Faculty of Medicine

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The role of pre-existing renal dysfunction on in-hospital morbidity and mortality in patients with acute coronary syndrome
(Oxford University Press (OUP), 2024-04)
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Bogevska, I
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Dobjani, A
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Shehu, E
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Taravari, H
Introduction The baseline renal function is an important predictor for the prognosis of patients with acute coronary syndrome (ACS). The aim of our study was to analyse the impact of pre-existing renal failure (RF) and the risk profile of patients with ACS on the development of in-hospital morbidity and mortality. Materials and methods This was a single-center cross-sectional cohort study on 2702 patients with ACS. The main exclusion criterion was pre-existing left ventricular (LV) dysfunction. Demographical and clinical characteristics, biochemical parameters, the anatomical distribution of coronary artery disease, and the final outcomes were analysed according to presence of RF at the moment of the index event. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease Study Group Equation (MDRD), where patients with eGFR<60 ml/min/1.73 m2 had moderate to severe renal dysfunction. Results 777 (22.3%) out of 2702 patients had eGFR <60 ml/min at the moment of the index event. These patients were predominantly female, 34.1% (333) vs.17.7% (444), p=0.0004,OR 1.921(95%CI 1.701-2.168);older (70.0±9.7vs.60.5±10.7;p <0.000). They had significantly higher values of cardiac troponin (p=0.007), stress glycemia (p=0.000019), glycated hemoglobin (p=0.000012), and WBC (p=0.00001), meaning the extent of myocardial injury was bigger, with a more activated neuro-hormonal and inflammatory response in the conditions of the notably widespread anatomical distribution of CAD. However, patients with significantly reduced eGFR were less likely to be offered coronary angiography and PCI treatment, OR 0.524 (95%CI 0.434–0.632),p <0.000. As expected, anemia predominated in these patients (RBC 4.88±0.75 vs 4.53±0.58, p=0.000001; OR 1.27 (95% CI 1.09-1.48), and Hgb 143.81±16.69 vs 132.03±21.34, p=0.00001). They had a significantly lower level of sodium (p=0.008) and a higher level of potassium (p=0.00003). Interestingly, patients with eGFR <60 ml/min had lower lipoprotein levels. In-hospital mortality rate was 4.2%, however, significantly higher in reduced eGFR group (12% vs 1.9%, OR 6.9 (95% CI 4.9–9.8), p <0.00004). These patients were more likely to develop acute kidney injury [25.7% vs. 1.3%, OR 1.6 (95% CI 1.3-1.9, p = 0.000021)], pulmonary oedema [8% vs. 1.8%, OR 1.12 (95% CI 1.02-1.23, p = 0.000021), and cardiogenic shock [19.5% vs. 2.6%, OR 1.22 (95% CI 1.2-1.4), p = 0.00023]. Independent variables associated with RF were: advanced age, female gender, extracardiac ASCVD, previous CVI, previous RAAS treatment, stress glycemia, triglyceride, cholesterol, LDL-C, Hgb, WBC, and potassium level. Conclusion Patients with reduced eGFR (<60 ml/min) have a very specific risk profile, as identified in our study, and reduced eGFR is a major contributor to the prognosis of ACS, highly responsible for in-hospital morbidity and mortality.
