Impact of COVID-19-related public containment measures on the ST elevation myocardial infarction epidemic in Belgium: a nationwide, serial, cross-sectional study

Objective: To determine in hospital early complications in diabetics’ vs non diabetics with acute ST elevation myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug to Nov 2019. Methodology: A comparative cross sectional study was conducted on 380 patients (190 patients with diabetes and 190 patients without diabetes) who presented with acute ST-Elevation MI in age group 30 to 70 years to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Patients with rescue PCI and new onset of LBBB were also included. Patients with age group lesser than 30 years or greater than 70 years with STEMI were excluded. Sampled with consecutive non probability technique in patients was assessed with ECG, cardiac enzymes, transthoracic echocardiography, renal Doppler and RFTs. All patients were admitted in wards and were followed up during hospital stay. Patients were evaluated and their record of Primary PCI and thrombolysis was also noted. Data was entered and analyzed with SPSS-23. Results: A total of 380 patients with STEMI were included in this study consisting of 292 (76.8%) male and 88 (23.1%) female from 30 to 70 years. The patients were divided in two groups i.e. diabetic and non-diabetic, 190 patients were included in each group. It was found that frequency of ST-Elevation MI was higher in diabetic group as compared to non-diabetic group. All the patients were analyzed for complications occurred after STElevation MI. LV failure, Brady arrhythmias, atrial fibrillation, post MI angina and cardiogenic shock were the main complications noted. It was found that all these complications are more in diabetic group post MI angina which occurred most frequently in non-diabetic group. Conclusion: In our study we observed that left ventricular failure and arrhythmias were the major complications. Mortality was higher in diabetic patients than non-diabetic patients. In both groups PPCI and SK reduced mortality. Post MI angina were found more frequent in non-diabetic group.

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Evaluation of Door To Needle Time For Fibrinolytic Therapy of ST Elevation Myocardial Infarction (STEMI) Management In Emergency And Traumatology Department (ETD), Hospital Sultan Haji Ahmad Shah (HOSHAS), Temerloh, Pahang. Malaysia.

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v16i3.32864 ◽

2017 ◽

Vol 16 (3) ◽

pp. 407-412

Author(s):

Wadiah Mustafar ◽

Sazwan Reezal Shamsuddin ◽

Amelia Amir

Keyword(s):

Myocardial Infarction ◽

Medical Science ◽

Time Frame ◽

Cross Sectional Study ◽

Fibrinolytic Therapy ◽

Time Dependent ◽

Sectional Study ◽

Cross Sectional ◽

Good Outcome ◽

St Elevation

Introduction: Acute myocardial infarction is known with high mortality. The benefits of fibrinolytic administration in STEMI are time dependent. The purpose of this study is to evaluate the door-to-needle time for fibrinolytic therapy in STEMI patients.Methods: A cross sectional study of all patients who had STEMI was carried out to evaluate the management of STEMI. The duration from door-to-ECG time, door-to-needle time and the factors that contribute to the time frame in receiving treatment was reviewed. The outcomes and complications from fibrinolytic therapy were documented as well. The outcomes of the delayed in administering the treatment were also analyzed in the study.Result: Out of 19 patients received fibrinolytics within 30 minutes, 16 patients (84.2%) had good outcome. In 17 patients received fibrinolytics between 30 minutes to 1 hour, 6 patients (35.2%) had good outcome. In 15 patients received fibrinolytics more than 1 hour, 8 patients (53.3%) had good outcome.Conclusion: This study showed that a shorter door-to-needle time results in better outcome.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.407-412

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Frequency of fragmented QRS in patients with acute Non ST elevation Myocardial Infarction (NSTEMI).

