An analytical Study to Evaluate the correlation between Serum Uric Acid Levels and Deaths in Acute Myocardial Infarction Patients At a Tertiary Level Institute Catering to Rural Population of Western Maharashtra

2021 ◽  
Vol 8 (3) ◽  
pp. 94-98
Author(s):  
Dr. Jalindar Baravkar ◽  
Dr. Shivnath Parkhe ◽  
Dr. Satish M. Kopurwad ◽  
Dr. Amrut A. Swami

Introduction: Cardiovascular diseases are the number one cause of mortality all over the world. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease. We conducted this study to assess serum uric acid levels on admission as a potential predictor of short-term mortality (7 days) in acute myocardial infarction patients. Methodology: Total of 200 patients diagnosed with the myocardial infarction (MI) in our hospital along with 200 age and gender matched controls were selected for this study. The clinical history, examination, ECG changes and biochemical markers were evaluated on day 0, 3 and 7. Association with Killips class and mortality in STEMI / NSTEMI cases was done. Results: The study had 200 cases and 200 controls. The mean age of cases was 62.54 ± 18.24 years and controls was 61.94±17.25 years. There were majority males among both cases 114 (57%) and controls 112 (56%). The patients were classified using Killip’s class. Majority belong to class I 98 (49%) followed by II 42 (21%). There were 26 (13%) of class III and 34 (17%) into class IV. There is significant difference seen between uric acid levels of cases and control on day 1, 3 and 7 (p<0.001). There was 25% mortality (50 deaths) seen among the cases. There was association seen between Killips class III & IV and mortality, there was higher mortality seen in STEMI as compared to NSTEMI (i.e. p<0.05). Conclusion: Our study concludes that the serum uric acid (SUA) levels have significant association with Killip‘s class and mortality in Acute Myocardial Infarction cases.

2021 ◽  
Vol 10 (7) ◽  
pp. 409-413
Author(s):  
Shivakumar B.G. ◽  
Shivakumar N ◽  
Siddharth Gosavi ◽  
Shashank Shastry

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.


2019 ◽  
Vol 7 (1) ◽  
pp. 51
Author(s):  
Hardeep Singh Deep ◽  
Jasmine Kaur ◽  
Gaurav Chopra ◽  
Jaskiran Kaur ◽  
Jasleen Kaur ◽  
...  

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.


2021 ◽  
Vol 34 (1) ◽  
pp. 26-32
Author(s):  
Md Amzad Hossain Sardar ◽  
Md Khalilur Rahman ◽  
Md Mahidul Alam ◽  
Md Aminul Hasan ◽  
Ashoke Sarker ◽  
...  

Background: Among non-communicable diseases, acute myocardial infarction (AMI) is a common killer of people in the world. The management of AMI patients is one of the major challenges in the field of cardiology. Uric acid has several effects of potential interest in cardiovascular disease. There are some markers indicating an unfavorable prognosis in AMI patients. Uric acid is one of the markers that have been evaluated in research. Objective: The aim of this study was to assess the association between serum uric acid level and in-hospital outcomes of AMI patients. Patients and methods: This longitudinal descriptive study was conducted over 115 AMI patients in the Cardiology Unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Baseline characteristics such as age, sex, BMI, BP, RBS, risk factors (hypertension, DM, smoking, family history of IHD, dyslipidemia), and outcomes of AMI patients (acute LVF, arrhythmia, conduction block, cardiogenic shock, death) were recorded. We measured the serum uric acid of this patient at admission.  Results: The mean age of patients was 52.83±10.71 years. Out of 115 patients, 83.5% were male, and 16.5% were female. Among the risk factors, 65.2% of patients had HTN, 20.9% DM, 64.3% smoking, 16.5% family history of IHD, and 47.8% dyslipidemia. Out of 115, 35.7% of patients demonstrated high serum uric acid. In outcomes of AMI patients, acute LVF 24.4% (p=0.031) and death 12.2% (p=0.041) were significantly higher in patients with high serum uric acid levels. Conclusion: Significant association was found between high serum uric acid level and in-hospital outcomes of AMI patients. So, estimation of serum uric acid may offer an inexpensive, quick, and non-invasive method for identifying such high-risk patients. TAJ 2021; 34: No-1: 26-32


2020 ◽  
Vol 7 (8) ◽  
pp. 1256
Author(s):  
Piyush Gosar ◽  
Ajay Pal Singh ◽  
Pravi Gosar ◽  
Bhawana Rani

Background: Elevated levels of serum uric acid are associated with increased cardiovascular morbidity and mortality. However, this association with cardiovascular diseases is still unclear, and perhaps controversial. The objective of study was to assess the serum uric acid level in patients with Acute Myocardial Infarction (AMI).Methods: Sixty patients with AMI were studied in Department of Medicine/ Department of Cardiology, J.A. Group of Hospitals between 2016 -2018.Details of age, sex, smoking, alcohol consumption and history of ischemic heart disease (IHD) was obtained and recorded. Serum uric acid level was estimated and compared with control group (healthy subjects).Results: Serum uric acid level was significantly higher among AMI patients (6.43±2.60) as compared to control group (4.05±0.95) (p<0.001). Majority (46.7%) of the AMI patients had uric acid level of >7.1 followed by 20% patients who had uric acid level between 4.5-5.9 (p<0.001). Uric acid level was comparable between smoker and non-smokers (p=0.803), alcoholic and non-alcoholic (p=0.086), hypertensive and non-hypertensive (p=0.668), patients with and without diabetes (p=0.278) and patients with a history of IHD and without history of IHD (p=0.403).Conclusions: Serum uric acid may be useful for prognostication among those with pre-existing AMI.


2017 ◽  
Vol 69 ◽  
pp. S26
Author(s):  
P. Patil ◽  
V. Somannavar ◽  
V. Kothiwale ◽  
R. Katheria

1975 ◽  
Vol 49 (3) ◽  
pp. 19P-20P
Author(s):  
P. Ghosh ◽  
A. M. G. Cochrane ◽  
P. W. N. Gordon

2014 ◽  
Vol 13 (2) ◽  
pp. 55-58
Author(s):  
Hasan Murad ◽  
Rajiv Dey ◽  
Md Atiquel Islam Chowdhury ◽  
Hridi Hedayet Ullah ◽  
Md Abdur Rouf

The association between serum uric acid and ischemic heart disease remains controversial and it has been difficult to identify the specific role of elevated serum uric acid because of its association with established cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia and obesity. Our objective was to study the association of serum uric acid level with confirmed cases of Acute Coronary Syndrome i.e. Unstable Angina, Acute Myocardial Infarction(AMI). The study was conducted in Chittagong Medical College (CMC) & University of Science and Technology(USTC) and nearby diagnostic centre. The study was based on Patients with Acute Coronary Syndrome proved by ECG and/or raised serum Troponin I. The aim of the study was to determine the relationship between serum uric acid and Unstable angina or myocardial infacrtion. There were 35% males & 5% females. The mean age of respondent was 50 years and age ranges from 35 to 70 years. In this study 50 cases of diagnosed myocardial infarction were selected and subsequently investigated with ECG, Radiological and Echocardiographic investigations. Increased serum uric acid levels are a common finding in patients with high blood pressure, insulin resistance, obesity and Cardiovascular disease. The clinical findings, chest X-ray and ECG findings of patients with risk factors for myocardial infarction were extensively studied and the findings are consistent with findings stated in textbooks.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21070


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