Faculty Opinions recommendation of Mortality from heart failure, acute myocardial infarction and other ischaemic heart disease in England and Oxford: a trend study of multiple-cause-coded death certification.

BACKGROUND The study was conducted in an attempt to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with acute myocardial infarction and to assess any influence of serum uric acid levels on predicting prognosis in patients with acute myocardial infarction. Ischaemic heart disease, particularly acute myocardial infarction is one of the leading causes of death across the world accounting for 12.7 % of global mortality. Low and middle-income countries are facing 80 % of the global burden of ischaemic heart disease death. Since the pathophysiology of acute myocardial infarction is complicated, proper risk stratification is essential for appropriate management and better outcome. Serum uric acid levels (SUA) have been correlated with coronary artery calcification and atherosclerosis. High SUA levels also have been identified as a risk marker for cardiovascular disease development, progression and mortality. METHODS The study design was a one-year cross-sectional study. 100 patients admitted with acute myocardial infarction within one day of the start of symptoms in the Department of Cardiology & Medicine were included from September 2018 to September 2019. In this study, patients with known causes of elevated uric acid levels (chronic kidney disease, gout, haematological malignancy, hypothyroidism, metabolic syndrome, myeloproliferative disease, lymphoproliferative disease, drugs– pyrazinamide, diuretics, ethambutol, ethanol, malignancy, G6PD deficiency and psoriasis) were included. Patients on drugs which raise serum uric acid e.g., salicylates (2 gm / d, hydrochlorothiazide, pyrazinamide), and chronic alcoholics were not included. Patients were further subjected to investigations like serum uric acid, ECG, 2D echo and other routine investigations. Urine albumin levels, troponin I, chest x-ray, fundoscopy, and fasting lipid profile were done. Investigation reports were analysed with the clinical profile and the data was compiled and appropriate statistical test was applied. RESULTS There were more cases of myocardial infarction above 40 years as compared to below 40 years of age and males (69 %) were more as compared to females (31 %) with the commonest presentation as chest pain. Majority of the patients had inferior wall myocardial infarction (IWMI) (40 %) and most (91 %) of the patients had left ventricular (LV) dysfunction (mild, moderate and severe). More patients with Killip class III and IV had abnormal uric acid levels as compared to class I, and II. Among 27 patients who expired, 23 were in Killip class III and IV (13 in Killip class III and 10 in class IV) and the mean serum uric acid levels of expired patients were elevated on all the 3 days with maximum elevation on day 1. CONCLUSIONS Patients with higher Killip class had higher levels of serum uric acid in comparison to patients of lower Killip class. Serum uric acid level in association with Killip class is a good predictor of the severity of heart failure and short-term mortality after myocardial infarction.

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Drugs and pacemakers for complete heart block

Drug and Therapeutics Bulletin ◽

10.1136/dtb.5.5.19 ◽

1967 ◽

Vol 5 (5) ◽

pp. 19-20

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Heart Rate ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Heart Block ◽

Complete Heart Block ◽

Bundle Of His

Complete heart block can occur in ischaemic heart disease, and can acutely complicate myocardial infarction. Most other cases are associated with fibrosis of the bundle of His of unknown cause, or are congenital. In some patients with chronic heart block, especially the congenital type, adequate output is maintained. In other patients chronic or intermittent heart block may cause Stokes-Adams attacks, or heart failure may not respond to digitalis and diuretics until the heart rate is increased. These require treatment by drugs or, when this fails, by use of anartifical pacemaker.

