AMI Patients Research Articles

A Comparative Evaluation of Ischemic Mitral Regurgitation in AMI Patients Managed by Revascularization Vs Optimal Medical Therapy

Objectives: Ischemic mitral regurgitation (IMR) is one of the frequent complications associated with coronary artery disease (CAD); but the optimal management of IMR is controversial. Our aim was to evaluate and compare the impact of medical therapy versus revascularization on the degree of MR.Methods: We performed observational follow up study on 114 patients admitted to our hospital with AMI and mild to moderate degree of MR. Multiple parameters were used to assess the severity of MR at baseline and after 1 year of follow up to assess the change in MR severity after medial therapy and revascularization.Results: In the medically managed group, MR grade improved in 28.57% of patients while 53.57% patients remained in the same grade as before. The grade of MR deteriorated from moderate to severe in 17.86% patients during follow up. In revascularization group; improvement in MR grade was observed in 60.71% of patients while 32.14% patients remained in the previous grade. Deterioration from moderate to severe occurred in 7.14% of patients. PCI and CABG subgroup analysis showed almost similar impact on degree of MR during follow up.Conclusion: From our study we concluded that revascularization; either in form of PCI or CABG, is associated with improvement in degree of MR when compared to optimal medical therapy alone.

Potential biomarkers of acute myocardial infarction based on weighted gene co-expression network analysis

BackgroundAcute myocardial infarction (AMI) is the common cause of mortality in developed countries. The feasibility of whole-genome gene expression analysis to identify outcome-related genes and dysregulated pathways remains unknown. Molecular marker such as BNP, CRP and other serum inflammatory markers have got the notice at this point. However, these biomarkers exhibit elevated levels in patients with thyroid disease, renal failure and congestive heart failure. In this study, three groups of microarray data sets (GES66360, GSE48060, GSE29532) were collected from GEO, a total of 99, 52 and 55 samples, respectively. Weighted gene co-expression network analysis (WGCNA) was performed to obtain a classifier which composed of related genes that best characterize the AMI.ResultsHere, this study obtained three groups of microarray data sets (GES66360, GSE48060, GSE29532) on AMI blood samples, a total of 99, 52 and 24 samples, respectively. In all, 4672 genes, 3185 genes, 3660 genes were identified in GSE66360, GSE48060, GSE60993 modules, respectively. We preformed WGCNA, GO and KEGG pathway enrichment analysis on these three data sets, finding function enrichment of the differential expression gene on inflammation and immune response. Transcriptome analysis were performed in AMI patients at four time points compared to CAD patients with no history of MI, to determine gene expression profiles and their possible changes during the recovery from myocardial infarction.ConclusionsThe results suggested that three overlapping genes (FGFBP2, GFOD1 and MLC1) between two modules could be a potential use of gene biomarkers for the diagnose of AMI.

In-Hospital outcomes in acute coronary syndrome patients with concomitant severe chronic kidney disease undergoing percutaneous coronary intervention

Objective:To determine in-hospital mortality and major adverse cardiac events (MACE) in acute coronary syndrome (AMI) patients with underlying severe chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).Methods:We conducted a retrospective cohort study from June’2013-December’2017 at Tabba Heart Institute, Karachi. Data was drawn from institutes’ database modeled after US National Cardiovascular data CathPCI registry. All AMI (STEMI: ST-elevation myocardial infarction and NSTEMI: non-ST-elevation myocardial infarction) patients undergoing PCI with creatinine clearance <30ml/min or ESRD on hemodialysis were included in the study.Results:During 54 months study period, 160 severe CKD patients underwent PCI. Mean age was 62.9±12.2 years. Men were 61.9%, hypertensive (81.3%) and diabetic (63.8%). Excluding dialysis patients, Creatinine clearance was 21.1±6.6ml/min/1.73m2. STEMI were 46.9% and 61.9% were Killip I. Mean SYNTAX score was 16.6±7.3. MACE occurred in 32.5% patients, of which 6(11.5%) had new hemodialysis and mortality: 17.5% were deceased. MACE predictor were cardiogenic shock (OR: 2.81, 95%CI: 1.17-6.74) and prior heart failure (OR: 6.84, 95%CI: 1.39-33.74), Predictor of mortality was cardiogenic shock or cardiac arrest (OR: 7.90, 95%CI: 2.95-21.17).Conclusion:Severe CKD patients undergoing PCI for AMI have drastically poor outcomes therefore individualization and patient-centric care management is mandatory.

