Factor In Acute Myocardial Infarction Research Articles

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<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.

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.

Retracted: Clinical Influencing Factors of Acute Myocardial Infarction Based on Improved Machine Learning.

[This retracts the article DOI: 10.1155/2021/5569039.].

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.

Correlation between admission red cell distribution width and GRACE risk score as an early mortality marker in patients with acute myocardial infarction

Background: Red blood cell distribution width (RDW) is a measurement of the size variation of red blood cells in circulation. The Global Registry of Acute Coronary Events (GRACE) score is the most commonly used risk-stratification scoring system to predict mortality in acute coronary syndrome for both ST- elevated myocardial infarction (STEMI), non-ST elevated myocardial infarction (NSTEMI). The aim of this study was to assess the easily determinable red blood cell distribution width (RDW) as an early mortality marker of acute myocardial infarction (MI) mortality and the correlation of RDW-CV on admission with GRACE risk score in patients with acute myocardial infarction. Methods: This hospital-based, prospective observational study included 211 patients (mean age 58.15 +/- 12.45 years, male 176) admitted with acute MI (STEMI/NSTEMI) from January 2022 to June 2022. The study population was divided into two groups basing on the 50th percentile of the admission RDW-CV value -13.7. The GRACE score was calculated on admission to predict the GRACE in hospital mortality score within 24 hours of admission. Results: The study found that the higher RDW-CV values were associated with adverse prognostic factors in acute myocardial infarction like increased age, lower systolic blood pressure, heart failure, cardiac arrest, higher cardiac biomarker levels and higher in-hospital mortality (p = 0.049, level of significance p&lt; 0.05) and this correlated with a higher GRACE score (Pearson’s correlation coefficient R= 0.47, P&lt;0.05). Conclusion: Thus, RDW can be used as a useful parameter for predicting in-hospital mortality in acute MI patients.

Association of body mass index, metabolic health status and clinical outcomes in acute myocardial infarction patients: a national registry-based study.

Obesity is an important risk factor for acute myocardial infarction (AMI), but the interplay between metabolic health and obesity on AMI mortality has been controversial. In this study, we aimed to elucidate the risk of short- and long-term all-cause mortality by obesity and metabolic health in AMI patients using data from a multi-ethnic national AMI registry. A total of 73,382 AMI patients from the national Singapore Myocardial Infarction Registry (SMIR) were included. These patients were classified into four groups based on the presence or absence of metabolic diseases, diabetes mellitus, hyperlipidaemia, and hypertension, and obesity: (1) metabolically-healthy-normal-weight (MHN); (2) metabolically-healthy-obese (MHO); (3) metabolically-unhealthy-normal-weight (MUN); and (4) metabolically-unhealthy-obese (MUO). MHO patients had reduced unadjusted risk of all-cause in-hospital, 30-day, 1-year, 2-year, and 5-year mortality following the initial MI event. However, after adjusting for potential confounders, the protective effect from MHO on post-AMI mortality was lost. Furthermore, there was no reduced risk of recurrent MI or stroke within 1-year from onset of AMI by the MHO status. However, the risk of 1-year mortality was higher in female and Malay AMI patients with MHO compared to MHN even after adjusting for confounders. In AMI patients with or without metabolic diseases, the presence of obesity did not affect mortality. The exception to this finding were female and Malay MHO who had worse long-term AMI mortality outcomes when compared to MHN suggesting that the presence of obesity in female and Malay patients may confer worsened outcomes.

Clinical presentation and angiographic findings of acute myocardial infarction in young adults in Jazan region

BackgroundThere is a paucity of information about the clinical features and angiographic findings in young patients with acute myocardial infarction (MI), especially in the Arab Peninsula countries.ObjectiveThe aim of this study was to assess the proposed risk factors, clinical presentation, and angiographic findings of acute myocardial infarction in young adults.MethodsThis prospective study included young (range, 18 to 45 years) patients who presented with acute MI based on clinical evaluation, laboratory investigation, and electrocardiogram, and they underwent a coronary angiography procedure.Key findingsData of 109 patients with a diagnosis of acute MI were collected. Patients’ mean age was 39.98 ± 7.52 years (range, 31 to 45 years), and 92.7% (101) were male. Smoking was the highest risk factor in 67% of patients, obesity and overweight in 66%, sedentary lifestyle in 64%, dyslipidaemia in 33%, and hypertension in 28%. Smoking was the most common risk factor for acute MI in males (p = 0.009), whereas sedentary lifestyle was the most common risk factor in females (p = 0.028). Chest pain typical of acute MI was the most common presenting symptom in 96% of patients (p < 0.001). On admission, 96% of patients were conscious, and 95% were oriented. On angiography, the left anterior descending artery (LAD) was affected in 57%, the right coronary artery (RCA) was affected in 42%, and the left circumflex artery (LCX) was affected in 32% of patients. The LAD was severely affected in 44%, the RCA was severely affected in 25.7%, and the LCX was severely affected in 19.26% of patients (p < 0.001).ConclusionSmoking, obesity, sedentary lifestyle, dyslipidaemia, and hypertension were the most common risk factors for acute MI. Smoking was the most common risk factor in males and sedentary lifestyle in females. The LAD was the most commonly affected coronary artery, followed by the RCA and LCX arteries, with the same order for severity of stenosis.