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Left ventricular systolic function in patients with acute coronary syndrome-risk profile
(Oxford University Press (OUP), 2024-04)
Dobjani, A
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Bogevska Naumovska, I
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Shehu, E
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Taravari, H
Introductions and objectives Left ventricular (LV) systolic dysfunction is one of the most important determinants of long-term outcome in acute coronary syndrome (ACS). Aim To determine the impact of the patient’s risk profile on the LV systolic function. Methods A single-center cross-sectional cohort study that included 3093 patients with ACS without pre-existing LV dysfunction. The comparison was performed between patients who did or did not develop a reduction in LV systolic function during the index event (<50%/≥50%), analyzing patients’ demographic, clinical, biochemical data, LV functional data, and anatomical distribution of the coronary artery disease (CAD). Result 1369 patients out of 3093 developed LV systolic dysfunction (44.3%). They were predominantly males 75.1% (1028), p=0.002; older (63.39±11.04 vs 61.21±11.12, p<0.00000); had higher level of cardiac troponin (p=0.00002), higher stress glycemia (9.2±5.3; p=0.0000001), HbA1c (6.9±1.8, p=0.000003), WBC (11.7±4.1, p=0.00001), blood urea nitrogen (BUN) (6.8±3.7, p=0.000003), and creatinine (93.2±45.1 p=0.000167), and had anemia (OR 0.35 (CI 0.29–41, p=0.000012). They had more severe CAD (SINTAX score 16.8±8.4 p=0.000012). Patients with preserved LV systolic function were predominantly females (29.7%, OR 1.1 95% CI 1.0-1.2), p = 0.002), younger (p<0.00000), and severely metabolically burdened (hypothyreosis (2.7%, OR 1.28 95% CI 0.93-1.76, p=0.052), higher levels of triglycerides (2.2±1.7 vs 1.9±1.5, p = 0.001), cholesterol (5.3±1.4 vs 5.2±1.4, p = 0.002), non-HDL-C (4.1±1.5 vs 3.9±1.3, p=0.006), however less likely to have pre-existing DM (OR 0.8 (CI 0.78–0.92), p=0.000094). They were more often NSTEMI [851 (49.4%), p = 0.000012]. Independent variables associated with a reduction in LV function were: advanced age, male gender, previous DM and anemia, stress glycemia, WBC, creatinine, and BUN. Conclusion Patients who developed reduced LV function had a very specific risk profile with bigger neuro-hormonal activation and inflammation, higher degree of myocardial damage, and worse renal function, whereas those with preserved LV systolic function after ACS were younger, predominantly females, more severely metabolically burdened, more often with NSTEMI and without LAD involvement.
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Acute kidney injury in patients with acute coronary syndrome - risk profile
(Oxford University Press (OUP), 2024-04)
Bogevska-Naumovska, I
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Dobjani, A
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Shehu, E
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Taravari, H
Introduction Acute kidney injury (AKI) is a strong predictor of in-hospital adverse outcomes, which is a common complication of acute coronary syndrome (ACS). Aim To analyse the risk profile of patients treated for acute coronary syndrome who develop acute kidney injury. Material and methods This is a single-centre cross-sectional cohort study on 3507 patients with ACS. The main exclusion criteria was left ventricular dysfunction. Demographical and clinical characteristics, biochemical parameters, the anatomical distribution of coronary artery disease (CAD) and the final outcomes were analysed according to RF at the moment of the indexed event. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease Study Group Equation (MDRD), where patients with eGFR<60ml/min 1.73 m2 had moderate to severe renal dysfunction. Results 74 (2.1%) out of 3507 patients developed acute kidney injury (AKI). Those were predominantly males [62.2% (46), OR 1.55 (95% CI 0.98-2.47), p=0.044], significantly older (68.95±9.9. vs 62.5±11.2; p <0.000001), more often with preexisting HBI (OR 4.72 (95% CI 2.20-10.30, p=0.000070), HTA(OR 1.89 95%CI 1.11-3.23, p=0.020), diabetes(OR 1.88 95%CI 1.18-3.00, p=0.008), cancer(OR 2.92 95%CI 1.15-7.44, p=0.024), anaemia (beta -.104, p=0.000032), while less often were smokers (OR 0.51, 95% CI 0.31-0.83, p=0.006). They had statistically significantly higher values of cardiac troponin (beta .075, p=0.000011), stress glycemia (beta .104, p=0. 0.000019), and WBC (beta .074, p=0.000013), higher BUN (beta .325, p=0.000011), creatinine (beta .268, p=0.000016), and lower eGFR at admission (beta -.211, p=0.000032), lower sodium (beta -.101, p=0.000012), and higher potassium levels (beta .087, p=0.0008). Vice versa, total cholesterol, LDL-C and non-HDL-C (beta -.051, p=0.002, -.049, p=0.003, and -.047, p=0.005 respectively), were lower, the same for Hgb (beta -.107, p=0.000021). It is worth mentioning that 18(11.5%), of AKI patients were not PCI treated. Independent variables associated with AKI were: preexisting renal failure, cancer, and WBC. Outcomes: AKI carried a significantly higher in-hospital mortality rate (4.2% in general population, and 21.1% of all deaths were AKI patients, OR 23.01 (95% CI 14.04-47.03, p=0.00002)]. It was significantly associated with the development of pulmonary oedema (OR 17.94, 95% CI 9.67-33.26, p=0.000012), cardiogenic shock (OR 21.59, 95% CI 12.79-36.47, p=0.00006), any type of dysrhythmia (OR 1.83, 95%CI 1.53-2.18, p=0.0001), and any type of bleeding complications (OR 1.61, 95%CI 1.14-2.27, p=0.007). Conclusion AKI is a relatively rare complication in ACS patients, however, it is associated with significant in-hospital morbidity and mortality. Patients with pre-existing renal failure, and cancer, as well as patients who developed more pronounced inflammatory reactions, were more prone to AKI.
