Factor In Acute Myocardial Infarction Research Articles

Single-cell sequencing combined with transcriptomics and invivo and invitro analysis reveals the landscape offerroptosis in myocardial ischemia-reperfusion injury.

Myocardial ischemia-reperfusion injury (MIRI) is a significant risk factor for acute myocardial infarction and is closely associated with ferroptosis. This study aimed to identify key ferroptosis-related genes as potential diagnostic markers for MIRI and to explore their roles in immune infiltration and therapeutic targeting in myocardial tissue. We obtained single-cell RNA sequencing (scRNA-seq) and RNA-seq data on MIRI from the GEO database, applied Seurat and UMAP for data processing and clustering, and analyzed ligand-receptor interactions using CellPhoneDB. By scoring ferroptosis in cardiomyocytes, we identified differentially expressed genes and conducted GO and KEGG pathway analyses. A protein interaction network was then constructed using the STRING database, and seven key genes (Atp5h, Vdac2, Pkm, Cycs, Hspa8, Tpi1, Ldha) were identified through Lasso regression modeling, showing significant associations with immune responses. Invivo experiments in a mouse ischemia-reperfusion model confirmed the roles of these seven genes in MIRI via RT-qPCR. To further investigate the role of Hspa8 in ferroptosis and MIRI, siRNA knockdown experiments were performed in H9C2 rat cardiomyocytes, and its involvement in ferroptosis was validated by JC-1 staining and PCR analysis. This study reveals the importance of ferroptosis-related genes in MIRI through integrated bioinformatics and experimental approaches, offering new insights into diagnostic markers and immune-related therapeutic targets for MIRI.

Triglyceride-glucose index as a prognostic factor in acute myocardial infarction

Triglyceride-glucose index as a prognostic factor in acute myocardial infarction

Association of Risk Factors of Acute Myocardial Infarction and Heart Blockage Among non-diabetic Patients in a Tertiary Care Hospital – An Observational Study

Introduction: Cardiovascular diseases (CVDs) are a leading cause of death in the world. In 2015, an estimated 442.7 million prevalent cases of CVD were present worldwide. Cardiovascular diseases account for more than 17 million deaths globally each year. Previous studies identified diabetes mellitus, hypertension, hypercholesterolemia, smoking, alcohol consumption, obesity and sedentary lifestyle as risk factors. Aim of the study: The aim of this study was to determine the risk factors for acute myocardial infarction associated with heart blockage among non-diabetic patients. Methods: This was an observational study conducted in the Department of Cardiology of Jashore Medical College Sadar Hospital, Jashore, Bangladesh during the period from April, 2021 to March, 2022. In this study, we included 120 non-diabetic patients who were diagnosed with myocardial infarction. Result: Mean age was 53.03±11.3 years & most of our patients were male. Among all patients, majority (65%) patients had >60% blockage, followed by 30(25%) patients had 40%-60% artery blockage, and <40% blockage was found in 10% patients. Hypertension, dyslipidemia & dyslipidemia with hypertension, age ≥60 years, family history of CHD, smoking, diabetes & obesity were individual risk factors of CHD among non-diabetic patients. The most common risk factors for heart blockage were age >45 years, high blood pressure, high LDL, unhealthy diet, and stressful life. Conclusion: In our study, we found hypertension, history of CHD, dyslipidemia, dyslipidemia with hypertension, stress, age ≥60 years, and obesity were individual risk factors for CHD. These elements work as crucial risk factors for myocardial infarction in non-diabetic patients. Risk factors like age >45 years, high blood pressure, high LDL, unhealthy diet, and stressful life were responsible for the highest heart blockage in myocardial infarction patients. J Inv Clin Cardiol 2023; 5(2): 38-44

Low ambient temperature and incident myocardial infarction with or without obstructive coronary arteries: a Chinese nationwide study.