Correlation of SMARCA4 rs1122608 and ZFHX3 rs2106261 polymorphisms with acute myocardial infarction susceptibility in Egyptian population

ObjectivesOur objective is to assess SMARCA4 rs1122608 and ZFHX3 rs2106261 polymorphisms as risk factors for acute myocardial infarction (AM)I. BackgroundThe fact that there is documented familial clustering of myocardial infarction (MI) cases, shows that there is a genetic component to MI in addition to the traditional acquired risk factors. To our knowledge, this is the first study to evaluate the impact of participation of SMARCA4 and ZFHX3 polymorphisms in AMI patients in Egyptian population. Patients and methodsThis study was conducted on AMI patients (n = 100) and healthy controls (n = 100). SWI/SNF related, matrix associated, actin dependent regulator of chromatin A4(SMARCA4) (rs1122608) and Zinc Finger Homeobox 3 (ZFHX3) (rs 2,106,261) SNP assays were performed separately by real-time PCR for all participants. ResultsPatients with an acute myocardial infarction exhibited significantly higher levels of cardiac markers, total cholesterol, triglyceride, and low-density lipoprotein. The present work found considerably higher homozygous mutant T/T genotype and mutant T allele of SMARCA4 (rs1122608) in AMI patients than in healthy controls (p 0.001), which is confirmed under the dominant, over-dominant, and recessive mode of inheritance. Moreover, the results revealed that the TT genotype can increase the risk of AMI by OR (95% CI) [5.359(1.94014.81)], the T allele can also increase the risk of AMI by OR (95% CI) [4.472(2.797–7.151)]. Regarding the genotype and alleles distribution of ZFHX3 (rs 2,106,261), there was nonsignificant difference regard the genotypes TT, TC and CC between two studied groups which is confirmed under the dominant, over-dominant, and recessive mode of inheritance. ConclusionOur findings suggest that SMARCA4 (rs1122608) is associated with an increased risk of AMI in Egyptians.

Compositional alterations of the gut microbiota in acute myocardial infarction patients with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a risk factor for acute myocardial infarction (AMI) and a common comorbidity in patients with AMI. T2DM doubles the fatality rate of patients with AMI in the acute phase of AMI and the follow-up period. However, the mechanisms by which T2DM increases the fatality rate remain unknown. This study sought to investigate changes in the gut microbiota of patients with AMI and T2DM (AMIDM) to extend understandings of the relative mechanisms from the aspects of gut microbiota. Patients were recruited and divided into 2 groups comprising 15 patients with AMIDM and 15 patients with AMI but without T2DM (AMINDM). Their stool samples and clinical information were collected. 16S ribosomal DNA sequencing was used to analyze the structure and composition of the gut microbiota based on the operational taxonomic units. A significant difference was observed in the gut microbiota β diversity between the 2 groups. At the phylum level, the AMIDM patients showed an increase in the abundance of Firmicutes and a decrease in the abundance of Bacteroidetes compared to the AMINDM patients. At the genus level, the AMIDM patients showed an increase in the abundance of Companilactobacillus, Defluvitaleaceae UCG-011 and UCG-009, and a decrease in the abundance of Phascolarctobacterium and CAG 56 compared to the AMINDM patients. At the species level, the AMIDM patients showed an increase in the abundance of species unclassified NK4A214 group, Bacteroides clarus, Coprococcus comes, unclassified Defluviltaleaceae UCG-011, uncultured rumen bacterium, unclassified CAG 56, Barnesiella intestinihominis, Lachnospiraceae bacterium, Bacteroides nordii, unclassified UCG-009, and the Family XIII AD3011 group compared to the AMINDM patients. The gut microbiota function predictions indicated that the nucleotide metabolism-related pathway was significantly more increase in the patients with AMIDM than those with AMINDM. Additionally, the patients with AMIDM showed an increase in gram-positive bacteria and a decrease in the proportion of gram-negative bacteria. Our correlation analysis results on the gut microbiota and clinical parameters might extend understandings of the progression of AMI. Changes in the gut microbiota composition of patients with AMIDM affect the severity of the metabolic disturbance and may be responsible for poorer clinical outcomes and worse disease progression in patients with AMIDM compared to those with AMINDM.

