scholarly journals Outcome of Patients Having Acute Myocardial Infarction with and without Streptokinase

2019 ◽  
Vol 31 (2) ◽  
pp. 68-71
Author(s):  
Faruque Uddin ◽  
AK Fazlul Hoque

Introduction: Acute myocardial infarction is the leading cause of death. Streptokinase is the most commonly used thrombolytic agent. This study was conducted to compare in-hospital outcome of patients with acute myocardial infarction receiving streptokinase with those not receiving it. Materials & Methods: This descriptive observational study was conducted at Coronary Care Unit, North East Medical College Hospital from 1st July August 2016 to 30th June 2018. 340 patients having acute MI were in- cluded in the study. Two groups were formed: sk group receiving streptokinase and non-sk group not receiving. In-hospital mortality was the primary end point while mechanical and electrical complications were the secondary end points. Results: Among 340 patients, 255(75%) were males and 85(25%) females. Out of those 218 received strep-tokinase, while 122 did not. Mean age of sk group was 53.15±10.30 years and non-sk group 60.5±16 ears. Mean time of arrival to the hospital after symptom onset was 10.41±9.97 hours. SK group patients reached in 5.9±4.76 hours while non-sk group in 19.4±10.5 hours. In-hospital mortality in sk and non-sk group was 19(8.7%) and 25(20.5%) respectively, p=0.002. Complication rate was significantly higher in the non-sk group, 54.09% vs 34.86%, p=0.04. Conclusion: Patients of acute myocardial infarction receiving streptokinase have significantly lesser in-hospital mortality and complications as compared to patients not receiving it. Medicine Today 2019 Vol.31(2): 68-71

2021 ◽  
Vol 33 (1) ◽  
pp. 42-44
Author(s):  
Md Nazrul Islam ◽  
Sabikun Nahar Chowdhury ◽  
Md Sajjadur Rahman ◽  
Sk Moazzem Hossain

Introduction: Acute myocardial infarction is very common in Bangladesh. It is one of the most common causes of mortality worldwide. The clinical course is associated with various complications. Materials and Methods: To assess the short-term outcome of acute coronary syndrome we select 100 patients. The study was conducted at the Medicine wards of Khulna Medical College Hospital, Khulna from February’2019 to August’2019. We observed the clinical presentations, ECG findings, echocardiographic findings, short term complications and outcome. Results: We found that most of the patients (61%) were within 45-64 years of age. Chest pain was the most common (85%) presentation. NSTEMI is more common than STEMI. 53% patients developed complications. Acute LVF is the most common (23%) complication. AV block is the most common arrythmia (10%). We found overall mortality 38%. Conclusion: Early detection of complications is essential for reduction of morbidity and mortality. This study will help to evaluate short-term complications and to give appropriate management. Medicine Today 2021 Vol.33(1): 42-44


2009 ◽  
Vol 36 (3) ◽  
pp. 570-575 ◽  
Author(s):  
MANSI A. SHAH ◽  
AMBER M. SHAH ◽  
ESWAR KRISHNAN

Objective.Systemic lupus erythematosus (SLE) is associated with higher risk for acute myocardial infarction (MI); but the post-infarction outcomes among these patients are unknown. Our objective was to compare post-acute MI outcomes in patients with SLE to those with diabetes mellitus (DM) and those with neither condition.Methods.We analyzed the risk for prolonged hospitalization and in-hospital mortality following acute MI in the 1993–2002 US Nationwide Inpatient Sample. We used logistic regression to calculate odds ratios (OR) for prolonged hospitalization and Cox proportional hazards regression to calculate hazard ratios (HR) for in-hospital mortality with and without adjustments for age, sex, race/ethnicity, socioeconomic status, and presence of congestive heart failure.Results.For the SLE (n = 2192), DM (n = 236,016), SLE/DM (n = 474), and control (n = 667,956) groups, the in-hospital mortality rates were 8.3%, 6.2%, 5.7%, and 4.7%, respectively. In multivariable regression models, all 3 disease groups had higher adverse outcome risk compared to control. The OR for prolonged hospitalization was higher for those with SLE (OR 1.48, 95% CI 1.32–1.79) compared to those with DM (OR 1.30, 95% CI 1.28–1.32). A similar pattern was observed for hazard ratios for in-hospital mortality as well (SLE, HR 1.65, 95% CI 1.33–2.04; DM, HR 1.11, 95% CI 1.07–1.14).Conclusion.SLE, like DM, increases risk of poor outcomes after acute MI. These patients need to be triaged appropriately for aggressive care.


