European Journal of Molecular & Clinical Medicine

Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide. The prevalence of Coronary artery disease and the incidence of ACS are very high among Indians.
Objectives-The primary aim of this study was to assess the varying clinical presentation of patients with ACS and to determine the effectiveness of various treatment modalities establish an association between base line variable and ACS presentation.
Methods-A retrospective descriptive study was conducted in Department of Medicine (Cardiology) in MGM Muthoot Hospital, Kozhencherry for the period of One year. Medical records of patients admitted with ACS during the period of study. A total of 100 patients admitted with ACS through Non probability convenience sampling technique.
Results-There is significant association between outcome and Type-II diabetes mellitus.Since the p value is 0.048 is less than 0.05, there is significant association between outcome and Hypertension.Since the p value is 0.528 is greater than 0.05, there is no significant association between outcome and Dyslipidemia but no association with demographic profile. 2 the association between treatment modality and outcome is highly significant (p<0.05). PTCA was found to be most common treatment modalities done in more than 90% of patients.
Conclusion-The study reveals that from the Chi-square test analysis, it is found that there is no significant association between outcome and base line variables. But the significant association has been obtained between complications, Treatment modalities and outcome since the ‘p’ value is 0.000.Furthermore, studies with large sample size must be conducted for better accuracy of results with longer duration.

Introduction: The main goals of treatment for patients with acute coronary syndromes (ACS) are to increase survival and relieve symptoms. Quality of life measurement deteriorates quickly after diagnosis. Professionals in the fields of health and social services are placing an increasing emphasis on maintaining and enhancing patients' quality of life as an important outcome or objective
Material and Methods:  This was a non-experimental, quantitative, survey based research conducted among Acute Coronary Syndrome Patients and totally 60 samples was selected by Simple Random technique. The samples included in this study were who fulfilled the inclusion criteria. Ethical permission was obtained before the data collection. After obtaining permission from the setting, the samples were asked their willingness to participate in the study and informed consent was obtained.  Socio-demographic data such as age, gender, marital status was collected and Quality of life was assessed by using the structured questionnaire.
Results: Results shows 8 (13.4%) samples were having low quality of life, 43 (71.6%) samples were having moderate quality of life and 9(15%) were having high quality of life.
Conclusions: study concluded that patients with Acute Coronary Syndrome had relatively average and low level of Quality of life and there was no any significant association found with demographic variables. 

Aim: The aim of the present study was to assess the electrical complications in patients of Acute Coronary Syndrome, within 48 hours of admission.
Methods: The present prospective observational study was conducted on 100 patients of age >18 years with confirmed diagnosis of ACS, admitted in medical intensive care unit of Dr. D.Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune during the period from OCTOBER 2020– SEPTEMBER 2022.
Results: Majority of patients in this study were in the 51-60 age group (34%) followed by 61-70years (22%) and 41-50years of age (21%). The majority of patients in this study were in the 51-60 age group. It was observed that majority of the patients with acute coronary symptoms were male with proportion of 57%, followed by 43% females. 51% patients had normal BMI, 33% were overweight, and 16% were obese. It was observed that among the STEMI patient’s Chest pain was the most common symptom and it was followed by Dyspnea, Fatigue and Palpitation. Among the NSTEMI patients Dyspnea was most common presenting sign and symptom.
Conclusion: Thus, our study concludes that majority of the patients with Acute Coronary Syndrome were middle-aged above 50 years of age with male preponderance. Hypertension and dyslipidaemia were the most common reported risk factors. Majority of the patients were of NSTEMI with respect to coronary heart disease, followed by STEMI and Unstable Angina.

Background: Patients with diabetes mellitus (DM), have  poor long term glycaemic control,  even when fasting glucose concentrations are normal.^{3, 4}, Glycosylated haemoglobin (HbA1c) is a useful index of glucose intolerance and hyperglycaemia.HbA1cis an established marker of long-term glycaemic control. HbA1c can be assessed in the non-fasted state and has higher reproducibility than fasting glucose
Aim of the study : To study the blood levels of HbA1C in patients of Acute Coronary Syndrome at the time of admission and to find out the correlation with the angiographic pattern.
Materials and methods :Cross sectional study was conducted in the Department of general medicine, at Sundaram Arulrhaj Hospitals Tuticorin, Tamil Nadu in Patients with a confirmed diagnosis of Acute Coronary Syndrome .
Reslts : Among the people with SVD,18 (100%) participants had<6.5% HbA1c, 27 (56.25%) participants had 6.5-8.5 HbA1c and 8 (36.36%) participants had 8.5 – 10.5 HbA1c. Among the people with DVD,16 (33.33%) participants had 6.5-8.5 HbA1c, 10 (45.45%) participants had 8.5 – 10.5 HbA1c and 3 (25%) participants had >10.5 HbA1c. Among the people with TVD,5 (10.41%) participants had 6.5-8.5 HbA1c, 4 (18.18%) participants had been with 8.5 – 10.5 HbA1c and 9 (75%) participants had>10.5 HbA1c
 
Conclusion : Our data suggest that HbA1c level is a significant and independent maker for the severity of angiographic lesion in ACS patients, irrespective of other cardiovascular risk factors, age, and gender, smoking, alcoholism. HbA1c values can be a predictor of the prevalence of complex coronary artery lesions.  It may be used as a cardiac marker in risk stratification of the patients presenting with acute coronary syndrome and indicated for coronary angiography.HbA1c levels are also to be included in investigations apart from routine Blood sugar  levels  in Out Patient Clinics and adoption of lifestyle changes & medications are to be taken to prevent the cardiovascular complications and morbidity from Diabetes mellitus.