Although non-optimum ambient temperature is a major non-traditional risk factor for acute myocardial infarction, there is no prior knowledge on whether non-optimum ambient temperature could differentially affect myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Using the Chinese Cardiovascular Association database-Chest Pain Center Registry, a nationwide, time-stratified, case-crossover investigation was conducted from 2015 to 2021. Meteorological data were obtained from an established satellite-based model, and daily exposures were assigned according to the onset of myocardial infarction in each patient. A conditional logistic regression model combined with distributed lag non-linear models (10 days) was used to estimate the exposure-response relationships. A total of 83 784 MINOCA patients and 918 730 MI-CAD patients were included. The risk of MINOCA and MI-CAD associated with low temperature occurred at lag 2 day and lasted to 1 week. Extremely low temperature was associated with a substantially greater odds ratio (OR) of MINOCA [OR 1.58, 95% confidence interval (CI) 1.31-1.90] than MI-CAD (unmatched: OR 1.32, 95% CI 1.23-1.43; equally matched by age and sex: OR 1.25, 95% CI 1.04-1.50), compared with the corresponding reference temperatures (30°C, 35°C, and 30°C). Stronger associations were observed for patients who were aged ≥65 years, female, or resided in the south. There was no significant difference for the impacts of high temperature on MINOCA and MI-CAD. This nationwide study highlights the particular susceptibility of MINOCA patients to ambient low temperature compared with that of MI-CAD patients.

Severe infections as risk factors for acute myocardial infarction: a nationwide, Danish cohort study from 1987 to 2018

Abstract Aims Infections have been associated with acute myocardial infarction (AMI), but differences in risk between infection types and age groups are unclear. This study aims to investigate whether infections are associated with subsequent AMI and whether the risk differs across infection sites and age groups. Methods and results Nationwide registers were used to include 702 596 adults hospitalized between 1987 and 2018 with either pneumonia (n = 344 319), urinary tract infection (UTI) (n = 270 101), soft tissue/bone infection (n = 66 718), central nervous system (CNS) infection (n = 17 025), or endocarditis (n = 4433). Patients were sex and age matched with two unexposed controls. Outcome was first-time AMI within 10 years. A time-dependent Cox proportional hazards model with cut-offs at 30 and 90 days was used for calculating adjusted hazard ratios (HRs). Pneumonia, UTI, and soft tissue/bone infection were associated with increased relative rates of AMI compared to matched, unexposed controls. Highest relative rates were found within the first 0–30 days post-exposure: pneumonia: HR 3.39 [95% confidence interval (CI) 3.15–3.65]; UTI: HR 2.44 (95% CI 2.21–2.70); soft tissue/bone infection: HR 1.84 (95% CI 1.45–2.33). Relative rates decreased over time but remained significantly elevated throughout the follow-up period and were increased in all age groups. No association was found for CNS infection and for endocarditis only at 31–90 days, HR 2.28 (95% CI 1.20–4.33). Conclusion Acute infections are associated with increased relative rates of AMI across different infection sites and age groups with higher relative rates found for pneumonia. This indicates that some infections may act as a trigger for AMI with a site and/or pathogen specific risk.

Clinical Profiles and Risk Factors of Acute Myocardial Infarction in Young Adults: A Cross-Sectional Study in Myanmar.

Introduction Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, with an increasing prevalence of acute myocardial infarction (AMI) among younger populations. Despite this rising trend, there are limited data from Myanmar on the clinical profile and associated risk factors for premature CAD in young adults. This study aims to investigate the clinical characteristics and predisposing risk factors for AMI in individuals aged 40 years and below, contributing to a better understanding of disease patterns in this population. Methods A cross-sectional descriptive study was conducted at the coronary care unit of Yangon General Hospital over a 12-month period from January 1, 2019, to December 31, 2019. A total of 59 young adults, diagnosed with AMI based on the Fourth Universal Definition of Myocardial Infarction, were included. Clinical data, laboratory investigations, and demographic characteristics were collected and analyzed. Results Among the 59 participants, 46 (78%) were male, and smoking was prevalent in 45 (76.3%) cases. Dyslipidemia was common, with 46 (77.9%) exhibiting low high-density lipoprotein (HDL) cholesterol levels and 27 (45.8%) having elevated total cholesterol. Hypertension was observed in 31 (52.5%) patients, and 32 (54.2%) reported a family history of premature atherosclerotic cardiovascular disease. Furthermore, 28 (47.5%) of the cohort were classified as overweight, and 26 (44.1%) demonstrated low levels of physical activity. Chest pain was universally reported by all 59 (100%) patients as the presenting symptom. ST-segment elevation myocardial infarction (STEMI) was the predominant type, affecting 47 (79.6%) patients, with anterior wall involvement in 36 (61%) cases. Conclusion The findings of this study reveal that AMI in young adults is more prevalent among males, with smoking and dyslipidemia being the most significant risk factors. The high prevalence of low physical activity, hypertension, and overweight status further underscores the need for early lifestyle interventions. These results can be directly applied to clinical practice and public health policy in Myanmar by prioritizing smoking cessation programs, improving dyslipidemia management, and promoting physical activity in young populations. Additionally, this study provides a foundation for further research to explore more specific risk factors and paves the way for broader studies focusing on young AMI cases in Myanmar.

