scholarly journals ACUTE MYOCARDIAL INFARCTION;

2018 ◽  
Vol 21 (02) ◽  
pp. 258-263
Author(s):  
Mukhtiar Hussain Jaffery ◽  
Khalida Shaikh ◽  
Ghulam Hussain Baloch ◽  
Syed Zulfiquar Ali Shah

Objective: This descriptive case series study evaluates the frequency ofhypomagnesemia in patients with acute myocardial infarction. Patients and methods: Thismultidisciplinary conducted at Liaquat University Hospital Hyderabad and a private hospitalHyderabad from May 2010 to October 2010. All patients diagnosed as acute myocardialinfarction were further evaluated for type of myocardial infarction and serum magnesium level.Results: Out of 100 diabetic patients, 77 were males and 23 patients were females. The meanage and standard deviation of patients of male and female was 54.78 ± 8.82 (SD) and 53.64 ±10.82 (SD), respectively. The mean ± SD for serum magnesium in overall subjects was 1.24±0.48. Regarding the type of AMI inferior wall in 22 (29%), lateral wall in 17 (22%), anteroseptal in12 (16%), anterolateral -V1 in 07(09%), right ventricular in 10 (13%) and posterior wall in 07 (09%).The mean duration of acute MI in male and female population was 8.71±6.73 hours and17.70±14.57 hours (p<0.01) where as the mean duration of acute MI in hypomagnesemic andnormomagnesemic patient was 5.16±2.49 hours and 26.60±8.27 (p = 0.02) respectively. Themean serum magnesium level in male as well as female population was 1.32 ±0.21 mg/dl and1.46± 0.53 mg/dl p = 0.05, respectively. Regarding the hypomagnesemia in male and femalepopulation was 34(75.6%) and 16(53.3%) p=0.04, respectively. The hypomagnesemia was morepredominant in inferior 18(36.0%) and lateral 16 (32.0%) wall MI. Conclusions: Thehypomagnesemia was observed in patients with acute myocardial infarction with statisticalsignificance

Author(s):  
M. Poorna Chandran ◽  
J. Kumanan

Background: Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complication like arrhythmia. Magnesium improves myocardial metabolism, inhibits calcium accumulation and myocardial cell death. Objective was to know the relationship between the serum magnesium levels and arrhythmias in patients with acute myocardial infarction.Methods: It was a hospital based cross sectional study. By using simple random method, 50 cases of acute myocardial infarction, admitted in a tertiary care hospital in Chennai for the period of two years. Simple descriptive analysis was done to find out frequencies and percentages. For the test of significance the Chi-square test was used.Results: In our study group of 50 subjects, 28 (56%) of patients developed arrhythmias and 22 (44%) of patients recovered without any complications. Variation in type of Myocardial Infarction among our study 50 patients were 22 (44%) had anterior wall MI, 21 (42%) patients had Inferior wall MI and 7 (14%) patients had anteroseptal MI. The mean Mg level for the arrhythmias patients for the day 1 and day 5 were 1.70±0.16 and 1.76±0.51 and 2.10±0.19 and for patients without arrhythmias 2.26±0.20. There is a significant difference in the magnesium levels in patients with arrhythmias and without arrhythmias.Conclusions: In acute myocardial infarct ion, patients with low magnesium levels are more prone to get arrhythmias. So magnesium treatment can be considered in patients of acute myocardial infarct ion with low magnesium levels.