1970 ◽  
Vol 4 (1) ◽  
pp. 53-57 ◽  
Author(s):  
PK Das ◽  
S Ghafur ◽  
B Bhattarcharjee ◽  
A Dey ◽  
AL Mollah ◽  
...  

Background: Coronary artery disease (CAD) is now an emerging epidemic in developing countries including Bangladesh. Younger people are being affected here more and more. Young individuals with acute myocardial infarction (AMI) may have unique presentation, risk factor, angiographic profile and outcome which may have an influence on the preventive strategies. This study is an attempt to investigate the same. Methods: Young patients (aged d” 40 yrs) with AMI admitted to the coronary care unit of Chittagong Medical College Hospital over a period of one year were included in the study. Assessments of the patients were done with clinical history, physical examination and systemic evaluation. Location and types (STEMI, NSTEMI) of myocardial infarction were determined by ECG and serum troponin- 1 assay. Blood for glucose and lipid profile was drawn within 24 hours of admission. High sensitivity testing for C-reactive protein (hs CRP) was done in all patients. Coronary angiography was done within 6 weeks of hospital discharge. Results: A total of 83 Patients with age d” 40 years were included .Age range were 21-40 years (34.21 ± 5.07 yrs). There were 71 male (85.5%). Male: female ratio was 5.9:1. Most of the young AMI patients presented lately to the hospital. Majority of these patients were thinly built, came from urban or semiurban areas, engaged in heavy physical activities and belonged to lower socioeconomic group. A positive family history of CAD was present in 18 patients (28.68 %). Smoking was the most prevalent risk factor followed by a raised serum triglyceride or low high density lipoprotein (HDL). A raised hs CRP was present in 47 patients (49.39%). The overall in hospital mortality was only 3.61 %. Coronary angiography done in 38 patients revealed single vessel disease in the majority. Conclusion: The study focuses our attention to the rising incidence of AMI in young individuals who are less prone to CAD. Early detection of AMI and timely intervention needs high index of suspicion in this age group. These young patients have got low BMI High TG, Low HDG High hs CRP & habit of smoking. Avoidance of smoking, controlling high TG and/or low HDL may reduce incidence of AMI among young patients. Use of high dose of statin at an early age in young persons with raised CRP may be considered. Keywords: Myocardial infarction; Young. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9390 Cardiovasc. J. 2011; 4(1): 53-57


2016 ◽  
Vol 5 (3) ◽  
pp. 195
Author(s):  
YJ Visweswara Reddy ◽  
Chinta Rajkumar ◽  
EKiran Kumar ◽  
Avin Subhash ◽  
NilamKumari Singh ◽  
...  

Angiology ◽  
2020 ◽  
pp. 000331972097530
Author(s):  
Mustafa Kilickap ◽  
Mustafa Kemal Erol ◽  
Meral Kayikcioglu ◽  
Ibrahim Kocayigit ◽  
Mesut Gitmez ◽  
...  

This recent Turkish Myocardial Infarction registry reported that guidelines are largely implemented in patients with acute myocardial infarction (MI) in Turkey. We aimed to obtain up-to-date information for short- and midterm outcomes of acute MI. Fifty centers were selected using probability sampling, and all consecutive patients with acute MI admitted to these centers (between November 1 and 16, 2018) were enrolled. Among 1930 (mean age 62 ± 13 years, 26% female) patients, 1195 (62%) had non-ST segment elevation myocardial infarction (NSTEMI) and 735 (38%) had ST segment elevation myocardial infarction (STEMI). Percutaneous coronary intervention (PCI) was performed in 94.4% of patients with STEMI and 60.2% of those with NSTEMI. Periprocedural mortality occurred in 4 (0.3%) patients. In-hospital mortality was significantly higher in STEMI than in patients with NSTEMI (5.4% vs 2.9%, respectively; P = .006). However, the risk became slightly higher in the NSTEMI group at 1 year. Women with STEMI had a significantly higher in-hospital mortality compared with men (11.2% vs 3.8%; P < .001); this persisted at follow-up. In conclusion, PCI is performed in Turkey with a low risk of complications in patients with acute MI. Compared with a previous registry, in-hospital mortality decreased by 50% within 20 years; however, the risk remains too high for women with STEMI.


Author(s):  
Paul L Hess ◽  
Elise C Gunzburger ◽  
Chuan-Fen Liu ◽  
Jacqueline Jones ◽  
Daniel D Matlock ◽  
...  