Missed opportunities with underprescription of appropriate secondary prevention treatment at discharge in AMI patients at high risk. The FAST-MI programme

Full secondary prevention medication regimen is often under prescribed after AMI. We aimed to analyze rates of appropriate medical treatment at discharge after AMI across risk categories defined by the TIMI Risk Score for Secondary Prevention (TRS-2P), in a routine-practice population and to determine the efficacy of appropriate therapy on one-year mortality according to risk level. We used data from the 2005, 2010 and 2015 FAST-MI registries, including 12,290 consecutive AMI patients admitted to cardiac intensive care units and discharged alive. Level of risk was stratified in 3 groups using the TRS-2P score calculated at discharge: G1 (Low-risk; TRS-2P = 0 or 1); G2 (Intermediate-risk; TRS-2P = 2); and, G3 (High-risk; TRS-2P ≥ 3). Appropriate secondary prevention treatment was defined according to the latest ESC guidelines (dual antiplatelet therapy and statins for all, and ACEi/ARB and beta-blockers as indicated). Prevalence of G1, G2, and G3 was 43%, 25% and 32% respectively. Appropriate secondary prevention treatment was used in 76%, 62% and 46%, respectively. After multivariate adjustment, appropriate therapy at discharge was associated with improved survival in all risk categories: 0.60 (0.38–0.97, P = 0.03) in G1, 0.61 (0.40–0.91, P = 0.02) in G2, and 0.67 (0.55–0.82, P < 0.001) in G3. Lack of appropriate treatment at discharge resulted in an increased absolute risk of death which was considerably higher in the high-risk group ( Table 1 ). Use of appropriate medical treatment at discharge is inversely correlated with patient risk. It is associated with similar relative risk reductions in one-year death across risk categories, but in absolute terms, the increased hazard related to lack of prescription of recommended medications is much greater in high-risk patients. Specific efforts should be directed at better prescription of recommended treatment, particularly in high-risk patients.

Acute infection not only related to type 2, but also to type 1 myocardial infarction. A large prospective study from the “ObseRvatoire des Infarctus de Côte d’Or” (RICO) survey

Acute infection has been suggested to be involved in acute myocardial infarction (MI) triggering. However, pathogenesis and prognosis of infection-related MI remains unknown. To characterize infection-related MI and determine factors of in-hospital mortality. All the consecutive patients with an acute infection on admission for an acute MI were prospectively identified from the RICO database. Acute infection was diagnosed on clinical and biological criteria. Type 1 (plaque rupture or erosion) or Type 2 (ischaemic imbalance) MI were systematically adjudicated according to the 3rd universal definition of MI. Among the 465 AMI patients with infection (mean age 74 y, 60% male), 312 (67%) had a respiratory tract infection, 78 (17%) urinary tract infection and 75 (16%) another or undetermined site of infection. Type 2 MI was much more frequent than Type 1 MI (72 vs. 28%, P < 0.001). Patients with Type 2 MI were significantly older (79[69–85] vs. 68 [57–81] y, P < 0.001), had more frequent cardiovascular history, more severe clinical presentation [KILLIP > 1: (59 vs. 40%, P < 0.001)] but less severe angiographic lesions (SYNTAX score: 10[0–20] vs. 13[6–20], P = 0.03) compared with T1MI patients. In-hospital mortality was similar for both groups (11%). In Cox regression multivariate analysis, type 1 MI (vs. type 2 MI) and pulmonary tract infections (vs. non-pulmonary tract infection) were strongly associated with mortality [HR (95% CI): 3.1 (1.3–7.5) and 2.3 (1.0–5.1) respectively], as well as C-reactive protein level [HR 1.004(1.001-1.008), per mg/L]. In this large prospective study of infection-related MI, the largest to date, respiratory tract infection was the main infectious factor and was associated with a worse hospital prognosis. Moreover, our findings show that type 1 MI with infection was frequent and associated with a higher risk of in-hospital mortality.