2018 ◽  
Vol 5 (5) ◽  
pp. 1138
Author(s):  
Jella Ramdas ◽  
Vasantha Jella

Background: Acute myocardial infarction is one of the very common ailments, that quite often ends in mortality. The risk factors for AMI has been identified as smoking, alcoholism, high cholesterol, obesity, left ventricular hypertrophy, high triglyceride levels and diabetes mellitus. This study was done to evaluate diabetes as a risk factor for the incidence of acute myocardial infarction in our area.Methods: Demographic details such as age, sex, height, weight, BMI, blood pressure, details of alcoholism or smoking were taken. Physical examination was conducted for all the patients. Previous clinical and medical history was taken for all the patients. The predictors for calculation of 10 years risk factor for SCORE were age, sex, smoking, cholesterol and triglyceride levels and blood pressure.Results: The mean age of the males was 66.1±2.7 and women was 68.8±4.9. 27.3% of the males and 29.4% of the females were obese while 34.6% of males and 32.4% of females were overweight. The mean random blood sugar among the diabetic patients was around 143.5 mg/dL, and in the non-diabetics it was 84.4mg/dL. Out of the 48 diabetic patients, 32 of them (66.7%) had a previous history of MI while in non-diabetes, 53.7% had a previous MI attack.Conclusions: It is essential for the early detection of diabetes and control of the sugar levels, so as to reduce the risk of cardiovascular ailments, since diabetes is one of the independent risk factors.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marianne Zeller ◽  
Claudia Korandji ◽  
Jean-Claude Guilland ◽  
Pierre Sicard ◽  
Catherine Vergely ◽  
...  

Background . From a prospective cohort of patients with acute myocardial infarction (MI), we aimed to analyse the predictive value of ADMA concentrations on mortality at 1 year follow-up. ADMA is an endogenous competitive inhibitor of NO synthases. Patients . Blood samples from 204 consecutive patients hospitalised for acute MI < 24 hr were taken on admission. Serum levels of ADMA, its stereoisomer, symmetric dimethylarginine (SDMA), were determined using high-performance liquid chromatography and fluorescence. Results . The mean (SD) ADMA level was 1.07(0.37) μmol/L. ADMA was positively related to age, homocysteine, SDMA and L-arginine. The glomerular filtration rate (GFR) showed a trend toward an inverse relation with ADMA. ADMA concentrations showed a trend towards a higher level in women than in men (p=.101) and were lower in current smokers vs past or non smokers (p=0.022). Baseline ADMA and SDMA levels were higher in patients who had died than in patients who were alive at 1 year follow-up (respectively 1.22(1.06–1.54) vs 0.98(0.78–1.24), p=0.012 and 0.77(0.54–1.03) vs 0.47(0.35–0.64), p<0.001). By Cox stepwise multivariate analysis, high levels of ADMA were one of the strongest predictors for mortality (HR(95%CI), 6.63(2.55–17.21)), even when adjusted for potential confounders, such as biological and clinical factors, and reperfusion. In contrast, SDMA failed to independently predict the outcome (HR(95%CI): 1.88(0.33–10.70). Conclusion . Our study suggests that measurement of ADMA levels at baseline improves cardiovascular risk prediction after acute MI, beyond traditional risk factors and biomarkers. ADMA may thus constitute a novel and useful marker for risk stratification in acute MI.


2020 ◽  
Vol 14 (2) ◽  
pp. 71-73
Author(s):  
Mohammad Rezaul Quader ◽  
Sharmin Rahman ◽  
Nasima Sultana ◽  
Suranjit Kumar Saha

Dyslipidemia is an established risk factor of acute myocardial infarction (AMI), but measurement of macro metals like magnesium can be helpful in the prevention and better management of AMI. The aim of this study was to estimate serum magnesium in AMI. This is a case control type of study carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka during the period of January 2015 to December 2015 with a total number of 100 study subjects. Acute myocardial infarction patients were selected as case (50) from coronary care unit (CCU), Department of Cardiology, Dhaka Medical College Hospital. Normal healthy individuals were selected as control (50) from the attendants of patients, relatives and doctors. Serum level of magnesium were assessed for both case and control groups. The mean values of the variable were compared between them by statistical analysis using SPSS version 16. For all the statistical analysis P<0.05 was considered as significant. The mean values of serum magnesium were 1.63±0.27mg/dl in cases. The mean values of serum magnesium were 2.35±0.28 mg/dl in control group. Significant differences were found in mean values between case and control groups and differences were highly significant (p<0.001). In AMI, serum magnesium level was found to be lower in this study. Serum magnesium is an important trace element that act as cofactor in many biochemical reactions. Decrease level of this important trace element may contribute to pathogenesis of AMI. So with other biochemical risk parameters, routine assessment of serum magnesium level is advocated, which might be helpful for prevention and better management of AMI. Faridpur Med. Coll. J. Jul 2019;14(2): 71-73


