scholarly journals NMR Plasma Metabolomics Study of Patients Overcoming Acute Myocardial Infarction: in the First 12 h After Onset of Chest Pain With Statistical Discrimination Towards Metabolomic Biomarkers

2020 ◽  
pp. 823-834
Author(s):  
M PETRAS ◽  
D KALENSKA ◽  
M SAMOS ◽  
T BOLEK ◽  
M SARLINOVA ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Blood Plasma ◽  
Plasma Levels ◽  
Statistical Discrimination ◽  
Plasma Metabolites ◽  
Metabolomics Study ◽  
History Of ◽  
The Impact

Acute myocardial infarction (AMI) is one of the leading causes of death among adults in older age. Understanding mechanisms how organism responds to ischemia is essential for the ischemic patient’s prevention and treatment. Despite the great prevalence and incidence only a small number of studies utilize a metabolomic approach to describe AMI condition. Recent studies have shown the impact of metabolites on epigenetic changes, in these studies plasma metabolites were related to neurological outcome of the patients making metabolomic studies increasingly interesting. The aim of this study was to describe metabolomic response of an organism to ischemic stress through the changes in energetic metabolites and aminoacids in blood plasma in patients overcoming acute myocardial infarction. Blood plasma from patients in the first 12 h after onset of chest pain was collected and compared with volunteers without any history of ischemic diseases via NMR spectroscopy. Lowered plasma levels of pyruvate, alanine, glutamine and neurotransmitter precursors tyrosine and tryptophan were found. Further, we observed increased plasma levels of 3-hydroxybutyrate and acetoacetate in balance with decreased level of lipoproteins fraction, suggesting the ongoing ketonic state of an organism. Discriminatory analysis showed very promising performance where compounds: lipoproteins, alanine, pyruvate, glutamine, tryptophan and 3-hydroxybutyrate were of the highest discriminatory power with feasibility of successful statistical discrimination.

scholarly journals Diagnostic markers for discriminating between acute aortic dissection and acute myocardial infarction during the pre-hospital phase: analysis of 3,195 cases

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Watanabe ◽  
H Yoshino ◽  
T Takahashi ◽  
M Usui ◽  
K Akutsu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Back Pain ◽  
Chest Pain ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Diagnostic Markers ◽  
Network Database ◽  
History Of ◽  
First Contact

Abstract   Both acute aortic dissection (AAD) and acute myocardial infarction (AMI) present with chest pain and are life-threatening diseases that require early diagnosis and treatment for better clinical outcome. However, two critical diseases in the very acute phase are sometimes difficult to differentiate, especially prior to arrival at the hospital for urgent diagnosis and selection of specific treatment. The aim of our study was to clarify the diagnostic markers acquired from the information gathered from medical history taking and physical examination for discriminating AAD from AMI by using data from the Tokyo Cardiovascular Care Unit (CCU) Network database. We examined the clinical features and laboratory data of patients with AAD and AMI who were admitted to the hospital in Tokyo between January 2013 and December 2015 by using the Tokyo CCU Network database. The Tokyo CCU Network consists of >60 hospitals that fulfil certain clinical criteria and receive patients from ambulance units coordinated by the Tokyo Fire Department. Of 15,061 patients diagnosed as having AAD and AMI, 3,195 with chest pain within 2 hours after symptom onset (537 AAD and 2,658 AMI) were examined. The patients with out-of-hospital cardiac arrest were excluded. We compared the clinical data of the patients with chest pain who were diagnosed as having AAD and AMI. The following indicators were more frequent or had higher values among those with AAD: female sex (38% vs. 20%, P<0.001), systolic blood pressures (SBPs) at the time of first contact by the emergency crew (142 mmHg vs. 127 mmHg), back pain in addition to chest pain (54% vs. 5%, P<0.001), history of hypertension (73% vs. 58%, P<0.001), SBP ≥150 mmHg (39% vs. 22%, P<0.001), back pain combined with SBP ≥150 mmHg (23% vs. 0.8%, P<0.001), and back pain with SBP <90 mmHg (4.5% vs. 0.1%, P<0.001). The following data were less frequently observed among those with AAD: diabetes mellitus (7% vs. 28%, P<0.001), dyslipidaemia (17% vs. 42%, P<0.001), and history of smoking (48% vs. 61%, P<0.001). The multivariate regression analysis suggested that back pain with SBP ≥150 mmHg (odds ratio [OR] 47; 95% confidence interval [CI] 28–77; P<0.001), back pain with SBP <90 mmHg (OR 68, 95% CI 16–297, P<0.001), and history of smoking (OR 0.49, 95% CI 0.38–0.63, P<0.001) were the independent markers of AAD. The sensitivity and specificity of back pain with SBPs of ≥150 mmHg and back pain with SBPs <90 mmHg for detecting AAD were 23% and 99%, and 4% and 99%, respectively. In patients with chest pain suspicious of AAD and AMI, “back pain accompanied by chest pain with SBP ≥150 mmHg” or “back pain accompanied by chest pain with SBP <90 mmH” is a reliable diagnostic marker of AAD with high specificity, although the sensitivity was low. The two SBP values with back pain are markers that may be useful for the ambulance crew at their first contact with patients with chest pain. Funding Acknowledgement Type of funding source: None