Temporal trends, in-hospital outcomes, and risk factors of acute myocardial infarction among patients with epilepsy in the United States: a retrospective national database analysis from 2008 to 2017.

The relationship between epilepsy and risk of acute myocardial infarction (AMI) is not fully understood. Evidence from the Stockholm Heart Study indicates that the risk of AMI is increased in people with epilepsy. This study aims to analyze the temporal trends in prevalence, adverse clinical outcomes, and risk factors of AMI in patients with epilepsy (PWE). Patients aged 18 years or older, diagnosed with epilepsy with or without AMI and hospitalized from January 1, 2008, to December 31, 2017, were identified from the National Inpatient Sample (NIS) database. The Cochran-Armitage trend test and logistic regressions were conducted using SAS 9.4. Odds ratios (ORs) were generated for multiple variables. A total of 8,456,098 inpatients were eligible for our analysis, including 181,826 comorbid with AMI (2.15%). The prevalence of AMI diagnosis in PWE significantly increased from 1,911.7 per 100,000 hospitalizations in 2008 to 2,529.5 per 100,000 hospitalizations in 2017 (Ptrend < 0.001). Inpatient mortality was significantly higher in epilepsy patients with AMI compared to those without AMI (OR = 4.61, 95% CI: 4.54 to 4.69). Factors significantly associated with AMI in PWE included age (≥75 years old vs. 18 ~ 44 years old, OR = 3.54, 95% CI: 3.45 to 3.62), atherosclerosis (OR = 4.44, 95% CI: 4.40 to 4.49), conduction disorders (OR = 2.21, 95% CI: 2.17 to 2.26), cardiomyopathy (OR = 2.11, 95% CI: 2.08 to 2.15), coagulopathy (OR = 1.52, 95% CI: 1.49 to 1.54), dyslipidemia (OR = 1.26, 95% CI: 1.24 to 1.27), peptic ulcer disease (OR = 1.23, 95% CI: 1.13 to 1.33), chronic kidney disease (OR = 1.23, 95% CI: 1.22 to 1.25), smoking (OR = 1.20, 95% CI: 1.18 to 1.21), and weight loss (OR = 1.20, 95% CI: 1.18 to 1.22). The prevalence of AMI in PWE increased during the decade. Mortality rates were high among this population, highlighting the need for comprehensive attention to prophylaxis for risk factors and early diagnosis of AMI in PWE by physicians.

Risk factors for acute myocardial infarction in patients with alcohol-related cirrhosis - a Danish nested case-control study

