acute mi
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2022 ◽  
Vol 7 (1) ◽  
pp. 11-17
Author(s):  
Rahmat Ali Khan ◽  
Syed Munib ◽  
Mohammad Shahzad ◽  
Mufti Baleegh ◽  
Liaqat Ali ◽  
...  

  Background: Acute kidney injury may increase the risk for CKD and end-stage renal disease. In an attempt to summarize the literature and provide more compelling evidence, we conducted a systematic review comparing the  risk for CKD (chronic kidney disease), AKI (Acute kidney injury), Acute gastroententeritis, postnatal   AKI, Acute MI (myocardial infarction), AKI  2ndry to chemotherapy, AKI  2ndry to abstractive Nephropathy, AKI 2ndry to sepsis, AKI 2ndry to Drugs (NSAIDS and ARBS), AKI 2ndry to AGN (acute Glomerulonephritis), AKI 2ndry to Rhabdomyolysis, and lest AKI 2ndry to Malaria, death in patients with AKI,HD, CKD (chronic kidney disease). There have been several important developments in the literature recently regarding the association between acute kidney injury (AKI) and chronic kidney disease (CKD). First, when the National Kidney Foundation promulgated their highly influential Kidney Disease Outcomes Quality Initiative CKD guidelines in 2002, six chapters were devoted to the complications associated with decreased glomerular filtration rate (GFR) including hypertension, anemia, nutritional status, bone disease/disorders of calcium, and phosphorus metabolism, neuropathy Objective: To study the outcomecute kidney injury following chronic kidney disease; systematic review.  Methods: This was a prospective observational study from January 2018 to December 2020. Patients visiting department of Nephrology Nawaz Sharif Kidney center Swat, number of patients included study 351. All ages and both sexes were considered. Patients treated elsewhere or who has undergone in this study. Complete medical history, detailed examination like age, sex, diagnosis, and outcome, of AKI, examination under microscope and investigations, and necessary blood investigations were carried out. Results: Three fifty one (351) patients were included in this study. The age distribution showed (75%) patients between 40-95 years and 25(25%) between 32-39 years. Mean age was 43 years with Standard Deviation of ± 35.66. Among 351 patients 162 (45%) patients were male and 189 (55%) patients were female. Duration of symptoms in 24(17%) was <4 months and 112(75%) had >4 months, with mean of 4 months and SD ± 2.315. Total 351 participants AKI 45(12%) postnatal AKI 33(9%) Acute MI 18(6%) AKI 2ndry chemotherapy 15(5.72%) AKI 2ndry to abstractive Nephropathy 55 (14%) AKI 2ndry to sepsis 63 (17%) AKI 2ndry to Drugs (NSAIDS and ARBS)   54 (14%) CKD (chronic kidney disease) 48 (15%) AKI 2ndry to Rhabdomylysis 18(6%) Conclusions: The study concludes that the acute kidney injury following CKD systematic reviewing among patients presenting with AKI,CHD ,AKI sepsis, ,AKI Drugs(NSIAD)  in local hospital  settings This can be reduced with proper health education in general public regarding prevention of the disease and hence its complications.  


2022 ◽  
pp. 16-32
Author(s):  
Abhishek Kumar Singh ◽  
Rakesh Kumar Jat

Myocardial infarction (MI), commonly known as a heart attack is the disease of the blood vessels supplying the heart muscle (Myocardium) i.e. coronary heart disease. The area of heart muscle that has either zero flow or so little flow that it cannot sustain cardiac muscle function is said to be infracted and the overall process is called a myocardial infarction. MI are of two types; transmural and subendocardial. Mainly it is caused due to oxidative stress and atherosclerosis.Chest pain is the most common symptom of acute MI and is often described as a sensation of tightness, pressure, or squeezing. Other symptoms include diaphoresis (an excessive form of sweating), Shortness of breath (dyspnea), weakness, light-headedness, nausea, vomiting, and palpitations. The most common symptoms of MI in women include dyspnea, weakness, and fatigue, sleep disturbances. It can be treated by using  blockers, diuretics, ACE inhibitors, calcium channel blockers and nitrates.


TH Open ◽  
2021 ◽  
Author(s):  
Shumpei Kosugi ◽  
Yasunori Ueda ◽  
Haruhiko Abe ◽  
Kuniyasu Ikeoka ◽  
Tsuyoshi Mishima ◽  
...  

