Use of mobile applications assessing motor activity of patients after myocardial infarction for improving indicators of physical rehabilitation

Considering the widespread use of mobile phones, cellular communication systems wide coverage of the territory of the Russian Federation, the free or low cost of mobile applications for assessing motor activity, convenient interface and high accuracy of measurements of the apps; the usage of the modern technologies while involving underwent myocardial infarction patients into rehabilitation programs could increase the percentage of these programs participants and improve the results obtained during the implementation of the programs.Research goal. assessment of the impact of the usage of mobile applications, that could monitor the level of motor activity, on the results of a six-minute walk test (6 MWT) among the patients with myocardial infarction who were on the second stage of cardiac rehabilitation.Materials and methods. Materials and methods: 224 patients were examined: 99 (44.2 %) men and 125 (55.8 %) women aged 60.6 ± 11.5 years, who had had myocardial infarction from 6 days to 6 months ago (median 16 [10; 139] days), which passed the second stage of rehabilitation for 11.6 ± 1.4 days in the conditions of the specialized cardiology department of the Resort-hotel ‘Sosnovka’ (Berdsk, Russia). At the time of admission, in the middle of the rehabilitation course (on the 6th day) and before discharge (on the 12th day), a six-minute walk (6 MWT) test was performed (6 MWT1, 6 MWT2 and 6 MWT3, respectively). Changes in these parameters over time were estimated as the difference between the second and first 6 MWT, the third and first 6 MWT test results, and compared in two groups.Results obtained. The results of 6 MWT1 performed on admission of patients to the department did not differ between the two groups (F = 3.068; p = 0.81). 6 MWT2, conducted on average one week after the start of the second stage of the cardio-rehabilitation program revealed a statistically significant difference between the groups (F = 21.758; p < 0.001), which became more visible when 6 MWT3 was conducted at the end of the second week in the department (F = 66.615; p < 0.001), indicating the advantages of the group using the mobile application.Conclusion. The active introduction of mobile applications into real clinical practice effectively, non-invasively, does not require additional financial investments from the health care system and personal time of the doctor, being a positive determinant of the preventive behavior of patients.

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Impact of Face Masks on 6-Minute Walk Test in Healthy Volunteers

Pulmonary Circulation ◽

10.1177/2045894020988437 ◽

2021 ◽

Vol 11 (1) ◽

pp. 204589402098843

Author(s):

Kevin M. Swiatek ◽

Charnetta Lester ◽

Nicole Ng ◽

Saahil Golia ◽

Janet Pinson ◽

...

Keyword(s):

Healthy Volunteers ◽

Face Mask ◽

Walk Test ◽

Six Minute Walk Test ◽

Significant Difference ◽

6 Minute Walk Test ◽

The Impact ◽

Minute Walk

Our objective was to establish the impact of wearing a face mask on the outcome of six-minute walk test in healthy volunteers. In a study of 20 healthy volunteers who each completed two 6MWTs, one with a mask and one without, there was no difference in distance walked. However, there was a significant difference in perception of dyspnea between the two groups.

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Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.265 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

R King ◽

D Giedrimiene

Keyword(s):

Myocardial Infarction ◽

Primary Care ◽

Acute Myocardial Infarction ◽

Primary Care Physician ◽

Care Physician ◽

Adverse Outcomes ◽

Coronary Syndrome ◽

Number Of Patients ◽

Significant Difference ◽

The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

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Abstract 257: Urban Teaching and Non-Teaching Hospitals Outcomes: Myocardial Infarction

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.257 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Priscilla O Okunji ◽

Johnnie Daniel

Keyword(s):

