scholarly journals Role of telemedicine network provided by pharmacies to detect acute myocardial infarction in patients with chest pain during coronavirus pandemia

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Fioretti ◽  
M Piazzani ◽  
D S Cani ◽  
A Madureri ◽  
G F Gensini ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Hospital Admissions ◽  
Public Institution ◽  
Lombardy Region ◽  
Outbreak Period ◽  
Italian Regions ◽  
Number Of Patients ◽  
The Impact

Abstract Background During the lockdown period in Italy, from March 11th to May 4th 2020, a progressive increase in COVID-19 cases occurred in all Italian regions, in particular in the Lombardy Region. The current rise in COVID-19 cases has led to an increasing involvement of hospitals, in order to face the Coronavirus outbreak, shifting healthcare resources towards the management of COVID+ patients. This has led, on the other hand, to a progressive decrease in hospital admissions due to conditions not associated with SARS-CoV2 infection. During COVID-19 outbreak period, it has been observed a decrease in hospital admissions for acute myocardial infarction. This phenomenon put in serious difficulty the clinical management of COVID-free patients with cardiovascular disease, at the beginning of phase 2 (starting from May 4 2020). Purpose In this scenario, we aimed to verify the impact of telemedicine during lockdown, in comparison with the same period in 2019. Materials and method We analyzed 12-lead ECGs recorded by 5000 country pharmacies, evaluated and stored in one telemedicine platform provided by Health Telematic Network (HTN), in cooperation with our Cardiology Department, Federfarma (Pharmacists' National Association), and Italian National Health Institute. Results During the lockdown period, were recorded 6,104 ECGs in territorial pharmacies, compared to 17,280 ECGs done in the same period in 2019. Chest pain symptom represented the cause of recording ECG in 298 patients (4.88%) during the lockdown period, compared to 402 patients (2.33%) in the same period in 2019, with an increase of 109.86%. In the Lombardy Region, during lockdown period, were reported 118 accesses to territorial pharmacies for chest pain (about 39.50% of total cases in Italy). Among these, 36 accesses were in the province of Brescia (about 30.50%), whereas 28 of them were in the province of Bergamo (about 23.73%). Among ECGs performed, 8 showed typical abnormalities of acute myocardial infarction with ST elevation (STEMI, 2.68%) in the lockdown period, compared to 7 STEMIs (1.74%) detected in the same period in 2019, with an increase of 54.17%. These patients were referred to Emergency Department (ED) suddenly, for the therapeutic intervention. Conclusion These data shown that a large number of patients with cardiovascular symptoms preferred to go to territorial pharmacies rather than hospitals during the COVID outbreak period. Telemedicine played a prominent role in managing patients with cardiovascular symptoms at home. Moreover, this service allowed patients with STEMI to access to the hospitals faster, avoiding the risks of a serious diagnostic delay. Furthermore, by analyzing the data of Lombardy Region, it was possible to show how a significant component of access to local pharmacies for chest pain occurred in the region most affected by the COVID-19 outbreak. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): University of Brescia Number of ECGs recorded for chest pain Data recorded in Lombardy Region

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

Abstract P84: The Impact of a Potential Nationwide Comprehensive Smoking Ban on Acute Myocardial Infarction Hospitalizations

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Mouaz H Al-Mallah ◽  
Owais Khawaja ◽  
Fadi Alqaisi ◽  
David Nerenz ◽  
W Douglas Weaver
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Cost Savings ◽  
Smoking Ban ◽  
Disease States ◽  
Established Risk Factor ◽  
Department Of Health ◽  
The Impact

Introduction: Smoking is a well established risk factor for acute myocardial infarction (AMI). The potential impact of a nationwide comprehensive smoking ban (CSB) legislation on the incidence of AMI hospital admissions is not known. The aim of this analysis is to determine the impact of a nationwide CSB legislation on the incidence of AMI hospitalizations. Methods: We contacted the department of health at states with no CSB law for information on the total number of AMI discharges (ICD-9-CM 410), length of stay and charges in dollars for 2007. Expected decrease in the number of AMI in the year following a potential implementation of a nationwide CSB was calculated by multiplying the current number of AMI by the pooled relative risk reduction (RRR) obtained from a recent published meta analysis (RR 0.89). Results: In 2007, 37 States had CSB laws. There were 169,043 AMI hospitalizations in states without CSB. A nationwide smoking ban would result in 18,596 less AMI hospitalizations in the year following such a ban. This is associated with more than 92 million dollars in direct cost savings. Conclusion: A nationwide CSB legislation would result in significant reduction in the number of AMI hospitalizations. This is associated with significant cost saving. Further studies are needed to evaluate the impact of CSB on admission from other disease states.

scholarly journals NMR Plasma Metabolomics Study of Patients Overcoming Acute Myocardial Infarction: in the First 12 h After Onset of Chest Pain With Statistical Discrimination Towards Metabolomic Biomarkers