Gambaran Serum Elektrolit Pada Pasien Acute Miocard Infark (AMI) Di Ruang Intensive Cardiovaskuler Care Unit (ICVCU) RSUD Dr. Moewardi Di Surakarta

Abstract Background: AMI is a myocardial necrosis caused by inadequate blood supply.The cardiac muscle contractility has very important role in pumping blood. Contraction of the heart in pumping blood is regulated by cardiac action potential,such as role is sodium (Na +) and potassium (K +). AMI is a myocardial necrosis caused by inadequate blood supply. Objective of this research to describe the serum electrolytes such as sodium (Na +) and potassium (K +) in patients with AMI who undergoes treatment in ICVCU of Regional General Hospital Dr. Moewardi Surakarta in 2016.Reasearch Methods: This research uses descriptive research. The subject of this research is the patients who is treated in ICVCU of Dr. Moewardi hospital with Acute Myocardial Infarction a number of 57 respondents. The researh was conducted in two months. The sampling techniques is by total sampling. The data collection method uses observation technique. Results: The average of AMI respondents are 41-60 years old in which as much as 57.9%, male respondents are as much as 75.4%, the highest classification of AMI STEMI are 75.4%, the majority of respondents whose the results of sodium levels are in &lt;136 mmol / L (low) are 71.9%, the result of potassium levels which are between 3.3 to 5.1 mmol / L (normal) are 82.5%. Conclusion: Average AMI patients are 41-60 years, the majority of respondents is male with the highestclassification of AMI STEMI and have the level of sodium is &lt;136 mmol / L (low)

A new score based on the PEGASUS-TIMI 54 criteria for risk stratification of patients with acute myocardial infarction

BackgroundAcute myocardial infarction (AMI) patients are at increased risk of death and recurrent ischemic events. We aimed to elaborate a risk score, based on the PEGASUS-TIMI 54 criteria, to predict mortality and non-fatal AMI in AMI patients. MethodsWe retrospectively analyzed two prospectively collected AMI cohorts. We calculated a cut-off for the developed score and investigated its 1-year prognostic power in the derivation cohort (n = 1257). We externally validated our score in 913 AMI patients with a longer follow-up. ResultsIn the derivation cohort, the area under the curve of the score for the primary endpoint (1-year death and non-fatal AMI) was 0.70 (95% CI 0.65–0.76; P < 0.0001) and a cut-off of 6 was identified. The primary endpoint incidence in patients with a score above and below the cut-off was 12% and 3% (P < 0.001) in the derivation cohort and 16% and 6% in the validation cohort (P < 0.001). At multivariate analysis, the HR for the primary endpoint associated with a score ≥ 6 was 4.45 (P < 0.0001) in the derivation cohort and 2.86 (P < 0.0001) in the validation cohort. One-year major bleeding rate was low (<0.2% overall) and similar between risk groups. The prognostic performance of the score cut-off persisted beyond the first year after AMI in the validation cohort, maintaining a similar risk for death and non-fatal AMI (HR 3) at every following year. ConclusionsOur score, based on the PEGASUS-TIMI 54 criteria, may identify AMI patients at high risk of recurrent ischemic events, who might benefit from thorough preventive strategies.

Components Analysis of Metabolic Syndrome in Acute Myocardial Infarction Patients

Background: Metabolic syndrome confers the risk of developing acute myocardial infarction which is the most common form of coronary heart disease and the single most important cause of premature death worldwide. The frequency and association of different components of metabolic syndrome on AMI are not well understood and has not been well evaluated.Objective: The aim of this study was to assess the components of the metabolic syndrome and its association with AMI patients. This study will help in awareness building in reducing AMI by early detection of components of metabolic syndrome.Patients and methods: This was a prospective observational study consisted of 325 AMI patients who were aged &gt;20 years. Patients with first time AMI arriving in CCU of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview, clinical examination, and laboratory tests within 24 hrs of AMI. Five components of metabolic syndrome were defined according to criteria set by modified NCEP ATP III (according to ethnic variation).Results: In AMI patients (n=325), no metabolic components were in 24 (7.4%) patients, one in 53 (16.3%), 2 components in 91(28.0%), 3 components were in 61(18.8%), 4 in 67(20.6%) and all 5 components were in 29 (8.9%) patients. In this study, there was no component in 7.4% of AMI patients, at least 1 component was 92.6%, at least 2 components were 76.3%, at least 3 components were 48.3%, at least 4 components were 29.5% and at least 5 components were 8.9%. The Metabolic syndrome was 48.3% (n=157). Among metabolic syndrome (≥3 components) in AMI (n=157, 48.3%) 4 components (20.6%) were more, next was 3 components (18.8%) and than 5 components (8.9%). Overall frequencies of components in acute myocardial infarction (n=325) were in order of abdominal obesity (54.8%) &gt; high blood pressure (54.5%) &gt; high FPG (54.2%) &gt; Triglyceride (46.2%) and low HDL-C (46.2%) in acute myocardial infarction. Highest percentage was observed in abdominal obesity (54.8%) followed by high blood pressure (54.5%) and FPG (54.2%).TAJ 2016; 29(2): 6-10

