scholarly journals Association of Risk Factors and Glycemic Status in Hospital Patients of Different Types of Myocardial Infarction in a Tertiary Care Hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 3-6
Author(s):  
Aparna Rahman ◽  
Md Babul Miah ◽  
Shabnam Jahan Hoque ◽  
Md Zahid Alam ◽  
SM Rezaul Irfan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Glucose ◽  
Hba1c Level ◽  
Fasting Blood Glucose ◽  
Care Hospital ◽  
Glycemic Status ◽  
Significant Difference ◽  
Different Types ◽  
St Elevation

Background: Glycometabolic state at hospital admission is an important risk marker for long-term mortality in patients with acute myocardial infarction. Our aim was to ascertain the associated risk factors and glycemic status in patients with different types of myocardial infarction, and to assess whether such abnormalities can be identified in the early course of myocardial infarction.Methodology: This cross sectional observational study was carried out enrolling 100 subjects with ST elevation (42 subjects) and non ST elevation (58 subjects) myocardial infarction, in the Department of Cardiology, BIRDEM General Hospital, Shahbagh, Dhaka, over a period of six months from January 2012 to June 2012. We did fasting blood glucose and glycatedhaemoglobinA1C (HbA1C) level next day following admission with or without history ofdiabetes mellitus and observed the difference between two types of myocardial infarction (ST elevation and non ST elevation ).Results: Mean age and gender difference was significant between ST elevation and non ST elevationmyocardial infarction. Significant differences in pre-existing risk factors such as Diabetes (95.2%,vs 86.2% ), Dyslipidemia (72.91%, vs 44.82%), Hypertension (79.16%, vs 36.2%) and family history of Ischemic Heart Disease(75%, vs 29.31%) were observed between ST elevation and non ST elevation groups. It was revealed that mean fasting blood glucose (FBG) in ST elevation and non ST elevation was 10.23 mmol/l and 8.42 mmol/l respectively. Mean HbA1C level was 9.2% and 8.9% in ST elevation and non ST elevation. Significant difference in fasting blood glucose and HbA1C was observed between ST elevation and non ST elevation group.Conclusion: Glycemic status is relatively more uncontrolled in ST elevated MI and must be managed with all possible therapeutic modules to minimize further complications.Bangladesh Crit Care J March 2017; 5(1): 3-6

scholarly journals Influence of Maternal Glycemic Status (HbA1c) at Delivery and Risk of Hypoglycemia in Infants of Diabetic Mothers

2012 ◽  
Vol 2 (2) ◽  
pp. 84-88
Author(s):  
Mst Nurun Nahar Begum ◽  
M Quamrul Hassan ◽  
Maherun Nessa ◽  
Kishwar Azad
Keyword(s):  
Blood Glucose ◽  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
Good Control ◽  
Significant Negative Correlation ◽  
Glycemic Status ◽  
Infants Of Diabetic Mothers ◽  
Significant Difference ◽  
Control Study ◽  
Diabetic Mothers

Objective: To examine the influence of maternal HbA1c level at delivery and risk of hypoglycemia in infants of diabetic mothers. Method: This case-control study was done with sixty neonates born to diabetic mothers in BIRDEM hospital. Out of sixty neonates, 30 neonates who developed hypoglycemia during the first 24 hours of age were considered as cases and another 30 neonates who did not develop hypoglycemia during the first 24 hours were considered as controls. Maternal glycemic status was examined by measurement of Glycosylated hemoglobin (HbA1c) and level of <6 % considered good control. Babies were screened for hypoglycemia at birth, then 4, 6, 8, 12, 18 and 24 hours of life. Blood glucose value of less than 2.6 mmol/l was considered as hypoglycemia. Results: Clinical characteristics of newborns and their mothers of cases and controls did not show any significant difference. In majority of cases (73.3%) hypoglycemia was detected by 6 hours of age. Most of babies were asymptomatic (93.3%). Majority of mothers (76.7%) in controls and 46.7% of were in good glycemic controls (HbA1c <6%). The mean HbA1c level of mothers of cases was significantly higher than that of control mothers (6.02 ± 0.98 vs 5.44 ± 0.78; P = 0.014) and significant negative correlation between maternal HbA1c and blood glucose level of neonates ( r=0.422 p= 0.001). Conclusion: There is an association between maternal HbA1c level and neonatal hypoglycemia in infants of diabetic mothers.DOI: http://dx.doi.org/10.3329/birdem.v2i2.12308 (Birdem Med J 2012; 2(2): 84-88)

scholarly journals Relationship between Random Blood Glucose, Fasting Blood Glucose, and Gensini Score in Patients with Acute Myocardial Infarction