2020 ◽  
pp. 823-834
Author(s):  
M PETRAS ◽  
D KALENSKA ◽  
M SAMOS ◽  
T BOLEK ◽  
M SARLINOVA ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Blood Plasma ◽  
Plasma Levels ◽  
Statistical Discrimination ◽  
Plasma Metabolites ◽  
Metabolomics Study ◽  
History Of ◽  
The Impact

Acute myocardial infarction (AMI) is one of the leading causes of death among adults in older age. Understanding mechanisms how organism responds to ischemia is essential for the ischemic patient’s prevention and treatment. Despite the great prevalence and incidence only a small number of studies utilize a metabolomic approach to describe AMI condition. Recent studies have shown the impact of metabolites on epigenetic changes, in these studies plasma metabolites were related to neurological outcome of the patients making metabolomic studies increasingly interesting. The aim of this study was to describe metabolomic response of an organism to ischemic stress through the changes in energetic metabolites and aminoacids in blood plasma in patients overcoming acute myocardial infarction. Blood plasma from patients in the first 12 h after onset of chest pain was collected and compared with volunteers without any history of ischemic diseases via NMR spectroscopy. Lowered plasma levels of pyruvate, alanine, glutamine and neurotransmitter precursors tyrosine and tryptophan were found. Further, we observed increased plasma levels of 3-hydroxybutyrate and acetoacetate in balance with decreased level of lipoproteins fraction, suggesting the ongoing ketonic state of an organism. Discriminatory analysis showed very promising performance where compounds: lipoproteins, alanine, pyruvate, glutamine, tryptophan and 3-hydroxybutyrate were of the highest discriminatory power with feasibility of successful statistical discrimination.

scholarly journals Study on Seasonal Variation of Acute Myocardial Infarction Hospitalization

2020 ◽  
Vol 12 (2) ◽  
pp. 126-134
Author(s):  
Md Sajjadur Rahman ◽  
Abdul Wadud Chowdhury ◽  
Khandker Md Nurus Sabah ◽  
Md Gaffar Amin ◽  
Sudhakar Sarker ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Seasonal Variation ◽  
Hospital Admission ◽  
Hospital Admissions ◽  
Public Health Issue ◽  
P Value ◽  
College Hospital ◽  
Post Monsoon ◽  
Number Of Patients

Background: Coronary artery disease is an important medical and public health issue as it is common and leading cause of mortality and morbidity in Bangladesh as it is throughout the world. This study was carried out to determine the existence of seasonal rhythms in hospital admissions due to acute myocardial infarction (AMI) in Dhaka Medical College Hospital. Methods: This cross-sectional observational study was conducted during the period of April 2015 to March 2016 among the patients with AMI admitted at the Cardiology Department of DMCH. 882 patients were enrolled. Results: The highest number of patients were admitted during winter (n=285, 32.3%) followed by post monsoon (n=213, 24.1%) and monsoon (n=194, 22.0%). The lowest number of patients were admitted during summer (n=190, 21.5%). The hospital admission was significantly higher in winter compared to other seasons (p-value versus summer, monsoon and post monsoon was 0.008, 0.011 and 0.042 respectively). Conclusion: A seasonal variation in the hospital admission due to AMI with a peak in winter was clearly demonstrated in the study. Persons admitted to hospital with AMI tend to be all age groups and both sexes present a stronger seasonal variation peak admission in winter. Cardiovasc. j. 2020; 12(2): 126-134

The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
W. Frank Peacock ◽  
Phillip D. Levy ◽  
Deborah B. Diercks ◽  
Shuang Li ◽  
James McCord ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Pain Center ◽  
The Impact

The impact of the Danish smoking ban on hospital admissions for acute myocardial infarction

2012 ◽  
Vol 21 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Tabita Maria Christensen ◽  
Lisbeth Møller ◽  
Torben Jørgensen ◽  
Charlotta Pisinger
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Admissions ◽  
Smoking Ban ◽  
The Impact

THROMBOLYTIC THERAPY IN ACUTE MYOCARDIAL INFARCTION: THE SCOPE IN A DISTRICT GENERAL HOSPITAL

1987 ◽  
Author(s):  
R G Murray ◽  
J Jagger ◽  
M K Davies ◽  
W A Littler
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Thrombolytic Therapy ◽  
General Hospital ◽  
District General Hospital ◽  
Peptic Ulcers ◽  
Hospital Data ◽  
Number Of Patients ◽  
Recent Acute Myocardial Infarction