Intrusion and Confusion—The Impact of Medication and Health Professionals after Acute Myocardial Infarction

2005 ◽  
Vol 4 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Mona From Attebring ◽  
Johan Herlitz ◽  
Inger Ekman
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Secondary Prevention ◽  
Health Professionals ◽  
Long Run ◽  
Starting Point ◽  
History Of ◽  
Previously Treated ◽  
Positive Feelings ◽  
The Impact

Background: Secondary prevention is important in preventing new cardiovascular events after acute myocardial infarction (AMI). Aim: To explore patients' experiences of secondary prevention after a first AMI. Methods: A qualitative approach with hermeneutical analysis of in depth interviews was used. Results: Twenty patients (12 men and 8 women, aged 34–79 years) were interviewed. None of the patients was previously treated for cardiovascular disease except one that had a history of angina pectoris. Two main themes emerged from the analysis. 1) Impact of medication: patients interpreted bodily sensations as a consequence of being medicated rather than as a result of their heart attack. The medication led to feelings of being intruded upon but also to positive feelings of security. 2) Impact of health professionals: communication with health professionals resulted in confusion about both treatment and the severity of the coronary disease. Patients expressed a need of being reassured by their physician regarding their physical status. Conclusions: Health professionals need to consider the impact of pharmacological treatment on patients' life, at least in patients who suffer from a first AMI. The point of departure in secondary preventive work must be patients' beliefs about their condition and the treatment they receive. Nurses and physicians must be aware of the information each patient has been given, and from this starting point, they have to be in concordance with one another. From the patients' perspective it is deemed necessary for the physicians to discuss the disease and the consequences it may have, both in the near future and in the long run, as soon as possible.

scholarly journals The impact of angiotensin-converting-enzyme inhibitors versus angiotensin receptor blockers on 3-year clinical outcomes in patients with acute myocardial infarction without hypertension

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242314
Author(s):  
Ae-Young Her ◽  
Byoung Geol Choi ◽  
Seung-Woon Rha ◽  
Yong Hoon Kim ◽  
Cheol Ung Choi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Repeat Revascularization ◽  
History Of ◽  
Receptor Blockers ◽  
The Impact