ВЗАИМОСВЯЗЬ ТИПА ЛИЧНОСТИ D И НАРУШЕНИЯ ФУНКЦИИ ЭНДОТЕЛИЯ У ПАЦИЕНТОВ С ОСТРЫМ ИНФАРКТОМ МИОКАРДА

Introduction. Major psychosocial risk factors for acute myocardial infarction include depression, anxiety (various anxiety syndromes and disorders), pessimistic D personality type, work and family stress, anger/hostility, lack of social support, and low socioeconomic status. There are few studies evaluating the association between psychological factors and myocardial infarction. Aim. The aim of the study was to study the relationship of personality type D with the development of endothelial dysfunction in patients with acute myocardial infarction. Material and methods. The study included 158 patients, mean age 58.2±2.5 years, who were admitted to the hospital for ST-segment elevation myocardial infarction. The diagnosis was established according to the clinical guidelines of the Russian Society of Cardiology, 2020. In addition to the traditional clinical and instrumental examination, on the 3rd–7th day after the development of myocardial infarction, patients underwent an assessment of plasma concentrations of inflammatory biomarkers and psychological testing using anxiety and depression rating scales. In the group of patients, individuals with and without personality type D were identified. Results and discussion. Personality type D was found in 29.1% of patients with acute myocardial infarction. Patients with personality type D were significantly younger, employed and married, had a higher body mass index and a significantly greater hereditary burden of arterial hypertension. In patients with personality type D, the values of pro-inflammatory markers were statistically significantly different from the comparison group, which indicates the intensity of subclinical inflammation and cytokine imbalance. Personality type D was significantly associated with total inflammation score and total endothelial dysfunction score. Significant differences were found in the ratio of patients with depressive conditions in subgroups of patients with personality type D. The values of echocardiographic parameters were also associated with the presence of personality type D. Conclusion. Personality type D was associated with impaired endothelial function in men with acute myocardial infarction, they were more likely to have depressive disorders. An adverse effect of personality type D on the cardiovascular system in patients with myocardial infarction was revealed.

FRI-454 - Risk factors for acute myocardial infarction in patients with alcohol-related liver cirrhosis-a nationwide register-based nested case-control study

FRI-454 - Risk factors for acute myocardial infarction in patients with alcohol-related liver cirrhosis-a nationwide register-based nested case-control study

Trends and predictions of metabolic risk factors for acute myocardial infarction: findings from a multiethnic nationwide cohort

Understanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI. The incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity. From 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality. The incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality. This research was supported by theNUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131).The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore.

5 years incident stroke, heart failure, acute myocardial infarction, and death in patients having undergone atrial fibrillation ablation according to BMI

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Novo Nordisk Introduction Both atrial fibrillation (AF) and obesity have reached epidemic proportions. Obesity is an established risk factor in acute myocardial infarction (AMI), de novo AF, and AF recurrence after ablation. AF increase the risk of stroke, heart failure (HF), and death. The link between body mass index (BMI) and incident stroke, HF, AMI, or death in an AF ablation population is unknown. Purpose To examine incident stroke, HF, AMI, or death by BMI. Method Using Danish nationwide registries, all Danish patients above 18 years who underwent first-time AF ablation from January1st 2010 to December31st 2018 were identified and included at the date of ablation. Underweight patients (BMI &amp;lt; 18.5) were excluded. Exposure of interest was BMI and patients were stratified as normal-weight (BMI 18.5-24.9), overweight (BMI 25.0 – 29.9), obese (30.0 – 34.9), and morbidly obese (BMI ≥ 35.0). The primary endpoint was combined of either first-reached incident stroke, HF, AMI, or death. The 5-year cumulative incidence of the primary endpoint stratified by BMI, was estimated using the Aalen-Johansen estimator. The relative rates were examined using normal-weight as reference in both univariate- and multivariate-Cox models adjusted for prior HF, hypertension, age, diabetes, prior stroke, prior atherosclerotic vascular disease, and sex. Results The study cohort consisted of 7,701 patients. Median age [IQR] decreased from 64 [57, 70] to 60 [53, 66] in normal-weight and morbidly obese respectively. The prevalence of HF, ischemic heart disease, diabetes, and hypertension increased by BMI while prior stroke remained stable. Use of oral anticoagulants remained stable at around 98%. In total 1,285 patients reached the primary endpoint. By decreasing order, the most frequent endpoints were HF (564, 44%), AMI (431, 34%), stroke (199, 15%), and death (91, 7%). The cumulative incidence of the primary endpoint increased incrementally from 15%, 16%, 19%, and 21% from normal-weight to morbidly obese respectively (Figure 1). In the univariate analysis, the Hazard ratio (HR, [95% confidence interval]) increased incrementally from 1.03 [0.90 to 1.18], 1.28 [1.10 to 1.49], 1.43 [1.17 to 1.74] in overweight to morbidly obese respectively (Figure 2). In the multivariate analysis no significant differences were found. The HRs were 0.94 [0.82 to 1.08], 1.05 [0.89 to 1.23], 1.01 [0.82 to 1.24] in the overweight to morbidly obese respectively (Figure 2). Conclusion When identifying obese and morbidly obese AF ablation patients in clinical practice, the risk of either stroke, HF, AMI, or death is higher compared to normal-weight AF ablation patients, but only due to the underlying comorbidities.

