scholarly journals Efficacy of Telecardiology in improving the results of Cardiac Rehabilitation after acute myocardial infarction

2016 ◽  
Vol 66 (1) ◽  
Author(s):  
Francesco Giallauria ◽  
Rosa Lucci ◽  
Francesco Pilerci ◽  
Anna De Lorenzo ◽  
Athanasio Manakos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Exercise Testing ◽  
Control Group ◽  
Maximal Heart Rate ◽  
Home Based ◽  
Group 15 ◽  
Group A ◽  
Group B

Background: This study was addressed to verify if Telecardiology (TC) improves the results of Cardiac Rehabilitation in patients following a home-based Cardiac Rehabilitation Program (CRP) after acute myocardial infarction (AMI). Materials and Methods: We studied three groups of patients after AMI: Group A (control group): 15 patients, who followed a standard in-hospital CRP of 3 weekly sessions of 2 months duration; Group B (study group): 15 patients, who were enrolled in a home-based CRP of similar duration and were monitored by TC with the aid of an ecg-device (Sorin Life Watch CG 6106); Group C (second control group): 15 patients, who followed a home-based CRP without ecgmonitoring by TC. All patients performed a symptom-limited exercise testing at the beginning of the CRP. Psychometric data (STAI-Y1, STAI-Y2, BDI) were also evaluated. At the end of the CRP all patients underwent repeated exercise testing and psychometric evaluation. Results: TC applied to the home-based CRP was associated with a good compliance to the program. Compared to Group C, in Group B we observed an increase of maximal heart rate, exercise duration, maximal work-load, and an improvement of anxiety, a trend to reduction of depression, and an improvement of quality of life. These results were very similar to Group A patients following a hospital-based CRP. Conclusions: TC improves compliance, functional capacity and psychological profile of patients undergoing a home-based CRP, compared to patients enrolled in a homebased CRP without ecg-monitoring by Telecardiology.

scholarly journals Serum uric acid levels in patients of acute myocardial infarction

2019 ◽  
Vol 7 (1) ◽  
pp. 51
Author(s):  
Hardeep Singh Deep ◽  
Jasmine Kaur ◽  
Gaurav Chopra ◽  
Jaskiran Kaur ◽  
Jasleen Kaur ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Congestive Heart Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Control Group ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Following Myocardial Infarction some proteins and enzymes, CPK-MB/ Troponin-I, T, are released into the blood from the necrotic heart muscle. Serum Uric Acid (SUA) may be a risk factor and negative prognostic marker for cardiovascular diseases. Aim of the study was to study serum uric acid levels in patients of acute Myocardial infarction with congestive heart failure, its relation with stages of congestive heart failure as per Killip classification and the role of serum uric acid levels as a marker of mortality.Methods: The case control study was conducted on 120 patients divided into two groups. Group A included 60 patients of acute Myocardial infarction. Group A was further divided into two categories. One includes 30 patients of with congestive heart failure and another includes 30 patients without congestive heart failure. Group B consists of 60 control patients. Serum uric acid levels were measured in Group A on 1st, 3rd and 7th day of hospital admission and in Group B on 1st day.Results: The study showed females have higher degree of hyperuricemia than males. SUA was significantly higher in patients of acute myocardial infarction than control group patients. SUA were also higher in patients with history of IHD, in patients with BNP >100 and it correlates with Killip class and mortality rates. Patients of acute myocardial infarction with diabetes mellitus had higher degree of hyperuricemia than nondiabetic and control group. No significant difference in SUA levels were observed with regard to age, alcohol intake, lipid profile, ejection fraction and hypertension.Conclusions: In acute myocardial infarction, patients with hyperuricemia had higher mortality and may be considered as poor prognostic biomarker.

scholarly journals Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Hoon Kim ◽  
Ae-Young Her ◽  
Myung Ho Jeong ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Outcomes ◽  
Secondary Outcome ◽  
Drug Eluting Stent ◽  
Diabetes Group ◽  
Repeat Revascularization ◽  
Group A ◽  
Group B ◽  
Diabetes Patients

AbstractWe investigated the effects of stent generation on 2-year clinical outcomes between prediabetes and diabetes patients after acute myocardial infarction (AMI). A total of 13,895 AMI patients were classified into normoglycemia (group A: 3673), prediabetes (group B: 5205), and diabetes (group C: 5017). Thereafter, all three groups were further divided into first-generation (1G)-drug-eluting stent (DES) and second-generation (2G)-DES groups. Patient-oriented composite outcomes (POCOs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcome. Stent thrombosis (ST) was the secondary outcome. In both prediabetes and diabetes groups, the cumulative incidences of POCOs, any repeat revascularization, and ST were higher in the 1G-DES than that in the 2G-DES. In the diabetes group, all-cause death and cardiac death rates were higher in the 1G-DES than that in the 2G-DES. In both stent generations, the cumulative incidence of POCOs was similar between the prediabetes and diabetes groups. However, in the 2G-DES group, the cumulative incidences of Re-MI and all-cause death or MI were significantly higher in the diabetes group than that in the prediabetes group. To conclude, 2G-DES was more effective than 1G-DES in reducing the primary and secondary outcomes for both prediabetes and diabetes groups.

