Abstract 357: Comparison of Comorbidities Between Patients Admitted With Index Myocardial Infarction and Recurrent Myocardial Infarction

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen A Kravitz ◽  
Moses Anabila ◽  
Jeevanantham Rajeswaran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Medical Center ◽  
Modifiable Risk Factors ◽  
Risk Factor Management ◽  
Recurrent Myocardial Infarction ◽  
Artery Disease ◽  
The Relationship ◽  
Risk Factor Burden

Background: Several comorbidities are known to increase the risk of coronary artery disease. However, the relationship between modifiable risk factors and recurrent Myocardial Infarction (MI) has not been clearly defined. The purpose of our study was to assess if there were certain comorbidities that increase the risk of recurrent myocardial infarction. Methods: We reviewed 6,626 cases of MI at a single quaternary care medical center from January 1 st , 2010 to January 1 st , 2017 (29% STEMI, 71% NSTEMI), and we identified all cases of readmission with a recurrent MI within 90 days after index MI. All patients with index MI were screened for accompanying comorbidities and compared with patients with recurrent MI. Results: There were a total of 2051 readmissions (31%) within 90-days of index MI, of which 168 readmissions were for recurrent MI. Hypertension and Dyslipidemia appeared to be the most prominent modifiable risk factors in patients with index MI and recurrent MI (86%, 94% for HTN & 81%, 93% for DLP). All comorbidities were substantially more prevalent in patients with recurrent MI than in patients with index MI. Conclusion: Patients with recurrent MI have a higher risk factor burden than the general population with MI. This highlights the importance of risk factor management in patients with acute Myocardial infarction.

scholarly journals Patients’ Needs on Nutritional Counseling and Risk Factor Management Among Myocardial Infarction Patients in Cardiac Rehabilitation

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Yusshy Kurnia Herliani ◽  
Urip Rahayu ◽  
Chandra Isabella Hostanida Purba ◽  
Hasniatisari Harun
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Program ◽  
Nutritional Counseling ◽  
Risk Factor Management ◽  
Counseling Needs ◽  
The Relationship ◽  
Program Data

The needs of nursing care for Myocardial Infarction (MI) patients who performing Cardiac Rehabilitation (CR) Program have been investigated previously. Despite, nutritional counseling and risk factors management were reported as the most needs of MI patients who performed CR Program, information related to the MI patients’ needs on nutritional counseling and risk factor management are very limited. Moreover, the relationship between patients’ needs on nutritional counseling and risk factor management are not clear yet. To investigate patients’ needs on nutritional counseling and risk factor management among MI patients and its relationships those factors. This was quantitative approach with descriptive correlational and convenience sampling was used for this study. The participants included 38 MI patients admitted to the Cardiac Rehabilitation Unit. Data collection employed from questionnaires that were filled in by the respondents using a retrospective technique at the end of cardiac rehabilitation program.  Data were analyzed using descriptive and correlational statistics. The study signified that MI patients required cardiac rehabilitation towards risk factors management and nutritional counseling from nurses (92.1%).The finding also indicated that there is a statistically positive relationship between nutritional counseling needs and risk factor management (r = 0.503, p <0.01). Patients’ needs on nutritional counseling and risk factor management among MI patients are correlated positively. Therefore, the information regarding nutrition and risk factor management for MI patients should be provided simultaneously to complement each other.

ID: 35: ASSOCIATION BETWEEN HELICOBACTER PYLORI INFECTION WITH CORONARY ARTERY DISEASE AND ACUTE MYOCARDIAL INFARCTION: A RETROSPECTIVE CHART ANALYSIS

2016 ◽  
Vol 64 (4) ◽  
pp. 940-941
Author(s):  
N Vyas ◽  
H Alkhawam ◽  
E Saker ◽  
R Sogomonian ◽  
RA Ching Companioni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Helicobacter Pylori ◽  
Risk Factor ◽  
Coronary Artery ◽  
Medical Center ◽  
Control Group ◽  
Igg Antibody ◽  
Artery Disease

