scholarly journals Effectiveness of thrombolytic therapy in patients with acute myocardial infarction within 12 hours of symptoms

2020 ◽  
Vol 8 (6) ◽  
pp. 1985
Author(s):  
Muneer Ahmad Siddiquei ◽  
Zafar Iqbal ◽  
Majid Bashir ◽  
Mudassar Iqbal ◽  
Syed Nouman Ali ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Thrombolytic Therapy ◽  
Female Gender ◽  
St Elevation Myocardial Infarction ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
St Elevation

Background: Atherosclerotic coronary artery disease particularly myocardial infarction is the leading cause of morbidity and mortality all over the world and its incidence is also on the rise in Pakistan. This study was done to assess the effectiveness of thrombolytic therapy in patients with acute myocardial infarction and comparison between diabetics and non- diabetics.Methods: This cross sectional study was conducted at Department of Cardiology, Bahawal Victoria Hospital, Bahawalpur from January to June 2019. Total 380 patients of aged 30-70 years either male or female with diagnosis of acute ST-elevation myocardial infarction presenting within 12 hours of the onset of chest pain were selected. Patients were given thrombolytic therapy with Streptokinase 1.5 MIU over 1 hour and post therapy, efficacy was assessed.Results: Mean age of the patients was 51.37±10.08 years. Mean duration of diabetes mellitus was 5.99±3.47 years. Duration of chest pain ranged from 1 hour to 12 hours with mean duration of 4.66±2.98 hours. Out of 380 patients of MI, treatment was found effective in 202 (53.2%) patients. Female gender, type of MI, and duration of chest pain were significantly associated with reduced efficacy (p value < 0.05). Presence of hypertension, smoking, dyslipidemia or family history of MI did not alter the efficacy significantly (p>0.05) while patients having diabetes had significantly reduced efficacy (p value < 0.001).Conclusions: There is reduced effectiveness of thrombolytic therapy in diabetic patients with ST elevation myocardial infarction.

scholarly journals DIFFERENTIAL CELL COUNT AS DIAGNOSTIC AND PROGNOSTIC MARKER OF ACUTE MYOCARDIAL INFARCTION

2018 ◽  
Vol 24 (2) ◽  
pp. 175
Author(s):  
Sri Anita ◽  
Liong Boy Kurniawan ◽  
Darwati Muhadi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cell Count ◽  
Inflammatory Marker ◽  
St Elevation Myocardial Infarction ◽  
Chi Square ◽  
Cross Sectional ◽  
Differential Cell Count ◽  
Differential Cell ◽  
St Elevation

Myocardial infarction is a necrosis of myocardial cells due to lack of blood and oxygen supply caused by obstruction of coronary arteries, mostly due to atherosclerosis processes. Increased inflammatory marker level is associated with poor cardiovascular prognosis. This study was aimed to know whether leukocytes count, differential cell count and the Ratio of Neutrophils-Lymphocytes (RNL) could distinguish between types of Acute Myocardial Infarction (AMI) and to evaluate its correlation with mortality. This was a cross-sectional retrospective study using medical records patients which were diagnosed as AMI by clinicians in Cardiac Centre of the Dr. Wahidin Sudirohusodo Hospital during the period of April 1st, 2015 - May 31st, 2016. Statistical analysis used the Mann-Whitney and Chi-Square test, p<0.05 was considered as significant. The total subjects were 435 patients divided into 289 ST- Elevation Myocardial Infarction (STEMI) and 146 Non-ST-Elevation Myocardial Infarction (NSTEMI). There were significant differences in that mean of leukocytes, neutrophils, lymphocytes, monocytes, eosinophils counts and RNL between STEMI and NSTEMI (p <0.05). Significant differences were also found in leukocyte, neutrophils, lymphocytes, eosinophils, basophils and RNL mean between those who died and survived (p <0.05) and a significant correlation between increased leukocytes, neutrophils, basophils counts with mortality (p <0.05). In conclusion, the number of leukocytes and leukocyte count can be used as diagnostic markers of AMI between STEMI and NSTEMI, as well as prognostic markers among patients who died and survived. Routine blood sampling cohort studies in patients with AMI can avoid the bias of the results obtained. 