scholarly journals Effects of Phase IV Pedometer Feedback Home-Based Cardiac Rehabilitation on Cardiovascular Functional Capacity in Patients With Myocardial Infarction: A Randomized Controlled Trial

2019 ◽  
Vol 4 (2) ◽  
pp. 75-80
Author(s):  
Mostafa Dehghani ◽  
Mostafa Cheraghi ◽  
Mehrdad Namdari ◽  
Valiollah Dabidi Roshan
Keyword(s):  
Myocardial Infarction ◽  
Randomized Controlled Trial ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
Home Based

Introduction: Pedometer feedback home-based cardiac rehabilitation (PFHCR) programs have been effective in augmenting exercise tolerance. Our aim was to investigate the effects of PFHCR on cardiovascular functional capacity in patients with myocardial infarction (MI).Methods: Forty MI patients were divided into two intervention and two control groups (n=10)in a randomized controlled trial. The intervention group received a PFHCR program including routine medications along with continuous exercise program, whereas the control group received traditional care without PFHCR. Baseline evaluations and cardiovascular stresses were controlled during the 8-week follow-up rehabilitation program in all patients. Data analysis was conducted using one-way ANOVA and paired sample student’s t-test (P ≤ 0.05).Results: At baseline, no significant differences were observed between the groups. After eight weeks of PFHCR, the intervention groups had significantly higher metabolic equivalent(P = 0.001), VO2max (P = 0.001), total exercise times (P = 0.001), and total distance traveled(P = 0.003) when compared with the control groups. However, no significant intra-group or inter-group differences in variables were observed between the men and women.Conclusion: Our results showed that PFHCR exhibited significant optimal effects on the cardiovascular functional capacity in MI patients.

scholarly journals Association of low Serum Magnesium level with occurrence of Ventricular Arrhythmia in patients with Acute Myocardial Infarction

2020 ◽  
Vol 35 (1) ◽  
pp. 39-46
Author(s):  
Nizam Uddin ◽  
Abdul Wadud Chowdhury ◽  
Mohsin Ahmed ◽  
Md Khalequzzaman ◽  
Gaffer Amin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Arrhythmia ◽  
Serum Magnesium ◽  
Magnesium Level ◽  
Serum Magnesium Level ◽  
Mortality And Morbidity ◽  
Group A ◽  
Group B ◽  
Plasma Magnesium

Background: Acute Myocardial Infarction is the leading cause of morbidity and mortality throughout the world. Its prevalence among developing countries has increased significantly over the past two decades. Acute myocardial infarction is associated with electrolyte imbalance most commonly hypomagnesemia and hypokalaemia. Both are associated with ventricular arrhythmia which can lead to increase hospital mortality and morbidity. Objectives: To find out association of hypomagnesemia with ventricular arrhythmia in patients with acute myocardial infarction. Methods: Patients with acute myocardial infarction admitted in the department of Cardiology, DMCH, within the study period and who fulfilled the inclusion and exclusion criteria were taken as study sample. Informed consent was taken from all patients and then the patients were evaluated by detailed history, clinical examination and relevant investigations. Serum magnesium level was measured after admission. The sample population was Grouped into Group A(Acute myocardial infarction with normal serum magnesium) and Group B(Acute myocardial infarction with hypomagnesemia). Patients were followed up regularly till discharge or death for evidence of ventricular arrhythmia. Then the obtained data was analysed with SPSS 22.0. Results: Among 110 patients of Acute MI, 44 patients were in Group A who had plasma magnesium level e”0.7 mmol/ l and 66 patients were in Group B who had plasma magnesium level <0.7 mmol/l. Incidence of hypoagnesemia was 60% and more common in male. Male vs female percentage of hypomagnesemia were 61% vs 39%. Mean age was 54.16±11.72 yrs vs 57.52±10.59 yrs in group A vs group B. On admission serum magnesium level was 0.9218 vs 0.523 mmol/L( group A vs group B). The study showed that group B patients were more haemodynamically unstable and mean SBP and DBP were found 89.39±19.93 and 60.67±11.56 mm-Hg respectively. Troponin I was markedly increased in group B than A (i.e 4.7±1.79 vs 14.6±4.3 vs ng/ml). Adverse cardiac events such as cardiogenic shock (group A vs group B = 11.36% vs 28.27%) and ventricular arrhythmias(group A vs group B = 34% vs 72.73%) were also higher in group B than group A. Mean hospital stay for group B patient was higher than group A(6.78±0.85 vs 5.31±0.35 days). The study result showed that ventricular arrhythmia is negatively correlated with serum magnesium and the correlation coefficient was - 0.541. It also showed that serum Magnesium is positively correlated with Potassium(r= 0.831, p<0.01) and Calcium(r= 0.902, p<0.001). Multiple logistic regression analysis showed that hypomagnesemia is an independent risk factor for ventricular arrhythmia. Conclusions: This study showed that in patients with acute myocardial infarction, hypomagnesemia is common and it is significantly associated with ventricular arrhythmia. So the presence of hypomagnesemia should alert the physicians to adopt corrective measures as it increases both mortality and morbidity. Bangladesh Heart Journal 2020; 35(1) : 39-46