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Biomarkers of oxidative stress in patients with acute coronary syndrome
(2016-05-16)
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Kamceva Gordana
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Kitanoski Darko
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Purpose: To evaluate comparatively association between biomarkers of oxidative stress(OS) in patients with acute vs chronic coronary artery disease, and in comparison with healthy volunteers. Methods :Cross-sectional observational study was performed in patients admitted because of coronary artery disease (CAD). Pts were evaluated for their demographics, risk factors and co-morbidities, lipoprotein profile, HgbA1C and markers of oxidative stress: malondialdehyde (MDA) and hydroperoxids (HP), and antioxidant enzymes: superoxide dizmutaza (SOD), CATALASE and glutathione peroxidase (GPS). Pts were divided in 2 groups: pts with acute coronary syndrome (ACS) and chronic coronary artery disease (HCAD), and then subdivided, ACS pts in: STEMI, NSTEMI and APNS, HCAD in: asymptomatic CAD, revascularized and post MI patients. Statistical analysis: descriptive, t-test, ANOVA, Kruskall-Wallis ANOVA, correlation. Significance was determined at level of 0.05.Results :300 pts. 194 males and 106 females at mean age of 62.9±11,2 y were analyzed. 187 were with ACS and 113 with HCAD. 62,3% of pts. had HTA, 42,7% HLP, 28,3% DM, 57% smokers, 8% had anemia. There was no significant difference in the risk profile between the two groups. Mean values of the markers of OS (Table 1). Statistically significant differences didn’t existed between ACS and HCAD groups but inside the groups(Table 1), in lipid profile and HgbA1C in ACAD pts compared to HCAD.ACAD pts had higher HgbA1C, total, LDL and ApoB, but lower HDL-C and ApoA1. Correlation was found for HgbA1C and MDA (r=-,154**, p=0,008); age and total HP (r=-,143*, p=0,013); ApoA1 and total HP (r=-,157*, p=0,035);Conclusion: Markers of oxidative stress were significantly higher, and antioxidative activity was lower compared to healthy volunteers, but between ACAD and HCAD group significant differences were found only for HP from pro-oxidative, and SOD from anti-oxidative markers. Inside the groups, revascularized HCAD pts were with the highest pro-oxidative and lowest anti-oxidative activity, while in ACAD group, different markers of OS were the most pathological in different ACAD groups
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Predictors of early rehospitalization in patients with acute coronary syndrome
(2014-10)
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Chaparovska Emilija
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Pocesta Bekim
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Shehu Enes
Purpose:To analyze early rehospitalization rate (defined as 90 days after the acute event) in patients with ACS, and to identify predictors of risk for readmission. Methods:463 randomly selected patients with ACS,were retrospectively analyzed.Analyzed variables:type of ACS(STEMI/NSTEMI/APNS),location of MI,gender,age,risk factors:HTA,HLP,DM,COPD,CAD,PVD,CVD,EF,type of treatment(PCI vs. noninvasive),extensiveness of coronary disease,GRACE and TIMI risk score, type of morbidity,and reason for rehospitalization.Comparative analysis was performed between patients with early rehospitalisation and others.Statistical analysis:t-test,Chi square,univariate and multivariate linear regression. Results:463 patients were enrolled:68.9% males mean age 60.4±10.9, and 31.1% females mean age 64.94±12.0(p 0.000).MI type:STEMI 75.8%,NSTEMI 11.2%,APNS 13%; MI location:40.2% anterior,39,7% inferior,3% lateral and 3.7% multiple locations(p 0.000).Risk profile:15.3% HCAD,27% HF,62% HTA,28.1% DM,5.8% PVD,2.6% COPD.Mean BMI was 27±2.9,mean SBP 138.8±28.5mmHg,mean HR 84.3±24.2,mean EF (in 208 pts.) 50.2±10.4%, mean GRACE score(in 72 pts.) was 148.9±60.6,mean TIMI score(in 263 pts.) was 3.9±2.3. 