Background: Emergency medical services (EMS) transport to hospital is recommended in acute coronary syndrome (ACS) guidelines, but only half of patients with ACS currently use EMS. The recent Australian Warning Signs campaign conducted by the Heart Foundation addressed some of the known barriers against using EMS. Our aim was to examine the influence of awareness of the campaign on these barriers in patients with ACS.
Methods: Interviews were conducted with patients admitted to an Australian tertiary hospital between July 2013 and April 2014 with a diagnosis of ACS. Patient selection criteria included: aged 35-75 years, competent to provide consent, English speaking, not in residential care and medically stable. Multivariable logistic regression was used to examine factors associated with EMS use.
Results: Only 54% of the 199 patients with ACS interviewed used EMS for transport to hospital. Overall 64% of patients recalled seeing the campaign advertising, but this was not associated with increased EMS use (52.0%vs56.9%, p=0.49) or in the barriers against using EMS. A large proportion of patients (43%) using other transport thought it would be faster. Factors associated with EMS use for ACS were: age >65 years, ST-elevation myocardial infarction, a sudden onset of pain and experiencing vomiting.
Conclusion: In medically stable patients with ACS, awareness of the Australian Warning Signs campaign was not associated with increased use of EMS or a change in the barriers for EMS use. Future education strategies could emphasise the clinical role that EMS provide in ACS.
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http://dx.doi.org/10.1136/emermed-2016-206396 | DOI Listing |
J Am Heart Assoc
January 2025
Center for Coronary Artery Disease, Division of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing China.
Background: The circadian rhythm of myocardial infarction (MI) in patients with obstructive sleep apnea (OSA) remains disputable and no studies have directly evaluated the relationship between nocturnal hypoxemia and the circadian rhythm of MI. The aim of the current study was to evaluate the association of OSA and nocturnal hypoxemia with MI onset during the night.
Methods: Patients with MI in the OSA-acute coronary syndrome (ACS) project (NCT03362385) were recruited.
Res Pract Thromb Haemost
January 2025
Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalo Universitaire de St-Etienne, Saint-Etienne, France.
Background: Rates of venous thromboembolism (VTE) recurrence and bleeding remain high in patients with cancer who are prescribed anticoagulants (ACs) such as low-molecular-weight heparin (LMWH) after an initial VTE event.
Objectives: To identify patient characteristics associated with VTE recurrence and bleeding in patients receiving LMWH for cancer-associated VTE and to explore secondary AC management and clinical outcomes in these patients.
Methods: An observational study was conducted using nationwide French data for adults with active cancer who were hospitalized with VTE in 2013-2018 and were reimbursed for LMWH ≤ 30 days after hospital discharge.
Acute chest pain is one of the most common reasons for ED visits in the United States. Most patients are eventually admitted to the hospital to "rule out ACS" even when there are no significant EKG abnormalities or elevated cardiac enzymes. In addition to undergoing expensive tests while in the hospital, patients are also exposed to iatrogenic harm thereby worsening the overall healthcare costs.
View Article and Find Full Text PDFRev Cardiovasc Med
January 2025
Department of Cardiology, Renmin Hospital of Wuhan University, 430060 Wuhan, Hubei, China.
Background: Ceramide, a key molecule in sphingolipid metabolism, is recognized as a standalone predictor of long-term major adverse cardiac events (MACE). We explore if integrating the global registry of acute coronary events (GRACE) score with the ceramide risk score (ceramide test 1, CERT1) improves MACE prediction in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
Methods: This cohort study included 210 participants with ACS undergoing PCI.
Cureus
December 2024
Critical Care, Captain James A. Lovell Federal Health Care Center, Rosalind Franklin University of Medicine and Science, North Chicago, USA.
This is a case of a young, 20-year-old, male Navy recruit who was admitted to our healthcare facility with intermittent atypical chest pain and limiting exertional symptoms and was diagnosed with myocardial bridging (MB) as the most likely etiology of his chest after the complete cardiac workup, leading to his career limitations due to potential risks. Our patient presented with atypical chest pain and limiting exertional symptoms. Chest pain was non-radiating.
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