Risk Factors of Acute Coronary Syndrome: The Experience from Iran

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Abstract

Aims:

This study was conducted with the aim of identifying the risk factors of coronary artery disease in patients referred to Imam Khomeini Hospital in Jiroft.

Background:

Acute coronary syndrome (ACS) is a spectrum of symptoms compatible with acute myocardial ischemia. Understanding these factors can have an effective impact on the prevention, diagnosis, and management of ACS.

Methods:

This is a descriptive study. Participants in this study were all patients diagnosed with acute coronary syndrome and acute myocardial infarction in 2020. Data collection was done by reviewing patients' clinical records. Data analysis was performed by SPSS version 21.

Results:

Out of a total of 228 patients, 149 (65%) were male and 79 (35%) were female. 88% of patients complained of heart pain upon arrival, 43% had a history of drug abuse, 98.2% had retrosternal pain, 48.1% had an average length of hospitalization of four days, 32% were under ischemic treatment, and 68% were under ischemic treatment. They were on thrombolytic therapy. The majority of patients (65.1%) had an EF greater than 40%. 13.9% mortality, 18.9% discharge with survival and recovery, 62.7% recovery and referral to a higher center to complete treatment and angiography, and 4.5% leaving the hospital with It was personal satisfaction.

Conclusion:

The main risk factors related to chest pains in the Jiroft region and the reason for more patients going to the hospital include hypertension, high blood sugar on arrival, low WMR, high BMI, drug abuse, leukocytosis, and non-compliance with post-treatment recommendations.

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To determine whether an association exists between mean platelet volume (MPV) and acute myocardial infarction (AMI) and other cardiovascular events. Platelet activity is a major culprit in atherothrombotic events. MPV, which is widely available in clinical practice, is a potentially useful biomarker of platelet activity in the setting of cardiovascular disease. We performed a systematic review and meta-analysis investigating the association between MPV and AMI, all-cause mortality following myocardial infarction, and restenosis following coronary angioplasty. Results were pooled using random-effects modeling. Pooled results from 16 cross-sectional studies involving 2809 patients investigating the association of MPV and AMI indicated that MPV was significantly higher in those with AMI than those without AMI [mean difference 0.92 fL, 95% confidence interval (CI) 0.67-1.16, P < 0.001). In subgroup analyses, significant differences in MPV existed between subjects with AMI, subjects with stable coronary disease (P < 0.001), and stable controls (P < 0.001), but not vs. those with unstable angina (P = 0.24). Pooled results from three cohort studies involving 3184 patients evaluating the risk of death following AMI demonstrated that an elevated MPV increased the odds of death as compared with a normal MPV (11.5% vs. 7.1%, odds ratio 1.65, 95% CI 1.12-2.52, P = 0.012). Pooled results from five cohort studies involving 430 patients who underwent coronary angioplasty revealed that MPV was significantly higher in patients who developed restenosis than in those who did not develop restenosis (mean difference 0.98 fL, 95% CI 0.74-1.21, P < 0.001). Elevated MPV is associated with AMI, mortality following myocardial infarction, and restenosis following coronary angioplasty. These data suggest that MPV is a potentially useful prognostic biomarker in patients with cardiovascular disease. Whether the relationship is causal, and whether MPV should influence practice or guide therapy, remains unknown.