This study aimed to investigate the impact of angiotensin-converting-enzyme inhibitors (ACEI) and angiotensin II type 1 receptor blockers (ARB) on 3-year clinical outcomes in acute myocardial infarction (AMI) patients without a history of hypertension who underwent successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES). A total of 13,104 AMI patients who were registered in the Korea AMI registry (KAMIR)-National Institutes of Health (NIH) were included in the study. The primary endpoint was 3-year major adverse cardiac events (MACE), which was defined as the composite of all-cause death, recurrent myocardial infarction (MI), and any repeat revascularization. To adjust baseline potential confounders, an inverse probability weighting (IPTW) analysis was performed. The patients were divided into two groups: the ACEI group, n = 4,053 patients and the ARB group, n = 4,107 patients. During the 3-year clinical follow-up, the cumulative incidences of MACE (hazard ratio [HR], 0.843; 95% confidence interval [CI], 0.740–0.960; p = 0.010), any repeat revascularization (HR, 0.856; 95% CI, 0.736–0.995; p = 0.044), stroke (HR, 0.613; 95% CI, 0.417–0.901; p = 0.013), and re-hospitalization due to heart failure (HF) (HR, 0.399; 95% CI, 0.294–0.541; p <0.001) in the ACEI group were significantly lower than in the ARB group. In Korean patients with AMI without a history of hypertension, the use of ACEI was significantly associated with reduced incidences of MACE, any repeat revascularization, stroke, and re-hospitalization due to HF than those with the use of ARB.

scholarly journals Acute Myocardial Infarction in Snake bite Envenomation – A Case Report

2015 ◽  
Vol 16 (1) ◽  
pp. 46-47
Author(s):  
NS Neki
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Rare Complication ◽  
Snake Bite ◽  
St Elevation Myocardial Infarction ◽  
History Of ◽  
Electrocardiographic Changes ◽  
St Elevation

Snake bite envenomation is a common problem in tropical countries, especially in rural parts of India. We came across a 30 year old male who presented to the hospital after 4 hours with history of Russell’s viper snake bite developing acute non ST elevation myocardial infarction (MI). Myocardial infarction was confirmed by history of left sided chest pain radiating to left arm with diaphoresis and electrocardiographic changes with increased serum troponin levels. Myocardial infarction is a rare complication of snake bite hence case report.DOI: http://dx.doi.org/10.3329/jom.v16i1.22401 J MEDICINE 2015; 16 : 46-47

scholarly journals Non-rheumatic streptococcal myocarditis mimicking acute myocardial infarction in an adolescent male

2018 ◽  
Vol 28 (3) ◽  
pp. 454-457 ◽  
Author(s):  
Caitlin E. O’Brien ◽  
John D. Coulson ◽  
Priya Sekar ◽  
Jon R. Resar ◽  
Kristen Nelson McMillan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Young Adults ◽  
Chest Pain ◽  
Streptococcal Pharyngitis ◽  
Adolescent Male ◽  
Coronary Angiogram ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of

AbstractAn adolescent male with a recent history of streptococcal pharyngitis presented with severe substernal chest pain, troponin leak, and ST-segment elevation, which are suggestive of acute inferolateral myocardial infarction. The coronary angiogram was normal. The patient was subsequently diagnosed with non-rheumatic streptococcal myocarditis. He was treated with amoxicillin and had excellent recovery. Non-rheumatic streptococcal myocarditis is an important mimic of acute myocardial infarction in young adults.

The Impact of American College of Cardiology Chest Pain Center Accreditation on Guideline Recommended Acute Myocardial Infarction Management

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
W. Frank Peacock ◽  
Phillip D. Levy ◽  
Deborah B. Diercks ◽  
Shuang Li ◽  
James McCord ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Pain Center ◽  
The Impact

Influenza vaccination and in-hospital mortality in patients with acute myocardial infarction with history of prior PCI or CABG: a nationwide cohort analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.P Patil ◽  
K Gonuguntla ◽  
C Rojulpote ◽  
A.J Borja ◽  
V Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Influenza Vaccination ◽  
Lower Risk ◽  
Bypass Graft ◽  
The United States ◽  
Risk Of Death ◽  
History Of ◽  
The Impact

