scholarly journals Impact of Raised Blood Glucose Level on In-Hospital Outcome of Thrombolysed Patients with Acute Myocardial Infarction

2020 ◽  
Vol 35 (1) ◽  
pp. 14-19
Author(s):  
Musammat Sufia Akhter ◽  
Md Faruque ◽  
Md Toufiqur Rahman ◽  
Mohammad Arifur Rahman ◽  
Mirza Abul Kalam Mohiuddin ◽  
...  

Background: Diabetes mellitus (DM) is an established major cardiovascular risk factor associated with increased prevalence of coronary artery disease (CAD). Patients with diabetes often have numerous concomitant cardiac risk factors with a higher incidence of acute myocardial infarction (AMI) and congestive heart failure (CHF). Patients either with or without a prior history of DM may present with hyperglycemia during AMI. We analysed our population to determine whether admission hyperglycemia was a strong risk factor for in-hospital mortality and morbidity in patients with AMI and may be even stronger than a previous history of diabetes.In-hospital death risk of AMI patients without DM was about 2 to 4 times higher in patients with hyperglycemia than in those without hyperglycemia. Methods: This Prospective observational study was carried out at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total number of 200 STsegment elevation AMI patients were enrolled in this study as per inclusion and exclusion criteria. They were subdivided on the basis of admission blood glucose into two groups. Group-1A and 2A were 50 patients with blood glucose <200mg/dl (<11.1mmol/l) and Group-1B and 2B were 50 patients with blood glucose ≥200mg/dl (11.1 ≥mmol/l). The numerical data obtained from the study were analyzed and significance of differences were estimated by using statistical methods. Computer based SPSS (Statistical Package for Social Science) were used. Results: In the present study mean age of the male and female were 56.10±11.86 and 57.83±13.74 years, p>0.05%. There was no significant difference regarding risk factors and smoking was higher in both group. Regarding inhospital adverse outcome, death was significantly higher in hyperglycemic non diabetic group (p<0.0001). It was two times (56%) higher than diabetic hyperglycemic (28%) group.Cardiogenic shock (66%) and CHF (56%) were also more common in hyperglycemic non diabetic group. Lowest patients (8%) died of AMI without DM with random blood glucose <11.1 mmol/l (controlled). On the other hand highest improvement was in the controlled group (p<0.0001).Multivariate analysis showed Diabetic status with normal blood sugar was a predictor of adverse outcome; but patients with hyperglycemia and no history of diabetes had a worse outcome and were independently associated with significant risk of in-hospital mortality. Age group >65 years and Male sex were also associated with significant in-hospital mortality. Conclusion: Independent of diabetic status, the occurrence of hyperglycemia during AMI is associated with a subpopulation of patients at particularly high risk for an adverse clinical outcome. Even with the highly efficacious treatment strategies currently available, persons presenting with AMI and hyperglycemia are at increased risk for cardiogenic shock and CHF or death in hospital. Bangladesh Heart Journal 2020; 35(1) : 14-19

2016 ◽  
Vol 23 (03) ◽  
pp. 293-297
Author(s):  
Rafaqat Malik ◽  
Shazma Begum ◽  
Muhammad Nazar Afridi

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.