87.5% were treated with PCI procedure, with mean disease’s CA 1.84(range 1-5), median 1(p 0.000). Hospital morbidity was present in 16% of pts.,6.9% minor, 3% major bleeding complications, 2.4% acute HF, 1.9% pericardial effusion, and 1.1% early stent thrombosis.Early rehospitalization rate was 6.3% (29/463):14 ischemic/trombotic events;9 acute heart failures, 3 malignant arrhythmias, and three fatal events. Univariate predictors of RH: HR(R square 0.014, p 0.014, beta .116, r -.217, p 0.002);EF(%) (R square 0.055, p 0.001, beta -.234, r -.231, p 0.001).HTA was significantly associated with reduced hospitalization risk (Chi square 4.28, p 0.039, exp B .405, p 0.054),diabetes(Chi square 10.04, p 0.002, exp B 3.45, p 0.001),PVD (expB 2.85, p 0.070),early in-hospital morbidity(expB 2.12, p 0.084),and NSTEMI pts. had OR 1.3, and APNS pts. OR 1.16 for rehospitalization(higher but not significantly in comparison to STEMI pts.). Multivariate model with variables that were found significantly associated with HR, identified two strong independent predictors of early rehospitalization(mean square.424, sig 0.000),EF(beta -.220, p 0.001),and diabetes(t 2.52, p 0.012) Conclusions:LV systolic dysfunction was again proven to be a strong predictor of clinical outcome in terms of early hospital readmission in ACS patients no matter how they were treated for ACS, and diabetes was the single strong independent predictor-risk factor for this event.
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Prognosticators of heart failure in patients after treatment because of acute coronary syndrome
(2016-05)
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Bekim Pocesta
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Gorjan Krstevski
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Hajber Taravari
Aim of the study was to identify frequency and predictors of heart failure in patients treated for acute coronary syndrome (ACS). Patients and methods: Patients with ACS treated medically or with PCI, were extracted from the hospital registry. Analyzed variables: age, gender, risk factors, SBP and HR at hospital admition, type of MI, location, CAD severity, LV function, type of treatment, in-hospital morbidity, pharmacologic treatment post discharge, time to event. Statistical analyze: descriptive and comparative analyze, uni and multivariate regression analyze, Caplan-Meier event free survival analyze. Results: 437 patients treated for ACS, at mean age 63,2±11,1 years, 294(67,3%) males and 143(32,7%) females, were followed up for mean 17,3±10,3 months. A total of 128(29,3%) patients had 136 cardiac events (CE), 32(25%) of whom heart failure (HF). Mean time to HF was 5,9±7,4 (SE), CI(3,3-8,6) (Figure 1). As univariate predictors of HF in ACS treated patients we identified: length of hospitalization (for ACS treatment) 3,9±2,2 vs 5±2,5 days (beta .169, p=0,009); diuretic utilization during ACS hospitalization (beta 1.992, p=0,001); EF (%) (beta -0.092, p=0,001); reduced EF (<40%) had OR for HF 3.282 (CI 1,129-9,542, p=0,011); receiving PPCI (beta -1.584, p=0,011, exp(B) 0.205); known DM (beta0.741, p=0,007, exp(B) 2,098); previous MI (beta 0.832, p=0,068, exp(B) 2,297); statin therapy prior ACS (beta-0.955, p=0,028, exp(B) 0,385); PCI performed (beta-0.990, p=0,043, exp(B) 0,372); in-hospital morbidity (beta 0.868, p=0.028, exp(B) 2,382). In multivariate analyze (binary logistic regression) four independent predictors were identified: known diabetes (p=0,004), PCI treatment for ACS (p=0,006), diuretic therapy during ACS hospitalization (p=0,004) and LV function (p=0,024). Conclusion: Predictors of HF development in pts. after ACS, seems to be preexisting DM, need for diuretic therapy during ACS event, and reduced LV systolic function as negative ones, but, receiving PCI (myocardial revascularization) is the most important positive predictor.