Abstract Introduction Influenza vaccination is associated with lower risk of death as well as major adverse cardiovascular events, including acute myocardial infarction (AMI), heart failure and stroke. Purpose The impact of Influenza vaccination on in-hospital mortality in patients with AMI with a prior history of percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is largely unknown. We hypothesize that such individuals who develop AMI have better outcomes if they had received influenza vaccine. Methods We analyzed the United States National Inpatient Sample Database from 2010–2014 to identify patients with primary discharge diagnosis of AMI (STEMI, NSTEMI) with a history of prior PCI or CABG. In this cohort, patients with influenza vaccination were identified using ICD-9 code V04.81. The primary outcome was in-hospital mortality. Chi-square test and multivariate regression model controlling for age, gender, race, type of AMI and co-morbidities were employed for statistical analysis. Results A total of 495,619 patients with ACS were identified who had prior PCI or CABG and 6525 had positive influenza vaccination status. Influenza vaccination was independently associated with lower risk of in-hospital mortality in patients with AMI (aOR = 0.253, 95% CI: 0.196–0.328; p&lt;0.001). Conclusion Vaccination against influenza was associated with lower risk of in-hospital mortality in patients with prior PCI or CABG who developed AMI. Figure 1 Funding Acknowledgement Type of funding source: None

STUDY OF RISK FACTORS AND CLINICAL PROFILE OF ACUTE MYOCARDIAL INFARCTION IN FEMALES

2021 ◽  
pp. 65-68
Author(s):  
Bhaurao D. Nakhale ◽  
Jitendra P. Bhagat ◽  
Abhijit Y. Nugurwar
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Central Obesity ◽  
Age Group ◽  
Men And Women ◽  
History Of ◽  
Artery Disease

Cardiovascular disease is the most important health issue facing mankind and continues to be major cause of morbidity and mortality.Women are disproportionately affected by coronary artery disease(CAD) compared with men.There are different clinical presentations of heart disease and acute myocardial infarction in women than in men.Also different studies shows that there is difference in the major cardiovascular risk factors amongst men and women at younger age.The present study was undertaken with a view to understand the clinical prole of acute myocardial infarction in women and observe the variations in acute myocardial infarction between men and women. Materials and methods-This observational and analytical study includes 118 female cases of acute myocardial infarction admitted to ICCU and randomly selected 118 male cases of acute myocardial infarction admitted to ICCU during the same tenure.Various necessary th investigations were carried out and risk factors of acute myocardial infarction were determined.All the cases were followed up on the 7 day of admission and one month after discharge from the hospital for various complications.Data thus collected was analysed at the end of study. Results-Maximum number of female cases were in age group 60-69 years(45.6%)while maximum number of male cases were in age group 50- 59 years(33.05%).Anterior wall myocardial infarction was the commonest type of acute myocardial infarction in both groups.ST elevation myocardial infarction was more common in males(94.9%)as compared to females(83.89%) whereas non ST elevation myocardial infarction was common in females(10%) as compared to males (5%).Atypical chest pain was more common in female cases(50.8%)whereas typical chest pain was more common with male cases(52.4%).Also dyspnoea as presenting symptom was signicantly more in female cases(51.6%)as compared to male cases(20.3%).Among the risk factors as Diabetes mellitus,signicant difference was observed in female(45.7%) vs male cases(30.5%).Other risk factors like lack of physical activity was signicantly more in female cases(84.7%) as compared to male cases(50%).Central obesity and family history of CAD were more common in female cases . 42(35.6%) female cases had arrthymias during hospital stay as compared to 50(42.4%) male cases.Post MI angina was present in 21 (20.38%) female cases and 12(11.11%) male cases during one month follow up.Mortality was more common in female cases(12.7%) compared with the male cases(8.47%)but it was not statistically signicant. Females suffer from coronary artery disease slightly at older age Conclusions- as compared to males.Atypical chest pain and dyspnoea are more common presenting symptoms in females compared to males.Diabetes mellitus,central obesity, lack of physical activity and family history of CAD are most common risk factors in female cases for acute myocardial infarction.ST elevation myocardial infarction is less common in females as compared to males.Complications like congestive cardiac failure ,arrthymias are more common in females as compared to males.The overall mortality with acute myocardial infarction are common in females than males.

