![]() With the population’s increasing age and advancing medical techniques, healthcare costs are a critical issue in many countries. In addition, this causes the occupation of hospital beds through admission of such patients and associated increase in medical costs. Clearly, when treated as ACS, the latter will be prone to unnecessary risks of various treatments, including the side effects of medication or radiation. These patients may be discharged immediately with minimal testing or intervention. The challenge in the ED is not only to identify patients at the highest risk, but also to identify patients with non-urgent diseases or even the absence of disease. ![]() A variety of other diseases may mimic ACS, such as pleural and pericardial irritations, gastro-intestinal reflux, pulmonary embolism, hyperventilation, musculoskeletal pain and cholecystitis. However, STEMI patients represent only a small percentage of all chest pain patients in this setting. In a number of cases, a diagnosis can be made quickly, in particular in case of ST-segment elevation acute myocardial infarction (STEMI). An acute coronary syndrome (ACS) needs to be distinguished from a variety of other cardiac and non cardiac diseases that may cause chest pain. The HEART score facilitates risk stratification of chest pain patients in the ED.Ĭhest pain is one of the most common reasons for patients to present to the emergency department (ED). The HEART score was validated in a retrospective multicenter study and proved to be a strong predictor of event free survival on one hand and potentially life threatening cardiac events on the other hand. The more recently developed HEART score is specifically designed to stratify all chest pain patients in the ED. An evidence-based systematic stratification and policy for these patients does not currently exist. The vast majority of patients with chest pain due to causes other than ACS were not evaluated in these trials. However, none of these risk scores has been used in the identification of an ACS in the emergency setting. ![]() The PURSUIT, TIMI, GRACE and FRISC risk scores are well validated with this respect. An acute coronary syndrome (ACS) needs to be distinguished from a variety of other cardiac and non-cardiac diseases that may cause chest pain.įor patients with confirmed ACS, several scoring methods can be applied in order to distinguish patients in the coronary care unit who may benefit most from therapies. Absolute criteria for Acute Coronary Syndrome without ST elevation (NSTE-ACS) are lacking. Patients with TIMI score > 4 were more likely to have significant three vessel CAD and LMS versus those with TIMI risk score 4 should be referred for early invasive coronary evaluation to derive clinical benefit.Chest pain is a common reason for presentation to the emergency department (ED). The extent of CAD was evaluated on angiography and significant CAD was defined as ≥ 70% stenosis in any one of the three major epicardial vessels and ≥50% in LMS.Results : Among 100 patients with UA/NSTEMI, 82% of patients have one or more risk factors and only 18%of patients lacked any of 4 conventional risk factors.Smoking is the most common risk factor in male patients while diabetes mellitus and dyslipidemia are common among female patients, and all these results are statistically significant.There were 64 % patients with TIMI score 4 (high TIMI risk score). The TIMI risk score was stratified on seven standard variables. Extensive epidemiological research has established cigarette smoking, diabetes, hyperlipidemia, and hypertension as independent risk factors for CADObjective: To determine the prevalence of the 4 conventional risk factors(cigarette smoking, diabetes, hyperlipidemia, and hypertension) among patients with CAD and to determine the correlation of Thrombolysis in Myocardial Infarction (TIMI) risk score with the extent of coronary artery disease (CAD) in patients with unstable angina /non ST elevation myocardial infarction (UA/NSTEMI).Methods: We conducted a descriptive study among 100 patients admitted with UA/NSTEMI to three major cardiac centers in Iraq: Iraqi Centre for Heart Disease ,Ibn- Al-Bitar Hospital for cardiac surgery and Al -Nasyria Cardiac Centre from January 2010 to January 2o11.Frequency of each conventional risk factors and number of conventional risk factors present among patients with CAD, compared between men and women and by age are estimated at study entry. ![]() Unstable angina, Thrombolysis in Myocardial Infarction score, risk factors Abstractīackground: Appreciation of the crucial role of risk factors in the development of coronary artery disease (CAD) is one of the most significant advances in the understanding of this important disease. ![]()
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