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Yuhan Qin ◽  
Gaoliang Yan ◽  
Yong Qiao ◽  
Changle Ma ◽  
Juchuan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Glucose ◽  
Coronary Angiography ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Multiple Logistic Regression ◽  
Gensini Score ◽  
Stress Hyperglycemia ◽  
Independent Risk Factors

Objective. To examine the relationship between admission random blood glucose (RBG), fasting blood glucose (FBG), and Gensini score in patients with acute myocardial infarction (AMI) to clarify the effects of RBG and FBG on the severity of coronary artery disease. Method. A total of 958 consecutive AMI patients who underwent emergency coronary angiography at the Cardiology Department of Zhongda Hospital (affiliated with Southeast University) were enrolled in this study from January 1, 2016, to December 31, 2018. The Gensini score of each patient was calculated according to the results of coronary angiography. The RBG, FBG, baseline data, hematological indexes, echocardiography parameters, coronary angiography data, and the use of intra-aortic balloon pump (IABP) were recorded. Patients with an RBG level >11.1 mmol/L were classified into the stress hyperglycemia group, and those with an FBG level >7.0 mmol/L were classified into the elevated FBG group. The Gensini scores in the stress hyperglycemia and elevated FBG groups were compared to those in the control group, and correlations between the RBG and FBG levels and the Gensini scores of AMI patients were evaluated. Independent risk factors for the Gensini score were analyzed by multiple linear and multiple logistic regression analyses. Results. The Gensini scores of the stress hyperglycemia group and the elevated FBG group were higher than those of the control group. RBG and FBG were positively correlated with the Gensini score, and there were significant differences between RBG and FBG in different Gensini score groups. After adjusting for confounding factors, multiple linear regression analysis showed that sex, diabetes, estimated glomerular filtration rate (eGFR), and FBG were independent risk factors for the Gensini score. Multiple logistic regression analysis showed that age and FBG were independent risk factors in group 2 compared to group 1, eGFR and FBG were independent risk factors in group 3, and eGFR and FBG were independent risk factors in group 4. Diabetes and RBG were not independent risk factors for the Gensini score. Conclusion. The Gensini scores of patients in the stress hyperglycemia group and the elevated FBG group were significantly higher than those in the control group. RBG and FBG were positively correlated with the Gensini score in AMI patients, and FBG was an independent risk factor for the Gensini score in AMI patients.

Frequency of Modifiable and Non-Modifiable Risk Factors of ST elevation Myocardial Infarction at Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 3040-3042
Author(s):  
Mubashir Kolachi ◽  
Zahid Naseeb Ansari ◽  
Tahir Hussain ◽  
Imran Karim ◽  
Muhammad Khan Soomro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Male Gender ◽  
St Elevation Myocardial Infarction ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Type Ii ◽  
St Elevation

Objective: To determine the frequency of modifiable and non-modifiable risk factors of acute ST elevation myocardial infarction at tertiary care Hospital. Methods: This study was conducted in the department of Cardiology, Liaquat University Hospital Jamshoro, from July 2019 to January 2020. All the patients those presented with myocardial infarction and either of gender were included in the study. After taking complete clinical examination and diagnosis, patients were interviewed regarding family history, hypertension, diabetes, smoking, alcohol consumption, dietary habits and life style activities. Non modifiable predisposing risk factors were defined as age, gender and family history. Modifiable risk factors were defined as elevated serum cholesterol, presence of type II DM, cigarette smoking, obesity, a sedentary lifestyle and hypertension. All the data was recorded in self-made proforma. Data analysis was done by SPSS version 21 Results: Total 100 patients were studied; most common age group was 41-50 years (45.0%), and 51-60 years (35.0%). According to the types of myocardial infarction, Acute anterior wall MI was in 25.0%, Acute inferior MI was in 20.0%, EXT ANT WALL MI was in 16.0% and Acute inferior +RV MI was in 15.0% of patients. Elevated age in 70.0% and male gender in 69% of cases were found to be most common non-modifiable risk factors, while frequently seen Modifiable risk factors were smoking, type II diabetes, hypercholesteremia, hypertension, and physical activities. Conclusion: It was observed that elevated age, male gender, smoking, diabetes and hypertension are frequent risk factors for ST elevation myocardial infarction. Keywords: Modifiable, non-modifiable, risk factors, MI