Author(s):  
Bapugouda Sahebagouda Patil ◽  
Naser Ashraf Tadvi

Background: Sulfonylureas are primarily used in the treatment of diabetes mellitus act by inhibiting ATP sensitive potassium ATP (K-ATP) channels. Similar channels are also present are also present in heart venticular muscle. Previous studies reveal that these drugs are able to reduce the electrocardiographic ST- segment elevation changes during an acute myocardial infarction. Hence, the present study was designed to evaluate the attenuating effect of sulfonylureas on ST- segment elevation in diabetic patients presenting with acute myocardial infarction.Methods: This cross sectional study included 73 diabetic patients presenting with the signs and symptoms of acute myocardial infarction of less than 24 hours duration along with CPK levels of more than 25 IU/L. Of them 5 were excluded from the study. The remaining 68 patients were included in the study, out of which 36 patients were in the study group (sulfonylurea group), and 32 patients were in the control group (non-sulfonylurea group).Results: No statistically significant difference was seen in the demographic parameters like age, sex, duration of diabetes mellitus and CPK levels (p>0.05). Among 68 patients 38 patients were diagnosed as STEMI. The mean magnitude of ST-elevation in the study group (n=16) was 2.3±0.12 and in control group (n=22) patients it was 3.7±0.33. The percentage of NSTEMI was significantly higher in study group compared to control. Statistically significant difference (p<0.05) was seen only between CPK level of range 25 and 100IU/L and mean magnitude of ST-segment elevation in STEMI patients. Significant difference in the mean magnitude of ST-segment elevation was observed in case of females among the study and control groups (p<0.05).Conclusions: Sulfonylureas drugs play a significant role in attenuation of ST-segment in diabetic patients presenting with acute myocardial infarction. Further, large multicentric studies are required to confirm the exact correlation between sulfonylureas and ST-segment.


2015 ◽  
Vol 14 (2) ◽  
pp. 186-189
Author(s):  
Md Ashraf Ali ◽  
Dilara Alo ◽  
Md Abdul Latif Molla

Aim: The aim of the study was to observe the epidemiology and pattern of fascicular block following ST elevated acute myocardial infarction (AMI).Background: Fascicular block following S-T elevated acute myocardial infarction is often seen in CCU. It predicts poorer in-hospital outcome and signifies underlying extensive myocardial damage with jeopardized conducting system.Materials and Method: This one year prospective observational study was carried out among the S-T elevated AMI patients in the CCU of NICVD during the period of January 2004 to December 2004. Hundred consecutive patients of first attack of AMI with or without fascicular block were included in this study. The patients suffering from congenital heart disease, cardiomyopathy, valvular heart disease and the patients having permanent pacemaker or preexisting syndrome were excluded from the study. Case selection was done with the help of history, physical examination, twelve leads surface ECG and echocardiography.Results: The mean age of the studied patients was 54.2±10.0 years. Highest percentage (38%) was in the age group 51-60 years. The mean age of male Patients was 51.0±9.9 years. Analysis reveals that the mean age of the female patients was significantly higher than the male patients. Among the studied patients, highest percentage had history of smoking 67% followed by hypertension (39%), diabetes mellitus (39%) etc. Among the studied patients 66% had anterior MI and 34% had inferior MI. Highest percentage of patients presented with isolated RBBB (54.0%), followed by LBBB (18%), bi-fascicular (16.0%), tri-fascicular block (8.0%) and isolated LAHB (4.0%). Among the patients with anterior MI, highest percentage presented with RBBB (42.4%) followed by bi-fascicular block (24.2%), LBBB (15.2%) and LAHB (6%) whereas with inferior MI, 76.5 percentage had RBBB followed by LBBB (23.5%).Conclusion: In this study majority of the patients were male. Most of the patients were in the age group 50-60 years. Number of anterior MI was higher (66%) than inferior MI (34%). Anterior MI showed highest incidence of fascicular block than inferior MI which is statistically significant. Among the fascicular blocks, RBBB was the highest (54.0%) and next common fascicular block was LBBB, least common was LAHB. Left posterior hemi-block was not found in this study. Statistical variation among the different types of fascicular blocks observed in this study was significant. Smoking was the most important risk factor. So, fascicular blocks following acute MI are more prone to develop complications than acute MI without fascicular block. Message is that patient with fascicular blocks following acute MI needs special care and treatment.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.186-189


