scholarly journals Risk factors for in-hospital mortality in patients with acute myocardial infarction during the COVID-19 outbreak

2020 ◽  
Vol 73 (12) ◽  
pp. 985-993
Author(s):  
Jorge Solano-López ◽  
José Luis Zamorano ◽  
Ana Pardo Sanz ◽  
Ignacio Amat-Santos ◽  
Fernando Sarnago ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality

scholarly journals Factors associated with acute myocardial infarction in older patients after hospitalization with community-acquired pneumonia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu Kang ◽  
Xiang-Yang Fang ◽  
Dong Wang ◽  
Xiao-Juan Wang
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Older Patients ◽  
Geriatric Patients ◽  
Community Acquired Pneumonia ◽  
Artery Disease

Abstract Background Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in older patients. Little is known regarding characteristics of AMI in older patients hospitalized for CAP. Therefore, we investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients. Methods Eleven thousand nine adult inpatients consisted of 5111 patients≥65 years and 5898 patients< 65 years in respiratory ward diagnosed with CAP were retrospectively analyzed by electronic medical records. Results 159 (3.1%) older patients in respiratory ward experienced AMI during hospitalization for CAP. AMI were more frequently seen in patients≥65 years compared with patients< 65 years (3.1% vs. 1.0%). Patients≥65 years who experienced AMI during hospitalization for CAP had higher percentage of respiratory failure (P = 0.001), hypertension (P = 0.008), dyspnea (P = 0.046), blood urea nitrogen (BUN) ≥7 mmol/L (P < 0.001), serum sodium< 130 mmol/L (P = 0.005) and had higher in-hospital mortality compared to patients< 65 years (10.1% vs. 6.6%). AMI was associated with increased in-hospital mortality (odds ratio, OR, with 95% confidence interval: 1.49 [1.24–1.82]; P < 0.01). Respiratory failure (OR, 1.34 [1.15–1.54]; P < 0.01), preexisting coronary artery disease (OR, 1.31[1.07–1.59]; P = 0.02), diabetes (OR, 1.26 [1.11–1.42]; P = 0.02) and BUN (OR, 1.23 [1.01–1.49]; P = 0.04) were correlated with the occurrence of AMI in the older patients after hospitalization with CAP. Conclusions The incidence of AMI during CAP hospitalization in geriatric patients is notable and have an impact on in-hospital mortality. Respiratory failure, preexisting coronary artery disease, diabetes and BUN was associated with the occurrence of AMI in the older patients after hospitalization with CAP. Particular attention should be paid to older patients with risk factors for AMI.

scholarly journals Impact of Raised Blood Glucose Level on In-Hospital Outcome of Thrombolysed Patients with Acute Myocardial Infarction

2020 ◽  
Vol 35 (1) ◽  
pp. 14-19
Author(s):  
Musammat Sufia Akhter ◽  
Md Faruque ◽  
Md Toufiqur Rahman ◽  
Mohammad Arifur Rahman ◽  
Mirza Abul Kalam Mohiuddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Blood Glucose ◽  
Hospital Mortality ◽  
Adverse Outcome ◽  
Diabetic Group ◽  
Diabetic Status ◽  
History Of

Background: Diabetes mellitus (DM) is an established major cardiovascular risk factor associated with increased prevalence of coronary artery disease (CAD). Patients with diabetes often have numerous concomitant cardiac risk factors with a higher incidence of acute myocardial infarction (AMI) and congestive heart failure (CHF). Patients either with or without a prior history of DM may present with hyperglycemia during AMI. We analysed our population to determine whether admission hyperglycemia was a strong risk factor for in-hospital mortality and morbidity in patients with AMI and may be even stronger than a previous history of diabetes.In-hospital death risk of AMI patients without DM was about 2 to 4 times higher in patients with hyperglycemia than in those without hyperglycemia. Methods: This Prospective observational study was carried out at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total number of 200 STsegment elevation AMI patients were enrolled in this study as per inclusion and exclusion criteria. They were subdivided on the basis of admission blood glucose into two groups. Group-1A and 2A were 50 patients with blood glucose <200mg/dl (<11.1mmol/l) and Group-1B and 2B were 50 patients with blood glucose ≥200mg/dl (11.1 ≥mmol/l). The numerical data obtained from the study were analyzed and significance of differences were estimated by using statistical methods. Computer based SPSS (Statistical Package for Social Science) were used. Results: In the present study mean age of the male and female were 56.10±11.86 and 57.83±13.74 years, p>0.05%. There was no significant difference regarding risk factors and smoking was higher in both group. Regarding inhospital adverse outcome, death was significantly higher in hyperglycemic non diabetic group (p<0.0001). It was two times (56%) higher than diabetic hyperglycemic (28%) group.Cardiogenic shock (66%) and CHF (56%) were also more common in hyperglycemic non diabetic group. Lowest patients (8%) died of AMI without DM with random blood glucose <11.1 mmol/l (controlled). On the other hand highest improvement was in the controlled group (p<0.0001).Multivariate analysis showed Diabetic status with normal blood sugar was a predictor of adverse outcome; but patients with hyperglycemia and no history of diabetes had a worse outcome and were independently associated with significant risk of in-hospital mortality. Age group >65 years and Male sex were also associated with significant in-hospital mortality. Conclusion: Independent of diabetic status, the occurrence of hyperglycemia during AMI is associated with a subpopulation of patients at particularly high risk for an adverse clinical outcome. Even with the highly efficacious treatment strategies currently available, persons presenting with AMI and hyperglycemia are at increased risk for cardiogenic shock and CHF or death in hospital. Bangladesh Heart Journal 2020; 35(1) : 14-19