scholarly journals Dual Prosthetic Heart Valve Presented with Chest Pain: A Case Report of Coronary Thromboembolism

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Supakanya Wongrakpanich ◽  
Natanong Thamcharoen ◽  
Pakawat Chongsathidkiet ◽  
Sarawut Siwamogsatham
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Heart Valve ◽  
Prosthetic Heart Valve ◽  
Coronary Syndrome ◽  
Satisfactory Outcome ◽  
History Of ◽  
Rheumatic Heart

Coronary embolism from a prosthetic heart valve is a rare but remarkable cause of acute coronary syndrome. There is no definite management of an entity like this. Here we report a case of 54-year-old male with a history of rheumatic heart disease with dual prosthetic heart valve and atrial fibrillation who developed chest pain from acute myocardial infarction. The laboratory values showed inadequate anticoagulation. Cardiac catheterization and thrombectomy with the aspiration catheter were chosen to be the treatment for this patient, and it showed satisfactory outcome.

scholarly journals Assessment of serum cardiac troponin-I over serum CPK-MB in early diagnosis of acute myocardial infarction (AMI)

2018 ◽  
Vol 5 (3) ◽  
pp. 722
Author(s):  
Santosh Kumar ◽  
Sachin Patil
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Early Diagnosis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Anterior Wall ◽  
Cardiac Troponin I ◽  
History Of ◽  
Serum Cardiac Troponin

Background: The early mortality rate from AMI is 30% with about half of them occurring within 1hour of disability. Although the mortality rate after admission for AMI has declined by 30% over the past decades, approximately 1 of every 25 patients who survive the initial hospitalization die in the first year after AMI. The gold standard for diagnosis of MI has been an elevated serum level of creatinine kinase – myocardial band (CK- MB), the cardiac-specific isoenzyme of CK. However, elevated CK-MB may not detect all myocardial necrosis. In patients who die suddenly after severe or silent episodes of ischemia, autopsies frequently reveal micronecrosis that was not reflected in routine CK-MB measurements. The present study was undertaken to know that serum Cardiac Troponin-I is more sensitive marker than serum CPK-MB in early diagnosis of acute myocardial infarction (AMI).Methods: The study was carried out in tertiary care hospital in Gulbarga. The study was undertaken with an aim to study that serum cardiac troponin-I (cTnl) is more sensitive than serum CK-MB in early diagnosis of acute myocardial infarction (AMI). The study was conducted on patients admitted with history of chest pain suggestive of AMI as diagnosed by WHO criteria to medicine ward of Basaveshwar Teaching and General Hospital, Gulbarga. The period of study was from June 2012 to June 2014. The sample size included 100 patients with history of chest pain suggestive of AMI, selected by simple random method.Results: Our results revealed that cardiac troponin I was more sensitive (62%) than CK-MB in overall cases admitted in between 6-24 hrs from the onset of chest pain. Maximum number (41%) of AMI patients were affected on the anterior wall followed by Inferior wall of AMI. 11 percent were affected with Antero lateral wall wereas 5 to 6 percent were affected with anteroseptal and global acute and right ventricular AMI was seen among 2 percent of patients. Anterior wall AMI was the significantly affected site with AMI (ʎ2:12.5, P:0.0004). The maximum number of acute myocardial infarctions were ST elevation myocardial infarctions. 28% of cases where CKMB is normal, the cTnI detects the AMI cases indicating its sensitivity.Conclusions: Cardiac troponin-I (cTnI) was more sensitive serum marker than CKMB in the early diagnosis of acute myocardial infarction (AMI). Anterior wall was the most significantly affected site of AMI. In the future, further improvements in analytical performance may open additional diagnostic windows.

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