scholarly journals Prevalence of First Diagnosed Atrial Fibrillation in Patients Admitted with Acute Coronary Syndrome and with Impaired Renal Function with and without Diabetes Mellitus

2021 ◽  
pp. 123-128
Author(s):  
Nandlal Rathi ◽  
Muhammad Zaman Balouch ◽  
Shazia Kazi ◽  
Salman Ahmed ◽  
Abdul Mueed ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Renal Function ◽  
Risk Factor ◽  
Impaired Renal Function ◽  
P Value ◽  
Coronary Syndrome ◽  
History Of ◽  
Sugar Levels

Objective: To determine the prevalence of first diagnosed atrial fibrillation in patients admitted with acute coronary syndrome and with impaired renal function with and without diabetes mellitus. Methodology: A total of 434 patients were selected from two different hospitals, 361 from NICVD, Tando Muhammad Khan and 73 from Isra University Hospital, Hyderabad. Both males and females, aged between 18 years to 70 years, first ever presented & admitted with acute coronary syndrome (ACS) and renal impairment were included and whereas, patients with atrial fibrillation (AF) other than first diagnosed, previous history of myocardial infarction/coronary artery bypass grafting (CABG), known case of chronic kidney disease/on dialysis, history of cerebrovascular accident (CVA), patient with valvular heart disease, and pregnant women were excluded from this study. Baseline and clinical data was collected to determine the association with the prevalence of first diagnosed AF through chi-square test and a p value of <0.05 was considered as statistically significant. Results: The mean age ± SD was 49.32±12.47 years. Among them majority were males 66.35% and rural residents 51.15% respectively. The most common risk factor observed in our study was presence of hypertension (N = 231, 53.22%) and among all ACS patients, most common type of ACS was unstable angina (N = 195, 44.93%). The overall prevalence of first diagnosed atrial fibrillation was 12.44% (N = 54) and the overall prevalence of diabetes mellitus was 39.63% (N = 172). Mean random blood sugar levels in diabetic patients was 203.32±105.60 mg/dL, hypertensive patients with DM (48.14%), and patients with STEMI with DM (12.96%) were significantly associated with increased prevalence of first diagnosed atrial fibrillation, p value <0.05. Conclusion: Prevalence of first diagnosed AF is comparatively higher in our study because of the underlying renal impairment. Modifiable risk factor like uncontrolled blood sugar levels has significance association with first diagnosed AF.

scholarly journals Metabolic Risk Factors and Outcomes in Acute Coronary Syndrome

2020 ◽  
pp. 46-50
Author(s):  
Ritu Attri ◽  
Harsimran Kaur ◽  
Raminderpal Singh Sibia ◽  
Mandip Singh Bhatia
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Positive Family History ◽  
Developed Countries ◽  
P Value ◽  
Health Crisis ◽  
Female Ratio ◽  
Medical College ◽  
Coronary Syndrome ◽  
History Of

Introduction: CAD is the most common cause of mortality in India. It is a common multifarious public health crisis today and a leading cause of morbidity and mortality in both developing and developed countries. Hence, understanding the predominant risk factors among the Indian population is important. Materials and Methods: This was a hospital based age and sex matched case control study, carried out at Government Medical College and Rajindra Hospital Patiala. A total of 100 patients of Acute coronary syndrome were studied. Patients and controls were enquired about  the presence of cardiometabolic risk factors and the significance of association of these risk factors with the occurrence of Acute coronary syndrome was given by p value of  <0.05. Results: Majority of the cases were in the age group 61-70 years (32%) with male to female ratio  of 1.25:1. Significant association was found between ACS and risk factors like smoking, positive family history of IHD, hypertension, diabetes, dyslipidemia, waist hip ratio and body mass index. Overall, most common outcome of ACS in the present study was NSTEMI (45%) followed by STEMI (35%) followed by Unstable angina (20%). Conclusion: Significant association was found between smoking and occurrence of STEMI and significant association was found between Hypertension and occurrence of NSTEMI.

Can left ventricular global function index be a novel marker of unfavorable outcome in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Minushkina ◽  
V Brazhnik ◽  
N Selezneva ◽  
V Safarjan ◽  
M Alekhin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Left Ventricular ◽  
Global Function ◽  
Coronary Syndrome ◽  
History Of ◽  
Coronary Events