scholarly journals Atorvastatin Reduces the Expression of COX-2 mRNA in Peripheral Blood Monocytes from Patients with Acute Myocardial Infarction and Modulates the Early Inflammatory Response

2006 ◽  
Vol 52 (2) ◽  
pp. 300-303 ◽  
Author(s):  
Ping Deng ◽  
Shui-ping Zhao ◽  
Hai-ying Dai ◽  
Xian-song Guan ◽  
Hong-guang Huang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Peripheral Blood ◽  
Blood Monocytes ◽  
Peripheral Blood Monocytes ◽  
Stable Coronary Heart Disease ◽  
Group A ◽  
Cox 2 ◽  
Group B ◽  
Routine Therapy

Abstract Background: We examined the effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI), and the plasma C-reactive protein (CRP) concentrations were also examined. Methods: Patients with AMI (n = 40) and with stable coronary heart disease (CHD; n = 18) were registered, and patients with AMI were randomly separated to a group that received routine therapy (group A, n = 20) or to a group that received routine therapy plus atorvastatin at 20 mg/day (group B, n = 20) for a week. Peripheral blood monocytes from patients with AMI both before and after treatment and from patients with stable CHD were isolated and cultured for 24 h. COX-2 mRNA expression was analyzed by reverse transcription-PCR. We measured concentrations of CRP in plasma by ELISA. Results: COX-2 expression was activated in peripheral blood monocytes from patients with AMI [0.92 (0.13)] compared with patients with stable CHD [0.19 (0.08)]; after a week of treatment, COX-2 expression in group B (reduced by 66%) was obviously lower than in group A (reduced by 24%; P &lt;0.05). Plasma concentrations of CRP from patients with AMI [43.3 (14.9) mg/L] were increased compared with those from patients with stable CHD [1.65 (0.78) mg/L; P &lt;0.05]; after a week of treatment, CRP concentrations in group B (reduced by 62%) were lower than in group A (reduced by 35%; P &lt;0.05). COX-2 expression in peripheral blood monocytes from patients with AMI was positively correlated with plasma CRP concentration (r = 0.662; P &lt;0.05). Conclusions: COX-2 may promote acute inflammatory process after AMI. Atorvastatin may improve the antiinflammatory effects through the COX-2 pathway.

DOSE-FINDING STUDY OF THROMBOLYSIS IN ACUTE MYOCARDIAL INFARCTION BY SINGLE-CHAIN PROUROKINASE

1987 ◽  
Author(s):  
C Diefenbach ◽  
R Erbel ◽  
J Meyer ◽  
C W Hamm ◽  
J Schofer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Occlusion ◽  
Dose Finding ◽  
High Dose ◽  
Single Chain ◽  
Duration Of Symptoms ◽  
Group A ◽  
Group B

In 24 patients (pts)(mean age 54.2 ± 12.1 years) with acute myocardial infarction (onset of symptoms <6 hrs; mean duration 181.8±54.4 minutes) single-chain prourokinase (PUK) was applied intravenously. PUK is an inactive proenzyme of human urokinase isolated from recombinant Escherichia coli. Efficiency and safety of low and high dose application were analysed. Complete coronary artery occlusion was proved before start of thrombolysis therapy. After 5000 IU heparine intravenously the first 12 pts were given 10 mg as a bolus followed by 30 mg within 1 hour (group A), the next 12 pts received the double dose: 20 mg as a bolus and 60 mg within 1 hour (group B). After PUK infusion 20 IU/ kg heparine were administered continously in all pts for 72 hours. There were no significant differences in age, bodyweight and duration of symptoms in both groups In group A in 6 of 12 pts (50%) reperfusion of the occluded coronary artery was achieved within 58.3±17.2 minutes; in group B 9 of 12 (75%) vessels reopened within 44.0±29.9 minutes. The remaining stenosis of coronary artery was 91% in both groups. In group A no drop of fibrinogen or plasminogen was observed; only 2 pts of group B showed significant drops of fibrinogen (below 100 mg%) and plasminogen (below 40%) plasma level. In no patient major bleeding or any other acute adverse effect occurred.Thus, intravenous application of 80 mg PUK is more effective than 40 mg PUK with low incidence of systemic side effects.