scholarly journals Gender-Related Differences of Cardiac Troponin-I Levels in Patients with Acute Myocardial Infarction at Time of Acute Chest Pain

2021 ◽  
pp. 199-205
Author(s):  
Mahir Abdulkadhum Khudhair Alzughaibi ◽  
Ammar Waheeb Obeiad ◽  
Nassar Abdalaema Abdalhadi Mera ◽  
Mohammed Sadeq Hamzah Al-Ruwaiee
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Troponin I ◽  
Statistical Significance ◽  
Acute Chest Pain ◽  
Blood Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Time Of Admission

Background: Cardiac Troponins-I (CTNI) are myoregulatory polypeptides that control the actin-myosin interface, considered specific to cardiomyocytes. Age and sex variances in the extent of CTNI levels have arisen a recent debatable emphasis. Existing revisions do not display a reliable clinical power of sex-specific CTNI 99th centiles, which actually might mirror procedural aspects. Nevertheless, from a biochemical viewpoint, the trends of sex-specific CTNI 99th centiles seem sensible for the ruling-in of acute myocardial infarction AMI. Vulnerable females may be missed when applying the male sex-specific threshold. This study aimed to determine whether gender differences in CTNI exist in patients with AMI presented with chest pain. Methodology: The study was a cross-sectional, single-center, included 236-patients with AMI diagnosis by cardiologists at Merjan teaching hospital during the period from April to July 2020 from patients attending the hospital for cardiac consultation complaining of acute chest pain suggestive of AMI. Blood analysis had initiated at the time of admission included serum creatinine, blood urea, R/FBS, WBCs, PCV, and serum CTNI. A p-value below 0.05 specifies statistical significance. All statistical bioanalyses had performed by IBM-SPSS, version-25 for Windows. Results: The mean age of participants was 67.5 years, the men were dominant 76.2%. The incidence of DM and hypertension were significantly high and 24.5% of the patients were current smokers. Biochemical serum analysis revealed mean creatinine, urea, sugar, and STI values were 79.8±4.2 mmol/l, 15.9±1.7 mmol/l, 10.9±0.9 mmol/l, and 7.9±0.6 ng/ml separately. Both hypertension and smoking were significantly (p-0.001) more among males compared to the females, which is not the case for the prevalence of DM. The males were heavier significantly than females (p-0.001). Almost, there was no impact of gender on most of the other study variables other than serum TNI levels, which were significantly higher among the males (p-0.001). Conclusion: In patients with AMI presented with acute chest pain, the routine of CTNI in the diagnosis of AMI is based on the patient's gender. The application of gender-dependent cutoff levels for CTNI analyses appears to be highly suggested.

THROMBOLYTIC EFFICACY OF STREPTOKINASE IN ELDERLY TYPE 2 DIABETES MELLITUS WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION USING ELECTROCARDIOGRAPHIC ST-SEGMENT RESOLUTION

2021 ◽  
pp. 67-70
Author(s):  
Mahendra Pratap ◽  
Somil Verma ◽  
S. L. Mathur
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patients ◽  
Thrombolytic Therapy ◽  
Care Center ◽  
Tertiary Care ◽  
St Elevation Myocardial Infarction ◽  
Diabetic Patients ◽  
Common Location ◽  
St Segment ◽  
St Elevation

Background: Age and diabetes are important prognostic factors in patients with acute ST-elevation myocardial infarction (STEMI) undergoing thrombolysis. In our study we compared the post-thrombolytic effect of streptokinase in elderly diabetic and non-diabetic patients. Methods: A prospective observational study was conducted in tertiary care center of India in which 140 elderly patients diagnosed with STEMI and undergoing thrombolytic therapy with streptokinase were enrolled after making necessary exclusions and were divided into diabetic (n=70) and non-diabetic (n=70) as study and control groups respectively. ECG was done immediately before and at 60 minutes after thrombolytic therapy. ST-segment resolution was measured and patients were classied as failed (<30%), partial (30-70%) and successful (>70%) resolution of STsegment. Results: Failed thrombolysis was evident in 34.3% non-diabetic and 57.1% diabetic patients (p=0.010). The incidence of successful thrombolysis was present in 41.4% non-diabetic and 28.6% diabetic patients, whereas partial thrombolysis was seen in 24.3% non-diabetic and 14.3% diabetics. Anterior wall was the most common location of infarction in elderly population but the proportion was higher in diabetics than non-diabetics (p=0.025). Conclusion: Failed thrombolysis with streptokinase was higher in diabetics than in non-diabetics after 60 minutes of streptokinase infusion in elderly patients warranting the need of using another cost effective and easily available agent for elderly diabetic population.