P3615The number of coronary risk factors and mortality in patients with acute myocardial infarction from Japanese nation-wide real-world database

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Mori ◽  
K Nishihara ◽  
S Honda ◽  
S Kojima ◽  
M Takegami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Real World ◽  
Japanese Patients ◽  
Advanced Age ◽  
Coronary Risk Factors ◽  
Inverse Association ◽  
Coronary Risk

Abstract Background Hypertension, diabetes, dyslipidemia and smoking are so-called coronary risk factors for coronary heart disease, which were established by extensive epidemiological research. However, in Japanese patients with acute myocardial infarction (AMI), the impact of number of coronary risk factors on in-hospital morality has not been elucidated. Methods The Japan Acute Myocardial Infarction Registry (JAMIR) is a nationwide real-world database integrated form 10 regional registries. We examined the association between number of coronary risk factors and in-hospital mortality from this JAMIR registry. Results The data were obtained from total of 20462 AMI patients (mean age, 68.8±13.3 years old; 15281 men, 5181 women). Figure 1 shows the prevalence of each coronary risk factors stratified by sex and decade. The prevalence of hypertension became higher with the advanced age while the prevalence of smoking became lower with the advanced age. Prevalence of diabetes and dyslipidemia were highest in middle age. Majority (76.9%) of the patients with AMI had at least 1 of these coronary risk factors and, 23.1% had none of them. Overall, except women under 50, number of coronary risk factor was relatively less in older age (Figure 2). In-hospital mortality by sex and decades was shown in figure 3. In-hospital mortality rates were 10.7%, 10.5%, 7.2%, 5.0% and 4.5% with 0, 1, 2, 3 and 4 risk factors, respectively (Figure 4A). After adjusting age and sex, there was an inverse association between the number of coronary risk factors and in-hospital mortality (adjusted odds ratio [1.68; 95% CI, 1.20–2.35] among individuals with 0 vs. 4 risk factors, Figure 4B). Conclusion In the present study of Japanese patients with AMI, who received modern medical treatment, in-hospital mortality was inversely related to the number of coronary risk factors. Acknowledgement/Funding Grant-in-Aid for Scientific Research

scholarly journals Acute Myocardial Infarction During Hospitalization for Community-Acquired Pneumonia in Geriatric Patients: A Cross-Sectional Study

2020 ◽  
Author(s):  
Yu Kang ◽  
Xiang-Yang Fang ◽  
Dong Wang ◽  
Xiao-Juan Wang
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Respiratory Failure ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Cross Sectional

Abstract Background: Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in elderly. Little is known regarding characteristics of AMI in elderly hospitalized for CAP. Therefore, we investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients.Methods: 11009 adult inpatients consisted of 5111 elderly patients≥ 65 years and 5898 patients＜65 years in respiratory ward and 1095 inpatients ≥65 years in geriatrics ward diagnosed with CAP were retrospectively analyzed by electronic medical records. Results: 159 (3.1%) elderly patients in respiratory ward and 77 (7.0%) patients in geriatrics ward experienced AMI during hospitalization for CAP. AMI were more frequently seen in elderly patients (3.1% vs. 1.0 %), Patients≥65 years who experienced AMI during hospitalization for CAP had higher percentage of respiratory failure (P = 0.001), hypertension (P = 0.008), dyspnea (P=0.046), blood urea nitrogen (BUN)≥7mmol/L (P < 0.001), serum sodium <130 mmol/L(P = 0.005) and had higher in-hospital mortality compared to patients＜65 years (10.1% vs. 6.6%). AMI was associated with increased in-hospital mortality (odds ratio, OR, with 95% confidence interval: 1.49 [1.24-1.82]; P<0.01). Respiratory failure (OR, 1.34 [1.15–1.54]; P<0.01), preexisting coronary artery disease (OR, 1.31[1.07–1.59]; P = 0.02), diabetes (OR, 1.26 [1.11–1.42]; P = 0.02), BUN (OR, 1.23 [1.01–1.49]; P = 0.04), and impaired consciousness (OR, 1.19 [1.07–1.32]; P = 0.03) were correlated with the occurrence of AMI in the elderly.Conclusions: The incidence of AMI during CAP hospitalization in geriatric patients is notable and have an impact on in-hospital mortality. Characteristics of the elderly differ from the general population. Particular attention should be paid to elderly patients with risk factors for AMI. Our study may represent useful information for clinical strategies aimed at preventing AMI and decreasing mortality in geriatric patients hospitalization for CAP.

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