Background & Aims Alcohol-related cirrhosis (ALD cirrhosis) has a weaker effect on acute myocardial infarction (MI) than on other arterial or venous thromboses, and the reasons for this pattern are unclear. This study aimed to identify risk factors of MI amongst patients with ALD cirrhosis. Methods This nationwide register-based nested case-control study was conducted within a cohort of all Danish patients diagnosed with ALD cirrhosis from 2000-2019. Patients with first-time MI after diagnosis of ALD cirrhosis were identified as cases, and matching cohort members (10:1) with no history of MI, using risk-set sampling. We selected candidate risk factors a priori and used conditional logistic regression to study the association between them and the adjusted odds ratio of MI. Results and conclusions We included 373 cases and 3,730 controls. We identified the following risk factors for MI: hospitalization for infection (adjusted odds ratio 2.26 [95% CI 1.38-3.71]), recent surgery (adjusted odds ratio 1.82 [95% CI 1.18-2.81]), history of atherosclerosis (adjusted odds ratio 1.89 [95% CI 1.39-2.57]), cardiac ischemia (adjusted odds ratio 6.23 [95% CI 4.30-9.04]), heart failure (adjusted odds ratio 2.83 [95% CI 1.90-4.22]) or chronic obstructive pulmonary disease (COPD) (adjusted odds ratio 2.26 [95% CI 1.62-3.17]). Use of anticoagulants had a protective effect (adjusted odds ratio 0.47 [95% CI 0.25–0.91]). Our findings contribute to the understanding of risk factors for MI in patients with ALD cirrhosis. They may have clinical implications e.g. for the decision to offer thromboprophylaxis.

Association of Risk Factors of Acute Myocardial Infarction and Heart Blockage among Non-Diabetic Patients in A Tertiary Care Hospital– An Observational Study

Introduction: Cardiovascular diseases (CVDs) are a leading cause of death in the world. In 2015, an estimated 442.7 million prevalent cases of CVD were present worldwide. Cardiovascular diseases account for more than 17 million deaths globally each year. Previous studies identified diabetes mellitus, hypertension, hypercholesterolemia, smoking, alcohol consumption, obesity and sedentary lifestyle as risk factors. Aim of the study: The aim of this study was to determine the risk factors for acute myocardial infarction associated with heart blockage among non-diabetic patients. Materials and Methods: This was an observational study conducted in the Department of Cardiology of Jashore Medical College Sadar Hospital, Jashore, Bangladesh during the period from April, 2021 to March, 2022. In this study, we included 120 non-diabetic patients who were diagnosed with myocardial infarction. Result: Mean agewas 53.03±11.3 years &amp; most of our patients were male. Among all patients, majority (65%) patients had &gt; 60% blockage, followed by 30(25%) patients had 40%-60% artery blockage, and &lt;40% blockage was found in 10% patients. Hypertension, dyslipidemia &amp; dyslipidemia with hypertension, age ­ 60 years, family history of CHD, smoking, diabetes &amp; obesity were individual risk factors of CHD among non-diabetic patients. The most common risk factors for heart blockage were age &gt;45 years, high blood pressure, high LDL, unhealthy diet, and stressful life. Conclusion: In our study, we found hypertension, history of CHD, dyslipidemia, dyslipidemia with hypertension, stress, age ­ 60 years, and obesity were individual risk factors for CHD. These elements work as crucial risk factorsfor myocardial infarction in non-diabetic patients. Risk factors like age &gt;45 years, high blood pressure, high LDL, unhealthy diet, and stressful life were responsible for the highest heart blockage in myocardial infarction patients. Medicine Today 2024, Vol.36 (2): 114-119

Connections Between Hypertension, Atherosclerosis, Acute Myocardial Infarction, and Risk of Dementia

As the percentage of geriatric patients continues to increase in both the United States and globally, the prevalence of both cardiovascular disease and dementia continues to climb. Both dementia and cardiovascular disease are devastating diseases that impose a significant burden economically, socially, and medically on both a local and systemic level. The most common fatal manifestation of cardiovascular disease is acute myocardial infarction, responsible for death in more than 80% of patients with cardiovascular disease. Prominent risk factors for acute myocardial infarction including hypertension and atherosclerosis have been independently associated with an increased risk for cognitive decline and all-cause dementia and Alzheimer disease, separate from vascular dementia. Acute myocardial infarction itself has also been independently associated with an increased incidence of all-cause dementia and Alzheimer disease. It is based on the connection between acute myocardial infarction, its major risk factors, and the incidence of dementia that it is of importance to define and explore the potential role that therapies for these conditions, as well as acute myocardial infarction itself, may play in mitigating the risk of dementia onset and severity. In this review, we assess current therapeutics that exist for atherosclerosis, hypertension and acute myocardial infarction that have been demonstrated to reduce later risk of dementia, and explore the mechanism that underlies the association between the incidence of acute myocardial infarction and the risk of dementia.

