scholarly journals Outcome of Thrombolysis in Acute Myocardial Infarction in a Tertiary Care Hospital

2019 ◽  
Vol 13 (2) ◽  
pp. 42-44
Author(s):  
Md Wali Ur Rahman ◽  
Syed Asif Iqbal ◽  
Syeda Aleya Sultana ◽  
Md Abdul Malek ◽  
Abu Yusuf Md Shahidul Alam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Thrombolytic Therapy ◽  
Complete Resolution ◽  
Left Ventricular ◽  
Military Hospital ◽  
Care Hospital ◽  
Risk Of Death ◽  
Increased Risk

Introduction: The main purpose of thrombolysis in acute myocardial infarction is early and complete reperfusion. Incomplete or delayed thrombolysis is associated with an increased risk of death and left ventricular dysfunction. The time to reperfusion and complete reperfusion remain the key determinants for appropriate outcome of cardiovascular events. Objective: To find out the effect of thrombolytic therapy and its outcome in relation with timing of thrombolysis and associated risk factors in ST elevated myocardial infarction (STEMI) patients. Materials and Methods: This cross-sectional interventional study was carried out in combined military hospital, Dhaka from July 2017 to May 2018. Total 85 patients of acute STEMI having specified criteria were selected and treated with Streptokinase at a dose of 1.5 million units diluted in 100 mL normal saline. Twelve-lead ECG was recorded immediately before the start of thrombolytic therapy and 180 min afterwards. Results: Among 85 STEMI patients 65 were male and the age range was 40-80 years. Sixty nine patients (81.2%) underwent thrombolysis within 12 hours of onset of chest pain among them complete resolution of ST segment occurs in 45(65.2%) patients while 16 patients (18.8%) received thrombolysis after 12 hours among them complete resolution occurs only in 7(43.8%) patients.  Fully reperfused patients have no complications. Patients having diabetes mellitus, presented with atypical chest pain and received thrombolytic therapy after 12 hours had various types of complication. Conclusion: STEMI patients received thrombolysis therapy within 12 hours of onset of chest pain responded well to thrombolytic therapy. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 42-44

scholarly journals Does sacubitril/valsartan work in acute myocardial infarction? The PARADISE-AMI study

2021 ◽  
Vol 23 (Supplement_E) ◽  
pp. E87-E90
Author(s):  
Laura Gatto
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Left Ventricular Dysfunction ◽  
Clinical Studies ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Laboratory Animals ◽  
Risk Of Death ◽  
Increased Risk

Abstract Patients with acute myocardial infarction (AMI) complicated by left ventricular dysfunction have an increased risk of death and heart failure. Numerous clinical studies have demonstrated the ability of ACE inhibitors in optimizing the outcome in this particular clinical setting. In recent years, the sacubitril/valsartan association has drastically improved the prognosis of patients with heart failure with reduced ejection fraction with a significant decrease in mortality from cardiovascular causes and hospitalizations due to acute heart failure. However, it has not yet been fully clarified whether this pharmacological association may play a role in patients with AMI. Pre-clinical studies have suggested the possibility that sacubitril/valsartan can reduce the size of the infarct scar and prevent the onset of ventricular arrhythmias in laboratory animals in which myocardial infarction was induced. On the other hand, small clinical experiences with patients after myocardial infarction have provided conflicting data. The results of the PARADISE-MI study were recently presented, which enrolled 5661 patients with AMI complicated by pulmonary congestion and left ventricular dysfunction randomized to therapy with ramipril or sacubitril/valsartan and followed up for ∼2 years. Although combination therapy was associated with an ∼10% reduction in the risk of death from cardiovascular causes or an episode of heart failure, this was not enough to achieve statistical significance. However, treatment with sacubitril/valsartan was shown to be more effective than ramipril in preventing recurrence of heart failure after the first one.

scholarly journals Outcome of Acute Myocardial Infarction Patients Admitted in a Tertiary Care Hospital

2017 ◽  
Vol 28 (1) ◽  
pp. 6-8
Author(s):  
Mona Islam ◽  
Biplob Bhattacharjee ◽  
Md Abu Yusuf Chowdhury ◽  
Abu Naser Siddique ◽  
Abul Mansur Md Rezaul Karim
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Tertiary Care Hospital ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Care Hospital ◽  
Risk Of Death ◽  
Increased Risk ◽  
History Of

