scholarly journals Risk Factors and Timing of Acute Myocardial Infarction Associated With Pregnancy: Insights From the National Inpatient Sample

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Courtney A. Balgobin ◽  
Xiaoyue Zhang ◽  
Fabio V. Lima ◽  
Cecilia Avila ◽  
Puja B. Parikh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Postpartum Period ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Labor And Delivery ◽  
National Inpatient Sample ◽  
Cerebrovascular Events ◽  
In Pregnancy

Background Pregnancy increases the risk of acute myocardial infarction (AMI). The purpose of this study was to examine timing and risk factors for AMI in pregnancy and poor outcome. Methods and Results National Inpatient Sample (2003–2015) was screened in pregnancy, labor and delivery, and postpartum. There were 11 297 849 records extracted with 913 instances of AMI (0.008%). One hundred eleven (12.2%) women experienced AMI during labor and delivery, 338 (37.0%) during pregnancy and most during the postpartum period (464; 50.8%). The prevalence of AMI in pregnancy has increased ( P =0.0005). Most major adverse cardiovascular and cerebrovascular events occurred in the postpartum period (63.5%). Inpatient mortality was 4.5%. Predictors of AMI include known coronary artery disease (odds ratio [OR], 517.4; 95% CI, 420.8–636.2), heart failure (OR, 8.2; 95% CI, 1.9–35.2), prior valve replacement (OR, 6.4; 95% CI, 2.4–17.1), and atrial fibrillation (OR, 2.7; CI, 1.5–4.7; P <0.001). Risk factors of traditional atherosclerosis including hyperlipidemia, obesity, tobacco history, substance abuse, and thrombophilia were identified ( P <0.001). Gestational hypertensive disorders (eclampsia OR, 6.0; 95% CI, 3.3–10.8; preeclampsia OR, 3.2; 95% CI, 2.5–4.2) were significant risk factors in predicting AMI. Risk factors associated with major adverse cardiovascular and cerebrovascular events included prior percutaneous coronary intervention (OR, 6.6; 95% CI, 1.4–31.2) and pre‐eclampsia (OR, 2.3; 95% CI, 1.3–3.9). Conclusions AMI is associated with modifiable, nonmodifiable, and obstetric risk factors. These risk factors can lead to devastating adverse outcomes and highlight the need for risk factor modification and public health resource initiatives toward the goal of decreasing AMI in the pregnant population.

The combined impact of Type D personality and depression on cardiovascular events after acute myocardial infarction

2021 ◽  
pp. 1-11
Author(s):  
Yini Wang ◽  
Xueqin Gao ◽  
Zhenjuan Zhao ◽  
Ling Li ◽  
Guojie Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Significant Risk ◽  
Type D Personality ◽  
Adverse Outcomes ◽  
Combined Effect ◽  
Continuous Variables ◽  
Type D

Abstract Background Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI). Methods This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period. Results A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (−) groups had a higher risk of MACE [95% confidence interval (CI) 1.74–6.07] (95% CI 1.25–2.96) and ISR (95% CI 3.09–8.28) (95% CI 1.85–6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (−) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients. Conclusions These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.

scholarly journals The importance of GRACE score in health care planning of patients after acute myocardial infarction

2021 ◽  
Vol 24 (82) ◽  
pp. 34-38
Author(s):  
Marina Đorđević ◽  
Jelica Davidović ◽  
Radmila Resimić ◽  
Dijana Otašević ◽  
Nataša Marković-Nikolić ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Health Care ◽  
Acute Myocardial Infarction ◽  
Patient Care ◽  
Adverse Outcomes ◽  
Nursing Interventions ◽  
Care Planning ◽  
Care Assessment ◽  
Grace Score

