From Inflammation to Acute Cardiovascular Events – a Complex Journey

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<p>Coronavirus disease (COVID-19) is a viral infection caused by SARS-CoV-2 that has become a global health emergency with a negative impact on patient care. The evolution of patients with COVID-19 is unpredictable, with an unfavorable evolution in the case of patients with comorbidities. This state-of-the-art review focuses on the role of hematological inflammatory biomarkers: the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in predicting major adverse cardiovascular events (MACE) and mortality in patients with COVID-19. In this review, we included 21 studies that investigated the role of biomarkers in the risk of mortality and MACE, reporting on a total of 7,588 patients. Regarding the clinical data, 57.49% of the patients presented hypertension (15 out of the 21 studies reported hypertensive patients), followed by ischemic heart disease in 33.56% of patients (13 studies) and diabetes in 30.37% of patients (17 studies). In additional, among the usual risk factors, 23.55% of patients presented obesity (7 studies) and 23.02% were active smokers (10 studies). We recorded an average cut-off value of 7.728 for NLR (range 2.6973–15.2), 0.594 for MLR (range 0.26–0.81), and 215.07 for PLR (range 177.51–266.9) for the risk of MACE and mortality. We also recorded an average area under the curve (AUC) of 0.783 for NLR, 0.744 for MLR, and 0.713 for PLR. Our findings suggest that these biomarkers exhibit prognostic value in predicting adverse outcomes, and that evaluating these biomarkers at admission could provide novel information in stratifying risk groups for improving patient management.</p>
</abstract>

“George Emil Palade” University of Medicine, Pharmacy, Science and Technology

The Prognostic Role of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Risk of Major Adverse Cardiovascular Events and Mortality in Patients with COVID-19: a State-of-the-Art Review

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<sec><h3>Background</h3><p>Healthcare-associated infections (HAIs) can pose significant risks to patients with cardiovascular disease due to the compromised nature of their health and potential vulnerabilities. In order to reduce the incidence of HAIs and prevent the spread of antibiotic-resistant organisms, it is mandatory to develop surveillance systems.</p></sec>
<sec><h3>Methods</h3><p>We undertook a retrospective case–control study of all patients presenting HAIs who were admitted to the intensive care unit (ICU) to assess risk factors associated with death among patients with cardiovascular disease.</p></sec>
<sec><h3>Results</h3><p>Patients admitted to the ICU who died were more likely to present an infection with a multidrug-resistant bacterium, an infection with <italic>Acinetobacter baumannii</italic>, and to suffer from acute myocardial infarction. Among the patients enrolled in the study, a higher probability of death was also observed in association with certain Gram-negative pathogens such as <italic>Klebsiella pneumoniae</italic>, <italic>Acinetobacter baumannii</italic>, and <italic>Pseudomonas aeruginosa</italic>.</p></sec>
<sec><h3>Conclusion</h3><p>The longer the patient remains admitted in the ICU, the higher the risk of acquiring an infection that can often become fatal. A nosocomial infection, particularly in patients with cardiovascular disease, also increases the length of hospitalization, which will lead to increased expenditure. For this reason, new prophylactic methods and therapeutic approaches are needed, and researchers’ efforts should be directed in this direction.</p></sec>
</abstract>

Department of Anesthesia and Intensive Care

Department of Obstetrics and Gynecology, Emergency County Hospital

The Risk of Death among Patients with Healthcare-associated Infections and Cardiovascular Diseases Admitted to the Intensive Care Unit in Romania

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<sec><h3>Introduction</h3>
<p>Thyroid hormones influence multiple systems, but most often the impact on the cardiovascular system is what brings the patient to the emergency department. Basedow’s disease, an autoimmune condition, is one of the most common causes of hyperthyroidism. The purpose of this presentation is to raise attention to an extracardiac cause that can lead to cardiac failure.</p>
</sec>
<sec><h3>Case presentation</h3>
<p>A 55-year-old woman presented to our cardiology service with rapid palpitations, shortness of breath on small efforts, and extreme fatigue. The electrocardiogram revealed sinus tachycardia with a heart rate of 144 beats per min. Paraclinical investigations and a multidisciplinary team consultation led to a diagnosis of thyrotoxicosis due to Basedow’s disease. Following the initiation of cardiological and endocrinological treatments, the patient’s condition improved.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>Although hyperthyroidism is an extracardiac cause, it brought the patient to the cardiology emergency service for heart failure symptoms. The key to achieving a correct diagnosis and determining an optimal treatment lies in the multidisciplinary approach of pathology.</p>
</sec>
</abstract>

