Online ISSN: 2515-8260

Keywords : Acute Myocardial Infarction


Study on role of C-reactive protein as a prognostic marker in diabetic and non-diabetic patients with acute myocardial infarction

Dr. Makarand Mane; Dr. Priyanka M Mane; Dr. Bammidi Rohit Kumar; Dr S R Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 888-897

Limited data is available about C Reactive protein (CRP) and its significance in mortality and morbidity in Acute Myocardial infarction (AMI) in diabetic patients. The aim of current study is to examine whether CRP levels are associated with for long-term all-cause, cardiovascular, and cardiac mortality in AMI patients with diabetes and those without separately.
Methods: This is a cohort study on 100 patients with Acute Myocardial Infarction out of which 50% are diabetics and 50% are non-diabetics.
Results: The CRP level cut off was taken as 7 mg/L in our study. The patients were divided into two groups, Diabetics and Non Diabetics. In diabetic patients with AMI, 96% of patients have crp levels more than 7 mg/L. In non-diabetic patients with AMI, 88% of patients have crp level more than 7mg/L. The mean CRP in diabetic group was 51.80 mg/l as compared to 15.78mg/l in non-diabetic group which was statistically significant (p<0.001). Diabetic patients who died in hospital presented with higher plasma levels of CRP on admission as compared to non-diabetic patients.
Thus, this study reveals that CRP can be used as a prognostic marker in diabetic patients with AMI.
Conclusion: In diabetic patients with AMI CRP levels are higher on admission, CRP value is an independent predictor of long term, all cause, cardiovascular and cardiac mortality after AMI.

ASSESSMENT OF RISK FACTORS IN YOUNG ACUTE MYOCARDIAL INFARCTION PATIENTS: AN OBSERVATIONAL STUDY

Dr Hariom Gupta, Dr Umesh Pratap Singh, Dr Sunil Kumar Tripathi, Dr Vijay kumar Shah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1179-1186

Purpose: The present study was aimed to determine the prevalence of risk factors in younger patients (age <45 years) presenting with ami.
Methods: In this observational, cross-sectional study, a total of 150 patients were studied between april 2020 and june 2021 for the risk factors of ami. Patients with characteristic electrocardiographic changes suggestive of coronary artery disease, within 15-44 years of age were included and data regarding baseline clinical characteristics were reported.
Results: Maximum patients (82%) were in the age group of 35-44 years where males (73.3%) outnumbered females (26.7%).Among all the risk factors, dyslipidemia (77.3%) was the most prevalent, and significantly higher in smokers, obese (body mass index ≥25) and diabetic patients. Major complication was arrhythmia (45.3%), and anterior wall myocardial infarction was the most prevalent pattern of myocardial infarction (61.3%). Majority of patients had two risk factors and maximum number of patients i.e, 141 (94%) were discharged from hospital after treatment while 9 (6%) died.
Conclusion: The present study revealed that dyslipidemia was the major modifiable risk factor of ami in the younger population followed by sedentary lifestyle, obesity, tobacco chewing, smoking, diabetes mellitus, systemic hypertension, and family history where majority of patients had two risk factors

EVALUATION OF SERUM POTASSIUM LEVELS IN AMI PATIENTS

Sehrish Khan, Jaspreet Singh, Kamalpreet Kaur, Ankush Kimmatkar, Harnoor Singh, Simrat Bhullar, Ashish Gupta, Sheetal Shrestha, Wajiha Noor Syed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3017-3022

Aim: To assess serum potassium levels in Acute myocardial infarction patients.
Materials & methods: 50 confirmed cases of AMI were included in the present study. Another set of 50 age and gender-matched healthy subjects were taken as control.  Collection of venous blood samples was done in the study group on the day of admission within 12 hours from anticubital vein with all aseptic precautions in plain and vacutainers for the purpose of routine baseline blood investigations. For serum potassium levels, blood was allowed to clot at room temperature for half an hour and then centrifuged at 3000 rpm for five minutes. The serum separated was used for the estimation of serum potassium levels. Results: Mean serum potassium levels among the patients of the study group and control group were 3.89mEq/L and 4.56 mEq/L respectively. While comparing statistically, significant results were obtained. Out 50 patients of the AMI group, hypokalaemia was seen in 24 percent of the patients.
Conclusion: It is recommended that potassium levels which affect the clinical outcomes in patients of acute myocardial infarction should be monitored, and potassium replaced whenever required.

Prospective Analysis of Prevalence of Acute Myocardial Infarction in Patients with Rheumatoid Arthritis: An Institutional Based Study

Satish Chandra Agarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2904-2907

Background: An excess burden of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is an established paradigm. The present study was conducted to assess the prevalence of acute myocardial infarction in patients with rheumatoid arthritis.
Materials & Methods: From the outpatient department, 150 patients with a confirmed diagnosis of RA were included in this study. Demographic factors including age, past and family history of MI were noted using a self-structured questionnaire.  MI was diagnosed based on symptoms, cardiac enzyme, and ECG. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) (IBM Corporation, Armonk, New York, USA). p-value of < 0.05 was considered significant.
Results: In the present study, 150 patients with a confirmed diagnosis of RA were included in which 53.33% were females and 46.66% were males. The mean age of patients was 48 years. 4.66% patients had previous history of MI and 6% patients had family history of MI. 14% RA patients had non-fatal MI and 4% RA patients had fatal MI. In 82% RA patients MI was absent.
Conclusion: The present study concluded that 14% RA patients had non-fatal MI and 4% RA patients had fatal MI.

Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction: A Prospective Study from North India

Dr. P S Nayyer, Dr.Harinder Kumar, Dr.Atindra Narayan, Dr.Niraj Kumar, Dr. Rajesh Ranjan,Dr. Amit Johari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2575-2581

Background: In India, cardiovascular disease (CVD) is the main cause of morbidity and
mortality. According to recent trends, this group of disorders has expanded to younger
age groups as well. Cardiovascular illnesses are on the rise in India, affecting both men
and women in both urban and rural areas. The objective of this study was to analyse
serum uric acid levels correlate these values with Killip class in patients of acute MI.
Materials and Methods: Study was prospective type conducted at Dr. Baba
SahebAmbedkar Medical College and Hospital, Rohini, New Delhi from September
2016 to August 2017. A total of 100 patients of acute MI admitted to the ICCU, falling
into inclusion criteria were enrolled. Information was collected through a pre tested
and structured proforma for each patient. Also, physical examination and laboratory
investigation with special reference to Killip classification of heart failure was carried
out. During data analysis, a p value of <0.05 was considered statistically significant.
Results: Mean age of population 54.77 years. This study population had male
predominance (69.0%). In our study out of 100 patients 85 (85%) patients were STEMI
and 15 (15%) patients were NSTEMI. Mean uric acid on day 7 in patients with Killip
class I was 4.72 mg/dl and subjects with Killip class II was 6.62 mg/dl. In multivariate
logistics regression no factors were significantly affecting mortality after adjusting for
confounding factors.
Conclusion: From our study, we conclude that serum uric acid levels are correlated
with Killip class and patients with higher Killip class have higher serum uric acid levels
in acute myocardial infraction.

Clinical and hemodynamic efficacy of prehospital thrombolysis in acute coronary syndrome with ST elevation

Kenjaev S.R

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2327-2331

According to the World Health Organization (WHO), cardiovascular disease (CVD) is the leading cause of death and disability in countries around the world, with ST segment elevated myocardial infarction (STEMI) leading the way. Despite advances such as the widespread introduction of many effective drugs, angioplasty and surgical treatments into clinical practice, CVD kills 17.3 million people annually, accounting for 30% of all deaths worldwide. This figure is projected to increase to 23.6 million by 2030. In the world, including in Uzbekistan, over the past two decades there has been an increase in morbidity and mortality from cardiovascular pathology.

Acute Myocardial Infarction And Its Associated Therapy

Amandeep Kaur

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 4007-4014

Acute myocardial infarction (AMI) is one of the common diseases in developing countries.(Sathisha et al., 2011)It is generally known as a heart attack, which occurs when there israpid blockage in flow of blood in one or more of Coronary arteries and decreases the supply of blood to heart muscle, leading to necrosis in which enormous death of cells andpermanent damage occur. If blockage is severe, then heart faces cardiac halt. This is very common because ofblockage occur in coronary artery following splitting of atherosclerotic plaque in which uneven collection of lipids,more commonly cholesterol and fatty acid as well as WBC’s specifically macrophagesoccur in walls of artery.AMI is one of an exampleof coronary artery disease, that results into greater than 2.4 million expiries in USA, greater than 4 million expiries in Europe and northern Asia,(Nichols, Townsend, Scarborough, & Rayner, 2014) as well as greater than one third of deaths in advanced countries per year. In this review article, the pathophysiology of acute myocardial infarction along with some uses of drugs is discussed.

Plasma atrial natriuretic peptide level and serum electrolyte status among patients with acute myocardial infarction complicated with cardiac arrhythmia

Prof. Abdul - Aziz Ahmed Aziz; Dr. Abdul-Hassan M. S.; Dr. Mohammed K. B.

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 4352-4360

Objective: Acute myocardial infarction is a leading cause of morbidity and mortality worldwide. Electrolyte imbalance among patients with acute myocardial infarction is not uncommon. The aim of the present study is to assess the status of serum sodium and potassium and plasma atrial natriuretic peptide level among patients with acute myocardial infarction complicated with cardiac arrhythmia.
Design: A case control study.
Setting: Ibn-Sena hospital/ Mosul-Iraq.
Participants: the study included 92 patients with acute myocardial infarction, divided into 2 group; Group I, included 44 patients with uncomplicated acute myocardial infarction; group II, included 48 AMI patients complicated with cardiac arrhythmia. The study also included 50 apparently healthy volunteers as a control group.
Methods: Plasma level of atrial natriuretic peptide, serum concentration of sodium, potassium were measured.
Results: The results of the study showed a significantly low serum sodium and potassium concentration in patients with AMI (p< 0.0001 and p<0.0001) in comparison with control group. The means of plasma level of atrial natriuretic peptide was significantly higher in patient with acute myocardial infarction in comparison with control group (p< 0.0001), atrial natriuretic peptide level was also higher in patient with complicated acute myocardial infarction in comparison with uncomplicated group (p< 0.0001). A significant negative correlation was observed between plasma atrial natriuretic peptide and serum sodium concentration in patients with uncomplicated acute myocardial infarction (r =-0.825, p<0.0001) and complicated acute myocardial infarction (r =-0.884, p<0.0001). Conclusion: In acute myocardial infarction, electrolytes imbalance is a common fining and usually associated with a variety of cardiac arrhythmia, plasma level of atrial natriuretic peptide significantly increased in patients with acute myocardial infarction and negatively correlated with serum sodium concentration.