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.01.6185 ◽

2021 ◽

Vol 28 (01) ◽

pp. 60-65

Author(s):

Muhammad Yasir ◽

Muhammad Usman ◽

Munir Ahmed ◽

Rehan Riaz ◽

M Hamid Saeed

Keyword(s):

Myocardial Infarction ◽

Troponin I ◽

Operational Definition ◽

Cross Sectional Study ◽

St Elevation Myocardial Infarction ◽

P Value ◽

Qrs Complex ◽

Cross Sectional ◽

Fragmented Qrs ◽

St Elevation

Objective: To determine the frequency of fragmented QRS complex in patients with acute non-ST elevation myocardial infarction (NSTEMI). Study Design: Cross-Sectional Study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: July 15, 2019 to January 15, 2020. Material & Methods: One hundred and forty five diagnosed patients of NSTEMI on the basis of chest pain and positive troponin-I were included in this study. The electrocardiography (ECG) was performed to document the presence or absence of f QRS complex in these patients. A 12-lead ECG with paper speed of 25 or 50 mm per second and a voltage of 10 mm/mv was used. FQRS was labeled (as per operational definition). The collected data were entered and analyzed statistically by using SPSS v25.0. Data were stratified for age, gender, diabetes, smoking and hypertension. Post-stratification, f QRS complex was compared by Chi-Square test in stratified groups. A p-value ≤0.05 was taken as significant. Results: Total 145 patients presenting with NSTEMI were selected for this study. Mean age of the patients was 48.2±12.3 year. Among these patients, 90(62.1%) were males, while 55(37.9%) were females. Overall frequency of fQRS complex in patients with NSTEMI was 64(44.1%). Conclusion: There is an association of fQRS among patients with acute non-ST elevation myocardial infarction (NSTEMI). Further prospective studies are needed to determine the clinical significance of fQRS complex and identify its correlation with the incidence of possible complications.

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Predictive Value of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Immediate Outcomes of ST-elevation Myocardial Infarction: A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49214.15312 ◽

2021 ◽

Author(s):

Sneha Barkur Sadashiva ◽

KS Chenthil

Keyword(s):

Myocardial Infarction ◽

Risk Score ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

St Elevation ◽

Timi Risk Score

Introduction: There have been various inflammatory markers implicated in the pathogenesis of Acute Coronary Syndromes (ACS). However, the role of the Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as prognostic markers in ST-elevation Myocardial Infarction (STEMI) remains poorly researched. Aim: To determine the prognostic value of NLR and PLR to predict the immediate outcomes in patients with acute STEMI, and if any association exists between NLR/PLR and Thrombolysis in Myocardial Infarction (TIMI) risk score. Materials and Methods: This was a cross-sectional study conducted at a tertiary care centre, Puducherry, India, where 190 patients who presented to casualty with STEMI were enrolled. The patient co-morbidities, personal and family history were obtained. The routine laboratory parameters including platelets, lymphocytes, neutrophils and their corresponding ratios were calculated. Patients were grouped into low and high NLR/PLR groups and were assessed for occurrence of in-hospital mortality or Major Adverse Cardiovascular Events (MACE). Analysis was made to see if there is an association between NLR/PLR and MACE. Chi-square test and one-way ANOVA test was used for statistical significance. Results: Among 190 subjects, 157 male and 33 female with mean age of 55.72±11.24 years were included. A total of 8.94% patients 8.94% had MACE. NLR was positively associated with MACE (p-value=0.0006), whereas PLR was not associated with MACE. Patients with high NLR had 1.45 times higher odds of having MACE. NLR was significantly associated with TIMI risk score. Both NLR (F ratio=6.341) and PLR (F ratio=4.600) showed significant association with Killip classification, however NLR showed higher association (p-value <0.001). Conclusion: NLR can be used as a powerful prognostic marker for predicting immediate MACE and death in STEMI patients. In addition, NLR showed positive correlation with Killip classification and TIMI risk score.