Myocardial Infarction ◽

Mortality Rate ◽

Income Group ◽

The United States ◽

Teaching Hospitals ◽

Age Difference ◽

Age Group ◽

Urban Teaching ◽

Significant Difference ◽

The Impact

Background: Patients with myocardial infarction reportedly have different outcomes on discharge according to hospital characteristics. In the present study, we evaluated the differences between urban teaching hospitals (UTH) and non-teaching hospitals (NTH), discharged in 2012. We also investigated on the outcomes. Methods: Sample of 117,808 subjects diagnosed with myocardial infarction were extracted from a nationwide inpatient stay dataset using the International Classification Data, ICD 9 code 41000 in the United States, according to hospital location, size, and teaching status. Results: The analysis of the data showed that more whites were admitted to both teaching and non teaching hospitals with more males (~24%) admitted than their female counterparts. However, blacks were admitted more (~15%) in urban teaching hospitals than medium urban non teaching hospitals. Age difference was noted as well, while age group (60-79 years) were admitted more in UTH, inversely urban non-teaching hospitals admitted more older (80 years or older) age group. A significant difference (~28%) was observed in both hospital categories with UTH admitting more patients of $1.00 - $38,999.00 income group than other income categories. In addition, it was observed that patients with MI stayed more (~5%) for 14 or more days, and charged more especially for income group of $80,000 or above in UTH than NTH. No significant difference was found in the mortality rate for both hospital categories. Conclusion: The overall outcomes showed that the mortality rate between urban teaching and non-teaching hospitals were non significant, though the inpatients MI stayed longer and were charged more in UTH than NTH. The authors call for the study to be replicated with a higher level of statistical measures to ascertain the impact of the variables on the outcomes for a more validated result.

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Impact of collateralisation to a concomitant chronic total occlusion in patients with ST-elevation myocardial infarction: a subanalysis of the EXPLORE randomised controlled trial

Open Heart ◽

10.1136/openhrt-2018-000810 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000810 ◽

Cited By ~ 2

Author(s):

Ivo M van Dongen ◽

Joëlle Elias ◽

K Gert van Houwelingen ◽

Pierfrancesco Agostoni ◽

Bimmer E P M Claessen ◽

...

Keyword(s):

Myocardial Infarction ◽

Clinical Decision Making ◽

Controlled Trial ◽

Left Ventricular ◽

St Elevation Myocardial Infarction ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Significant Difference ◽

St Elevation ◽

The Impact

ObjectiveThe impact on cardiac function of collaterals towards a concomitant chronic total coronary occlusion (CTO) in patients with ST-elevation myocardial infarction (STEMI) has not been investigated yet. Therefore, we have evaluated the impact of well-developed collaterals compared with poorly developed collaterals to a concomitant CTO in STEMI.Methods and resultsIn the EXPLORE trial, patients with STEMI and a concomitant CTO were randomised to either CTO percutaneous coronary intervention (PCI) or no-CTO PCI. Collateral grades were scored angiographically using the Rentrop grade classification. Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) at 4 months were measured using cardiac magnetic resonance imaging. Well-developed collaterals (Rentrop grades 2–3) to the CTO were present in 162 (54%) patients; these patients had a significantly higher LVEF at 4 months (46.2±11.4% vs 42.1±12.7%, p=0.004) as well as a trend for a lower LVEDV (208.2±55.7 mL vs 222.6±68.5 mL, p=0.054) when compared with patients with poorly developed collaterals to the CTO. There was no significant difference in the total amount of scar in the two groups. Event rates were statistically comparable between patients with well-developed collaterals and poorly developed collaterals to the CTO at long-term follow-up.ConclusionsIn patients with STEMI and a concomitant CTO, the presence of well-developed collaterals to a concomitant CTO is associated with a better LVEF at 4 months. However, this effect on LVEF did not translate into improvement in clinical outcome. Therefore, the presence of well-developed collaterals is important, but should not solely guide in the clinical decision-making process regarding any additional revascularisation of a concomitant CTO in patients with STEMI.Clinical trial registrationNTR1108.

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Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in Slovenia

Balkan Journal of Medical Genetics ◽

10.2478/v10034-011-0011-6 ◽

2011 ◽

Vol 14 (1) ◽

pp. 3-9 ◽

Cited By ~ 9

Author(s):

S Kariž ◽

D Petrovič

Keyword(s):