Frequency of Metabolic Syndrome in Male Patients with Acute Myocardial Infarction

Background: Acute myocardial infarction is the most common form of coronary heart disease and the single most important cause of premature death worldwide. A large proportion of patients with coronary disease have metabolic syndrome, although the frequency and association of its different components are not well understood. The risk of the metabolic syndrome on AMI has not been well evaluated.Objective: The aim of this study was to assess the prevalence of the metabolic syndrome and its association with AMI patients. This study will help in awareness building in reducing AMI by early detection of metabolic syndrome.Patients and methods: This was a prospective observational study consisted of 222 persons of male AMI patients who were aged &gt;20 years. Patients with first time AMI arriving in CCU of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview, clinical examination, and laboratory tests. Five components of metabolic syndrome were defined according to criteria set by modified NCEP ATP III (according to ethnic variation) which had abdominal obesity (waist circumference), FBS, HDL-C, Triglyceride, and hypertension were measured within 24 hrs of AMI.Results: A total of 222 patients diagnosed with AMI were inducted in the study. The mean±SD age of the male was 53.51±11.63 years. Among the male patients highest percentage was in the age group 51-60 years (31.1%) followed by 41-50 years (27%) and then age group &gt;60 (24.3%). Study showed that acute Myocardial infarction patients was more in age group &gt;40 years of age. Highest percentage was observed in abdominal obesity (52.3%) followed by high blood pressure (50.0%) and FPG (46.4%). The Metabolic syndrome was 37.4 % (n=83).Conclusion: The metabolic syndrome was associated with an increased risk of AMI. The metabolic syndrome had a high prevalence in patients with AMI.TAJ 2014; 27(1): 57-61

Abstract 17414: Increased Activity of Brain Region Governing Stress Perception is Associated With Plaque Vulnerability and Vascular Inflammation in Acute Myocardial Infarction Population; Retrospective and Prospective Study Evaluated by 18 FDG-PET/CT and OCT

Backgrounds: Chronic mental stress is a major risk factor of coronary artery disease, but there is a lack of direct mechanistic evidence between brain amygdala activity, a neural stress center, versus plaque vulnerability in acute coronary syndrome. In this study, we aimed to evaluate whether brain amygdala activity in AMI patients assessed by 18 F-FDG PET/CT could be associated with vascular inflammation in carotid beds and high-risk coronary plaque features evaluated by OCT. Methods and Results: In retrospective analysis, the patients who underwent 18 F-FDG PET/CT and CAG at Korea University Guro Hospital (Seoul, Korea). Among 1802 patients underwent 18 F-FDG PET/CT from October 1 2009 to 31 December 31 2015, 230 patients received CAG. After excluding 36 patients who had active cancer or brain disease, 198 were stratified according to degree of coronary severity by syntax score [none (n=159); mild to moderate (n=26); severe (n=13)]. Brain amygdalar activity on PET was quantified as target-to-background ratio (TBR) of standardized uptake value (amygdalar SUV max /temporal SUV mean ). The amygdalar TBR was significantly higher in patients with severe coronary disease rather than those without coronary stenosis or mild to moderate stenosis assessed by syntax score (P=0.03). Intriguingly, among 13 patients with severe CAD, the amygdalar TBR significantly increased in the 6 patients presented as AMI compared to non-MI patients (P=0.03). In following prospective study, we performed 18 F-FDG PET/CT in AMI patients underwent percutaneous coronary intervention within index admission period, and in patients with chronic stable angina (CSA) as control. The plaque morphology in non-culprit segment of infarct-related artery (IRA) was estimated by OCT in AMI patients. Brain amygdalar TBR was significantly higher in AMI patients compared to CSA patients (p&lt;0.05). In AMI patients, amygdalar activity was significantly associated with vascular inflammation quantified as carotid TBR (p&lt;0.05). The increased amygdalar activity was associated with high-risk plaque characteristics of non-culprit segments of IRA. Conclusions: The amygdalar activity assessed by 18 F-FDG PET/CT was significantly higher in patients with AMI than CSA. This amygdalar activity was related to vulnerable plaque characteristics of IRA. Our results suggest that brain emotional activity in ACS could contribute to plaque instability in pan-vascular beds.

