The Prevalence of ST-Segment Elevation Myocardial Infarction in Patients Presenting in the Emergency Service of Galati Hospital from 2015 to 2019

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The limited number of patients and the fact that the data were based on observation forms are serious limitations of the study. As seen in this study, preventive measures for cardiovascular diseases should be emphasised by healthcare professionals, patients should be educated about cardiovascular risks and lifestyle changes, and risk factor management should be encouraged.The incidence of cardiovascular pathologies is higher among the elderly and its prevalence is increasing every year, as seen in this study. Although a direct association between multiple underlying pathologies and the primary diagnosis could not be established, this does not exclude potential associations with the development of cardiovascular emergencies. These are the main findings of the study overall. There are a few points that need to be emphasised:

1- The discussion section is relatively short and should be enriched with a comparison to the literature.

2- For this purpose: "Association between SYNTAX II score and electrocardiographic evidence of no-reflow in patients with ST-segment elevation myocardial infarction. Turk Kardiyol Dern Ars, 2018, 46.6: 455-463." and cite the study.

Author Response

I have done!

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The authors in this manuscript conducted a retrospective study on cardiovascular disease patients treated in a hospital emergency department over a five-year period (from January 1, 2015, to December 31, 2019) to assess the prevalence of cardiovascular diseases. I have the following comments:

1. I noticed inconsistency in the reported number of patients within the manuscript: Line 14 mentions 725 patients. Line 70 indicates a total of 724 patients were recruited for the study. However, Table 1 shows a total of 723 patients when combining male and female patients together. These discrepancies in the patient numbers should be addressed to ensure consistency and clarity in the manuscript.

2. In Table 1, percentages are presented using a comma (e.g., "72,89%"). The rest of manuscript uses a period for percentages (e.g., "4.83%"), please update Table 1 to use a period instead of a comma in the percentage numbers.

3. Line 113: the percentages mentioned in the text do not match the values presented in Table 1.

4. Based on the information in Table 1, there are a total of 527 male patients and 196 female patients. However, the patient numbers in smokers, ethylic, and environment categories are inconsistent with total male and female patient number. For example, the total number of male patients is 527, but the sum of smokers and non-smokers is 488. This is less than the total 527 male patients, suggesting that smoking information is missing for some patients. Please confirm if this is due to missing smoking information for the rest of the patients. Similar issues exist for the ethylic and environment rows, where the total numbers do not match the overall total of male patients. In addition, there are total 196 female patients. However, the numbers in the smokers, ethylic, and environment categories exceed 196.  Collectively, Table 1 is confusing.

5. The numbers in Table 3 are repeated from Table 2.

6. The study focuses on patients admitted to the hospital emergency department, primarily for conditions requiring urgent treatment, such as ST-segment elevation myocardial infarction. Conversely, diseases like diabetes mellitus, cardiac, neurological, psychiatric, and hepatic pathologies generally do not need immediate hospital admission. As a result, the majority of cases in this study likely be ST-segment elevation myocardial infarction patients due to the nature of diseases. Consequently, these findings may not be considered novel.

Overall, the values presented in the tables are confusing, and the calculated values are not consistent, which makes the statistical analysis and the conclusions derived from it questionable. In addition, it is likely that the study's findings are heavily influenced by the specific characteristics of patients admitted to the hospital emergency department.

Comments on the Quality of English Language

Moderate editing of English language is suggested. The introduction section can be improved.

Author Response

I have corrected.

Comments and Suggestions for Authors

The authors in this manuscript conducted a retrospective study on cardiovascular disease patients treated in a hospital emergency department over a five-year period (from January 1, 2015, to December 31, 2019) to assess the prevalence of cardiovascular diseases. I have the following comments:

1. I noticed inconsistency in the reported number of patients within the manuscript: Line 14 mentions 725 patients. Line 70 indicates a total of 724 patients were recruited for the study. However, Table 1 shows a total of 723 patients when combining male and female patients together. These discrepancies in the patient numbers should be addressed to ensure consistency and clarity in the manuscript.

I have updated the Table 1

2. In Table 1, percentages are presented using a comma (e.g., "72,89%"). The rest of manuscript uses a period for percentages (e.g., "4.83%"), please update Table 1 to use a period instead of a comma in the percentage numbers.

I have  updated the Table 1

 

3. Line 113: the percentages mentioned in the text do not match the values presented in Table 1.
   I have corrected
4. Based on the information in Table 1, there are a total of 527 male patients and 196 female patients. However, the patient numbers in smokers, ethylic, and environment categories are inconsistent with total male and female patient number. For example, the total number of male patients is 527, but the sum of smokers and non-smokers is 488. This is less than the total 527 male patients, suggesting that smoking information is missing for some patients. Please confirm if this is due to missing smoking information for the rest of the patients. Similar issues exist for the ethylic and environment rows, where the total numbers do not match the overall total of male patients. In addition, there are total 196 female patients. However, the numbers in the smokers, ethylic, and environment categories exceed 196.  Collectively, Table 1 is confusing. 
   I have corrected
5. The numbers in Table 3 are repeated from Table 2. I have corrected
6. The study focuses on patients admitted to the hospital emergency department, primarily for conditions requiring urgent treatment, such as ST-segment elevation myocardial infarction. Conversely, diseases like diabetes mellitus, cardiac, neurological, psychiatric, and hepatic pathologies generally do not need immediate hospital admission. As a result, the majority of cases in this study likely be ST-segment elevation myocardial infarction patients due to the nature of diseases. Consequently, these findings may not be considered novel.

Overall, the values presented in the tables are confusing, and the calculated values are not consistent, which makes the statistical analysis and the conclusions derived from it questionable. In addition, it is likely that the study's findings are heavily influenced by the specific characteristics of patients admitted to the hospital emergency department.

 I have corrected.

Comments on the Quality of English Language . I have corrected

Moderate editing of English language is suggested. The introduction section can be improved.

 

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

The authors have revised the manuscript and addressed the issues or concerns raised by the reviewers. The manuscript is well organized, clearly presented, and thoroughly discussed. The conclusions are well-supported by the data. I have no further comments.