July 2019
                : 26 November 2019
                : 6 December 2019
                Categories
                Research Article

                Emergency medicine & Trauma
                Emergency medicine & Trauma

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