Author(s):  
Dr. Umesh Teltumbadr

INTRODUCTION:  Coronary heart disease (CHD) is the leading cause of death in the Western countries. Acute myocardial infarction (AMI) in young is relatively uncommon but it is of great concern for the physician as these patients present with the different clinical presentation, risk factors and better prognosis than the older patients. In younger patients and the first onset of angina which rapidly progresses to fully evolved MI is often the case in patients less than 45 years of age. In a young patient presenting with MI care full history should be taken and risk factors such as smoking, obesity, diabetes and history of recurrent venous and arterial thrombosis should also be noted. MATERIAL AND METHODS: 34 patients of age >18 years and <45 years were included in the study who presented with the acute myocardial infarction. Informed consent was obtained from all the patients who were included in the study. Clinical presentation and risk factors were recorded in the prescribed format. Anthropometric and clinical examination was carried out for each patient. Body weight and height were measured and Body mass index (BMI) was calculated using Quetlet’s formula as weight in kg/square of the height in meters. RESULTS: Mean age of the patients presenting with acute MI was 32± 6.21years. The youngest patient was 27 years old while the most common age group was 35-40 with 17(50%) patients. Out of 34 patients 33 (97.05%) were male while only 1 (2.95%) was female. Maximum patients were from urban area 22 (64.70%) while 12 (35.29%) were from the rural area. Smoking and physical inactivity was the most common associated risk factor in MI patients 29(85.29%). All smokers were male. Second most common risk factor was obesity and stressful life 18(52.94%) followed Hypertension in 13(38.24%) cases. In 12(35.29%) cases diabetes was associated as a risk factor. Family history of premature CAD, and dyslipidemia was seen in 11(32.35%) and 8(23.53%) cases respectively. CONCLUSION: Smoking, Physical inactivity, family history of premature CAD, and obesity were the most common risk factors. Early stabilisation in golden hour should be followed by risk stratification, and early revascularisation.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044564
Author(s):  
Kaizhuang Huang ◽  
Jiaying Lu ◽  
Yaoli Zhu ◽  
Tao Cheng ◽  
Dahao Du ◽  
...  

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.


2021 ◽  
Vol 34 (1) ◽  
pp. 26-32
Author(s):  
Md Amzad Hossain Sardar ◽  
Md Khalilur Rahman ◽  
Md Mahidul Alam ◽  
Md Aminul Hasan ◽  
Ashoke Sarker ◽  
...  

Background: Among non-communicable diseases, acute myocardial infarction (AMI) is a common killer of people in the world. The management of AMI patients is one of the major challenges in the field of cardiology. Uric acid has several effects of potential interest in cardiovascular disease. There are some markers indicating an unfavorable prognosis in AMI patients. Uric acid is one of the markers that have been evaluated in research. Objective: The aim of this study was to assess the association between serum uric acid level and in-hospital outcomes of AMI patients. Patients and methods: This longitudinal descriptive study was conducted over 115 AMI patients in the Cardiology Unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Baseline characteristics such as age, sex, BMI, BP, RBS, risk factors (hypertension, DM, smoking, family history of IHD, dyslipidemia), and outcomes of AMI patients (acute LVF, arrhythmia, conduction block, cardiogenic shock, death) were recorded. We measured the serum uric acid of this patient at admission.  Results: The mean age of patients was 52.83±10.71 years. Out of 115 patients, 83.5% were male, and 16.5% were female. Among the risk factors, 65.2% of patients had HTN, 20.9% DM, 64.3% smoking, 16.5% family history of IHD, and 47.8% dyslipidemia. Out of 115, 35.7% of patients demonstrated high serum uric acid. In outcomes of AMI patients, acute LVF 24.4% (p=0.031) and death 12.2% (p=0.041) were significantly higher in patients with high serum uric acid levels. Conclusion: Significant association was found between high serum uric acid level and in-hospital outcomes of AMI patients. So, estimation of serum uric acid may offer an inexpensive, quick, and non-invasive method for identifying such high-risk patients. TAJ 2021; 34: No-1: 26-32


2020 ◽  
Vol 14 (3) ◽  
pp. 122-129
Author(s):  
Ahmed Adam ◽  
Jared McDowall ◽  
Sunday Joseph Aigbodion ◽  
Callistus Enyuma ◽  
Sean Buchanan ◽  
...  

Acute myocardial infarction (AMI) occurs as a manifestation of coronary atherosclerotic disease. The occurrence of erectile dysfunction (ED) following AMI is well documented and this association and pathophysiology is often interrelated. Few studies have objectively assessed the diagnostic value of ED as a risk factor for AMI, in general. In this review, we aimed to better outline the diagnostic predictability of ED as a precursor for ‘first/new onset' AMI. This review was performed using selective search terms, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The Cochrane, Embase, PubMed, Scopus and Web of Science databases were searched (September 2018). Selected studies were further assessed for relevance and quality (Critical Appraisal Skills Program tool-Oxford). Four studies [573 participants; mean 143 (SD ± 76.3604) and median 141 participants] were eligible for analysis. Meta-analysis of the studies resulted in a pooled sensitivity of 51.36% (95% CI: 47.37-55.33%). For the single study which reported true negative and false positive cases, a specificity of 76.53% (95% CI: 68.57-83.00%) was calculated. The results of this systematic review and meta-analysis suggest that a history of ED should be used as a risk factor for new onset AMI.