Myocardial Infarction ◽

Type 2 Diabetes ◽

Gene Polymorphisms ◽

Serum Levels ◽

Control Group ◽

Interleukin 18 ◽

Significant Difference ◽

Promoter Gene ◽

The Impact

Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in SloveniaType 2 diabetes is a major risk factor for myocardial infarction (MI) and chronic inflammation may play a central role in both diseases. Interleukin (IL)-18 is a potent proinflammatory cytokine, which is considered important in acute coronary syndromes and type 2 diabetes. We investigated the association of the -137 (G>C), polymorphism (rs187238) and the -607 (C<A) polymorphism (rs1946518) of the IL-18 gene promoter region in 495 Caucasians with type 2 diabetes, of whom 169 had MI and 326 subjects had no clinically evident coronary artery disease (controls). We also investigated the impact of these polymorphisms on the serum IL-18 level in subsets of both groups and in a normal group. Genotype distributions of the polymorphisms showed no significant difference between cases and controls. However, IL-18 serum levels were significantly lower in diabetics with the137 CC genotype than in those with other genotypes (241.5 ± 132.7 ng/Lvs.340.2 ± 167.4 ng/L; p <0.05). High sensitivity C-reactive protein and IL-18 serum levels were higher in diabetics in the MI group than in the control group. We conclude that these IL-18 promoter gene polymorphisms are not risk factors for MI in Caucasians with type 2 diabetes.

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Impact of glycosylated haemoglobin (HbA1c) levels on outcomes in patients with myocardial infarction

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20210077 ◽

2021 ◽

Vol 8 (2) ◽

pp. 186

Author(s):

Prabhat Pandey ◽

Neeraj Dokania ◽

Pooja Pandey ◽

Ajay Singh Raghuwanshi

Keyword(s):

Myocardial Infarction ◽

Glycosylated Hemoglobin ◽

Age Group ◽

Percentage Mortality ◽

Coronary Syndrome ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Impact ◽

Hba1c Levels

Background: People with diabetes have an increased prevalence of atherosclerosis and coronary heart disease (CHD) and experience higher morbidity and mortality after acute coronary syndrome and myocardial infarction than people without diabetes. Diabetes also appears to be a major cause of the higher rate of both short and long-term mortality observed in women hospitalized with acute MI compared to men. Objective of the study was to observe the impact of glycosylated hemoglobin (HbA1c) levels on outcomes in MI.Methods: The prospective observational study was conducted on 200 patients from the age group more than 36 years and lesser than 95 years presented with acute myocardial infarction (STEMI or NSTEMI). Patients were divided into group A (Diabetics) and group B (non-diabetics). Investigations performed were FBS, RBS, HbA1c, CBC, LFT, RFT, lipid profile, ECG and echocardiography. Patients were followed up till discharge/death and all complications like arrhythmias, cardiac failure, cardiogenic shock and re infarction were noted.Results: Majority of the 34.5% patients belongs to the age group of 56-65 years. No significant difference found between the subject population of the diabetic and non-diabetic group. The percentage of mortality in male patients was reported higher in the group having HbAlc level ≥7 (21.15%) in comparison to a group having HbAlc level <7 (6.15%) whereas in females the percentage of mortality was 11.63% in the group having HbAlc ≥7 , higher than the group having HbAlc level <7, 2.5%. Percentage mortality was higher in the patients having HbAlc >7, in both groups’ patients aged below 60 years 14.81% and 17.65% in the group of patients aged above 60 years.Conclusions: Higher HbAlc level significantly affects the outcome of MI patients. The percentage mortality due to MI was higher in male with aged above 60 years and having HbAlc level >7.

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The impact of the cardiac rehabilitation program in patients with mid-range heart failure (40-50%) in improving cardio respiratory predictors

European Journal of Cardiovascular Nursing ◽

10.1093/eurjcn/zvab060.074 ◽

2021 ◽

Vol 20 (Supplement_1) ◽

Author(s):

HR Rodrigues ◽

V Ferreira ◽

L Alves ◽

D Sousa ◽

J Pinto ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Cardiac Rehabilitation ◽

