The metabolic syndrome a concurrence of disturbed glucose and insulin metabolism, overweight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent development of type 2 diabetes mellitus and cardiovascular disease (CVD). Despite its high prevalence in Asians, no national estimate is currently available on the metabolic syndrome in patients with acute myocardial infarction in Pakistan.A matched case control study using questionnaire and analysis of components of metabolic syndrome was carried out at tertiary care hospitals of Peshawar Pakhtunkhwa.The result showed that patients were 6.19 times more likely to have three or more diagnostic criteria of metabolic syndrome than the controls i.e. 55% vs 17%. This study contributed to the fact that metabolic syndrome is more common in patients with acute myocardial infarction. Screening of adults with central obesity for other parameters of the metabolic syndrome may help to reduce the prevalence of metabolic syndrome as well of myocardial infarction at an early age, which is the complication of metabolic syndrome.
Acute Myocardial Infarction is one of the leading causes of cardiovascular deaths. Left ventricular thrombus is a frequent and potentially dangerous complication of acute myocardial infarction, and is associated with increased risk of systemic embolization and higher mortality rates after acute myocardial infarction. Mural thrombosis with embolism typically occurs in the setting of a large (especially anterior) ST segment elevation acute MI. Thus, in patients with anterior ST segment elevation acute MI and in other high-risk patients, echocardiography should be performed during hospitalization to detect LV thrombus. This work is designed to highlight the magnitude of left ventricular thrombus in patients suffering from acute anterior myocardial infarction. The results of this study can be used to guide future recommendations for importance of diagnosis of this complication and guide treatment strategies in the post infarct patients, because significant frequency of left ventricular thrombus warrant early diagnosis and management of this prognostically life threatening, yet silent complication of myocardial infarction.
Fibrinolytic therapy is a time critical intervention proven to reduce mortality and morbidity in patients with acute ST elevation myocardial infarction (STEMI). Limited data exists in South Africa regarding time to fibrinolytic therapy for STEMI patients and reasons for delayed therapy. We established the frequency of fibrinolytic therapy administration to patients presenting with STEMI to a single, urban center in Pretoria, South Africa. Furthermore, we identified reasons for delays in receiving fibrinolytic agents. We suggest potential solutions to address the myriad of challenges facing our country in this regard.
Myocardial infarction is a major cause of death and disability worldwide and in Palestine as well. Acute myocardial infarction is considered the main cause of death among males 15-59 year old. Mortality rate from myocardial infarction is 18.7% in males and 7.7% in females worldwide. However, recently it has become evidenced that there are certain modifiable factors that may contribute to the occurrence of myocardial infarction. Such factors if recognized and acted upon may prevent myocardial infarction or its recurrence. The aim of this study; was to determine the effect of an educational program on compliance of myocardial infarction patients in Gaza Strip. Research design; Quasi-experimental design (pre-test/post-test) was used in this study. The study sample; consisted of 65 clients suffering from myocardial infarction who were selected randomly from cardiac outpatient clinics in Shifa and Nasser hospital in Gaza Strip. Tools for data collection included structured interviewing questionnaire that was used to collect data on sociodemographic characteristics, pretest and post-test questionnaire about patient's knowledge and reported practices, then biochemical lipid profile levels
Daibetes mellitus is a strong risk factor for heart disease. In acute myocardial infarction, plasma glucose levels on admission ( in diabetics as well as non diabetics) affect the outcome and major adverse cardiac events. We studied the relationship between stress hyperglycemia and mortality in non- diabetic and diabetic patients having acute myocardial infarction. We also tried to correlate other variables like age, sex, systolic blood pressure , serum creatinine and lipid levels on admission, with the outcome.We concluded that admission plasma sugar levels can be regarded as a strong predictor of complications and mortality after acute myocardial infarction irrespective of presence or absence of diabetes. Thus stress hyperglycemia carries as bad a prognosis as diabetes mellitus in acute myocardial infarction.
This study concludes that there is a significant rise of Homocysteine level in patients of Acute Myocardial Infarction and this rise occurs not suddenly but over a long time when the disease is being in progress which ultimately reach to Acute Myocardial Infarction. The regular surveillance of plasma Homocysteine in patients above 40 years can be utilized for the possible prediction and prevention of Acute Myocardial Infarction.
Acute myocardial infarction is one of the major challenges faced by the physicians. It is now well established that timely detection and proper treatment of early complications of acute myocardial infarction (AMI) can save many lives and decrease immature death from myocardial infarction. Considering this matter, the early complications of AMI was observed in this study and found the following: a) the incidence of complications is higher during the 1st 1-2 days, but nevertheless, it may occur later on, b) the commonest complication was arrhythmia with ventricular ectopics at the top of the list. Fortunately, most of them resolved spontaneously without fatal outcome, c) the most important cause of in hospital mortality was cardiogenic shock, d) complications and mortality are higher with anterior myocardial infarction as compared with inferior myocardial infarction. With modern CCU care, development of thrombolytic therapy, use of heparin, beta-blocker and ACE inhibitor decreases overall complications and mortality, though cardiogenic shock is still a major problem for AMI patient.