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Platelet volume subpopulations in acute myocardial infarction: an investigation of their homogeneity for smoking, infarct size and site

Clinical Science ◽

10.1042/cs0680419 ◽

1985 ◽

Vol 68 (4) ◽

pp. 419-425 ◽

Cited By ~ 40

Author(s):

Y. T. Kishk ◽

E. A. Trowbridge ◽

J. F. Martin

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Platelet Count ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Mean Platelet Volume ◽

Control Group ◽

Disease Group ◽

Platelet Volume ◽

Asymptomatic Group

1. Mean platelet volume and count were measured in three groups: patients with acute myocardial infarction, a control group with myocardial ischaemia but no infarction and an asymptomatic group of young males. 2. Mean platelet volume was significantly larger in the myocardial infarction group compared with the ischaemic heart disease group or the asymptomatic group. 3. Two subpopulations were present within the myocardial infarction group. One subgroup had a large mean platelet volume and low count. The other subpopulation was indistinguishable, with regard to platelet count and mean volume, from the ischaemic heart disease group. 4. Over 60% of the myocardial infarction group lay in the area of high platelet volume and low count compared with 13% of the ischaemic heart disease control group and 38% of the asymptomatic group. Acute myocardial infarction is likely to be associated with a large mean platelet volume and low count compared with the ischaemic heart disease group. There is no statistical evidence that this condition is related to smoking or size and site of infarct. 5. This evidence suggests that large mean platelet volume and low platelet count could be a major risk factor for myocardial infarction.

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Changing Mortality from Ischaemic Heart Disease and Acute Myocardial Infarction

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1978.tb131642.x ◽

1978 ◽

Vol 2 (10) ◽

pp. 461-464 ◽

Cited By ~ 3

Author(s):

I. H. Craig ◽

E. Byrne ◽

R. C. B. Tiltman

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Disease ◽

Ischaemic Heart Disease

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Influenza and Ischaemic Heart Disease-a Possible Trigger for Acute Myocardial Infarction?

International Journal of Epidemiology ◽

10.1093/ije/7.3.231 ◽

1978 ◽

Vol 7 (3) ◽

pp. 231-239 ◽

Cited By ~ 76

Author(s):

DAVID BAINTON ◽

GLYNNE R JONES ◽

DAVID HOLE

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Disease ◽

Ischaemic Heart Disease

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Increased cardiovascular mortality in people with schizophrenia: a 24-year national register study

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000166 ◽

2017 ◽

Vol 27 (5) ◽

pp. 519-527 ◽

Cited By ~ 38

Author(s):

J. Westman ◽

S. V. Eriksson ◽

M. Gissler ◽

J. Hällgren ◽

M. L. Prieto ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

General Population ◽

Cardiac Arrhythmias ◽

Rate Ratio ◽

Hospital Admissions ◽

Age Groups

AimsPeople who have schizophrenia die earlier from somatic diseases than do people in the general population, but information about cardiovascular deaths in people who have schizophrenia is limited. We analysed mortality in all age groups of people with schizophrenia by specific cardiovascular diseases (CVDs), focusing on five CVD diagnoses: coronary heart disease, acute myocardial infarction, cerebrovascular disease, heart failure and cardiac arrhythmias. We also compared hospital admissions for CVDs in people who had schizophrenia with hospital admissions for CVDs in the general population.MethodsThis national register study of 10 631 817 people in Sweden included 46 911 people who were admitted to the hospital for schizophrenia between 1 January 1987 and 31 December 2010. Information from national registers was used to identify people who had schizophrenia and obtain data about mortality, causes of death, medical diagnoses and hospitalisations.ResultsCVDs were the leading cause of death in people who had schizophrenia (5245 deaths), and CVDs caused more excess deaths than suicide. The mean age of CVD death was 10 years lower for people who had schizophrenia (70.5 years) than the general population (80.7 years). The mortality rate ratio (MRR) for CVDs in all people who had schizophrenia was 2.80 (95% confidence interval (CI) 2.73–2.88). In people aged 15–59 years who had schizophrenia, the MRR for CVDs was 6.16 (95% CI 5.79–6.54). In all people who had schizophrenia, the MRR for coronary heart disease was 2.83 (95% CI 2.73–2.94); acute myocardial infarction, 2.62 (95% CI 2.49–2.75); cerebrovascular disease, 2.4 (95% CI 2.25–2.55); heart failure, 3.25 (95% CI 2.94–3.6); and cardiac arrhythmias, 2.06 (95% CI 1.75–2.43). Hospital admissions for coronary heart disease were less frequent in people who had schizophrenia than in the general population (admission rate ratio, 0.88 (95% CI 0.83–0.94). In all age groups, survival after hospital admission for CVD was lower in people who had schizophrenia than in the general population.ConclusionsPeople who had schizophrenia died 10 years earlier from CVDs than did people in the general population. For all five CVD diagnoses, mortality risk was higher for those with schizophrenia than those in the general population. Survival after hospitalisation for CVDs in people who had schizophrenia was comparable with that of people in the general population who were several decades older.