Association of endothelial nitric oxyde synthase (eNOS) levels and modifiable risk factors for acute myocardial infarction with ST-segment elevation (AMI-STE)

Background. The pathological process underlying myocardial infarction is atherosclerotic thrombosis that causes endothelial dysfunction. In the AMI-STE process, eNOS has functions as the body's defense mechanism to prevent more severe damage to the endothelium. Decreased eNOS levels were found in modifiable AMI risk factors. This study aimed to determine the association of eNOS levels based on modifiable risk factors for AMI-STE patients. Method. This study was an analytical observational study with a historical cohort design. The samples were patients with AMI-STE diagnosis who had undergone PPCI at M. Djamil Hospital Padang from March to June 2022. The eNOS levels were taken from the blood samples. Modifiable AMI risk factors were taken from patient’s medical record. The T test was carried out to determine statistical analysis. Results. The average age of the 38 subjects was 62.53 ± 8.2 years, and 92.1% among them were male, and 52.6% subjects were diagnosed with anterior AMI-STE. The average eNOS level in subjects was 47.47 ± 23.88 (normal level is 48.16 pg/mL). More than half (73.5%) of the subjects in low eNOS group had diabetes mellitus as risk factor (P&lt;0.0001) and most subjects (78.9%) in group with low eNOS had hypertension (p=0.022). Other risk factors, namely dyslipidemia and smoking, were also more common in group with low eNOS. However, statistical tests showed that there was no statistically association between eNOS levels with dyslipidemia and smoking. Conclusion. There was statistically significant association between eNOS levels with diabetes mellitus and hypertension as modifiable risk factors for AMI-STE.

Identification of co-expressed central genes and transcription factors in acute myocardial infarction and diabetic nephropathy

BackgroundAcute myocardial infarction (AMI) and diabetic nephropathy (DN) are common clinical co-morbidities, but they are challenging to manage and have poor prognoses. There is no research on the bioinformatics mechanisms of comorbidity, and this study aims to investigate such mechanisms.MethodsWe downloaded the AMI data (GSE66360) and DN datasets (GSE30528 and GSE30529) from the Gene Expression Omnibus (GEO) platform. The GSE66360 dataset was divided into two parts: the training set and the validation set, and GSE30529 was used as the training set and GSE30528 as the validation set. After identifying the common differentially expressed genes (DEGs) in AMI and DN in the training set, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses and protein–protein interaction (PPI) network construction were performed. A sub-network graph was constructed by MCODE, and 15 hub genes were screened by the Cytohubba plugin. The screened hub genes were validated, and the 15 screened hub genes were subjected to GO, KEGG, Gene MANIA analysis, and transcription factor (TF) prediction. Finally, we performed TF differential analysis, enrichment analysis, and TF and gene regulatory network construction.ResultsA total of 46 genes (43 up-regulated and 3 down-regulated) were identified for subsequent analysis. GO functional analysis emphasized the presence of genes mainly in the vesicle membrane and secretory granule membrane involved in antigen processing and presentation, lipopeptide binding, NAD + nucleosidase activity, and Toll-like receptor binding. The KEGG pathways analyzed were mainly in the phagosome, neutrophil extracellular trap formation, natural killer cell-mediated cytotoxicity, apoptosis, Fc gamma R-mediated phagocytosis, and Toll-like receptor signaling pathways. Eight co-expressed hub genes were identified and validated, namely TLR2, FCER1G, CD163, CTSS, CLEC4A, IGSF6, NCF2, and MS4A6A. Three transcription factors were identified and validated in AMI, namely NFKB1, HIF1A, and SPI1.ConclusionsOur study reveals the common pathogenesis of AMI and DN. These common pathways and hub genes may provide new ideas for further mechanistic studies.

Prognostic value of pulmonary hypertension with a nomogram in acute myocardial infarction patients with reduced left ventricular function.