Acute myocardial infarction (AIM) resulting change in the size and shape of left ventricle (LV). Aim- to determine whether parameters of echocardiography are important in AIM in predicting LV remodeling and in prediction of adverse cardiovascular events after AMI. Methods- The study included 70 patients with AMI. Patients were examined the clinical, laboratory and ECHO (dwo-dimensional, pulsed and tissue doppler) and angiographic and reviewed after 30 days. The outcomes were: death, reinfarction, or heart failure ((HF). Results- ECHO findings showed reduced systolic and diastolic LV function in the first 24 hours of AMI, while the E/Ea manifest high values > 9, After 30 days volumes increase in enddiastole and endsystole 18,6% patients had an ejection fraction (EF) 8 After 30 days 2D ECHO demonstrated that the HF significantly higher in patients with an increased dimensions and volume LV , an enlarged left atrium, mitral regurgitation and low EF, higher E wave and lower septal S Conclusion- ECHO parameters have prognostic significance in predicting recovery of LV after early reperfusion therapy and in predicting adverse events.
The prognosis of patients with acute myocardial infarction (AMI) or heart attack has shown a steady improvement over the last three decades. Nevertheless, it remains a major public health problem both in developed and developing countries including Malaysia. This book provided important prognostic data and information for patients with acute myocardial infarction in a local setting. The content of this book includes overview of AMI globally and locally, comprehensive methods on retrospective record review design for survival study, detail results of Kaplan Meier Product-limit Estimate and Cox Proportional Hazard Regression Model survival analysis and discussion. It will benefit the researchers who interested in coronary heart disease epidemiology, prevention and control. In addition, it will definitely provides a good guide to researchers or post graduate students who conduct survival study and analysis.
Acute Myocardial Infarction is one of the leading causes of mortality worldwide . Arrhythmic events account for the major out of hospital mortality and also contributes significantly to the in hospital mortality. Various markers of adverse outcome in acute Myocardial infarction are in vogue and measurements of arrhythmogenic potential are believed to predict the risk in such patients. In this study we evaluated whether Heart Rate variablity and QT dispersion had prognostic significance in patients admitted with acute myocardial infarction.
The outcome of an acute myocardial infarction depends not only on the formation and stability of an occlusive thrombus, but also on the efficacy of the endogenous thrombolytic system, which allows reperfusion of the infarct related artery and prevents recurrent ischaemic episodes. Endogenous thrombolysis has been a neglected entity,and its beneficial effects on cardiovascular outcomes have not been studied in depth in the past. This book demonstrates the importance of endogenous thrombolysis in cardiac patients, and the effect of impaired endogenous thrombolysis on cardiovascular outcomes in patients admitted to hospital with an acute coronary syndrome.
Anxiety and depression have been reported to be quite common after a myocardial infarction. These symptoms have been associated with increased mortality and overall poorer outcomes. Studies worldwide have attempted to estimate the prevalence of depression and anxiety in patients with myocardial infarction. Research from the developing world has been sparse in this regard. This work established that anxiety and depression are quite common after a myocardial infarction in the Indian population. Relationship of these symptoms with a wide variety of clinical parameters have been assessed in this study. Symptoms of anxiety and depression have a likelihood of being missed in a busy outpatient service. Proper assessment and management of these symptoms can improve clinical outcome and quality of life of patients.
Metabolic Syndrome refers to the clustering of risk factors including obesity, elevated blood pressure (hypertension), elevated blood sugars, dyslipidaemia (high triglycerides & low HDL concentration) and hence increased risk for developing many serious medical conditions including type 2 diabetes, myocardial infarction, and stroke & early death. Lifestyle changes, one of the main factor, due to fast increasing urbanization, especially in developing countries like India, has led to the development of serious health problems like obesity, hypertension, diabetes, etc. which in turn lead to the complications like Metabolic Syndrome . About one third of the urban population in India’s major cities have Metabolic Syndrome. The National Cholesterol Education Program Adult Treatment Panel III simplified the definition of Metabolic Syndrome to make it user friendly for medical practitioners. Our study included faculty members of different professional streams using NCEP ATPIII criteria and was concluded that medical faculty had maximum percentage of subjects having Metabolic Syndrome. Early lifestyle modification leads to the reduction in these risk factors and hence to Metabolic Syndrome.
The aim of this book is to find out the most common types and causes of myocardial infarction in young people in comparison to old people. As during my work as physician in Cardiac Care Unit in Erbil/ Kurdistan of Iraq I have seen many young people had Myocardial infarction and I noticed that the inferior Myocardial infarction was the most Common type. It really influenced me to do a research to find out the most Common types and causes of myocardial infarction among young people as a comparative to old people.
Myocardial Infarction (MI) is irreversible necrosis of heart muscle secondary to prolonged ischemia. Atherosclerosis of the coronary arteries commonly causes MI and angina pectoris .Free oxygen radicals act directly on the endothelial cells and has a close interaction with lipid peroxidation, causing a modification of LDL and facilitating LDL deposition, with the consequent formation of atherosclerotic plaques. Free radical production is catalyzed and accelerated in the presence of iron. Such molecules are highly reactive. Superoxide anions produced by oxidative stress and reducing agents have been found to be capable of mobilizing iron from ferritin. Lipid hydroperoxides decompose in the presence of iron to form cytotoxic aldehydes, such as Malondialdehyde. This potential toxicity of reactive oxygen species is counteracted by cytoprotective enzymes such as Glutathione peroxidase which limit the damage caused by such species. The present study is an humble effort to evaluate the role of ferritin as an oxidant and to test whether excess body iron stores as estimated by serum ferritin concentration is associated with increase in risk of Myocardial Infarction.