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Mid-term clinical outcome of patients treated for acute coronary syndrome-data from the registry
(2016-10)
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Bekim Pocesta
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Taravari Hajber
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Shehu Enes
Aim of the study: what are the prognosticators of mid-term outcome in patients treated because of acute coronary syndrome. Methods: Longitudinal retrospective-prospective single center study that analyze, type of ACS (STEMI/NSTEMI/APNS), hemodynamic parameters (heart rate and SBP on the admition), type of treatment (PCI vs medical), LV ejection fraction, extent and severity of CAD, medication used, medications post discharge, type and time to event. Statistical analyze: descriptive and comparative analyze, uni and multivariate regression analyze, Caplan-Meier event free survival analyze. Results: 364 patients treated for ACS, at mean age 63,1±11,1 y., 246(67,4%) males and 119(32,6%) females, were followed up for mean 18.6±10,4 months. A total of 95 cardiac events (CE) in 94(25,8%) patients during the 364pts./563.7 y. follow up were registered, or 17.6% annually. 8 (2.2%) cardiac deaths (CD) were registered, or 1.5% annually death rate. Ischemic events were the most frequent (59-15,7%): angina-14(3,9%), scheduled revascularization after ACS because of multivassel CAD-31(8.5%), and acute ischemic event leading to re-revascularization-12(3.3%) pts. Symptomatic heart failure-20(5.5%) pts. leading to CD in 5, 7(1,4%), ischemic CVI with one fatal event, atrial arrhythmias in 8(2,2%) and malignant ventricular arrhythmias in 4(1,1%) pts. one with fatal ending, and one sudden CD. 58(61,7%) out of 94 events occurred during the first 6 months after the ACS. Univariate predictors were: medications used: DAPT: beta -2.147, p=0.000, expB 0.117; beta blockers: beta -.952, p=0,004, exp(B) 0,386; BB+RAAS inhibitors: beta -.765, p=0,015, exp(B) 0,465; diuretics: beta 1,189, p=0,007; exp(B) 3.284; ASA prior the first event: beta -1.055, p=0,000; exp(B) 0.345; diabetes: beta .788, p=0.006, exp(B) 2.199; anemia: beta1,090, p=0,006, exp(B) 2.975; age: beta.155, t 2.198, p=0.029; HR beta.155, t 3.274, p=0.001; number of lesions: beta.105, t 2.009, p=0.045; In a backword conditional logistic regression model six independent predictors were identified: ASA prior the first event exp(B) .537, p=0.049; DAPT exp(B) 2.245, p=0.000; BB+RAAS exp(B) .492, p=0.046; diuretics exp(B) 3.087, p=0.18; DM exp(B), p=0.014; Conclusion: The prevalence of CE during the mid-term follow up in ACS patients was 17.6%, with 1.5% death rate annually. Diabetes is a powerful independent predictor of mid-term outcome in patients treated for ACS. But taking aspirin therapy prior to the event, DAPT, combined BB+RAAS inhibitor after the treatment for ACS are significant positive prognosticators, as opposite taking diuretic therapy is a negative prognosticator of mid-term outcome in these patients.
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Incidence of Major Gastrointestinal Bleeding in Patients with Acute Coronary Syndrome treated with dual antiplatelet and anticoagulant therapy-Data from the Registry.
(2017)
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Bekim Pocesta
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Hajber Taravari
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Shehu Enes
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Kitanoski Darko
Aim of the study: To investigate the incidence, predictors and prognosis of gastrointestinal bleeding in patients treated for acute coronary syndrome. Materials and Methods: A retrospective study with data gathered from the registry. We analyzed different variables of STEMI, NSTEMI and unstable angina treated patients: clinical, angiographic, treatment type, medications use, in-hospital outcome. Upper gastrointestinal bleeding was defined as hematemesis and/or melena with Hgb reduction, requiring cessation of antiplatelet or anti-coagulant therapy and administration of erythrocyte transfusion and, if needed, upper GIT endoscopy. Statistical Analysis: Descriptive, comparative, univariate and multivariate linear and/or binary logistic regression analysis. Statistical significance was determined at a 0,05 level. Results: 874 patients (66,6% males and 33,4% females, mean age 65,7 ± 11,04 y) were analyzed. 75,4% of the patients had STE-MI, 12.5% had NSTEMI and 12,1% APNS. The predominant risk factors were: HTA (59.9%), smoking (56,9%), overweight/obesity (66,7%) and DM (27,8%). 11% had previous MI, 11,3% revascularization, 5,3% CVI and 5% had previous GIT symptomatology. Mean eGFR was 93 ml/min, although 16,4% of the patients had eGFR < 60ml/min. Preexisting anemia was registered in 9,7%. 