History Of Previous Myocardial Infarction Research Articles

Exploring Myocardial Infarction Knowledge, Attitudes, and Practice Among Mogadishu's Somali Residents.

Myocardial infarction and cardiovascular disease are significant global health issues, particularly in Somalia. The Somali population faces challenges due to armed conflict, limited education, and underdeveloped healthcare infrastructure. Cardiovascular risk factors like diabetes, hypertension, and obesity are prevalent, and Somali people face increased susceptibility. This study examined Somalia residents' perceptions, attitudes, and behaviors towards myocardial infarction using a cross-sectional paper-based questionnaire. The sample consisted of 313 urban residents in Mogadishu, aged 20 and above. The questionnaire was written in Somali and was designed for the demographic. Knowledge, attitude, and practice scores were categorized into two groups, with associations between knowledge, attitude, and practice with sociodemographic and health characteristics assessed using Logistic Regression. This study analyzed data from A random sample of participants who arrived at the hospital for various reasons regarding their perceptions, attitudes, and responses towards myocardial infarction. The mean age was 42 ±19 years, with 54% being male and 46% female. Hypertension was the most common comorbidity, followed by dyslipidemia and diabetes. Over half of the respondents had no formal education, and only 3.8% had a smoking history. About 5.7% had a previous history of myocardial infarction. The mean knowledge score was 11.07 ± 0.697, with 53.35% of respondents not knowing enough about myocardial infarction. The majority of the patients showed a favorable attitude, but only a slight majority could recognize symptoms of myocardial infarction. The majority of the patients had inadequate practice and behavior, with 53.6% not practicing regularly or engaging in sports. The research highlights gaps in Mogadishu's Somali community's knowledge and practices regarding myocardial infarction. It emphasizes the need for health education, primary care, and community involvement to improve cardiovascular health awareness and reduce MI incidence.

COVID-ECG-RSNet: COVID-19 classification from ECG images using swish-based improved ResNet model

Millions of humansworldwide have been impacted by consecutive COVID-19waves during the past threeyears. The correct treatment for COVID-19 has not yet been identified because vaccine receivers have also contracted the illness. People’s lives can be saved, and patients can be shielded from laborious treatments with the quick and accurate diagnosis of coronavirus. Investigators have utilized various clinical imaging modalities i.e.,CT-Scan and X-ray for the identification of coronavirus, while, less emphasis is spent on the utilization ofECG images in recognizing the COVID-19-affected patients. In contrast to CT-Scan and X-ray images, ECG samples arereadily accessible, hence we utilize them to diagnose coronavirus. Since scientists generally transform the ECG data into integer representation before using any approach, which indicates higher computing overhead. Accurateand quickcoronavirus identification from the ECG modalityis a difficult and cumbersome operation. In this study, we attempted to address these issues by leveraging the ECG filesdirectly in an improved deep learning (DL)methodology called the COVID-ECG-RSNet. Descriptively, a novel DL model is presented by altering the ResNet-50 model by introducing an optimized activation approach called the Swish method during the feature engineering process. Moreover, we introduced multiple dense layers at the end of the proposed CNN structure to ensure more robust sample features for classification purposes. The introduced COVID-ECG-RSNet model is proficient in categorizing the ECG samples as being normal, coronavirus, myocardial infarction (MI), abnormal heartbeats (AHB), and victims with Previous history of Myocardial Infarction (PMI) groups. A vast evaluation with the help of a complicated and publically accessible data sample of ECG images is accomplished to show the effectiveness of our approach in recognizing the coronavirus images in contrast to other categories of heart diseases and healthy samples via using the ECG modality. We have attained an accuracy score of 98.8%, along with precision, and recall scores of 98.9%, and 98.7% respectively indicating the efficacy of suggested approach.