Abstract   Left ventricular (LV) global function index (LVGFI) is a MRI marker of left ventricular remodeling. LVGFI has high predictive significance in young healthy individuals. The aim of the study was to assess prognostic significance in patients with acute coronary syndrome (ACS). We include into this analysis 2169 patients with ACS (1340 (61.8%) men and 829 (38.2%) women), mean age 64.08±12.601 years. All patients were observed in 2 Russian multicenter observational studies: ORACLE I (ObseRvation after Acute Coronary syndrome for deveLopment of trEatment options) (2004–2007 years) and ORACLE II (NCT04068909) (2014–2019 years). 1886 (87.0%) pts had arterial hypertension, 1539 (71.0%) – history of coronary artery disease, 647 (29.8%) – history of myocardial infarction, 444 (20.5%) - diabetes mellitus. Duration of the follow-up was 1 years after the hospital discharge. Cases of death from any cause, coronary deaths, repeated coronary events (fatal and non-fatal) were recorded. An echocardiographic study was conducted 5–7 days from the time of hospitalization. The LVGFI was defined as LV stroke volume/LV global volume × 100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). During the follow-up, 193 deaths were recorded (8.9%), 122 deaths (5.6%) were coronary. In total, repeated coronary events were recorded in 253 (11.7%) patients. Mean LVGFI was 22.64±8.121%. Patients who died during the follow-up were older (73.03±10.936 years and 63.15±12.429 years, p=0.001), had a higher blood glucose level at the admission to the hospital (8.12±3.887 mmol/L and 7.17±3.355 mmol/L, p=0.041), serum creatinine (110.86±53.954 μmol/L and 99.25±30.273 μmol/L, p=0.007), maximum systolic blood pressure (196.3±25.17 mm Hg and 190.3±27.83 mm Hg, p=0.042). Those who died had a lower LVGFI value (19.75±6.77% and 23.01±8.243%, p&lt;0.001). Myocardial mass index, ejection fraction and other left ventricular parameters did not significantly differ between died and alive patients. Among the patients who died, there were higher rate of women, pts with a history of myocardial infarction, heart failure, diabetes. In a multivariate analysis, diabetes mellitus OR1.67 95% CI [1.12–2.51] p=0.012, history of heart failure (1.78 [1.2.-2.59], p=0.003), a history of myocardial infarction (1.47 [1.05–2.05], p=0024), age (1.06 [1.05–1.08], p=0.001) and LVGFI &lt;22% (1.53 [1.08–2.17], p=0.015) were independent predictors of death from any cause. The LVGFI was also independently associated with the risk of coronary death, but not with the risk of all recurring coronary events. Thus, LVGFI may be useful the marker to assess risk in patients who have experienced an ACS episode. Funding Acknowledgement Type of funding source: None

Management and Outcome of Acute Coronary Syndrome Patients in Relation to Prior History of Atrial Fibrillation

2012 ◽  
Vol 28 (4) ◽  
pp. 443-449 ◽  
Author(s):  
Darar Al khdair ◽  
Lamia Alshengeiti ◽  
Basem Elbarouni ◽  
Raymond T. Yan ◽  
Francois R. Grondin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Prior History ◽  
Coronary Syndrome ◽  
History Of

scholarly journals Fragmented QRS Complex as a Predictor of Multivessel Disease in Acute Coronary Syndrome

2017 ◽  
pp. 130-6
Author(s):  
Idar Mappangara ◽  
Abdul Hakim Alkatiri ◽  
Stefan Hendyanto
Keyword(s):  
Acute Coronary Syndrome ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Multivessel Disease ◽  
P Value ◽  
Qrs Complex ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Fragmented Qrs ◽  
History Of

Background: The incidence of multivessel disease in acute coronary syndrome (ACS) is expected to be identified as early as possible in order to perform optimal management. The presence of multivessel disease can lead to ischemia or myocardial infarction. Fragmented QRS complex (fQRS) is a new electrocardiography (ECG) parameter that has been proven to be caused by ischemia or myocardial infarction.Methods: A cross-sectional study. Patients with ACS that admitted at Dr. Wahidin Sudirohusodo Makassar since December 2014 - March 2015 who are eligible were enrolled in this study.Presence of fQRS evaluated on first 12-lead ECG at hospital admission. Presence of multivessel disease based on coronary angiography. Data were analyzed by logistic regression. Data was significant if the p-value<0.05.Results: There are 63 subjects (56 men and 7 women) included in this study. Older age, history of ACS before, presence of dyslipidemia, and presence of fQRS were significantly more often in group with multivessel disease. After analyzed with logistic regression, the fQRS was the only significant predictor of multivessel disease with p value 0.003 and odds ratio 13.28.Conclusion: Presence of fQRS in the first 12-lead ECG when admitted to the hospital was an independent predictor of multivessel disease in patients with ACS.