A16381 Cardiovascular Risk Factors in Hypertensive Vs Non-Hypertensive Patients with Acute Myocardial Infarction in India

Objectives: Previous studies have shown that hypertension is a risk factor of mortality and morbid events following acute myocardial infarction. In addition, patients with hypertension may have other risk factors for acute myocardial infarction such as diabetes mellitus, tobacco use, physical inactivity. This study aimed to explore the distribution of cardiovascular (CV) risk factors among patients of acute myocardial infarction with and without hypertension. Methods: Participants were acute myocardial infarction patients (n = 3522) admitted to 22 tertiary care hospitals with hypertension (n = 1014) and without hypertension (n = 2508), aged 18–80 years, recruited for the Yoga-CaRe, a multicenter randomized controlled trial. Data on socio-demographics, clinical and behavioral characteristics of those with and without hypertension were compared and analyzed using multivariable logistic regression model. Results: The prevalence of hypertension among male and female AMI patients were 25.9% and 47.0% respectively. The mean age (years) for hypertensive patients was 57.1 ± 9.7 and for non-hypertensive patients was 51.8 ± 11.0. Patients with hypertension had higher odds of having diabetes, overweight, central obesity and being physically inactive (Table 1). No differences were found in ever tobacco use between hypertensive and non-hypertensive groups. Conclusion: Hypertensive acute myocardial infarction patients had higher odds of behavioral and physiological cardiovascular risk factors. Cardiac rehabilitation may be tailored to address these differentials.

Electrolyte dysfunction in myocardial infarction patients

Background: Myocardial Infarction (MI) is the term given for a state of myocardial necrosis which is secondary to an acute interruption of the coronary blood supply. Severity is dependent on level of occlusion, length of time of occlusion and presence or absence of collateral circulation. Myocardial infarction is now considered part of a spectrum referred to as acute coronary syndrome. It is a spectrum of acute myocardial ischemia that also includes unstable angina (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI). The changes in serum electrolytes were studied in this study with a special focus on sodium and potassium serum levels in patients suffering from AMI. Hence, the aim of the study was to examine the changes in serum electrolytes among AMI patients and then comparison was done with the healthy persons.Methods: The study comprised of 80 subjects, which were divided equally into study group and control group. The study group comprised cases of confirmed diagnosis of recent onset of AMI. Clinical data was collected using interviewing questionnaires. The blood samples of both groups were analysed for serum electrolytes (Na+, K+, Cl-, Ca+ and Mg+) with the help of ion sensitive electrode analyser along with quality control sera.Results: There was statistically significant decrease in sodium and potassium levels in AMI patients. It was found that there was decrease in sodium serum levels in AMI patients suffering with hypertension. Potassium levels were increased in AMI patients suffering from Diabetes Mellitus and Hypertension, which was found to be statistically significant.Conclusions: Hyponatremia and hypokalemia are indicators of acute myocardial infarction. Serum sodium and potassium levels are prognostic indicators, i.e., rise in sodium levels after initial fall was indicative of clinical improvement. Therefore, estimation of sodium and potassium level in acute MI patients can help assess their prognosis.