Gender differences in the development of heart failure after acute coronary syndrome: Insight from the CORALYS registry

BackgroundImpact of gender on heart remodeling after acute coronary syndrome (ACS) and consequently on development of heart failure (HF) remains to be elucidated. MethodsCORALYS is a multicenter, retrospective, observational registry enrolling consecutive patients admitted for ACS and treated with percutaneous coronary intervention. HF hospitalization was the primary endpoint while all-cause mortality and the composite endpoint of incidence of first HF hospitalization and cardiovascular mortality were the secondary ones. ResultsAmong 14,699 patients enrolled in CORALYS registry, 4578 (31%) were women and 10,121 (69%) males. Women were older, had more frequently hypertension and diabetes and less frequently smoking habit. History of myocardial infarction (MI), STEMI at admission and multivessel disease were less common in women. After median follow up of 2.9 ± 1.8 years, women had higher incidence of primary and secondary endpoints and female sex was an independent predictor of HF hospitalization (HR 1.26;1.05–1.50; p = 0.011) and cardiovascular death/HF hospitalization (HR 1.18;1.02–1.37; p = 0.022). At multivariable analysis women and men share as predictors of HF diabetes, history of cancer, chronic kidney disease, atrial fibrillation, complete revascularization and left ventricular ejection fraction. Chronic obstructive pulmonary disease (HR 2.34;1.70–3.22, p < 0.001) and diuretics treatment (HR 1.61;1.27–2.04, p < 0.001) were predictor of HF in men, while history of previous MI (HR 1.46;1.08–1.97, p = 0.015) and treatment with inhibitors of renin-angiotensin system (HR 0.69;0,49–0.96 all 95% CI, p = 0.030) in women. ConclusionsWomen are at increased risk of HF after ACS and gender seems to be an outcome-modifier of the relationship between a variable and primary outcome.

Female gender is an independent predictor of clinical benefit from cardiac resynchronisation therapy - results from the BIOWOMEN study

Abstract Background Presently, only indirect evidence indicates that women may benefit more from CRT than men. Since some gender-specific baseline variables are related to CRT benefit, it is unclear whether gender by itself is predictive of CRT benefit after correction for all these differences. We aimed to examine the impact of gender-specific differences on CRT response. Methods The BIOWOMEN study is a prospective, multicenter, international study, that enrolled 206 women and 214 men with a standard indication for CRT. The change in left-ventricular ejection fraction (LVEF) at 12 months follow-up after CRT was used as a primary endpoint to measure CRT benefit. The LVEF was quantified by a core lab blinded to gender and other patient characteristics. We used a median split to dichotomize continuous variables, if required. Uni- and multivariate analyses were used to identify baseline variables that are connected to an increase in LVEF. The latter model allows to estimate the change in LVEF that can be attributed to gender and other baseline variables. Results At baseline, women and men had similar LVEF, age and QRS duration, but there was a significant difference in the presence of left bundle branch block (88.3% vs. 79.9%, P=0.023). Women had less often ischemic heart disease (18.4% vs. 51.4%, P&amp;lt;0.001) and previous history of myocardial infarction (MI, 6.8% vs. 32.2%, P&amp;lt;0.001), but more severe heart failure symptoms (NYHA I/II/III 7%/51%/42% vs. 10%/63%/27%, P=0.019) and a shorter 6 minute walk test (345±117 vs. 409±148 m, P&amp;lt;0.001). In univariate analysis, women presented a significantly larger gain of 3.1 points in LVEF (+14.6±12.4% vs. +11.5±11.6%, P=0.004) compared to men. Additionally, the rate of CRT responders (defined as an improvement in LVEF &amp;gt;5%) was higher in women (82.0% vs. 70.6%, p=0.008). Other variables predictive of larger improvement in LVEF were LBBB (13.9±11.9% vs. 8.4±12.2%, P&amp;lt;0.001), NYHA I compared to NYHA II or III (I: 18.4±11.8%; II: 12.2±12.0%; III: 13.1±12.0%), no history of MI (14.0±11.6% vs. 8.9±13.0%, P&amp;lt;0.001), and an LVEF &amp;lt;32% at baseline (16.9±11.8% vs. 9.7±11.3%, P&amp;lt; 0.001). In multivariate analysis, female gender remained a significant predictor of a better improvement in LVEF (+2.6% absolute, P=0.036). Other significant predictors were LBBB (+5.2%, P&amp;lt;0.001), NYHA I (+6.9%, P&amp;lt;0.001 vs. NYHA II and +6.3%, P=0.004 vs. NYHA III), no history of MI (+4.1%, P=0.007), baseline LVEF &amp;lt;32% (+7.5%, P&amp;lt;0.001). Conclusion Gender has an important impact on the relevant baseline clinical differences that determine CRT response. Whereas women more often have LBBB and no prior-MI, suggesting more benefit from CRT, the BIOWOMEN study shows for the first time that female gender itself is linked to a larger clinical benefit from CRT. These gender-based baseline parameters need to be considered in daily clinical practice when screening patients for CRT, with particular attention to females.