4183New onset atrial fibrillation in acute coronary syndrome: early vs late onset

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Alves Guimaraes ◽  
F M Goncalves ◽  
S Borges ◽  
J J Monteiro ◽  
P S Mateus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Primary Endpoint ◽  
Major Bleeding ◽  
Late Onset ◽  
Prognostic Impact ◽  
Coronary Syndrome ◽  
History Of ◽  
Onset Atrial Fibrillation

Abstract Background The prognostic impact of the timing where new-onset Atrial Fibrillation (AF) occurs in Acute Coronary Syndrome (ACS) patients isn't well studied. Objective Evaluate the predictors and prognostic impact of early-onset AF (EAF) and late-onset AF (LAF) in ACS patients. Methods We analysed 17016 patients with ACS enrolled in a national multicenter registry from October 2010 to January 2019. Patients with history of valvular disease, valve replacement, AF present at hospital admission or those who died in the first 48 hours were excluded. EAF was defined as AF in the first 48 hours of hospitalization and LAF after 48 hours. The primary endpoint was a composite of death and readmission from cardiovascular causes at 1 year. Results The mean age was 65±13 years; 74% were males and 42% had STEMI). 324 (1.9%) had EAF and 344 (2.0%) had LAF. The predictors of EAF were age ≥75 years (OR 2.04, 95% CI 1.53–2.70, p<0.001); history of heart failure (OR 1.82, 95% CI 1.09–3.02, p=0.022), STEMI diagnosis (OR 2.74, 95% CI 2.06–3.61, p<0.001), admission Killip class (KK)≥2 (OR 2.70, 95% CI 1.98–3.69, p<0.001). The predictors of LAF were age ≥75 years (OR 3.15, 95% CI 2.36–4.19, p<0.001), history of stable angina (OR 1.42, 95% CI 1.06–1.90, p=0.018), cerebrovascular disease (OR 1.68, 95% CI 1.14–2.46, p=0.008), COPD (OR 2.33, 95% CI 1.58–3.44, p<0.001), STEMI diagnosis (OR 2.31, 95% CI 1.77–3.03, p<0.001), admission KK ≥2 (OR 2.06, 95% CI 1.54–2.76, p<0.001) and stress hyperglycemia (OR 1.54, 95% CI 1.15–2.05, p=0.003) In STEMI patients only those with LAF had higher symptoms time (245 (IQR 165–400) minutes vs 284 (IQR 200–425) min; p=0.02). During hospitalization, LAF patients had a worse prognosis with a higher rate of heart failure, re-infarction, stroke, major bleeding and death (Table 1). In the follow-up, in multivarite analysis, only LAF was a predictor of the primary endpoint (EAF: HR 0.79, 95% CI 0.50–1.25, p=0.314; LAF: HR 1.45, 95% CI 1.05–2.00, p<0.025). Complications during hospitalization No AF EAF LAF p Death 1.3 6.5 12.5 <0.001 Heart Failure 11.4 38.3 50.3 <0.001 Re-enfarction 1.0 0.9 3.5 <0.001 Stroke 0.5 0.9 3.8 <0.001 Major bleeding 1.3 4.3 4.1 <0.001 Kaplan Meier curve Conclusion Patients with EAF and LAF have different characteristics and outcomes with LAF patients having a worse in-hospital and long term prognosis.

scholarly journals Screening of Hemoglobin A1c in Gestational Diabetes among women attending metabolic clinic at a tertiary care hospital in Uttar Pradesh

2019 ◽  
Vol 10 (2) ◽  
pp. 26-30
Author(s):  
Vivek Sinha ◽  
Poonam Kachhawa
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
P Value ◽  
Close Monitoring ◽  
History Of

Background: Gestational diabetes mellitus (GDM) is a common medical condition that complicates pregnancies..Gestational diabetes mellitus (GDM) is a diabetic metabolic disorder that occurs in 4% of all pregnant women and 14% of ethnic groups with more prevalence of type II diabetes. It can be defined as increased or abnormal insulin resistance, decreased insulin sensitivity or glucose intolerance with first diagnosis during pregnancy. Aims and Objectives: The purpose of this study was to evaluate the diagnostic screening value of the HbA1c, prevalence of GDM and associated risk factors. Materials and Methods: The study was conducted at the metabolic clinic; in the department of Biochemistry located at SIMS, Hapur. A semi-structured pretested questionnaire was used for data collection. Following the DIPSI guidelines, patients with plasma glucose values >140 mg/dl were labeled as GDM. Statistical methods used were OR (CI95%), percentage, Chi square. Results: Out of 500, 6.72% had GDM. Among all GDM patients, 64.71% had age more than 30 years, 70.59% had BMI more than 25, 41.18% had gravida more than 3 and p- value was significant with regard to age and BMI. P value was found to be significant for risk factors namely positive family history of Diabetes Mellitus, history of big baby and presence of more than one risk factor. Conclusion: GDM is associated with high BMI, early pregnancy loss, family history of DM and previous history of big baby and there could be more than one risk factor. Thus universal screening followed by close monitoring of the pregnant women for early detection of GDM may help improving maternal and fetal outcomes.

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