scholarly journals The Significance of Dynamics of ST Segment Changes When Assessing the Effectiveness of Mechanical Reperfusion of the Myocardium in Hyperglycaemic Patients with Acute Myocardial Infarction with Persistent ST-Segment Elevation

2020 ◽  
pp. 1-6
Author(s):  
Marek Andres ◽  
Maciej Małecki ◽  
Ewa Konduracka ◽  
Jacek Legutko ◽  
Janusz Andres ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Glucose ◽  
Coronary Intervention ◽  
Glucose Metabolism Disorders ◽  
St Segment Elevation ◽  
Glucose Levels ◽  
St Segment ◽  
Significant Difference ◽  
St Elevation

Background: The coexistence of coronary heart disease and consequently, acute myocardial infarction with persistent ST-segment elevation (STEMI) and glucose metabolism disorders is well known. Still, glucose metabolism disorders in the STEMI population are not fully understood. We know that diabetes mellitus (DM) is a factor disabling the function of microcirculation, which in turn may affect the outcome of coronary intervention. The aim of this study was to evaluate the dynamics of ST-segment changes in ECG (electrocardiogram) in STEMI (ST-segment elevation myocardial infarction) patients with co-existing hyperglycaemia compared to those with normoglycaemia treated with a percutaneous coronary intervention (PCI), as well as to determine this parameter in the assessment of reperfusion effectiveness. Methods: The study included 92 patients with the diagnosis of STEMI enrolled in the PCI treatment and was divided into groups based on the glucose levels on admission (reactive hyperglycaemia): a group with higher glucose levels on admission (Glc ≥ 7.8 mmol/L, n = 46), a group with lower glucose levels on admission (Glc < 7.8 mmol/L, n = 46) and into groups based on the concentration of HbA1c: a group with a lower HbA1c level (<6.5% (48 mmol/mol), n=71) and a group with a higher level (≥6.5%, n=21). Results: On admission, there were no significant differences in terms of clinical characteristics between the groups of patients with normoglycemia and reactive hyperglycaemia. After PCI, the patients with normoglycemia had significantly higher (p = 0.021) dynamics of changes in the resolution of ST-segment elevation in ECG expressed in an indicator of sum STR (resolution of ST-elevation). A degree of resolution of ST elevation in ECG was significantly (p = 0.021) dependent on the level of blood glucose – higher the blood glucose level, weaker the resolution. The patients with glucose levels ≥7.8 mmol/L had significantly higher levels of CK and CK-MB during the first 48 hours of hospitalization. There was a statistically significant difference in the mean length of hospitalization between individuals from the group with lower and higher blood glucose levels on admission (p = 0.028). A 4-month follow-up revealed no significant difference in the incidence of major adverse cardiovascular events (MACE) in the study groups (p = 0.063). A 4-year follow-up of patients with higher levels of blood glucose on admission showed a higher incidence of MACE (p = 0.01). The patients with HbA1c ≥ 6.5% were older (p = 0.004), had a greater BMI > 30kg/m2 (p=0.019) and the lower ejection fraction of the left ventricle (p = 0.003) compared to those with the HbA1c levels <6.5%. The incidence of MACE in 4-month and 4-year follow-up was comparable in the study population.

scholarly journals Study of the Relationship Between Mean Platelet Volume and LAD as a Culprit Vessel in NSTEMI

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Ahmad Separham ◽  
Alireza Shahsavani ◽  
Ali Heidari Sarvestani
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Mean Platelet Volume ◽  
Complete Blood Count ◽  
St Elevation Myocardial Infarction ◽  
Platelet Volume ◽  
Good Tool ◽  
Cross Sectional ◽  
Significant Difference ◽  
St Elevation