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Frequency of Left Bundle Branch Block in Patients with Acute Myocardial Infarction; A Cross-Sectional Study

10.31661/gmj.v8i0.1576 ◽

2019 ◽

Vol 8 ◽

pp. 1576

Author(s):

Reyhaneh Niknam ◽

Mahmonir Mohammadi

Keyword(s):

Myocardial Infarction ◽

Heart Disease ◽

Family History ◽

Cross Sectional Study ◽

Sectional Study ◽

Contributing Factors ◽

Cross Sectional ◽

Bundle Branch Block ◽

History Of ◽

St Elevation

Background: Cardiovascular disease (CVDs) is important problems in both developing and developed countries. Currently, non-invasive methods for diagnosis of CVD, especially myocardial infarction (MI), is an interesting subject in the cardiology field. Some evidence showed left bundle branch block (LBBB) is more prevalent among patients with MI. Hence, this study aimed to investigate the frequency of LBBB and their contributing factors in patients with MI. Materials and Methods: In this cross-sectional study, 150 patients with ST elevation or non-ST elevation on their admission electrocardiography who referred to Boo-Ali and Amir-Al-Momenin hospitals, Tehran from January 2016 to June 2017 entered the study. Frequency of LBBB and right bundle branch block (RBBB) in participants and the contributing factors were determined. Results: In this study, of 150 cases (mean age: 60.35±12.88 years), 109 (72.7%) were male, and 41 (27.3%) were female. Out of 150 cases, 12 (8%) had LBBB, 5 (3.3%) RBBB, and 133 (89.7%) had not RBBB or LBBB. Contributing factors were family history, hypertension, and history of ischemic heart disease (P<0.05). Conclusion: Eight percent of patients with myocardial infarction would develop LBBB, which is related to hypertension, and self and family history of ischemic heart disease. [GMJ.2019;8:e1576]

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Clinical, Angiographic Profile and Short-term Prognosis in Patients with ST Elevation Myocardial Infarction- A Cross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/50021.15236 ◽

2021 ◽

Author(s):

Bijay Kumar Dash ◽

Nirmal Kumar Mohanty ◽

Chhabi Satpathy ◽

Satya Narayan Routray ◽

. Shantanu

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Chest Pain ◽

Coronary Angioplasty ◽

Cross Sectional Study ◽

Sectional Study ◽

Short Term ◽

Cross Sectional ◽

St Elevation ◽

Typical Chest Pain

Introduction: Acute Myocardial Infarction (MI) is one of the most common causes of death and disability throughout the world. The most common of all Acute Coronary Syndrome (ACS) in Indian patients is acute ST Elevation Myocardial Infarction (STEMI). Although acute MI more commonly occurs in patients older than 45 years of age, young men and women can also have MI. Aim: To study the risk factors, clinical presentation, angiographic profile and short-term prognosis in patients with STEMI with age <45 years. Materials and Methods: A cross-sectional study was carried out in the Department of Cardiology, SCB Medical College and Hospital, Cuttack, Odisha, India. A total of 198 patients of age ≤45 years with acute STEMI, of both genders diagnosed based on symptoms, Electrocardiogram (ECG), Echocardiogram (Echo) and biomarkers were enrolled from June 2019 to November 2020. Categorical variables were tabulated in frequency with percentage distribution and continuous variables were summarised in mean±SD (Standard Deviation). Results: This study included 198 patients, aged ≤45 years, with STEMI. STEMI was more common in males. The mean age was 38.28 and 42.15 years for males and females, respectively. Smoking (63.5%) was the most common risk factor, followed by dyslipidemia (28.5%). Most of the patients (86.5%) presented with typical chest pain. Killip’s Class I was most common (92.5%) at the time of admission. Anterior Wall Myocardial Infarction (AWMI) was the presentation in the majority (61%). Most patients (47%) had Single Vessel Disease (SVD). One third of the patients had re-canalysed vessels. Type A lesion was commonly seen (61%) and 60% patients underwent coronary angioplasty. Conclusion: In young STEMI patients males were commoner and smoking and dyslipidemia were found to be the common risk factors, smoking being twice more common than dyslipidemia. Typical chest pain of Killip Class I and AWMI were seen in majority. Half of the patients had SVD and one third was found to be re- canalysed. Type A was the commonest lesion and two thirds of the study population could undergo coronary angioplasty.

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