Pulmonary hypertension (PH) is a common prognostic factor for acute myocardial infarction (AMI) and its impact may increase when combined with reduced left ventricular function. This retrospective cohort study enrolled AMI patients with reduced left ventricular function at the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to January 2022. Basing on the systolic pulmonary artery pressure assessed by echocardiogram, patients were assigned to the PH group and control group. Propensity score matching (PSM) in sex, age and Killip classification was used to match patients between two groups. The primary outcome was defined as 1-year mortality rate, which were obtained from medical records and phone calls. After the PSM, a total of 504 patients were enrolled, with 252 in both groups. No significant difference of the adjusted factors was observed between the two groups. The 1-year mortality rate was significantly higher in the PH group compared with the control group (15.5% vs. 5.3%, P < 0.001). In the cox regression analysis, PH (HR: 2.068, 95% CI: 1.028-4.161, P = 0.042) was identified as an independent risk factor, alongside left ventricular ejection fraction (HR: 0.948; 95% CI: 0.919-0.979; P < 0.001), creatine kinase-MB isoenzymes (HR: 1.002; 95% CI: 1.000-1.003; P = 0.010) and pro-brain natriuretic peptide (HR: 1.000; 95% CI: 1.000-1.000; P = 0.018) for the 1-year mortality in AMI patients with reduced left ventricular function. A nomogram was established using the above factors to predict the 1-year mortality risks in these patients. AMI patients with reduced left ventricular function showed higher 1-year mortality rate when concomitant with PH. Four independent risk factors, including PH, were identified and used to establish a nomogram to predict the 1-year mortality risks in these patients. NCT06186713.

Risk factors for acute myocardial infarction in patients with acute cerebral infarction: a case-control study

Risk factors for acute myocardial infarction in patients with acute cerebral infarction: a case-control study

Ten-year trends in lipid management among patients after myocardial infarction in South Korea.

Dyslipidemia is an important risk factor for acute myocardial infarction. However, real-world data on its prevalence and lipid management trends for Korean patients with acute myocardial infarction are limited. This study aimed to determine the 10-year temporal trends in dyslipidemia prevalence and lipid management in this patient population. The study used a merged database of two nationwide observational cohorts (2011-2020) that included 26,751 participants. The primary endpoints were the achievement rates of the (1) absolute low-density lipoprotein cholesterol (LDL-C) target of <70 mg/dL (<1.8 mmol/L), (2) relative LDL-C target reduction of >50% from the baseline, (3) absolute or relative LDL-C target (American target), and (4) both absolute and relative LDL-C targets (European target). The dyslipidemia prevalence increased from 11.1% to 17.1%, whereas the statin prescription rate increased from 92.9% to 97.0% from 2011 to 2020. The rate of high-intensity statin use increased from 12.80% in 2012 to 69.30% in 2020. The rate of ezetimibe use increased from 4.50% in 2016 to 22.50% in 2020. The high-intensity statin and ezetimibe prescription rates (0.20% to 9.30% from 2016 to 2020) increased gradually. The absolute and relative LDL-C target achievement rates increased from 41.4% and 20.8% in 2012 to 62.5% and 39.5% in 2019, respectively. The American (45.7% in 2012 to 68.6% in 2019) and European (16.5% in 2012 to 33.8% in 2019) target achievement rates also increased. The adoption of lipid management guidelines in clinical practice has improved. However, continued efforts are needed to reduce the risk of recurrent ischemic events.

Evaluating of some heart and liver enzymes in patients with myocardial infarction in Wasit.