Background: Myocardial bridging can occasionally generate clinically important complications, despite usually being a benign condition. Myocardial bridging can be associated with stable and unstable angina, myocardial infarction, myocardial stunning, atrioventricular nodal block, ventricular tachycardia and sudden death. Present study was aimed to study clinical, angiographic profile and follow-up of patients with myocardial bridges at a tertiary hospital.
Material and Methods: Present study was single-center, prospective, observational study, conducted in patients, >18 years, of both sexes, who underwent diagnostic conventional coronary angiography. Myocardial bridge (MB) was identified based on narrowing of coronary artery in systolic phase resulting in at least 50% reduction of luminal diameter in comparison with the diastolic phase.
Results: During study period, out of 1962 diagnostic conventional coronary angiography procedures satisfying study criteria, myocardial bridge (MB) was noticed in 81 cases, incidence was 4.13 %. Common indications for diagnostic conventional coronary angiography among patients of myocardial bridge (MB) were unstable angina (USA) (19.75 %), STEIWMI (18.52 %), chronic stable angina (CSA) (16.05 %), STEAWMI (13.58 %), atypical chest pain (9.88 %), Others (8.64 %), pre-surgery (8.64 %) & NSTEMI (4.94 %). In patients of myocardial bridge (MB) on follow up symptoms noted were atypical chest pain (38.27 %), dyspnoea on exertion (27.16 %) & chest pain (23.46 %). On follow up, myocardial bridge (MB) was associated with 2 cases of acute myocardial infarction, no major adverse cardiac events, myocardial ischemia or cardiovascular death noted.
Conclusion: Clinical suspicion of Myocardial bridges should be considered in young patients with acute coronary syndrome with typical or atypical chest pain, though casual association needs further studies with larger sample size & longer follow up.

Recently, the prevalence of unstable variants of angina pectoris (NVS) among men at a young age has increased markedly. A significant role in the inflammation of the atherosclerotic plaque, which underlies the pathogenesis of NVS, is assigned to cytokines by the mediator. To date, the role of cytokine gene polymorphism in the development of NVS associated with inflammatory processes has been proven.

According to the World Health Organization (WHO), cardiovascular disease (CVD) is the leading cause of death and disability in countries around the world, with ST segment elevated myocardial infarction (STEMI) leading the way. Despite advances such as the widespread introduction of many effective drugs, angioplasty and surgical treatments into clinical practice, CVD kills 17.3 million people annually, accounting for 30% of all deaths worldwide. This figure is projected to increase to 23.6 million by 2030. In the world, including in Uzbekistan, over the past two decades there has been an increase in morbidity and mortality from cardiovascular pathology.

background: coronary artery disease is the leading cause of death in developing countries and the main treatment strategy includes pci which is usually followed by dual antiplatelet therapy (dapt) with aspirin and clopidogrel. Clopidogrel resistance from genetic polymorphisms incyp2c19 gene involved in hepatic activation of clopidogrel leads to clopidogrel nonresponsiveness and may result in increased adverse clinical outcomes. These polymorphisms in cyp2c19 gene and their impact in mace have been studied in southindian population only in limited number of studies.Methods:we studied 118 consecutive patients (mean age 55.7±10.7 years; 90% male) taking clopidogrel, with angiographically proven coronary artery disease for various genetic polymorphisms incyp2c19 gene. Relationship between loss of function mutation and clinical presentation with higher mace events including recurrent acute coronary syndromes, stent thrombosis were analyzed and genetic analysis. Results: out of 118 patients, 38 (32%) had normal genotype, 23 (20%) had loss offunction mutation( *2) the poor metabolizer type, and 57 (48%) had intermediate metabolizers (*2/*1). Final analyses included 118 patients, with 23 (20%) having loss of function. Seven patients developed stent thrombosis while on clopidogrel; all seven had loss of function mutationin cyp2c19 gene. Conclusion: we observed that the cyp2c19*2 and cyp2c19*1/*2 are the major determinants of clopidogrel efficacy. Acute stent thrombosis was observed in patients carrying cyp2c19*2 variant allele. In patients with an acute myocardial infarction who were receiving clopidogrel, with cyp2c19 loss-of-function alleles had higher rate of subsequent major cardiovascular events in comparison with normal genotype individuals.