Introduction: Acute myocardial infarction (AIM) is ischemic myocardial necrosis and is associated with a number of adverse outcomes that complicate patient health care. Assessment of patient status, risk factors, and adverse outcomes has a significant impact on patient care planning after AIM. The GRACE (Global Registry of Acute Coronary Events) score is of great importance in risk stratification in these patients. Objective: To determine the importance of determining the GRACE score in order to set priorities in the planning of patient care after acute myocardial infarction. Method: A retrospective study examined 50 patients, both sexes, aged 28 to 75 years, with a diagnosis of acute myocardial infarction, undergoing percutaneous coronary intervention (PKI), who were treated at the Zvezdara Clinical Hospital in Belgrade during the research period, from January to March 2020. Data were taken from the medical records of these patients. During the study, AIM type, comorbidities, CVD risk factors, GRACE score and frequency of complex nursing interventions in patients with low, moderate, and high-risk of adverse cardiac events were monitored. Results: Out of a total of 50 examinees with AIM treated with PKI, 74% had STEMI and 26% NSTEMI. 84% of patients had positive family history, 64% hypertension, 2% diabetes, 48% obesity, 52% were smokers and 6% of them were using alcohol. The values of the GRACE score were increased as follows: in four patients more than 140, while in one of them a moderate value was recorded, and in one low value of the GRACE score. In the course of six months, three patients, who had high GRACE scores on hospitalization, had a lethal outcome. Complex nursing interventions in the intensive care unit are more common in patients who have high GRACE score values after AIM. Conclusion: The GRACE score can be used as an important guideline in planning the health care of patients after an acute myocardial infarction.

Early Myocardial Infarction during Chemotherapy for Testicular Cancer

2000 ◽  
Vol 86 (5) ◽  
pp. 428-430 ◽  
Author(s):  
Claude Bachmeyer ◽  
Hervé Joly ◽  
Roland Jorest
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Testicular Cancer ◽  
Causal Relationship ◽  
Chemotherapy Regimen ◽  
Significant Risk

A 36-year-old man with testicular cancer had an acute myocardial infarction during the first course of chemotherapy with bleomycin, etoposide and cisplatin. Since the patient had no significant risk factors for coronary heart disease, the infarction was likely to be attributable to the chemotherapy regimen. The physiopathological mechanisms of this causal relationship are discussed here.

Abstract 17208: Trends in Hospitalizations Due to Cocaine-Induced Acute Myocardial Infarction: Results From National Inpatient Sample, 2005-2014

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Anshul Saxena ◽  
Muni Rubens ◽  
Sankalp Das ◽  
Venkataraghavan Ramamoorthy ◽  
Peter McGranaghan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Significant Risk ◽  
The United States ◽  
Categorical Variables ◽  
Age Group ◽  
Continuous Variables ◽  
National Inpatient Sample ◽  
Medicaid Coverage ◽  
Cocaine Use

Introduction: According to the National Institute on Drug Abuse, lifetime cocaine use has remained stable since 2009. An estimated 1.5 million individuals aged ≥12 years reported cocaine use in 2014. Cocaine use is a significant risk factor for acute myocardial infarction (AMI), especially in the age group 18-45 years. Hence, we examined trends in hospitalizations due to cocaine-induced AMI in the United States. Methods: The current study was a retrospective analysis of the National Inpatient Sample, collected during the period 2005-2014. Participants between 18 and 45 years were included in the analysis. Cocaine-induced AMI hospitalizations were identified using ICD-9-CM codes 304.2X and 305.6X for cocaine dependence or abuse, and 410.XX for AMI diagnosis. We used Cochran Armitage test for categorical variables and Cuzick nonparametric test for trends for continuous variables. Results: A total of 49,715 weighted cocaine-induced AMI hospitalizations were reported during the study period. Cocaine-induced AMI hospitalizations increased from 4,619 in 2005 to 5,065 in 2014 (relative increase, 9.7%, P trend =0.124). Majority of the patients were non-White (55.3%), men (79.3%), in the age group 41-45 years (83.1%), and with Medicare/Medicaid coverage (51.2%). Highest change in trend was observed for non-White population and Medicare/Medicaid payers. Conclusion: Our study showed that cocaine-induced AMI hospitalizations remained stable during the years 2005-2014. Initial results point towards structural and racial disparities in such hospitalizations, especially among non-White men and population with Medicare/Medicaid coverage. Effective interventions to reduce cocaine use are needed, and treatment must be based on 2008 AHA guidelines for cocaine-associated chest pain and myocardial infarction.

scholarly journals Sudden Death of a Pregnant Woman in Third Trimester with No Risk Factor