IntroductionHelicobacter pylori (HP) infection is known to target the gastrointestinal system and is associated with extra gastrointestinal manifestations, but there is limited literature on cardiac associations. The most supported pathogenesis uses chronic inflammation as a risk factor causing atherosclerosis resulting in cardiovascular disease. Our aim is to evaluate whether there is an association between HP infection and acute myocardial infarction (AMI) and coronary artery disease (CAD).MethodWe performed a retrospective single center study at our medical center from 2005 to 2014 consisting of 1,671 patients who underwent Coronary Angiography (CA). We divided these patients into two groups based on CA reports. Patients with CAD defined as left main stenosis of ≥50% or any stenosis of ≥70% versus normal coronaries. We reviewed each patient chart to determine the prevalence of positive serum HP IgG antibody. Smoking, hypertension, dyslipidemia and obesity were also considered in each group.ResultsOf 1,671 patients, 1,237 had evidence of CAD vs 434 with normal coronary arteries. Twelve percent of CAD patients were found to have seropositive HP (SPHP) versus 1% in the control group (OR: 7.3, 95% CI: 3.5–15, p<0.0001) as depicted in figure 1. When we looked at the CAD group and compared SPHP patients to seronegative HP (SNHP) patients we found a greater amount of multiple coronary vessels disease in the SPHP group (OR: 1.4, 95% CI: 1.1–2, P=0.04). With regards to AMI, 30% of the SPHP group presented with AMI versus 10% seen in the SNHP group (OR: 4.3, 95% CI: 3–6.5, p<0.0001). In the CAD group with SPHP there was more hyperlipidemia and a higher BMI than in the CAD SNHP group (p<0.0001 and <0.0001, respectively), but there was no statistical difference between the two groups for the risk factors of smoking, hypertension and diabetes.ConclusionAccording to this study, the results showed a correlation with SPHP patients and CAD. Patients with HP seropositivity also tend to have multiple coronary artery vessel disease. In addition, our results also confirmed that there is an association between with HP infection and AMI. We hypothesize that the associated maybe secondary to inflammatory reaction associated with HP. Additional studies with larger sample groups are needed to investigate the possible role of this pathogen as a risk factor for heart disease.Abstract ID: 35 Figure 1Twelve percent of CAD patients were found to have seropositive HP (SPHP) versus 1% in the control group (OR: 7.3, 95% CI: 3.5–15, p<0.0001).

scholarly journals A favorable lifestyle lowers the risk of coronary artery disease consistently across strata of non-modifiable risk factors in a population-based cohort

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kristian Dimovski ◽  
Marju Orho-Melander ◽  
Isabel Drake
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Relative Risk ◽  
Educational Level ◽  
Population Based ◽  
Modifiable Risk Factors ◽  
Parental History ◽  
History Of ◽  
Artery Disease

Abstract Background A healthy lifestyle has been shown to reduce the risk of coronary artery disease (CAD). The extent to which lifestyle influences the risk of CAD for people with pre-existing non-modifiable risk factors is less studied. We therefore examined the associations between a favorable lifestyle and incidence of CAD in population subgroups based on gender, age, educational level, and parental history of myocardial infarction. Methods A total of 26,323 men and women from the Malmö Diet and Cancer study were prospectively followed-up for 18 years. A favorable lifestyle was determined using a four-component lifestyle score based on data collected at baseline: no smoking, no obesity, regular physical activity, and a healthy diet. Cox proportional hazards regression models were used to estimate the relative risk of CAD during follow-up and cumulative risk during a 10-year interval. Results A favorable lifestyle was associated with a 44% (95% confidence interval, 38–48%) lower risk of CAD compared to an unfavorable lifestyle. The relative risk was similarly reduced among subjects subdivided by gender, age group, educational level, and parental history of myocardial infarction. These findings corresponded with a reduced standardized 10-year incidence of CAD of around 40% in each subgroup. Conclusion In this population-based cohort, a favorable lifestyle was associated with a significant reduction of CAD across strata of non-modifiable risk factors. These findings provide support for lifestyle modification as a means for risk reduction in a range of subgroups within a general healthy population.

Abstract 383: Effect of Race on Risk of Recurrent Myocardial Infarction After Index Myocardial Infarction

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen A Kravitz ◽  
Moses Anabila ◽  
Jeevanantham Rajeswaran ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
African Americans ◽  
Medical Center ◽  
White Americans ◽  
Recurrent Myocardial Infarction ◽  
Increased Risk ◽  
Artery Disease ◽  
Racial Factors ◽  
White Patients

Background: Though the prevalence of coronary artery disease is known to be highest in African Americans, it is unclear if there are any racial factors predisposing patients for a recurrent Myocardial Infarction (MI) after index MI. Methods: We reviewed 6,626 cases of MI at a single quaternary care medical center from January 1 st , 2010 to January 1 st , 2017 (29% STEMI, 71% NSTEMI), and we identified all cases of recurrent MI within 90 days of discharge after index MI. The patients were categorized according to their corresponding races into White Americans, African Americans, and Others. Result: Out of the 6626 initial cases of MI, 72% were white patients, 25% were African Americans and 3% belonged to other races. A total of 2051 patients were readmitted within 90 days of index admission, of which 168 patients were readmitted with an MI. Only 2.1% of White patients developed a recurrent MI whereas 4% of African Americans were readmitted with a recurrent MI (P=0.003). Conclusion: We observed that African Americans were more likely to be readmitted with a recurrent MI than White Americans. Understanding the reasons for this increased risk in MI can translate into improved care for African Americans.