Increased Neck Circumference and Increased Waist-Hip Ratio: Predictive Factors of Acute Myocardial Infarction.

Background We hypothesize that neck circumference (NC) is a better predictor of acute myocardial infarction (AMI) compared to the waist-hip ratio (WHR) in patients presenting with acute coronary syndrome (ACS). The objective of this study is to investigate the association between NC and WHR with AMI and determine whether NC is a superior predictor of AMI in ACS patients compared to WHR. Methods This cross-sectional observational study was conducted in the Department of Cardiology at the Medical Teaching Institute, Lady Reading Hospital, Peshawar. The study lasted from February 20, 2018, to September 12, 2018. Patients having ACS who presented to the emergency department were enrolled via non-probability convenient sampling. Demographic data and baseline variables, including NCand WHR, were documented using a pre-designed pro forma. SPSS V.20 (IBM Corp, Armonk, NY) was used for data analysis. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Chi-square tests were performed to determine the association between variables, and logistic regression models were used to measure odds ratios (ORs). Results In this study, 180 patients were included, with a mean age of 54.48±8.48 years and a male predominance of 51.5%. The results indicated a significant association between increased NCand WHRwith AMI. The chi-square values for NC and WHR were 78.26 (p≤0.001) and 43.38 (p≤0.001), respectively. As NC increased from <37 cm to >38.5 cm, the ORfor AMI increased from 0.46 to 4.51. Furthermore, the prevalence odds ratio (POR) of AMI increased by 2.185 times with an increase in WHR from 0.90. Conclusion Increased NC and increased WHR are statistically significantly associated and strong predictors of AMI in ACS patients. However, NC being more reliable, effective, and user-friendly should be the preferred measure.

Progress in the Study of Coronary Atherosclerosis and Prevention of Acute Myocardial Infarction

Cardiovascular disease stands as the leading cause of global mortality, with coronary atherosclerosis emerging as the prevailing pathological alteration within this condition. This lesion is distinguished by a notable escalation in oxidative stress. The prevalence of coronary atherosclerosis has exhibited a steady rise over time, leading to a consequential escalation in fatalities resulting from acute myocardial infarction caused by this condition. This alarming trend poses a significant threat to the well-being of our population. To address the imperative issue of preventing acute myocardial infarction caused by coronary atherosclerosis, this study offers a novel theoretical framework elucidating the pathogenesis and progression of acute myocardial infarction. By presenting and consolidating the findings of our research, this project aims to contribute to the prevention of acute myocardial infarction in recent years. The prevention of atherosclerotic plaque formation, narrowing of blood vessel lumen, obstruction, and myocardial ischemic infarction resulting from heightened oxidative stress in the human body, diminished vitamin C levels, impaired collagen formation, and unregulated cardiac wall repair system necessitates the reduction of oxidative intake, elimination of oxidative accumulation within the body, or augmentation of antioxidant intake. Furthermore, a substantial body of epidemiological evidence indicates that aberrant lipid metabolism serves as the primary predisposing factor for acute myocardial infarction. Additionally, both intermittent fasting and fat reduction therapy have demonstrated efficacy in preventing acute myocardial infarction. Moreover, it is worth noting that reducing non-high-density lipoprotein cholesterol (nHDL-C) is considered a secondary objective of fat reduction therapy. Moreover, magnesium is a significant dietary component that is frequently disregarded, yet numerous scientific investigations have substantiated the inverse relationship between the presence of magnesium ions in potable water and the prevalence of mortality due to coronary heart disease. However, iron, as an additional constituent, significantly contributes to the susceptibility of individuals to coronary artery disease and myocardial infarction.