Despite the interest in thrombolytic therapy in acute’ myocardial infarction, it has been reported.that only a small minority of patients considered for thrombloysis would be suitable. .To determine the demand for such therapy in a District General Hospital, data were collected for patients admitted with chest pain to our Coronary Care Unit over a six month period. Of 197 patients admitted with chest pain 131 patients (67%) were proven to have acute myocardial infarction. Criteria for thrombolytic therapy included presentation within six hours of the onset of symptoms, ST elevation ≥ 0.2 mV in 2 or more ECG leads and age ≤ 70 years. Sixty-seven (51%) of the 131 patients with subsequently proven acute myocardial infarction were eligible for thrombolysis. Criteria for thrombolysis were not fulfilled in 41 patients with acute myocardial infarction; 17 (13%) presented later than six hours, 15 (12%) failed to meet the ECG criteria and 9 (7%) were over 70 years. A further 12 (9%) patients were excluded for cardiogenic shock, patients had peptic ulcers, one patient sustained a recent acute myocardial infarction 2 weeks previously and data from 8 patients were lost.These results suggest that around 50% of patients with acute myocardial infarction and 34% of all patients presenting with chest pain would be suitable for thrombolytic therapy. These data do not support the view that such treatment may only be applicable to a small number of patients with acute myocardial infarction.

scholarly journals Incidence of cardiac arrhythmias in patients with acute myocardial infarction during the first 48 hours of the onset of chest pain

2017 ◽  
Vol 4 (4) ◽  
pp. 1144
Author(s):  
Puneet Rajendra Patil ◽  
Pankaj Khatana ◽  
Dilip Ratan Patil
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Cardiac Arrhythmia ◽  
Cardiac Arrhythmias ◽  
Anterior Wall ◽  
Age Group ◽  
Eligible Study ◽  
Number Of Patients ◽  
Acute Mi

Background: It is predicted that there will be an increase of 111% in cardiovascular deaths in India by the year 2020 compared to the year 1990. This is much higher than that predicted in any other region both in Asia as well as outside Asia. The objective of this study was to study the incidence of cardiac arrhythmias in acute myocardial infarction during the first 48 hours.Methods: The descriptive study was conducted over a period of two years from April 2016 to January 2017. A total of 102 patients were studied. They were admitted to ICU. Their admission was done as soon as they had chest pain. They were first confirmed to have acute myocardial infarction. All eligible study subjects as per inclusion and exclusion criteria were considered in the present study. Detailed history was taken. A thorough physical examination was done with emphasis on the cardiovascular system.Results: Maximum number of patients was in the age group 51-60 years in both males (37.97%) and females (65.22%). Acute MI observed mostly in the postmenopausal age in all the females. Incidence of myocardial infarction was significantly more in men (77.50%) compared to women (22.50%). 52.90% were smokers. Almost half of the patients had shown anterior wall infarction. The incidence of cardiac arrhythmias was 78.70%. Arrhythmias were more common among elderly female. Maximum arrhythmias were observed in the age group ranging from 50 to 60 years (36.27%).Conclusions: The incidence of cardiac arrhythmia was found to be 78.7% in the present study. The incidence of cardiac arrhythmia was more in the age group 50-60 years (36.27%).

scholarly journals Atypical Presentation of Acute Myocardial Infarction

2021 ◽  
Vol 22 (2) ◽  
pp. 88-94
Author(s):  
Mohammad Shamsuddoha Sarker Shanchay ◽  
Farhana Sultana ◽  
Aysha Begum ◽  
Md Titu Miah
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Hospital Mortality ◽  
Clinical Feature ◽  
Atypical Presentation ◽  
College Hospital ◽  
Atypical Symptoms ◽  
Number Of Patients ◽  
Atypical Presentations

Introduction: Chest pain has been reported as the cardinal clinical feature of Acute Myocardial Infarction (AMI). However, a substantial number of patients may have atypical or no symptoms on initial evaluation. The absence of typical chest pain and the vagueness of symptoms might result in a delay in seeking medical care. In this study atypical presentations of AMI and in-hospital mortality and outcome were evaluated. Material and Methods: A hospital based cross sectional study was performed among 110 patients of AMI admitted in the CCU who fulfilled the inclusion criteria. The Study was done from July, 2013 to January, 2014 in Dhaka Medical College Hospital, Dhaka, and National Institute of Cardiovascular Diseases (NICVD), Dhaka. Results: Among the 110 patients with AMI, 22 (20%) patients presented with atypical presentation. The maximum incidence of AMI with atypical presentations was in the age group of 65-74 years (28.57%). Dyspnoea (36.36%) was the most among the atypical symptom followed by vomiting 22.72% and the least incident with vertigo 4.54%. Inferior MI being the highest 46% among atypical MI where as mortality rate was high among the antero-septal MI (22.86%). The in hospital mortality of myocardial infarction patients who presented with typical and atypical symptoms were 15% and 36.36 %. Conclusion: The patients without chest pain represent a substantial segment of the MI population. Older patients presented with more atypical symptoms with breathlessness being the commonest atypical symptoms. Mortality was high among the patients who presented with atypical symptoms, increasing age, and who presented lately. J MEDICINE 2021; 22: 88-94

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