Background: Little contemporary data about the performance of Veterans Affairs (VA) hospitals related to mortality and readmission rates after an acute myocardial infarction (MI) are available. Accordingly, we sought to characterize the rates of in-hospital and 30-day mortality and 30-day unplanned readmission after an acute MI as well as associated site-level variation. Methods: Using data from the External Peer Review Program, which abstracts data from the records of all patients admitted with an acute MI, linked with administrative data from the Corporate Data Warehouse, we performed an observational analysis of patients admitted with an acute MI from January 1, 2011, to February 28, 2014. Results: A total of 16,024 patients were admitted with an acute MI; 806 (5.0%) patients died during hospitalization, 1299 (8.1%) died within 30 days of admission, and 2529 (16.9%) had an unplanned hospital readmission. The annual risk-standardized in-hospital mortality rate (Hazard Ratio (HR) 0.90, 95% Credible Interval (CI) 0.83-0.98) and the 30-day mortality rate (HR 0.94, 95% CI 0.88-1.00) but not the unplanned readmission rate (HR 1.00, 95% CI 0.96-1.04) decreased over time ( Figure ). Individual hospital rates for in-hospital mortality, 30-day mortality, and 30-day unplanned readmission were comparable to the system-wide rates, with little variation between hospitals. Conclusions: In Veterans Affairs hospitals from 2011 to 2014, in-hospital and 30-day mortality but not 30-day unplanned readmissions rates declined over time. Little site-level variation in mortality or readmission rates was observed.


2017 ◽  
Vol 69 ◽  
pp. S34-S45 ◽  
Author(s):  
Padmajan Sabin ◽  
Alummoottil George Koshy ◽  
Prabha Nini Gupta ◽  
Pattu Valappil Sanjai ◽  
Kunjukrishanpilla Sivaprasad ◽  
...  

2018 ◽  
Vol 24 (2) ◽  
pp. 82-84
Author(s):  
MMR Khan ◽  
MK Rahman ◽  
NK Sana ◽  
M Rais Uddin ◽  
MAL Khan ◽  
...  

This was a hospital based study done to see the prevalence of metabolic syndrome in acute myocardial infarction patients in Bangladesh. A total of 325 acute myocardial infarction patients attending in coronary care unit Rajshahi medical college hospital were included in this study. According to modified NCEP ATP III criteria 48.5% of subjects aged ≥ 20 years had the metabolic syndrome and it was more commonly seen in women than in men (72% vs 37.4%). The metabolic syndrome is associated with an increased risk of acute myocardial syndrome.TAJ 2011; 24(2): 82-84


2018 ◽  
Vol 4 (2) ◽  
pp. 95-100
Author(s):  
Larisa Anghel ◽  
Cristina Prisacariu ◽  
Cătălina Arsenescu Georgescu

Abstract Introduction: Cardiovascular disease is the leading cause of death among women irrespective of race or ethnicity, and about half of these deaths are caused by coronary artery disease. Several studies have reported that cardiovascular diseases manifest themself with a delay of about 7–10 years in women and that they have higher in-hospital mortality. It has not yet been established whether female gender itself, through biological and sociocultural differences, represents a risk factor for early in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI). The aim of our study was to identify the angiographic particularities in women with STEMI from North East Romania. Material and Methods: For one year, 207 (31.7%) women and 445 (68.3%) men diagnosed with acute myocardial infarction were hospitalized in the Cardiology Clinic of the “Prof. Dr. George I. M. Georgescu” Institute of Cardiovascular Diseases in Iași, Romania. Results: The highest incidence of symptom onset was between 6:00 a.m. and 12:00 a.m., this morning polarization being more obvious in women. Within the first two hours of admission to the hospital, coronary angiography was performed in 78.1% of men and only 67.3% of women, the difference being statistically significant (p <0.05). We found that a large number of women had multivascular coronary disease (47.9% vs. 42.3%). At the same time, we found that left main disease and multivascular disease were more frequent in women than in men (3.8% vs. 0.7%, p = 0.001 for left main plus two-vessel disease, and 19.4% vs. 14.8%, p = 0.0005 for three-vessel disease). Conclusions: In women, coronary events began more frequently in the morning, with atypical symptoms; also, fewer women presented to the hospital within the first 12 hours after the onset of the acute event. Compared to men, women from North East Romania present a higher incidence of multivascular atherosclerotic coronary lessions, indicating a higher severity of STEMI in the female population from this geographical area.


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