In-hospital Outcome of Patients Presenting with Acute Anterior STEMI with Complete Right Bundle Branch Block

Background: Patients with acute anterior ST-segment elevation myocardial infarction (STEMI) and right bundle-branch block (RBBB) have high mortality risk, which may be stratified by early ECG changes. Our objective was to find out and to compare in-hospital outcome of patients presenting with acute anterior STEMI with or without complete RBBB.Methods: This prospective cohort study was conducted in the Department of Cardiology, Dhaka Medical College Hospital, Dhaka, over a period of one year from March 2016 to February 2017. A total of 184 patients were included in this study of which 32 patients were included in group A (acute anterior STEMI with complete RBBB) and 152 patients were included in group B (acute anterior STEMI without any BBB or fascicular block).Results: RBBB was documented in 17.4% (32) of patients with acute anterior STEMI. Acute LVF (50.0% vs. 26.3%, p&lt;0.05), Cardiogenic shock (31.3% vs. 13.2%, p&lt;0.05) and mortality (21.9% vs 7.9%, P&lt;0.05) were more frequently observed in patients with complete RBBB in comparison to patients without any BBB or fascicular block (FB). Among the AMI patients with RBBB, permanent RBBB was associated with a greater incidence of acute LVF (54.2% vs 37.5%, p&gt;0.05), cardiogenic shock (37.5% vs 12.5%, p&gt;0.05) and mortality (25% vs 12.5%, p&gt;0.05).Conclusion: In this study right bundle branch block accompanying acute anterior STEMI was associated with high in-hospital adverse outcomes.Cardiovasc. j. 2018; 11(1): 31-38

P6257Missed opportunities with underprescription of appropriate secondary prevention treatment at discharge in AMI patients at high risk. The FAST-MI programme

P6257Missed opportunities with underprescription of appropriate secondary prevention treatment at discharge in AMI patients at high risk. The FAST-MI programme

Twelve-month clinical outcomes of acute non-ST versus ST-segment elevation myocardial infarction patients with reduced preprocedural thrombolysis in myocardial infarction flow undergoing percutaneous coronary intervention

Reduced preprocedural thrombolysis in myocardial infarction (TIMI) flow in patients with ST-segment elevation myocardial infarction (STEMI) is known to be associated with increased mortality. However, clinical implications of reduced preprocedural TIMI flow in patients with non-ST-segment elevation myocardial infarction (NSTEMI) have not been fully elucidated as yet. The aim of the present study was to compare the clinical influence of reduced preprocedural TIMI flows between patients with STEMI and NSTEMI undergoing percutaneous coronary intervention (PCI). From the Korea Acute Myocardial Infarction Registry, a total of 7336 AMI patients with angiographically confirmed reduced preprocedural TIMI flow (TIMI 0/1) during PCI were selected and divided into STEMI (n=4852) and NSTEMI (n=2484) groups. The 12-month composite of total death, nonfatal myocardial infarction, coronary artery bypass graft, and repeated PCI was compared between the two groups. After adjustment of baseline confounders by propensity score stratification, the NSTEMI group had lower incidences of major adverse cardiac events than the STEMI group (7.15 vs. 11.19%; hazard ratio: 0.63; 95% confidence interval: 0.47-0.84; P=0.001) at 12 months, which was largely attributable to the lower incidences of total deaths (2.43 vs. 3.99%; P=0.04) and repeated PCI (3.81 vs. 6.41%; P=0.01). Among AMI patients with TIMI 0/1, patients with NSTEMI had better outcomes compared with those of patients with STEMI on the basis of the incidences of 12-month outcomes. This could be attributable to lower total death and repeated revascularization in patients with NSTEMI.

P3428Changing profile and outcome of AMI patients with previously known coronary artery disease. The FAST-MI programme

P3428Changing profile and outcome of AMI patients with previously known coronary artery disease. The FAST-MI programme

P5587Guideline-recommended optimal medical therapy in AMI patients undergoing PCI with DES: adherence and clinical outcomes using national health insurance data

P5587Guideline-recommended optimal medical therapy in AMI patients undergoing PCI with DES: adherence and clinical outcomes using national health insurance data