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Asli Goker ◽  
Melek Civi ◽  
Ozgur Bayturan ◽  
N. Kemal Kuscu
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Healthy Woman ◽  
Respiratory Arrest ◽  
Clinical Approach ◽  
Third Trimester ◽  
Life Threatening ◽  
In Pregnancy

Acute myocardial infarction in pregnancy is rare and life-threatening for both the mother and the fetus. We present the case of a 31-year-old previously healthy woman with no risk factors at 32 weeks of gestation who applied with vomiting, dyspnea and orthopnea. A respiratory arrest developed followed by loss of the fetal viability, cardiac arrest, and failure of resuscitation. We aim to raise awareness about the clinical approach to pregnant patients who are to be considered with a broad spectrum of differential diagnosis.

scholarly journals Predictors of lethality in young patients with acute myocardial infarction

2017 ◽  
Vol 95 (8) ◽  
pp. 713-718
Author(s):  
A. A. Garganeeva ◽  
Kseniya N. Borel ◽  
S. A. Okrugin ◽  
E. A. Kuzheleva
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Patients ◽  
Adverse Outcomes ◽  
Medical Community ◽  
Early Evaluation ◽  
Risk Of Death ◽  
Group 2 ◽  
Group 1

The profile and combination of risk factors vary among patients with acute myocardial infarction (AMI) in different age groups. Their screening may help to improve prognosis in a young population. Aim. To identify the predictors of lethality in young patients with AMI. Material and methods. Using the data from the acute myocardial infarction registry, two groups of patients under 45 years were formed: deceased (group 1) and survivors (group 2) after AMI. Results. Patients in group 1 were younger than in group 2. Atypical pain syndrome or syncope were documented in 21,1% of the patients in group 1. For patients who died in different hospitals (n=13), duration of period between pain onset and ambulance call and between ambulance call and arrival were shorter in group 1. Only 38,5% of them were delivered to specialized units. The fraction of patients admitted to cardiological departments among survivors was 93,3% (p<0.001). Some patients of both groups reported changes in the state of health before AMI. In group 1, they often were nonspecific (weakness, blood pressure changes etc.). The risk of death for smokers was twice that for non-smokers. Hospitalization in a specialized hospital as well as timely seeking medical aid in case of unstable angina increased the chance of survival. Conclusions. An early appeal for help is very important for young patients with new/worsening symptoms threatening rapid onset of death. As far as patients having no histories of coronary disorders are concerned, efforts of the medical community should be focused on extensive screening of risk factors and their effective correction with the development of stratification scales for the early evaluation of the likelihood of adverse outcomes.

scholarly journals Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044564
Author(s):  
Kaizhuang Huang ◽  
Jiaying Lu ◽  
Yaoli Zhu ◽  
Tao Cheng ◽  
Dahao Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Factor ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Cochrane Library ◽  
Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

The Role of Uric Acid in the Acute Myocardial Infarction: A Narrative Review

Angiology ◽  
2021 ◽  
pp. 000331972110125
Author(s):  
Atalay Demiray ◽  
Baris Afsar ◽  
Adrian Covic ◽  
Masanari Kuwabara ◽  
Charles J. Ferro ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Uric Acid ◽  
Adverse Outcomes ◽  
Narrative Review ◽  
Background Information ◽  
Pathophysiological Role ◽  
Artery Disease ◽  
Pathologic Processes

Increased serum uric acid (SUA) levels have been associated with various pathologic processes such as increased oxidative stress, inflammation, and endothelial dysfunction. Thus, it is not surprising that increased SUA is associated with various adverse outcomes including cardiovascular (CV) diseases. Recent epidemiological evidence suggests that increased SUA may be related to acute myocardial infarction (AMI). Accumulating data also showed that elevated UA has pathophysiological role in the development of AMI. However, there are also studies showing that SUA is not related to the risk of AMI. In this narrative review, we summarized the recent literature data regarding SUA and AMI after providing some background information for the association between UA and coronary artery disease. Future studies will show whether decreasing SUA levels is beneficial for outcomes related to AMI and the optimum SUA levels for best outcomes in CV diseases.

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