The aim of the study was to evaluate some heart and liver enzymes in patients with myocardial infarction in Wasit . Myocardial infarction (MI) is a major cause of death and disability worldwideA heart attack, also known as myocardial infarction, occurs when blood flow to a section of the heart is cut off, resulting in the death of heart cells. This usually happens when a coronary artery becomes blocked due to the rupture of a vulnerable plaque made up of cholesterol, fatty acids, and white blood cells. The study took place in the cardiac resuscitation unit at Al-Zahra Teaching Hospital and Al-Karama Teaching Hospital in Wasit Governorate from November 2022 to January 2023. Its objective was to examine the significance of physiological, immunological indicators, and inflammatory biomarkers for accurately diagnosing, assessing risk, and predicting the future outcomes of patients with acute myocardial infarction. The study included 100 patients with acute myocardial infarction, including 71 men aged30-70 years, and 29 women aged 33-75 years. And 50 samples from the control, 28 samples from men and 22 samples from women, and they were divided into three age groups. The first group is 30-45 years old, the second group is 46-60 years old, and the third group is 61-75 years old. Taking into account the risk factors for acute myocardial infarction, which include Sex, age, high blood pressure, diabetes, smoking, and dyslexia. Lipid lipids through a questionnaire. The results of our study with regard to the diagnostic signs of myocardial infarction revealed a significant increase in troponin, myoglobin, and H-FABP, and a significant decrease in Creatine kinase. This study also indicated, regarding the results of liver enzymes, a significant increase in both AST and ALT at p≤ 0.5. Conclusions: In patients with AMI, The plasma level of significant increase in troponin, myoglobin, and H-FABP, and a significant decrease in Creatine kinase AST and ALT at p≤ 0.5.

Association of Frailty with Adverse Outcomes in Patients with Critical Acute Myocardial Infarction: A Retrospective Cohort Study.

Frailty is a risk factor for acute myocardial infarction (AMI). This study examined the association between the modified frailty index (MFI) and adverse outcomes in patients with critical AMI. Data were obtained from the Medical Information Mart for Intensive Care IV database. Logistic and Cox regression models and a competing risk model were applied. Of 5003 patients, 1496 were non-frail and 3507 were frail. Frailty was significantly associated with in-hospital mortality (per point, OR 1.13, 95% CI: 1.05-1.21; frail vs non-frail, OR 1.31, 95% CI: 1.04-1.65) and 1-year mortality (per point, HR 1.15, 95% CI: 1.11-1.20; frail vs non-frail, HR 1.37, 95% CI: 1.20-1.58). Frailty was significantly associated with post-discharge care needs (per point, OR 1.23, 95% CI: 1.14-1.33; frail vs non-frail, OR 1.47, 95% CI: 1.22-1.78). In the competing risk models, frailty was significantly associated with a lower probability of being discharged from the ICU (per point, HR 0.87, 95% CI: 0.85-0.90; frail vs non-frail, HR 0.73, 95% CI: 0.68-0.79) and hospital (per point, HR 0.82, 95% CI: 0.80-0.85; frail vs non-frail, HR 0.62, 95% CI: 0.57-0.68). Subgroup analyses showed the association of frailty with in-hospital and 1-year mortality was stronger in patients with a SOFA score ≤2 than in those with a SOFA score >2 (both p<0.05 for interaction). Frailty assessed by the MFI was an independent predictor of adverse outcomes in patients with critical AMI and may be helpful for prognostic risk stratification.

Risk Factor Profile and Hospital Outcomes in Patients ≤ 45 Years vs. &gt;45 Years of Age Presenting with Acute ST-Segment Elevation Myocardial Infarction