Background: Among acute coronary patients, the ratio of non ST-elevation myocardial infarction (NSTEMI) is increasing and according to recent studies, less than 30% of myocardial infarctions (MIs) are due to ST-elevation myocardial infarction (STEMI). Unlike STEMI, in NSTEMI the ECG is not able to identify the culprit vessel. Objectives: In this study, we aimed to evaluate the association of mean platelet volume (MPV) and NSTEMI due to left anterior descending lesion. Methods: In this cross sectional study 349 patients with NSTEMI were included. Major cardiac risk factors (cigarette, diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLP), angiographic findings, and drug history of patients were extracted from patients’ medical files. Then the MPV in complete blood count results and angiography findings were analyzed for any association. According to culprit lesions patients were divided into left anterior descending (LAD) and non-LAD groups. Results: There was a significant difference between the two groups (LAD vs. non-LAD) according to platelet count (P = 0.014), MPV (P = 0.001), HLP (0.024) and DM (0.048). Multivariate regression model has shown the MPV (OR = 0.46, 95%CI = 0.27 - 0.78) and DM (OR = 0.18, 95%CI = 0.06 - 0.54) as independent risk factors for NSTEMI due to LAD lesion. The significant positive correlation was also seen between MPV and left ventricle ejection fraction (LVEF) (r = 0.22, P = 0.006). The area under the curve (AUC) of MPV for predicting LAD culprit lesion was calculated as 69% (P < 0.0001). At cut off point of 9.15, has sensitivity and specificity of MPV for predicting LAD as culprit vessel was 100% and 30% respectively. Conclusions: In NSTEMI patients MPV might be a good tool to differentiate patients with LAD as culprit vessel.

scholarly journals The Metabolic Syndrome: Comparison of Newly Proposed IDF, Modified ATP III and WHO Criteria and their Agreements

2013 ◽  
Vol 6 (1) ◽  
pp. 17-22 ◽  
Author(s):  
AKM Mainuddin ◽  
KN Choudhury ◽  
KR Ahmed ◽  
S Akter ◽  
N Islam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Fasting Blood Glucose ◽  
T Test ◽  
Anthropometric Measurement ◽  
Who Criteria ◽  
Significant Difference

Background: Metabolic syndrome (MS) results from clustering of cardiovascular risk factors occurring in association with insulin resistance and obesity. With the increasing prevalence of obesity worldwide, MS is of keen interest in research. The disorder is defined in various ways, but one consolidated definition is needed to make studies comparable worldwide. The study was to determine the risk factors of metabolic syndrome in Bangladesh and comparison of newly proposed definition of International Diabetes Federation (IDF), modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the World Health Organization (WHO) criteria and their agreements. Materials and Methods: This was a cross sectional hospital based study. We randomly selected 229 participants. After obtaining informed written consent data collectors collected data by interview, clinical examination, anthropometric measurement and investigations. We calculated independent sample t-test means between to distinguish which risk factors were present in participants with and without MS, using SPSS v17. Results: The percentage of risk factors of MS among subjects according to different criteria was 72% of Modified ATP-III, 69% of IDF and 39% of WHO definition .In Modified NCEP ATP III when did independent sample t-test mean of BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, high density lipoprotein and triglyceride were present statistically significant difference between without MS and with MS (p<0.05). According to WHO criteria BMI, waist circumference, fasting blood glucose were statistically significant (p<0.05) and similarly fasting blood glucose & triglyceride were statistically significant difference between without MS and with MS (p<0.05) according to IDF criteria.ATP III and WHO criteria showed good agreement (k 0.56) compared to ATP III with IDF (k 0.31) and WHO with IDF (k 0.11) criteria. Conclusion: Metabolic syndrome is highly prevalent in Bangladesh. We detected the highest proportion of participants with MS using the ATP III definition, which emphasizes the predominant focus on the modified waist circumference for Asian participants. However, MS prevalence following WHO criteria in those with impaired glucose regulation is comparable with ATP III definition. Follow up study needed to examine the significance of MS following all definitions for the assessment of risk for diabetes and or cardiovascular disease. Cardiovascular Journal Volume 6, No. 1, 2013, Page 17-22 DOI: http://dx.doi.org/10.3329/cardio.v6i1.16110

scholarly journals Cigarette Smoking and Hyperglycaemia in Diabetic Patients

2018 ◽  
Vol 6 (4) ◽  
pp. 634-637 ◽  
Author(s):  
Mutiara Indah Sari ◽  
Nisrina Sari ◽  
Dewi Masyithah Darlan ◽  
Raka Jati Prasetya
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glucose Level ◽  
Hba1c Level ◽  
Fasting Blood Glucose ◽  
Postprandial Glucose ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Study Population ◽  
Postprandial Glucose Level