1993 ◽  
Vol 69 (04) ◽  
pp. 321-327 ◽  
Author(s):  
E Seifried ◽  
M Oethinger ◽  
P Tanswell ◽  
E Hoegee-de Nobel ◽  
W Nieuwenhuizen

SummaryIn 12 patients treated with 100 mg rt-PA/3 h for acute myocardial infarction (AMI), serial fibrinogen levels were measured with the Clauss clotting rate assay (“functional fibrinogen”) and with a new enzyme immunoassay for immunologically intact fibrinogen (“intact fibrinogen”). Levels of functional and “intact fibrinogen” were strikingly different: functional levels were higher at baseline; showed a more pronounced breakdown during rt-PA therapy; and a rebound phenomenon which was not seen for “intact fibrinogen”. The ratio of functional to “intact fibrinogen” was calculated for each individual patient and each time point. The mean ratio (n = 12) was 1.6 at baseline, 1.0 at 90 min, and increased markedly between 8 and 24 h to a maximum of 2.1 (p <0.01), indicating that functionality of circulating fibrinogen changes during AMI and subsequent thrombolytic therapy. The increased ratio of functional to “intact fibrinogen” seems to reflect a more functional fibrinogen at baseline and following rt-PA infusion. This is in keeping with data that the relative amount of fast clotting “intact HMW fibrinogen” of total fibrinogen is increased in initial phase of AMI. The data suggest that about 20% of HMW fibrinogen are converted to partly degraded fibrinogen during rt-PA infusion. The rebound phenomenon exhibited by functional fibrinogen may result from newly synthesized fibrinogen with a high proportion of HMW fibrinogen with its known higher degree of phosphorylation. Fibrinogen- and fibrin degradation products were within normal range at baseline. Upon infusion of the thrombolytic agent, maximum median levels of 5.88 μg/ml and 5.28 μg/ml, respectively, were measured at 90 min. Maximum plasma fibrinogen degradation products represented only 4% of lost “intact fibrinogen”, but they correlatedstrongly and linearly with the extent of “intact fibrinogen” degradation (r = 0.82, p <0.01). In contrast, no correlation was seen between breakdown of “intact fibrinogen” and corresponding levels of fibrin degradation products. We conclude from our data that the ratio of functional to immunologically “intact fibrinogen” may serve as an important index for functionality of fibrinogen and select patients at high risk for early reocclusion. Only a small proportion of degraded functional and “intact fibrinogen”, respectively, is recovered as fibrinogen degradation products. There seems to be a strong correlation between the degree of elevation of fibrinogen degradation products and the intensity of the systemic lytic state, i.e. fibrinogen degradation.


1966 ◽  
Vol 16 (03/04) ◽  
pp. 752-767 ◽  
Author(s):  
J. R O’Brien ◽  
F. C Path ◽  
Joan B. Heywood ◽  
J. A Heady

SummaryMethods for measuring and comparing day to day differences in the response of platelet aggregation in platelet-rich plasma to added ADP, 5-H.T., adrenaline and collagen are reported. Platelet aggregation induced by ADP, 5-H.T. and adrenaline was studied in patients with acute myocardial infarction and in others 3 months to 5 years after an infarct; some were receiving anti-coagulants and others not: these three groups were compared with three control groups. The mean platelet shape was rounder and the response to ADP and to 5-H.T. and one parameter of the response to adrenaline was significantly greater in all groups of patients with myocardial infarct taken together than in the controls. The platelet-rich plasma from patients with recent infarction were most responsive to ADP and 5-H.T. immediately after the infarct. Anti-coagulants had no effect on these tests. However, there was wide variation within the individuals and much overlap between groups, and these tests can only reliably distinguish between groups and not between individuals. The significance of these findings is discussed.


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