Objectives: In Pakistan, cardiovascular risk factors for acute myocardial infarction are increasing. There are few studies available on atherosclerotic risk factors in young patients and its outcome The purpose of this study was to compare pattern of traditional CVD risk factors, hospital mortality and major adverse cardiac events at discharge in young versus old patients (≤45years and above 45 years age respectively) admitted with STEMI and undergoing primary PCI.&#x0D; Methodology: This retrospective cohort study was conducted on consecutive patients presenting with STEMI between June 2013 and June 2018 in a single centre cardiac only tertiary care setup. Institute’s registry is fashioned along and is affiliated with US NCDR. Patients with cardiac arrest or cardiogenic shock at arrival were excluded. MACE was defined as post PCI cardiac arrest or cardiogenic shock, heart failure, major bleed or hospital death. Models were built using stepwise forward logistic regression method.&#x0D; Results: Total of 5343 patients were admitted with STEMI during study period, after exclusion data of 1642 patients were analyzed. Among young patients, the frequency of the male gender, any tobacco use and family history of premature coronary artery disease were significantly higher (all p values &lt; 0.001). While in older STEMI patients frequency of heart failure, hypertension, prior myocardial infarction, diabetes mellitus ,abnormal creatinine clearance (&lt;90 mL/min/1.73 m²) , multi-vessel coronary disease, advanced Killip class and higher body mass index was more prevalent (all P&lt;0.001). Among young patients advanced Killip class and femoral access site(all P values &lt;0.001), diabetes mellitus (p=0.03), abnormal creatinine clearance(p=0.04),and left ventricular ejection fraction less than 40%(p=0.01), were more significant in-hospital mortality predictor whereas advanced Killip class, Left ventricular ejection fraction less than 40% male gender(p=0.04), diabetes mellitus(p=0.001),femoral access site(p=0.001), and Left ventricular ejection fraction less than 40% were more significant MACE predictors (all P&lt;0.001).&#x0D; Conclusion: There were no significant difference in hospital mortality and MACE among young versus old STEMI patients when adjusted for diabetes mellitus, abnormal creatinine clearance (&lt;90 mL/min/1.73 m²), multi-vessel coronary disease, advanced Killip class. Tobacco use is the main modifiable risk factors for young patients with STEMI. Surprisingly, being a woman and having a positive family history with premature coronary artery disease were protective.

Myocardial Infarction in the Context of COVID-19

Abstract Introduction The COVID-19 pandemic that started in 2019 was a modern-world challenge for medical professionals. The SARS-Cov-2 virus targeted the respiratory and, later, the cardiovascular system. We aimed to identify the risk factors and particularities of acute myocardial infarction associated with SARS-Cov-2 infection. Material and Methods This cross-sectional study included 92 patients admitted to the Cardiology Department of Mureș County Emergency Hospital with myocardial infarction, divided into two groups: 46 patients with COVID-19 and 46 patients without COVID-19. Demographic data, risk factors, non-communicable diseases, and laboratory findings were studied and compared. Results The mean age of the patients was 65 years, and the majority were male. The identified risk factors were hypertension, body mass index &gt;25 kg/m2, and dyslipidemia. The risk factors for poor prognosis were leukocyte count, higher neutrophil-lymphocyte ratio, higher monocyte-to-lymphocyte ratio, and higher high sensitivity troponin I levels. Left ventricular ejection fraction was significantly lower in patients with COVID-19. Conclusions COVID-19 is an aggravating factor of acute myocardial infarction. This research highlights the importance of prevention against the SARS-CoV-2 virus.

The Incidence and Risk Factors of Acute Myocardial Infarction Among Patients with Gastrointestinal bleeding: A Retrospective Study.

Patients with gastrointestinal bleeding (GIB) and acute myocardial infarction (AMI) have higher mortality than that with either GIB or AMI alone. The aims of this study were to determine the incidence and risk factors of AMI in patients with GIB. From January 2015 to January 2018, we retrospectively studied 1287 patients with GIB in Renmin Hospital of Wuhan University. Various demographic, laboratory and outcome data were reviewed by charts. Thirty-seven patients had AMI and were placed in AMI group and the rest 1250 patients were in non-AMI group. Patients with AMI were more likely to be older than 70 years, have hypertension, coronary heart disease, chronic kidney disease, and have the recent history of taking aspirin before admission. The ROC curve of hemoglobin (HB) on admission showed area under curve was 0.762, the optimal cut-off value is 76.5g/L. Logistic regression analysis showed that age ≥ 70 years old, coronary heart disease and HB < 76.5g/L on admission were independent risk factors of AMI in patients with GIB. The mortality of patients during hospitalization in AMI group and in non-AMI group were 45.95% and 5.48%, respectively. Patients who displayed a history of liver disease and HB < 76.5g/L on admission had a higher death rate. GIB increased the risk of subsequent AMI, especially in patients over 70 years old, with history of coronary heart disease and HB < 76.5g/L on admission. Patients with GIB and AMI who had history of liver disease and HB < 76.5g/L on admission had a higher mortality rate. Clinicians should identify the high-risk patients of AMI among the GIB population early and prevent AMI.