2200Predictors of patient decision time in ST elevation myocardial infarction data from an observational cross sectional survey study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ericsson ◽  
I Thylen ◽  
K Hellstrom Angerud ◽  
E Swahn ◽  
A Stromberg ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Services ◽  
Female Gender ◽  
Decision Time ◽  
St Elevation Myocardial Infarction ◽  
Survey Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Early Action ◽  
St Elevation

Abstract Background Short time from symptom onset until reperfusion is imperative in ST-elevation myocardial infarction (STEMI). System delay has been successfully shortened but patients delay has had less favorable development. The aim of this study was to find out clinical, contextual, behavioral and cognitive factors associated with decision time in STEMI. Method SymTime was a multicenter observational cross-sectional self-reported survey study performed at five Swedish hospitals representing geographic diversity. Early and late action was defined as decision to seek care <20 min and >90 min, respectively. Results 532 patients were included. Among those 19.5% called Emergency Medical Services (EMS) as first medical contact (FMC) within 20 min, whereas 10.7% acted within 20 min, but did not call EMS as FMC. Twenty-eight % called EMS as FMC, but delayed >20 min and 41.7% neither acted promptly, nor called EMS as FMC. Predictors associated with decision time OR 95% CI Factors associated with decision time <20 min   Previous AF 0.43 0.19–0.94   Believing the symptoms originated from the heart 3.10 1.93–4.96   Symptoms waxing and waning 0.58 0.36–0.94   Getting STEMI off hours 0.66 0.45–0.97   Bystanders calling or recommending EMS (Emergency Medical Services) contact 1.67 1.07–2.59   Bystanders calling or recommending SHD (Swedish healthcare Direct) contact 0.56 0.37–0.85 Factors associated with decision time >90 min   Female gender 1.67 1.06–2.62   Diaphoresis 0.67 0.46–0.998   Nausea 0.60 0.36–0.998   Stomach pain 0.46 0.23–0.91   Believing the symptoms originated from the heart 0.46 0.32–0.68   Getting STEMI off hours 1.68 1.16–2.14   Low educational level 0.58 0.40–0.86   Bystanders calling or recommending EMS contact 0.45 0.30–0.67 Variable significant at the p 0.05 presented. Conclusion Surprisingly, no specific symptom or severity of symptom were associated with early action, neither age, nor gender. Instead correct interpretation of symptoms and bystanders assisting were factors associated with early action. Frightening symptoms such as diaphoresis was negatively associated, whereas female gender and getting MI off hours were positively associated with late action.

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

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.

scholarly journals A Comparative Study of St Segment Resolution between Diabetic and Non-Diabetic ST Segment Elevation Myocardial Infarction Patients following Streptokinase Thrombolysis

2019 ◽  
Vol 11 (2) ◽  
pp. 118-122
Author(s):  
Shahriar Iqbal ◽  
M Saiful Bari ◽  
MA Bari ◽  
Mirza Md Nazrul Islam ◽  
M Abdullah Al Shafi Majumder ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
St Elevation Myocardial Infarction ◽  
Diabetic Patients ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
St Elevation ◽  
Prolong Hospital Stay