Study of pro-oxidant status in acute myocardial infarction

Background: Apart from several well documented risk factors; oxidative stress may play an important role in the pathogenesis of myocardial infarction. Our study has been designed to investigate the pro-oxidant status in AMI patients who have no previous history of diabetes, hypertension and habit of smoking.Aims and Objectives: To measure the level of serum thiobarbituric acid reactive substances(TBARS) to assess the extent of oxidative damage in recently diagnosed cases of AMI and to look for any correlation between this stress marker and some of the lipid profile markers.Materials and Methods: A cross sectional study was conducted in a tertiary care hospital with 50 non-diabetic, non-hypertensive, non-smoker AMI patients of either sex as Cases and 50 age and sex matched healthy Controls. The biochemical parameters were measured by validated techniques.Results: Level of serum TBARS (4.78 ± 1.06 nmol/ml) has significantly increased (p&lt;0.001) in cases with respect to control group(2.19±0.41 nmol/ml); a positive correlation between serum TBARS and LDL; a negative correlation between serum TBARS and HDL in cases.Conclusion: Our study indicates an increased oxidative stress in AMI patients even in absence of some high risk factors which are oxidative stress inducers by themselves. This evidence suggests that oxidative stress itself may play an important role in the pathogenesis of myocardial infarction. So, the oxidative stress marker may have the importance in early diagnosis of AMI. It also suggests the potential appropriateness of antioxidant therapy in the prevention of AMI.Asian Journal of Medical Sciences Vol.9(4) 2018 31-34

Prevalent Prediabetes at Admission due to Acute Myocardial Infarction Does Not Affect One-Year Mortality Rates of Patients Who Were Discharged Alive

Background: Although prediabetes increases AMI risk, long-term clinical implication for prevalent prediabetes in AMI patients is not clear. The present study aimed to evaluate whether prediabetes at admission increases long-term cardiovascular (CV) and total mortalities in AMI patients who were discharged alive. Methods: We obtained AMI patient data from The Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) registry. Total and CV mortalities at 12 months after AMI were assessed. Results: A total of 13104 patients with AMI from the registry database were analyzed. 552 patients (4.2%) were destined to in-hospital mortality or hopeless discharge. We classified the remaining patients into control, prediabetes, and diabetes groups according to one of fallowing parameters: prevalent diabetes by past history, diabetes medication during hospitalization, or in the remaining cases with no diabetes history or medication data by hemoglobin A1c level at admission. Patients without any data about above-mentioned parameters were excluded in this study (n= 3583), and a total of 8969 AMI patients were available for analysis (control group, n=2379; prediabetes group, n=2321; and diabetes, n=4269). After adjustment for multiple factors, hazard ratios (HRs) (95% CI) for total mortality in prediabetic group vs. control group and diabetic group vs. control group were 1.536 (0.879-2.685, p=0.132) and 1.94 (1.184-3.190), p&amp;lt;0.01), respectively. However, CV mortality were not different between the three groups. Conclusions: Our results show that that prediabetic state at AMI admission do not increase CV mortality and all-cause mortalities at 1-year after survival discharge, whereas diabetes increase 1-year all-cause mortality. Disclosure I. Park: None. D. Lee: None. S. Yu: None. K. Lee: None.

ИЗМЕНЕНИЯ КОРОНАРНОГО КРОВОТОКА У БОЛЬНЫХ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ В СОЧЕТАНИИ С ОСТРЫМ ИНФАРКТОМ МИОКАРДА С ПОДЪЕМОМ СЕГМЕНТА ST ЭЛЕКТРОКАРДИОГРАММЫ ПО ДАННЫМ АНГИОГРАФИЧЕСКОГО ИССЛЕДОВАНИЯ

The aim of the study was to investigate coronary arteries damage during ST-elevation myocardial infarction (STEMI) manifestation in patients with chronic obstructive pulmonary disease (COPD). The protocols of coronary angiography of 90 patients who suffered STEMI were analyzed. The patients were divided into two groups depending on the presence of COPD. The first group (50 people) was formed from the patients who had ST elevation myocardial infarction (STEMI) and COPD. The second group (40 people) had STEMI and no COPD. It was found that in case of COPD and STEMI comorbidity the number of coronary stenosis is bigger than in case of mono AMI patients. In the group of patients with COPD and STEMI the angiographic picture of atherosclerosis damage of coronary arteries demonstrates the prevalence of medium and distal stenosis of major branches and coronary arteries of the second order unlike the group with isolated STEMI. The number of extended stenosis in the group with the comorbid pathology is also higher. The patients with STEMI have the same number of hemodynamically important stenosis as the other group. The correlation between the change of the vessel channel and smoking anamnesis, the level of the systematic inflammation marker (CRP) and the level of lipids in patients with COPD and STEMI was studied. The severity of coronary atherosclerosis directly correlates with CRP level, smoking anamnesis, level of cholesterol, LDLP. The number of distal stenosis, including those that are hemodynamically important, has reverse correlation with the level of HDLP.