Objective: Although blood thrombogenicity seems to be one of the determinant factors for the development of acute myocardial infarction (MI), it has not been dealt with in-depth. This study aimed to investigate blood thrombogenicity and its change in acute MI patients. Methods and Results: We designed a prospective, observational study that included 51 acute MI patients and 83 stable coronary artery disease (CAD) patients who underwent cardiac catheterization, comparing thrombogenicity of whole blood between: (1) acute MI patients and stable CAD patients; and (2) acute and chronic phase in MI patients. Blood thrombogenicity was evaluated by the Total Thrombus-Formation Analysis System (T-TAS) using the area under the flow pressure curve (AUC30) for the AR-chip. Acute MI patients had significantly higher AUC30 than stable CAD patients (median [interquartile range], 1771 [1585 - 1884] vs. 1677 [1527 - 1756], p = 0.010). Multivariate regression analysis identified acute MI with initial TIMI flow grade 0/1 as an independent determinant of high AUC30 (β = 0.211, p = 0.013). In acute MI patients, AUC30 decreased significantly from acute to chronic phase (1859 [1550 - 2008] to 1521 [1328 - 1745], p=0.001). Conclusion: Blood thrombogenicity was significantly higher in acute MI patients than in stable CAD patients. Acute MI with initial TIMI flow grade 0/1 was significantly associated with high blood thrombogenicity by multivariate analysis. In acute MI patients, blood thrombogenicity was temporarily higher in acute phase than in chronic phase.


2021 ◽  
pp. 60-66
Author(s):  
A. V. Marchenko ◽  
A. S. Vronskiy ◽  
P. A. Myalyuk ◽  
P. V. Lazarkov ◽  
Yu. S. Sinelnikov

Study objective: to present the immediate and mid-term results of onestage surgical treatment of patients in the volume of CEE and CABG based on a differentiated approach to patient selection.Materials and methods: in FCCVS n.a. S.G. Suhanov, Perm developed an algorithm for choosing treatment tactics in patients with combined atherosclerotic lesions of the coronary and brachiocephalic arteries. According to this algorithm, for the period from 01.07.2014-01.01.2021, one-stage correction of CABG + CEE was performed in 104 patients. The primary endpoints were all-cause death, acute myocardial infarction (MI), transient ischemic attack (TIA), and stroke. Hospital and midterm results were analyzed. The average follow-up time in the study of mid-long-term results was 40.3 ± 20.4 months.Results: in the study of hospital outcomes, the mortality rate was 0%. There were recorded 3 (2.9%) cases of perioperative stroke and 1 (0.9%) case of myocardial infarction. There were no cases of TIA. The combined endpoint (death, acute MI, stroke, TIA) reached 4 (3.8%) patients. In the study of mid-term results, we were able to contact 96 patients out of 104 operated on (92.3%). The survival rate was 94.8%. 5 (5.2%) people died. There were 2 (2.1%) cases of myocardial infarction, 4 (4.1%) cases of stroke.Conclusions: simultaneous revascularization of the carotid and coronary regions of CABG + CEE is safe and allows adequate elimination of the lesion in both regions.


2021 ◽  
Author(s):  
Salim Barywani ◽  
Magnus C Johansson ◽  
Silvana kontogeorgos ◽  
Zacharias Mandalenakis ◽  
Per-Olof Hansson

Abstract Background: Reduced left ventricular ejection fraction (LVEF) is associated with increased mortality after myocardial infarction (MI). However, the prognostic impact of elevated systolic pulmonary artery pressure (sPAP) in the elderly patients with MI is not well studied. Purpose: We aimed to study the impact of elevated sPAP on one- and five-year all-cause mortality after acute MI in patients 80 years of age and older.Methods: Of a total number of 353 patients(≥80 years old)that were hospitalized with acute coronary syndrome, 162 patients presenting with acute MI and with available data of sPAP on echocardiography were included and followed-up for 5 years. The survival analyses were performed using Cox-Regression models adjusted for conventional risk factors including LVEF.Results: Altogether 65 of 162 patients (40%) had ST-segment elevation MI, and 121 (75%) of patients were treated with percutaneous coronary intervention in the acute phase. Echocardiography during the admission revealed that 78 patients (48%) had a LVEF ≤ 45% and 65 patients (40%) had a sPAP ≥40 mmHg. After one and five years of follow-up, 23% (n=33) and 53% (n=86) of patients died, respectively. A multivariable Cox-Regression analysis showed that the elevated sPAP was an independent predictor of increased mortality in both one and five years after acute MI; HR of 3.4(95%, CI 1.4-8.2, P 0.006) and HR of 2.0(95%, CI 1.2-3.4, P 0.004) respectively, whereas LVEF did not show any statistically significant impact, neither on one- nor on five-year mortality (HR 1.4, 95% CI 0.8-2.4, p=0.158) and (HR 1.3, 95% CI 0.6-2.9, p=0.469), respectively.Conclusion:Elevated sPAP is an independent risk factor for one- and five-year all-cause mortality in patients with acute MI and it seems to be a better prognostic factor for death than LVEF. The risk of all-cause mortality in MI patients increased with increasing sPAP.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaoxiao Zhao ◽  
Ying Wang ◽  
Runzhen Chen ◽  
Jiannan Li ◽  
Jinying Zhou ◽  
...  