ID: 68: CORONARY ARTERY DISEASE AND ACUTE CORONARY SYNDROME IN PATIENTS ≤40 YEAR OLD

2016 ◽  
Vol 64 (4) ◽  
pp. 913.2-914
Author(s):  
H Alkhawam ◽  
R Sogomonian ◽  
N Vyas ◽  
A Al-khazraji ◽  
S Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Premature Coronary Artery Disease ◽  
Modifiable Risk Factors ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Single Vessel ◽  
Artery Disease

BackgroundCoronary artery disease (CAD) in the younger adult population has been commonly under-represented in clinical practice and research studies given its early latent asymptomatic course, in addition to the underestimation of this population's CHD lifetime risk by commonly used CHD risk predictors such as Framingham's score.ObjectiveTo assess the risk factor profile for premature coronary artery disease CAD and ACS presentation in younger adults.MethodsRetrospective chart analysis of 393 patient's ≤40 years old admitted from 2005 to 2014 for chest pain and underwent coronary angiography. The implication of modifiable risk factors and non-modifiable risk factors were evaluated in those with obstructive CAD (LM stenosis of ≥50% or stenosis of ≥70% in a major epicardial vessel), non-obstructive CAD (≥1 stenosis ≥20% but no stenosis ≥70%) and normal coronaries (no stenosis >20%). Additionally we evaluated the impact of the same risk factors on ACS presentation (NSTEMI vs STEMI) and the extent of CAD (single-vessel/multi vessel).ResultsOf 9012 patients who underwent cardiac catheterization, 393 (4.3%) patients were ≤40 years old.Out of 393, 212 (54%) had CAD (153 obstructive versus 59 non-obstructive) while 185 (46%) had normal coronaries.Fifty two (25%) patients presented with STEMI while 140 (66%) patients presented with NSTEMI.Of 153 patients with obstructive CAD, 87 (57%) patients had single vessel disease vs 66 (43%) multiple vessel disease.When compared to patients with normal coronaries patients with CAD were more likely to be smokers (p<0.0001), dyslipidemia (p<0.0001), Diabetic (p<0.0001) cocaine users (p 0.4) have a family history of premature CHD (<0.0001) and be males (p<0.0001) (figure=1).Smokers were more likely to present with acute coronary syndrome; 5 times more likely to present with STEMI (p<0.0001) and 1.7 with NSTEMI (p 0.0003) compared to the control group.When compared head to head, smokers were 2.2 times more likely to present with STEMI compared to NSTEMI (p<0.001).Smoking also, alone and with another risk factor increased the risk of obstructive versus no obstructive CAD (p=0.04 and 0.015, respectively).No significant difference was noted in the single vessel vs multi vessel CAD subgroups.Coronary artery disease was highest in South Asian population (38.4%), followed by Hispanic (13.7%), African-American (10%) and Caucasian (9%). The main in risk factors in African–American was Hyperlipidemia +/− Diabetes (47.8%) while the main risk factors in Hispanic and white were smoking alone (24.14% and 47.4% respectively). In East Asia population, Smoking with hyperlipidemia was the main risk factors (44%).ConclusionIn our population of young adults, smoking as a single risk factor was the most prevalent for earlier CAD. It was also associated with more STEMIs and obstructive CAD. Healthcare intervention in the general population through screening, counseling and education regarding smoking cessation is warranted to reduce premature coronary artery disease. Abstract ID: 68 Figure 1

scholarly journals Characteristics and Outcomes of Early Recurrent Myocardial Infarction After Acute Myocardial Infarction

2021 ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen Kravitz ◽  
Chetan Huded ◽  
Jeevanantham Rajeswaran ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Troponin T ◽  
Artery Bypass ◽  
Care Transitions ◽  
Risk Factor Management ◽  
Recurrent Myocardial Infarction ◽  
Artery Disease