Background: One of the most effective and used (in our settings) methods of reperfusion of ST elevation myocardial infarction (STEMI) is administration of streptokinase (SK) infusion. This study was conducted with the aim to compare ST segment resolution between diabetic and non-diabetic patients with ST segment elevation myocardial infarction after thrombolysis by streptokinase. Methods: A total of 100 patients with ST elevation myocardial infarction with or without diabetes mellitus were studied from December 2016 to November 2017. Among these half of patients were diabetic while rests were non-diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 min of streptokinase administration. Results: Failed reperfusion (<30% ST resolution) was significantly higher in diabetic as compared to nondiabetic patients (42% vs. 12%, p <0.001). In hospital complications were more in diabetic patients who has failed reperfusion following streptokinase thrombolysis. Cardiogenic shock occurred in 44% and acute LVF in 30% patients and EF (46.54%) was significantly lower in diabetic patients and higher number of diabetic patients had prolong hospital stay than non-diabetic patients with STEMI. Conclusion: The outcome of thrombolytic therapy is adversely affected by diabetes mellitus in patients with ST-elevation myocardial infarction. Cardiovasc. j. 2019; 11(2): 118-122

Prevalence of Low Circulatory Vitamin D Levels in Patients with Acute Myocardial Infarction - A Cross Sectional Study from a Tertiary Care Centre in Kozhikode, Kerala

2021 ◽  
Vol 8 (30) ◽  
pp. 2804-2810
Author(s):  
Nasreen Edavanam Kunnath ◽  
Muhammed Ashraf Kayakkal ◽  
Shaji Sreedhar ◽  
Geetha Panarkandy ◽  
Sandeep Appunni
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Vitamin D ◽  
Risk Factor ◽  
Vitamin D Deficiency ◽  
Troponin I ◽  
St Elevation Myocardial Infarction ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
St Elevation

BACKGROUND Vitamin D deficiency continues to be an unrecognized health disorder globally while ischemic heart disease (IHD) is the leading cause of premature mortality. Many recent studies have found high rates of cardiovascular diseases among patients with low vitamin D levels. Due to limited randomized control trials, it is reasonable to screen acute myocardial infarction (AMI) patients for vitamin D deficiency. Thus, the study aims to find out as to whether vitamin D deficiency is a risk factor for AMI and evaluate the association between their troponin I and vitamin D levels. METHODS In this cross-sectional study, cases included patients admitted with myocardial infarction in the medicine wards or ICU while controls were age and sex matched apparently healthy subjects. Detailed history was taken about duration of the illness and other significant medical illness. Serum troponin I (Trop I) levels and electrocardiogram (ECG) reports were assessed. Serum samples for 25- hydroxyvitamin D [25(OH)VitD] estimation by electrochemiluminescence method, were collected from both cases and controls. Statistical analysis was performed using SPSS version 22.0 software. RESULTS The mean 25(OH)VitD levels were found to be significantly lesser in cases [20.98 ± 6.29 ng/ml] as compared to controls [27.13 ± 10.50 ng/ml], further decreased in ST-elevation myocardial infarction (STEMI) (17 %) subjects [15.70 ± 4.43 ng/ml] as compared to non-ST elevation myocardial infarction (NSTEMI) (83%) [22.06 ± 6.10 ng/ml]. There exists a significant moderate negative correlation [ρ = -0.46] between troponin I levels and 25(OH)VitD levels in AMI. CONCLUSIONS Vitamin D deficiency hence can be a risk factor for development of myocardial infarction. But already established risk factors confounds to state it as an independent risk factor. KEYWORDS Acute Myocardial Infarction, 25-Hydroxyvitamin D, Troponin I, ST-Elevation myocardial infarction, Non-ST Elevation myocardial infarction

scholarly journals Acute Myocardial Infarction in Snake bite Envenomation – A Case Report

2015 ◽  
Vol 16 (1) ◽  
pp. 46-47
Author(s):  
NS Neki
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Rare Complication ◽  
Snake Bite ◽  
St Elevation Myocardial Infarction ◽  
History Of ◽  
Electrocardiographic Changes ◽  
St Elevation

Snake bite envenomation is a common problem in tropical countries, especially in rural parts of India. We came across a 30 year old male who presented to the hospital after 4 hours with history of Russell’s viper snake bite developing acute non ST elevation myocardial infarction (MI). Myocardial infarction was confirmed by history of left sided chest pain radiating to left arm with diaphoresis and electrocardiographic changes with increased serum troponin levels. Myocardial infarction is a rare complication of snake bite hence case report.DOI: http://dx.doi.org/10.3329/jom.v16i1.22401 J MEDICINE 2015; 16 : 46-47

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