Abstract Aim The present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI. Methods and outcomes A total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P = 0.005), plaque erosion (P = 0.045), macrophage infiltration (P = 0.026), and calcification (P = 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846. Conclusion The results of this study could be used in clinical practice to support risk stratification. Trial registration This study was registered at ClinicalTrials.gov as NCT03593928.


2021 ◽  
pp. 7-11
Author(s):  
A. V. Naumov ◽  
T. V. Prokofieva ◽  
O. S. Polunina ◽  
L. V. Saroyants ◽  
E. A. Polunina

Objective. Development of an algorithm for predicting the complicated course of acute MI (rhythm disturbances, acute left ventricular failure: pulmonary edema, cardiogenic shock) in patients with COPD.Materials and methods. 37 patients with acute myocardial infarction on the background of COPD were examined, undergoing inpatient treatment in the conditions of the regional vascular center of the State Budgetary Healthcare Institution of the Alexandro-Mariinsky Regional Clinical Hospital in 2017–2019. Clinical examination included assessment of complaints, life history and illness. The enzyme-linked immunosorbent assay was used to determine: the concentration of the HSP 70 protein using the HSP 70 High Sensitivity EIA Kits (Stressgen, USA), interleukins IL‑1β, IL‑2, IL‑6 with reagent kits of VEKTOR-BEST JSC (St. Novosibirsk, Russia) and neopterin test with the Neopterin ELISA kit (IBL International, Germany). Determination of the content of apoptotic cells from heparinized venous blood was performed using the Annexin-V-FITC / 7AAD reagent kit (Beckman Coulter, USA). Statistical data processing was carried out using the SPSS 26.0 (USA).Results. When analyzing the frequency of occurrence of the studied laboratory diagnostic signs, significant differences were found for the indices of circulating annexin V mononuclear cells at an early stage of apoptosis and neopterin. Based on the data obtained and the selection of predictors, the probability of complications (rhythm disturbances, acute left ventricular failure) was calculated using the logistic regression equation. Using ROC analysis, a cut-off was determined for the levels of circulating annexin V mononuclear cells at an early stage of apoptosis and neopterin.Conclusion. Information on the estimated high risk of developing complications of acute myocardial infarction, such as rhythm disturbances and acute left ventricular failure, will help to purposefully select the amount of preventive and therapeutic measures in patients with acute MI associated with COPD to minimize this risk.


2021 ◽  
Vol 10 (20) ◽  
pp. 4630
Author(s):  
Francesco Pelliccia ◽  
Mario Marzilli ◽  
William E. Boden ◽  
Paolo G. Camici

When acute myocardial injury is found in a clinical setting suggestive of myocardial ischemia, the event is labeled as acute myocardial infarction (MI), and the absence of ≥50% coronary stenosis at angiography or greater leads to the working diagnosis of myocardial infarction with non-obstructed coronary arteries (MINOCA). Determining the mechanism of MINOCA and excluding other possible causes for cardiac troponin elevation has notable implications for tailoring secondary prevention measures aimed at improving the overall prognosis of acute MI. The aim of this review is to increase the awareness that establishing the underlying cause of a MINOCA is possible in the vast majority of cases, and that the proper classification of any MI should be pursued. The initial diagnosis of MINOCA can be confirmed or ruled out based on the results of subsequent investigations. Indeed, a comprehensive clinical evaluation at the time of presentation, followed by a dedicated diagnostic work-up, might lead to the identification of the pathophysiologic abnormality leading to MI in almost all cases initially labeled as MINOCA. When a specific cause of acute MI is identified, cardiologists are urged to transition from the “all-inclusive” term “MINOCA” to the proper classification of any MI, as evidence now exists that MINOCA does not provide conceptual clarity for actionable decision-making in MI with angiographically normal coronary arteries.


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