Effect of intravenous application of nicorandil on area of myocardial infarction in patients with STEMI during the perioperative stage of PCI

2020 ◽  
pp. 1-13
Author(s):  
Zheng-Dong Wang ◽  
Hao Li ◽  
Ming Liu ◽  
Ping Li ◽  
Jian Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Stent Placement ◽  
Balloon Dilation ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Post Operation ◽  
Group A ◽  
Group B ◽  
Experimental Group ◽  
Malignant Arrhythmias

OBJECTIVE: The aim of the present study was to evaluate the effectiveness and safety of nicorandil in improving the area of myocardial infarction in patients with acute myocardial infarction (AMI). METHODS: One hundred and twenty patients with acute ST-segment elevation myocardial infarction (STEMI) admitted to our hospital between December 1, 2018 and December 31, 2019 were selected and randomly allocated to the experimental group (group A, n = 60) and the control group (group B, n = 60). In the experimental group, an infusion of nicorandil was given intravenously before the first balloon dilation or 1 minute before the stent placement, and with the completion of the infusion, nicorandil maintenance infusion was given. In the control group, only balloon dilation and stent placement were undertaken. RESULTS: The postoperative peak levels of myoglobin, creatine kinase isoform and hypersensitive troponin T were significantly lower in group A than in group B (p <  0.05). Moreover, the left ventricular ejection fraction (LVEF) on the 180th day post operation was substantially greater in group A than in group B (p <  0.01), and the area of myocardial infarction was significantly smaller in patients in group A than those in group B on the 180th day post operation (p <  0.01). In terms of the safety, there were no statistically significant differences in the incidence of slow flow/no reflow, malignant arrhythmias, and hypotension within 24 hours post operation between the two groups (p >  0.05), and no major adverse cardiovascular event (MACE) occurred in either group during the postoperative follow-up period of 180 days (p >  0.05). CONCLUSION: Intravenous administration of nicorandil in patients with STEMI during the perioperative percutaneous coronary intervention (PCI) period was effective in reducing the area of myocardial infarction and myocardial injury without increasing the incidence of malignant arrhythmias, hypotension, or composite cardiovascular events during the drug administration period.

Tetranectin Levels in Patients with Acute Myocardial Infarction and Their Alterations during Thrombolytic Treatment

1998 ◽  
Vol 35 (3) ◽  
pp. 400-407 ◽  
Author(s):  
E F Kamper ◽  
L Kopeikina ◽  
A Mantas ◽  
C Stefanadis ◽  
P Toutouzas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Healthy Subjects ◽  
Positive Association ◽  
Treated Group ◽  
Fibrin Clot ◽  
Thrombolytic Treatment ◽  
Group A ◽  
Group B ◽  
Plasmin Inhibitor

Tetranectin (TN), a new regulator of fibrinolysis, was studied in the plasma of 60 patients with acute myocardial infarction (AMI) and 30 healthy subjects (HS), in relation to D-dimer (DD) and α2-plasmin inhibitor (α2-PI), to investigate its possible involvement in the pathophysiology of AMI. Thirty patients underwent thrombolytic treatment with fibrin-specific plasminogen activator (rt-PA) (group A); the other 30 patients, according to the exclusion criteria, were conventionally treated (group B). Twenty of the thrombolysized patients established early recanalization (subgroup A1), while 10 failed to respond to thrombolytic treatment (subgroup A2). Median (interquartile range), baseline plasma TN levels were lower in AMI patients compared to HS [8·27 (2·75) mg/L versus 12·1 (0·55) mg/L, P <10−6]. In subgroup A1, TN increased at the end of rt-PA infusion and returned to the baseline levels 12 h later. A positive association between DD and TN release (3 h level minus baseline level) was found ( rs = 0·48, P = 0·03) in subgroup A1. No significant alterations of TN levels were observed during therapy in subgroup A2 and group B. TN, DD and α2-PI concentrations in group B remained relatively constant during the study period. This study provides evidence of a significant decrease of TN levels in AMI patients compared to healthy subjects and of a remarkable difference in the evolution of TN levels during thrombolytic treatment with rt-PA between recanalized and non-recanalized AMI patients. Thus, an involvement of TN in the formation and dissolution of fibrin clot in AMI patients is worthy of further investigation.

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