Acute myocardial infarction (AMI) is a common non - communicable disease prevailing in developed as well as in developing countries like Bangladesh, causing a great number of mortality and morbidity and impart a huge economic burden to family as well as to society. This study was designed to see the various complications and outcome of the patients of AMI, admitted in a tertiary care hospital in Bangladesh. In this observational study, 100 patient of AMI admitted in Cardiology ward of CMCH were enrolled. Clinical diagnosis was made from history and clinical examination and confirmed by ECG and biochemical markers. Informed written consent was taken from the patient or from the patient's attendant. Among the 100 cases of AMI, 89% were suffering from STEMI and 11% were from NSTEMI. Most of the patients (39%) were in 50-59 years age group. Majority of patient had chest pain (52%), followed by dyspnoea (23%), palpitation 10%, syncopal attack 7% and cardiac arrest 8% respectively. Important risk factors were history of smoking (37%), Diabetes (33%), Hypertension (31%), Dyslipidaemia (21%) and family history of IHD (16%). ECG showed ST-elevation in 80% of patients. It has been revealed that the important complications were cardiogenic shock(31%) followed by acute LVF(21%), bradyarrythmia (12%), tachyarrhythmia (10%), cardiac arrest(8%) and 12% patients died within 24 hours of admission. Patients with AMI have a substantially increased risk of death after hospitalization when shock, LVF or arrhythmias occur during their hospital stay. These complications should have to be treated promptly to achieve a good outcome.Medicine Today 2016 Vol.28(1): 6-8

scholarly journals Clinical presentation, risk factors, complications and outcome of acute myocardial infarction in elderly patients

2017 ◽  
Vol 5 (11) ◽  
pp. 4765 ◽  
Author(s):  
Sandhya S. ◽  
Mohanraj P.
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Elderly Patients ◽  
Epigastric Pain ◽  
Tertiary Care ◽  
Care Hospital ◽  
Wide Range ◽  
Atypical Presentations

Background: Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. This article enlightens the clinical features, risk factors, complications, prognosis and outcome of Acute myocardial infarction in elderly patients. The objective of this study was to assess the risk factors, various symptoms, complications, prognosis and outcome of elderly patients with Acute myocardial Infarction (AMI).  Methods: This is a prospective study done over a period of two years in a tertiary care hospital in South India. 80 elderly patients who were diagnosed as AMI were included in the study.Results: Among the eighty patients the majority of the patients belonged to the age group 60-69 years. Twenty percent of the patients presented without chest pain. The atypical presentations included dyspnoea, giddiness, vomiting, sweating and epigastric pain. Mortality rate was 20%.Conclusions: This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like shortness of breath, giddiness, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly though they may not present typically.  

D-dimer and the incidence of heart failure and mortality after acute myocardial infarction

Heart ◽  
2020 ◽  
pp. heartjnl-2020-316880 ◽  
Author(s):  
Xiaoyuan Zhang ◽  
Shanjie Wang ◽  
Jinxin Liu ◽  
Yini Wang ◽  
Hengxuan Cai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Plaque Rupture ◽  
Risk Of Death ◽  
Increased Risk ◽  
Clinical Covariates ◽  
All Cause Mortality ◽  
D Dimer

ObjectiveD-dimer might serve as a marker of thrombogenesis and a hypercoagulable state following plaque rupture. Few studies explore the association between baseline D-dimer levels and the incidence of heart failure (HF), all-cause mortality in an acute myocardial infarction (AMI) population. We aimed to explore this association.MethodsWe enrolled 4504 consecutive patients with AMI with complete data in a prospective cohort study and explored the association of plasma D-dimer levels on admission and the incidence of HF, all-cause mortality.ResultsOver a median follow-up of 1 year, 1112 (24.7%) patients developed in-hospital HF, 542 (16.7%) patients developed HF after hospitalisation and 233 (7.1%) patients died. After full adjustments for other relevant clinical covariates, patients with D-dimer values in quartile 3 (Q3) had 1.51 times (95% CI 1.12 to 2.04) and in Q4 had 1.49 times (95% CI 1.09 to 2.04) as high as the risk of HF after hospitalisation compared with patients in Q1. Patients with D-dimer values in Q4 had more than a twofold (HR 2.34; 95% CI 1.33 to 4.13) increased risk of death compared with patients in Q1 (p<0.001). But there was no association between D-dimer levels and in-hospital HF in the adjusted models.ConclusionsD-dimer was found to be associated with the incidence of HF after hospitalisation and all-cause mortality in patients with AMI.

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