Background We aimed to understand the characteristics and outcomes of patients readmitted with a recurrent myocardial infarction (RMI) within 90 days of discharge after an acute myocardial infarction (early RMI). Methods and Results We analyzed the timing of reinfarction, etiology, and outcome for all patients admitted with an early RMI within 90 days of discharge after an acute myocardial infarction between January 1, 2010 and January 1, 2017. We identified 6626 admissions for acute myocardial infarction (index myocardial infarction) which led to 168 cases of RMI within 90 days of discharge. The mean patient age was 65.1±13.1 years, and 37% were women. The 90‐day probability of readmission with an early RMI was 2.5%. Black race, medical management, higher troponin T, and shorter length of stay were independent predictors of early RMI. Medically managed group had a higher risk for early RMI compared with percutaneous coronary intervention ( P =0.04) or coronary artery bypass grafting ( P =0.2). Predominant mechanisms for reinfarction were stent thrombosis (17%), disease progression (12%), and unchanged coronary artery disease (11%). At 5 years, the all‐cause mortality rate for patients with an early RMI was 49% (95% CI, 40%–57%) compared with 22% (95% CI, 21%–23%) for patients without an early RMI ( P <0.0001). Conclusions Early RMI is a life‐threatening condition with nearly 50% mortality within 5 years. Stent‐related events and progression in coronary artery disease account for most early RMI. Medication compliance, aggressive risk factor management, and care transitions should be the cornerstone in preventing early RMI.

scholarly journals ACUTE MYOCARDIAL INFARCTION

2016 ◽  
Vol 23 (03) ◽  
pp. 293-297
Author(s):  
Rafaqat Malik ◽  
Shazma Begum ◽  
Muhammad Nazar Afridi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Modifiable Risk Factors ◽  
Common Risk Factor ◽  
Cardiology Department ◽  
The World ◽  
History Of

The frequency of modifiable risk factors of acute myocardial infarction variesgreatly in different countries and populations of the world. Objective: To find out the frequencyof modifiable risk factors in patients with acute myocardial infarction. Design: Cross-sectionalstudy. Setting: Cardiology Department. Ayub Teaching Hospital Abbottabad, Period: 1st Jan2015 and 30th June 2015. Material and Methods: A total of 224 patients of acute myocardialinfarction Patients were enquired about the presence of hypertension, diabetes mellitus,smoking and family history of ischemic heart disease. Fasting blood sugar and lipid profilewere recorded. Results: Out of 224, 90.6% patients had at least one risk factor. Hypertensionwas found to be the most common risk factor (55.4%), followed by smoking (43.8%) andDiabetes Mellitus (27.2%). Dyslipidemia was found to be the least common (23.2%) risk factor.Conclusion: Hypertension is the most common modifiable risk factor in patients of acutemyocardial infarction, followed by smoking and diabetes.

scholarly journals Smoking and comorbidities are associated with COVID-19 severity and mortality in 565 patients treated in Turkey: a retrospective observational study

2020 ◽  
Vol 66 (12) ◽  
pp. 1679-1684
Author(s):  
Tayfun Caliskan ◽  
Bengu Saylan
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Older Age ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Current Smoking ◽  
Icu Admission ◽  
Artery Disease ◽  
The Relationship

SUMMARY OBJECTIVE: We aimed to explore the prevalence of smoking rates and comorbidities and evaluate the relationship between them and disease severity and mortality in inpatients with COVID-19. METHODS: COVID-19 patients were divided into the following groups: clinic group, intensive care unit (ICU) group, survivors, and non-survivors. Non-COVID-19 patients were included as a control group. The groups were compared. RESULTS: There was no difference between patients with and without COVID-19 in terms of smoking, asthma, diabetes, dementia, coronary artery disease (CAD), hypertension, chronic renal failure and arrhythmia (p>0.05). Older age (Odds ratio (OR), 1.061; 95% confidence interval (CI): 1.041-1.082; p< 0.0001), chronic obstructive pulmonary disease (COPD) (OR, 2.775; 95% CI: 1.128-6.829; p=0.026) and CAD (OR, 2.696; 95% CI: 1.216-5.974; p=0.015) were significantly associated with ICU admission. Current smoking (OR, 5.101; 95% CI: 2.382-10.927; p<0.0001) and former smoking (OR, 3.789; 95% CI: 1.845-7.780; p<0.0001) were risk factors for ICU admission. Older age (OR; 1.082; 95% CI: 1.056-1.109; p<0.0001), COPD (OR, 3.213; 95% CI: 1.224-8.431; p=0.018), CAD (OR, 6.252; 95% CI: 2.171-18.004; p=0.001) and congestive heart failure (CHF) (OR, 5.917; 95% CI 1.069-32.258; p=0.042), were significantly associated with mortality. Current smoking (OR, 13.014; 95% CI: 5.058-33.480; p<0.0001) and former smoking (OR, 6.507; 95% CI 2.731-15.501; p<0.0001) were also risk factors for mortality. CONCLUSION: Smoking, older age, COPD, and CAD were risk factors for ICU admission and mortality in patients with COVID-19. CHF was not a risk factor for ICU admission; however, it was a risk factor for mortality.

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