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Objectives: The objective of the current study was to determine the frequency of anxiety and depression among patients diagnosed with acute coronary syndrome (ACS) at a tertiary care cardiac center in Pakistan. Methodology: This cross-sectional study was conducted at a tertiary care cardiac center in Pakistan from May to November 2019. We included patients of either gender, between 30 and 70 years of age, diagnosed with ACS, and presented within 72 hours of onset of symptoms. After the standard treatment of the condition, the Beck Depression Inventory Scale (BDI) and Beck Anxiety Inventory (BAI) were used to assess post-AMI depression and anxiety. The BDI =17 was categorized as depression and BAI =11 was taken as anxiety. Results: In the selected sample of 122 patients, the mean age was 58.7 ± 10.2 years and 88 (72.1%) patients were male. Diabetes mellitus was detected in 76 (62.3%) patients and 64 (52.5%) patients were smokers. The mean BDI score was 28.6 ± 6.5 and mean BAI score was 19.5 ± 5.1. Anxiety and depression were observed in 36 (29.5%) and 51 (41.8%) patients, respectively. Conclusion: Depression and anxiety are a common remnants of ACS, hence, in our day to day clinical practice, appropriate consideration should be given to the psychological wellbeing of patients in addition to the management of ACS. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship of serum LDL-C and HDL-C levels with Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) Scores to predict all-cause 30 days mortality following first onset Acute Coronary Syndrome (ACS). Study Design: Descriptive cross-sectional study. Place and Duration of Study: Inpatient departments of Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from Jan 2019 to Jun 2019. Methodology: Ethical approval was taken from Institutional Ethical Review Board (IERB), AFIC/NIHD. Patients of any age and both genders who presented with chest pain and satisfied criteria for type 1 Myocardial Infarction (MI), as stated in 4th Universal Definition of MI, were included in study by non-probability consecutive sampling technique. Patients with a previous history of ischemic heart disease, Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) surgery and patients taking lipids lowering medications over at least 3 months prior to admission were excluded. Both TIMI and GRACE scores for ST Elevation MI (STEMI) and Non-ST Elevation MI (NSTEMI) were calculated at time of admission. One non fasting blood sample was drawn for serum lipid levels from each patient within 24 hours of hospital admission and was analyzed using ROCHE cobas 6000 c501 analyzer. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Results: Out of 236 patients, 210 were male and 26 were female. Minimum recorded age was 25 years and maximum 90 years. Subjects presented with NSTEMI seem older (65.5 ± 7.3 years) than the ones presented with STEMI (59.7 ± 12.5 years). Anterior wall MI was the most common presentation (35%). Hypertension was the most common (57.6%) risk factor noted for Coronary Artery Disease (CAD). Serum lipids had a higher trend among STEMI subjects than NSTEMI and a lower trend among deceased subjects, as compared to survivors, in both STEMI and NSTEMI groups. Negative correlations were recorded between LDL-C and GRACE score in STEMI group (-0.277) and between HDL-C and both GRACE and TIMI scores (-0.349 and -0.299, respectively) in NSTEMI group. Conclusion: A significant paradoxical lower levels of serum lipids were found in deceased subjects who presented with ACS. [ABSTRACT FROM AUTHOR]

Objective: To determine the correlation of Global Registry for Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) scores with Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (SS) to predict the extent and severity of coronary artery disease (CAD) in patients presented with first onset STE levation Myocardial Infarction (STEMI) undergoing Primary Percutaneous Coronary Intervention (PPCI). Study Design: Descriptive cross-sectional study. Place and Duration of Study: Inpatient departments of Armed Forces Institute of Cardiology/ National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from Jan 2019 to Jun 2019. Methodology: Ethical approval was taken from Institutional Ethical Review Board (IERB), AFIC/NIHD. Patients of any age and both genders who presented with chest pain and satisfied criteria for Type 1 Myocardial Infarction (MI), as stated in 4th Universal Definition of MI, were included in study by non-probability consecutive sampling technique. Patients with a previous history of ischemic heart disease, Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG) surgery were excluded. Both TIMI and GRACE scores for STEMI were calculated at time of admission. The extent and severity of CAD were assessed by the SS-I. Each coronary lesion with a diameter stenosis of at least 50%, in vessels of at least 1.5 mm, were scored. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Results: Out of 376 patients, 327 (86.9%) were male and 49 (13.1%) were female. Anterior wall MI was the most common presentation 164 (43.6%). Among risk factors for CAD, hypertension was the most common one 215 (57.2%). A positive correlation was found between SS and GRACE low, intermediate and high-risk groups (0.145). Conclusion: Patients having high GRACE and TIMI scores were more likely to have severe CAD. In comparison with TIMI score, GRACE score was found to have better correlation with SS, but degree of that association was not strong enough to make it a reliable and sole predictor of CAD severity. [ABSTRACT FROM AUTHOR]