Heart Failure as the First Clinical Manifestation of Basedow’s Disease

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<sec><h3>Introduction</h3>
<p>We report a rare case of an 80-year-old male patient with acute transformation of myelodysplastic syndrome (MDS) in the pericardial cavity, leading to cardiac tamponade.</p>
</sec>
<sec><h3>Case presentation</h3>
<p>The patient had been diagnosed with MDS 7 months prior. One day before presentation, he suddenly developed dyspnea. At presentation, his blood pressure was stable, but he was in tachycardic atrial fibrillation; echocardiography revealed a pericardial effusion. Aortic dissection and acute myocardial infarction were excluded by examination upon admission. His blood pressure subsequently dropped, indicating pericardial tamponade. Pericardiocentesis was performed, and 800 ml of bloody pericardial fluid were withdrawn, stabilizing his blood pressure. The blasts ratio was higher in the pericardial fluid than in the peripheral blood; bone marrow examination revealed no evidence of acute transformation, but the presence of numerous cells with chromosomal abnormalities in the pericardial sac cavity confirmed acute MDS transformation. The patient died on day 15 due to progressive multiorgan failure. The autopsy revealed a neoplastic lesion extending circumferentially throughout the epicardium.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>When a patient with an acute onset history of hematogenous pericardial effusion is found to have a pericardial tamponade of cancerous origin, acute transformation of MDS should be considered in the differential diagnosis.</p>
</sec>
</abstract>

Department of Emergency and Critical Care Medicine

Osaka Medical and Pharmaceutical University

An Autopsy Case of Acute Transformation of Myelodysplastic Syndrome Leading to Carcinomatous Cardiac Tamponade

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Journal of Cardiovascular Emergencies

 The Journal of Cardiovascular Emergencies aims to publish top quality papers related to acute conditions in any cardiovascular pathology. The journal will mainly focus on recent advances in the field of diagnosis and treatment of the most common causes of cardiovascular emergencies, including acute coronary syndromes, acute heart failure, acute aortic diseases, pulmonary embolism, peripheral arterial diseases or cardiac arrhythmia. Interdisciplinary approaches will be extremely welcomed, presenting new advances in the approach of different other pathologies (i.e. stroke) from the cardiovascular perspective.  The Journal of Cardiovascular Emergencies will publish high-quality basic and clinical research related to these topics, in a common approach that will integrate the clinical studies with the pre-clinical work dedicated to discovery of new mechanisms involved in the development and progression of acute cardiovascular conditions.  Especially in the case of acute coronary syndromes, the journal will try to provide the entire cardiology community with the perspective of the regional cardiology networks in Central and Eastern European countries, reflecting the regional model of care in cardiovascular acute conditions.  The journal will primarily focus on publishing original research papers, but also other types of materials (such as review articles, case reports, state of the art papers, comments to editor, etc) will be extremely welcomed.  Rejection Rate   30%   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 

Journal of Cardiovascular Emergencies

Volume 10 (2024): Issue 2 (June 2024)

Editorial

From Inflammation to Acute Cardiovascular Events – a Complex Journey

Review

The Prognostic Role of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio in the Risk of Major Adverse Cardiovascular Events and Mortality in Patients with COVID-19: a State-of-the-Art Review

Original Research

The Risk of Death among Patients with Healthcare-associated Infections and Cardiovascular Diseases Admitted to the Intensive Care Unit in Romania

Case Report

Heart Failure as the First Clinical Manifestation of Basedow’s Disease

An Autopsy Case of Acute Transformation of Myelodysplastic Syndrome Leading to Carcinomatous Cardiac Tamponade

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