93,6% of STEMI, and 91,6% of NSTEMI/APNS patients received PCI. Regarding the patients medications, 98,4% were treated with ASA, 70% with 600 mg loading dose Clopidogrel, 90,4% with UFH and 18% received H 2 blockers or PPI. For the in-hospital morbidity, 5,6% of the patients had acute heart failure, 2,8% A-V block, 2,6% acute renal failure, 5,4% supraventricular arrhythmias, 6,4% ventricular arrhythmias, 0,8% in-stent thrombosis, and 0,3% of the patients had ischemic CVI. The most frequent bleeding complications were: 9,2% at the vascular access site, 1,5% GI bleedings and 1,6% UG bleedings. Hospital mortality was 6,8%, and the death Hazard Ratio among patients with GIB was 9,34 (CI 2,95-29,5). Univariate predictors of GIB were: age (beta ,085), BMI (beta-,073), eGFR < 60ml/min (beta-,081), Crusade bleeding risk score (beta ,141), Hgb (beta-,225), urea (beta ,386), old MI (OR 3,715), GPIIb/IIIa inhibitors (OR 9,267), H2/PPI (OR 10,840), anemia (OR 11,712), eGFR < 60 ml/min (OR 6,390), ARF (OR 7645), and supraventricular arrhythmias (OR 5,440). Previous MI (p = 0,010), use of GPIIb/IIIa inhibitors (p=0,031); H2 or PPI (p = 0,000); eGFR < 60 ml/min (p = 0,050); supraventricular arrhythmias (p = 0,002), and anemia prior ACS (p = 0,042) were identified as independent predictors. Conclusion: GIB is one of the most frequent bleeding complications in patients treated for acute coronary syndrome, associated with a significant in-hospital mortality risk.
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Demographic, clinical characteristics and medications of rehospitalized patients for acute coronary syndrome: boomerang study
(Medknow, 2021)
Oz, TugbaKemaloglu
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Kivrak, Tarik
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Almaghraby, Abdallah
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Abdelnabi, Mahmoud
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Tasar, Onur
Background: Rehospitalizations with acute coronary syndromes (ACSs) have declined over the last years, but there is a remaining need for potential further reduction of rehospitalization after ACS to determine the most predominant predictors that can guide strategies to reduce re-hospitalizations burden. Aim: This multi-center study aimed to evaluate the demographic, clinical characteristics, and medications of rehospitalized patients who suffered a new cardiac event in 12 months after admission due to ACS. Material and Methods: Patients age >18 years who have been hospitalized between November 1 2017, and April 1 2018, for ACS within12 months before the readmission for a new acute coronary event were enrolled. Results: The present study included a total of 628 (65.9% from Turkey) consecutive patients rehospitalized with ACS (ST-elevation myocardial infarction [STEMI], 23.0%; ACS without ST-elevation [NSTE-ACS], 76.9%) from 15 different countries. The majority of the rehospitalized patients were men (67.9%), and the mean age was 63.1 ± 12.53 years. 406 (64.6%) had typical, 209 (33.2%) of patients had atypical chest pain and 13 (2.07%) had not any chest pain complaint during readmission. 304 (48.41%) of patients were discharged from hospital earlier than 3 days and 107 (17.04%) of patients stayed more than 7 days. The subcategories of first index diagnosis were 227 (36.1%) STEMI; 401 (63.8%) NSTE-ACS. The mean time from index discharge to rehospitalization was 189.25 ± 118 days. 248 (39.4%) patients were re-hospitalized more than once after index discharge. The most common risk factors were diabetes mellitus (471, 75.0%). 175 (27.87%) of patients stopped taking medication before re-hospitalization. Most of the patients (69.4%) had multivessel disease. Conclusion: Several factors identify patients at higher risk of rehospitalization with ACS. Understanding and preventing these causes can prevent rehospitalization and improve their outcome.
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Coronavirus Disease 2019 and Catheterisation Laboratory Considerations: “Looking for Essentials”
(Radcliffe Group Ltd, 2020-07-29)
Naqvi, Syed Haseeb Raza
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Fatima, Madiha
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Gerges, Fady
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Moscatelli, Sara
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Oz, Tugba Kemaloglu
The current coronavirus disease 2019 (COVID-19) outbreak is a significant health crisis that impacts every healthcare system worldwide, and has led to a dramatic change in dealing with different diseases during the pandemic. Interventional cardiologists are frontline workers who deal with many cardiovascular emergencies, either in patients with proven COVID-19 or in suspected cases. Many heart associations worldwide are currently setting appropriate recommendations for the management of emergency cardiac interventions. In this expert opinion, the authors highlight the essential requirements in the cardiac catheterisation laboratory during the COVID-19 pandemic.</jats:p>

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