ABSTRACT
Background: Unstable angina constitutes a clinical syndrome that is usually caused by atherosclerotic coronary artery disease and is associated with an increased risk of cardiac death and myocardial infarction. Material and Methods: An open, prospective, observational, comparative study was conducted. The study included 50 cases in age group 20-80 years admitted in Government Medical College, Amritsar diagnosed as unstable angina ruled out by Trop T and CPK-MB at admission. Hs-CRP and Fibrinogen levels were estimated at time of admission and repeated after 48 hours. Results: There was significant difference in the mean value of Hs-CRP between favourable and unfavourable group at the time of admission (0.807±0.37mg/l v/s 3.57±1.70mg/l, p<0.001). A significant difference in the mean value of Hs-CRP was found between favourable and unfavourable group after 48 hours (0.51±0.22mg/l v/s 4.03±1.84mg/l, p<0.001) There was significant difference in the mean value of fibrinogen between favourable and unfavourable group at the time of admission (356.94±72.50mg/dl v/s 588.60±94.89mg/dl, p<0.001). A significant difference in the mean value of fibrinogen was found between favourable and unfavourable group after 48 hours (309.11±75.25mg/dl v/s 622.60±133.42mg/dl, p<0.001). Conclusion: It is concluded that in patients with unstable angina, elevated levels of Hs-CRP and Fibrinogen at admission indicate an adverse hospital outcome.
ABSTRACT
Background: The term “acute coronary syndrome” encompasses unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Antiplatelet therapy is one of the cornerstones of therapy in UA/NSTEMI. Objective: To compare efficacy and safety of Prasugrel and clopidogrel both theinopyridines antiplatelet drugs in high risk (TIMI Score 3 or more) medically managed UA/NSTEMI. Materials and Methods: A prospective, randomized study was conducted in GNDH, Amritsar. 100 patients were included, 50 patients received Prasugrel and 50 received clopidogrel. Outcomes like angina episodes, bleeding, stroke, ischemic ECG changes, and arrhythmia were compared during hospital stay and follow-up for 3 months. Results: Prasugrel was associated with significant lower incidence of major adverse cardiac event (MACE) 9 compared to 19 with clopidogrel during hospital stay. During follow up for 3 months 2 events occurred with Prasugrel and 3 with clopidogrel which were non-significant. Conclusion: Use of Prasugrel was associated with less number of MACE than the patients who were on clopidogrel. Although for the individual adverse coronary events, except for angina there was no statically significant difference, but when the total MACE observed during the study was compared, it was significantly less in the patient on Prasugrel therapy. Safety of the Prasugrel in present study was identical to clopidogrel.