BACKGROUND: The incidence rate of diabetes mellitus has increased throughout the year. Various studies indicate that smoking may affect glucose metabolism and cause hyperglycemia in diabetes mellitus. This study aimed to compare the blood glucose and HbA1c level in diabetic smoking patients and non-smoking diabetic patients.METHODS: This study used the cross-sectional approach. The study population consisted of 30 diabetic smoking patients and 30 non-smoking diabetic patients. The diabetes history and the smoking status of the study population obtained by questionnaire-based interview, the blood glucose and HbA1c level were measured by hexokinase and immunoturbidimetry method using cobas 6000 analyser module c501  (Roche Diagnostics, Switzerland).RESULTS: The result in this study showed the fasting blood glucose, postprandial blood glucose, and HbA1c were higher by 23.64 mg/dl (p = 0.325), 58.00 mg/dl (p = 0.016), 0.39% (p = 0.412) in smoking diabetic patients compared to non-smoking diabetic patients. After statistical analysis, there was a significant difference (p < 0.05) of postprandial glucose level between smokers group and non-smokers group, but the non-significant difference of fasting blood glucose and HbA1cCONCLUSIONS: This study concluded that there was a significant difference in postprandial glucose level between smokers group and non-smokers group but the non-significant difference of fasting blood glucose and HbA1c.

Risk factors of coronary microvascular obstruction (Preprint)

2020 ◽  
Author(s):  
Yong Li ◽  
Shuzheng Lyu
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Logistic Regression ◽  
Microvascular Obstruction ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Neutrophil Percentage ◽  
Percutaneous Coronary ◽  
St Elevation

BACKGROUND Coronary microvascular obstruction /no-reflow(CMVO/NR) is a predictor of long-term mortality in survivors of ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PPCI). OBJECTIVE To identify risk factors of CMVO/NR. METHODS Totally 2384 STEMI patients treated with PPCI were divided into two groups according to thrombolysis in myocardial infarction(TIMI) flow grade:CMVO/NR group(246cases,TIMI 0-2 grade) and control group(2138 cases,TIMI 3 grade). We used univariable and multivariable logistic regression to identify risk factors of CMVO/NR. RESULTS A frequency of CMVO/NR was 10.3%(246/2384). Logistic regression analysis showed that the differences between the two groups in age(unadjusted odds ratios [OR] 1.032; 95% CI, 1.02 to 1.045; adjusted OR 1.032; 95% CI, 1.02 to 1.046 ; P <0.001), periprocedural bradycardia (unadjusted OR 2.357 ; 95% CI, 1.752 to 3.171; adjusted OR1.818; 95% CI, 1.338 to 2.471 ; P <0.001),using thrombus aspirationdevices during operation (unadjusted OR 2.489 ; 95% CI, 1.815 to 3.414; adjusted OR1.835; 95% CI, 1.291 to 2.606 ; P =0.001),neutrophil percentage (unadjusted OR 1.028 ; 95% CI, 1.014 to 1.042; adjusted OR1.022; 95% CI, 1.008 to 1.036 ; P =0.002) , and completely block of culprit vessel (unadjusted OR 2.626; 95% CI, 1.85 to 3.728; adjusted-OR 1.656;95% CI, 1.119 to 2.45; P =0.012) were statistically significant ( P <0. 05). The area under the receiver operating characteristic curve was 0.6896 . CONCLUSIONS Age , periprocedural bradycardia, using thrombus aspirationdevices during operation, neutrophil percentage ,and completely block of culprit vessel may be independent risk factors for predicting CMVO/NR. We registered this study with WHO International Clinical Trials Registry Platform (ICTRP) (registration number: ChiCTR1900023213; registered date: 16 May 2019).http://www.chictr.org.cn/edit.aspx?pid=39057&htm=4. Key Words: Coronary disease ST elevation myocardial infarction No-reflow phenomenon Percutaneous coronary intervention

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