Cardiopulmonary Exercise Testing ◽

Rehabilitation Program ◽

Cardiac Rehabilitation Program ◽

St Segment Elevation ◽

Funding Sources ◽

Metabolic Equivalent Of Task ◽

The Impact

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Universitário Lisboa Central Methods We studied 30 patients (P) with ejection fraction (EF) 40-50%, in a number of 198 P that participated in cardiac rehabilitation program (CRP). Of these P, 24 (80%) male and 6 (20%) female, 20 P were diagnosed myocardial infarction with ST-segment elevation, 2 P myocardial infarction non ST and 8 P with myocardial hypertrophy non ischemic. Of these P 30% were diabetics, 56% hypertension, 70% dyslipidemia, 36% smokers previous to CRP and body mass index 26,3 medium. All P were submitted to previous echocardiogram, cardiopulmonary exercise testing (CET) and a rehabilitation program minimum 4 sessions and maximum 52 sessions. At the end of the total sessions the echocardiogram and CET were repeated. Results Of the 30 P that participated in CRP only 20 completed the program, while the other 10 P dropped out because of social and economic problems. Of the P that completed the CRP, 70% got better on EF, 80% improved VE/VCO2 slope < 33 therefore are classified VC-II in ventilatory classification (VC), 5% VE/VCO2 slope > 40 VC-III classification, and 15% maintained the initial classification. 50% of the P increased at least one level metabolic equivalent of task (MET) from the first CET. Only 3 of the 20 patients came, once, to the hospital after the CRP with heart failure, and one died but did not fulfill the program. Conclusion Patients with mid-range heart failure submitted to a CRP can improve cardiorespiratory predictors, leading to a better quality of life. However, it is important to find solutions to minimize the causes that make patients to give up CRP.

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Abstract 14181: Impact of Prehospital Mobile Cloud Electrocardiogram Transmission System to Reduce Door to Balloon Time and Onset to Recanalization Time in ST-elevation Myocardial Infarction

Circulation ◽

10.1161/circ.142.suppl_3.14181 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Motoko Kametani ◽

Takashi Unoki ◽

Daisuke Takagi ◽

Yudai Tamura ◽

Tomoko Nakayama ◽

...

Keyword(s):

Myocardial Infarction ◽

Hospital Mortality ◽

Transmission System ◽

St Elevation Myocardial Infarction ◽

Mobile Cloud ◽

Fire Departments ◽

Significant Difference ◽

St Elevation ◽

Door To Balloon ◽

The Impact

Background: Guidelines strongly recommend patients with ST-elevation myocardial infarction (STEMI) receive timely mechanical reperfusion, defined as door-to-balloon time (DTBT) ≤90 minutes. Objective: To evaluate the impact of the prehospital mobile cloud ECG transmission system (C-ECG) on DTBT and mortality in patients with STEMI. Methods: On June 2018, eight mobile C-ECG systems (SCUNA®, MEHERGEN GROUP) were implemented into the Uki and Kamimashiki fire departments in Kumamoto, Japan. Within two years, 428 ECGs of patients complaining of chest pain, difficulty in breathing and any other symptom that the emergency staff deemed necessary were transmitted to our hospital. 119 patients were diagnosed with ACS, 93 received emergency CAG and 69 were diagnosed with STEMI. After excluding eight patients with onset to arrival over 24 hours, a total of 137 consecutive STEMI patients received emergency PCI during the study period. Among them, 68 received PCI during the pre-C-ECG period (Pre: from June 2016 to May 2018), whereas 69 were received during the post-C-ECG period (Post: June 2018 to May 2020). We compared the DTBT, Onset to Recanalization time (OTRT), and in-hospital mortality between the two periods. Results: There was no significant difference in age, gender, Killip classification, and number of diseased coronary lesion between the two periods. The door to Cath-Lab time (DTCT) and DTBT were significantly shorter in the post-C-ECG period compared to the pre-C-ECG period (Pre: 34 min [IQR; 23-44] vs. Post: 24 min [IQR; 18-38]; P=0.01, Pre: 66 min [IQR; 48-80] vs. Post: 49 min [IQR; 42-71]; P=0.02, respectively). Furthermore, OTRT was also significantly shorter in the post-C-ECG period compared to the pre-C-ECG period (Pre: 190 min [IQR; 137-343] vs. Post: 153 min [IQR; 110-247]; P=0.02). However, peak-CPK and in-hospital mortality were not significantly different between the two periods (Pre: 2254 IU/L [IQR; 1153-4257] vs. Post: 1985 IU/L [IQR; 740-4021]; P=0.2, Pre: 5.9% vs. Post: 4.4%; P=0.7, respectively). Conclusion: Prehospital mobile cloud ECG transmission system reduced not only the DTBT but also OTRT.