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Diabetes mellitus type 2 and acute myocardial infarction: prognostic options for interaction in patients of different age groups

Diabetes Mellitus ◽

10.14341/dm8828 ◽

2018 ◽

Vol 21 (2) ◽

pp. 105-112 ◽

Cited By ~ 1

Author(s):

Alla A. Garganeeva ◽

Elena A. Kuzheleva ◽

Ksenia N. Borel ◽

Dina S. Kondratyeva ◽

Sergey A. Afanasiev

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Acute Myocardial Infarction ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Working Age

Background. Problems surrounding comorbidities of type 2 diabetes mellitus and coronary heart disease are some of the most important in medical science and practice, given their mutually negative impact on patients prognoses and quality of life. Aims. To study the impact of type 2 diabetes on the long-term prognoses of patients of different age categories, status-post acute myocardial infarction. (Data obtained from the Register of Acute Myocardial Infarction.) Materials and methods. The main data source was the Register of Acute Myocardial Infarction, maintained in Tomsk for more than 30 years. The study included 862 patients with acute myocardial infarction. The patients were monitored for 5 years. The primary endpoint was death from any cause during the observation period. Results. We separated the study cohort into 2 groups depending on patients ages: Group 1 (n = 358) included patients older than working age, Group 2 (n = 504) consisted of younger, employable patients. The combination of ischaemic heart disease and type 2 diabetes mellitus were diagnosed in 208 patients. The combination of ischaemic heart disease and type 2 diabetes was the cause of adverse prognosis among elderly patients and led to increased mortality rate during the 5-year post-infarction period (p = 0.0003). However, among younger, working patients who suffered myocardial infarction, the presence of type 2 diabetes did not have an independent negative effect on long-term disease prognosis. While in employable patients, a long history of diabetes mellitus significantly aggravated the course of the post-infarction period (p = 0.004). Conclusions. These data suggest an ambiguous prognostic effect of type 2 diabetes mellitus among working age and elderly patients status post myocardial infarction, in agreement with experimental studies conducted on laboratory animals. Further comprehensive analyses of the clinical and experimental data are needed to optimise therapies for patients who suffer from type 2 diabetes and comorbid ischaemic heart disease.

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Ischaemic Cardiac Disease (ICD)

10.1093/med/9780198713623.003.0006 ◽

2016 ◽

Author(s):

Patrizio Lancellotti ◽

Bernard Cosyns

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Cardiac Disease ◽

Poor Prognosis ◽

Ventricular Aneurysm ◽

Echocardiographic Examination ◽

Echocardiographic Findings

Echocardiography has established appropriate areas in the evaluation of patients with known or suspected ischaemic heart disease. This chapter highlights the main risk stratifications for assessment of acute myocardial infarction. It illustrates the main complications of acute myocardial infarction (e.g. wall rupture, ventricular aneurysm, ventricular pseudoaneurysm, thrombus, pericardial effusion, mitral regurgitation) with details of incidence, timing, echocardiographic findings and implications. This chapter also details poor prognosis risk factors found in echocardiographic examination of patients with chronic ischaemic heart disease.

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