2000 ◽  
Vol 85 (12) ◽  
pp. 1486-1489 ◽  
Author(s):  
Viola Vaccarino ◽  
Lori Parsons ◽  
Nathan R. Every ◽  
Hal V. Barron ◽  
Harlan M. Krumholz

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Mohd Zhafri Mohd Razib ◽  
Azarisman Shah M.Shah ◽  
Jamalludin A.Rahman ◽  
Aszrin Abdullah ◽  
Aida N.S M.Shah ◽  
...  

Introduction: Acute myocardial infarction (AMI) is a major cause of death around the world. There are limited studies of risk factor profile in young adults with AMI. This study aimed to assess the risk factor profile of young adults with AMI at the emergency department of Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. This is a preliminary result of young adults (age between 18 to 45 years old) who presented to the emergency department of HTAA. Materials and Methods: This cross-sectional study was conducted in HTAA from the 31st July 2017 to the 11th June 2018 involving 709 patients who were diagnosed with AMI. Seventy seven patients were less than 45 years old. However, only 55 were recruited for analysis who fulfilled the inclusion and exclusion criteria. Results: The prevalence of young adults with AMI was 10.9% with mean age of 38.8 ± 5.1 years old and 96.4% were male. Eighty percent of the patients were Malay followed by 10.9% Chinese and 9.1% were Indian. 83.6% were married while 14.5% were unmarried and 1.8% were divorcees. Majority of patients (81.8%) had income less than RM4000. The common risk factors of young adults with AMI presented to HTAA was smoking (80%) followed by increased waist circumference (54.5%), obesity (52.7%), hypertension (40%), hypercholesterolaemia (27.2%), family history of ischaemic heart disease (27.2%), and diabetes mellitus (21.8%). Conclusion: AMI in young adults almost exclusively occurs in male. Smoking and obesity were the most common risk factors in young adults with AMI in HTAA.


2014 ◽  
Vol 21 (06) ◽  
pp. 1200-1203
Author(s):  
Shahzad Alam Khan ◽  
Sohail Safdar ◽  
Asna Ijaz ◽  
Ijaz-Ul-Haque Taseer

Objective: To determine the frequency of family history of IHD and related risk factors in the first degree relatives of patients suffered from acute myocardial infarction (AMI). Study Design: Descriptive study. Setting: PMRC Research Centre, Nishtar Medical College, Multan, Cardiology unit Nishtar Hospital Multan and Chaudhry Pervez Elahi Institute of Cardiology, Multan. Duration: One year from July 2011 to June 2012. Material and methods: In this descriptive study 331 patients of AMI of either sex and age ≥ 20 years admitted in Cardiology unit of Nishtar Hospital Multan and Chaudhary Pervez Elahi Institute of Cardiology Multan were registered. For data collection non-probability convenient sampling technique was used. Informed consent was taken from each patient. The information were recorded in a pre-designed questionnaire. The data were analyzed through SPSS-11. Results: Mean age of the study cases was 54.99±11.25 years (Minimum age was 20 years and maximum was 90 years). Two hundred sixty four (79.8%) were male and 67 (20.2%) were female patients and male to female ratio was 3.9:1. Out of these 331 patients 111 (33.6 %) were having positive family history of IHD. In these 111 (33.6 %) cases history of diabetes was seen in 45 (40.5 %), 43(38.8 %) had history of hypertension and history of hyper-cholesterolemia was present in 23 (20.7 %) of cases. Conclusions: The family history of IHD in addition to traditional risk factors such as hypertension, hyperlipidemia, diabetes mellitus and smoking is itself an important risk factor for IHD. Relatives of the young patients with IHD should be considered as high risk group and it calls for close surveillance of their first degree relatives and early intervention. All their family members should be advised life style modification, appropriate management of risk factors and regular follow up of even apparently healthy descendents.


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