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Association between Atrial Fibrillation, Myocardial Infarction, Heart Failure and Mortality in Patients with Nontuberculous Mycobacterial Infection: a nationwide population-based study

Scientific Reports ◽

10.1038/s41598-019-51801-w ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Chan Soon Park ◽

Eue-Keun Choi ◽

Bongseong Kim ◽

Kyung-Do Han ◽

So-Ryoung Lee ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Atrial Fibrillation ◽

Mycobacterial Infection ◽

Population Based ◽

Newly Diagnosed ◽

Increased Risk ◽

Significant Difference ◽

Risk Patients ◽

The Impact

Abstract NTM infection demonstrates an increasing incidence and prevalence. We studied the impact of NTM in cardiovascular events. Using the Korean nationwide database, we included newly diagnosed 1,730 NTM patients between 2005 and 2008 and followed up for new-onset atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), ischemic stroke (IS), and death. Covariates-matched non-NTM subjects (1:5, n = 8,650) were selected and analyzed. Also, NTM infection was classified into indolent or progressive NTM for risk stratification. During 4.16 ± 1.15 years of the follow-up period, AF, MI, HF, IS, and death were newly diagnosed in 87, 125, 121, 162, and 468 patients. In multivariate analysis, NTM group showed an increased risk of AF (hazard ratio [HR] 2.307, 95% confidence interval [CI] 1.560–3.412) and all-cause death (HR 1.751, 95% CI 1.412–2.172) compared to non-NTM subjects, whereas no significant difference in MI (HR 0.868, 95% CI 0.461–1.634), HF (HR 1.259, 95% CI 0.896–2.016), and IS (HR 1.429, 95% CI 0.981–2.080). After stratification, 1,730 NTM patients were stratified into 1,375 (79.5%) indolent NTM group and 355 (20.5%) progressive NTM group. Progressive NTM showed an increased risk of AF and mortality than indolent NTM group. Screening for AF and IS prevention would be appropriate in these high-risk patients.

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Abstract 15151: The Prevalence of Covid-19 on the Door to Balloon Time in Patients With St-elevation Myocardial Infarction

Circulation ◽

10.1161/circ.142.suppl_3.15151 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

yuki matsubara ◽

Takeshi Yamada ◽

Soichiro Washimi ◽

Akihiko Takahashi ◽

Tetsuya Hata ◽

...

Keyword(s):

Myocardial Infarction ◽

Emergency Department ◽

Mortality Rate ◽

St Elevation Myocardial Infarction ◽

Primary Pci ◽

Time Duration ◽

Significant Difference ◽

St Elevation ◽

Door To Balloon ◽

The Impact

Background: Patients with ST-elevation myocardial infarction (STEMI) should undergo primary PCI (percutaneous coronary intervention) as a standard of care. However, with the increase in the prevalence of COVID-19, all patients with suspected STEMI should be treated as possible COVID-19 cases. Therefore, more time may be needed to establish an acute MI diagnosis and to perform a COVID-19 status assessment. There has been a paucity of data regarding its influence on the primary PCI procedure. Objective: We sought to evaluate the impact of the prevalence of COVID-19 on the door-to-balloon time and clinical outcome in patient with STEMI. Method: Between January 2019 and May 2020, 157 patients with STEMI underwent primary PCI in 3 Japanese PCI centers. Mean age of patients was 70.4±12.9 years, and 71.6% were male. Right distal radial artery access was used in 110 patients (94.8%). We divided these patients into two groups: a group before the COVID -19 outbreak and another group during the pandemic, and were retrospectively analyzed. The following patients’ baseline characteristics were obtained: door-to-balloon time, duration in the emergency department, finding of CT scan if conducted, peak CK, 30-day mortality rate. Results: We evaluated patients with STEMI who underwent PCI between January 2019 and January 2020 (before the pandemic) and between February 2020 and May 2020 (during the pandemic). The number of patients was 119 before pandemic and 37 during pandemic. Mean door-to-balloon time was 35.8 ± 24.5 min before the pandemic and 41.2 ± 20.8 min after the outbreak (p<0.05). Induration at the emergency department was 22.6 ± 18.6 min before the pandemic and 21.3 ± 13.3 min after the outbreak (p=0.329). CT evaluation was performed before PCI was conducted in 41 patients (34.5%) and 14 patients (37.8%) (p=0.699). The peak CPK was 1956.2 ±2141.9 U/L and 2801.1 ± 2982.5 U/L (P=0.006). There was no significant difference in a 30-day mortality rate (5% vs 0%; P=0.699). Of the 37 patients after the outbreak, no patient underwent PCR examination for COVID-19 virus. Conclusion: The COVID-19 pandemic changed the diagnostic procedure in the emergency department and affected door-to-balloon time in patients with STEMI.

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