Recurrence of acute coronary syndrome in the elderly: predictors and prognosis - insights from a multicentre national registry

Abstract The burden of cardiovascular (CV) disease remains at the top of society's health problems, with acute coronary syndromes (ACS) undoubtedly being one of the major causes. Patients with a known history of CVD are at increased risk of recurrent events. However, this recurrence's incidence rate and clinical impact vary between populations. Elderly patients represent a large proportion of patients admitted for a second ACS. The decision on its management lacks support in clinical guidelines, as studies generally exclude patients with significant comorbidities and tend to underrepresent this group. This study aimed to analyse the characteristics and outcomes of elderly patients admitted with ACS with a previous history of myocardial infarction (MI) versus those who did not. The authors performed a retrospective analysis of patients older than 75 years included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between 2010 and 2022. Comparison tests were performed. A COX proportional hazard regression method was applied to generate the proposed risk models. A p-value less than 0.05 was considered statistically significant. A total of 8658 patients older than 75 years admitted for ACS were analysed, 6630 (76.6%) without a history of MI (group 1) and 2028 (23.4%) with a previous MI. Table 1 shows the most important baseline characteristics and differences between groups. Table 2 demonstrates the group differences regarding admission diagnosis, complementary study results and treatment. Table 3 represents in-hospital complications. At discharge, 16.5% of group 1 and 21.2% of group 2 had a planned cardiac rehabilitation program (CRP) (p-value=0.01). At 1-year follow-up, 15,6% of patients with more than 75 years admitted for ACS died and 17.4% were re-hospitalized by a CV cause. COX-regression analysis identified the history of MI as a predictor factor of CV re-hospitalization (HR 1,43; 95%CI [1.10;1.86], p-value&amp;lt;0.01) and of the composite of mortality and CV re-hospitalization (HR 1,37; 95%CI [1.10;1.71], p-value&amp;lt;0.01). In conclusion, the elderly with a second episode of ACS tends to have more CV risk factors and comorbidities than those without a MI history. Furthermore, the recurrence of MI seems to be an independent predictor of 1-year re-hospitalization and the composite of mortality and CV re-hospitalization. Then, these results should increase the awareness of this group of patients.Table 1Table 2 (incomplete) and Table 3

Efficient Classification of ECG Images Using a Lightweight CNN with Attention Module and IoT.

Cardiac disorders are a leading cause of global casualties, emphasizing the need for the initial diagnosis and prevention of cardiovascular diseases (CVDs). Electrocardiogram (ECG) procedures are highly recommended as they provide crucial cardiology information. Telemedicine offers an opportunity to provide low-cost tools and widespread availability for CVD management. In this research, we proposed an IoT-based monitoring and detection system for cardiac patients, employing a two-stage approach. In the initial stage, we used a routing protocol that combines routing by energy and link quality (REL) with dynamic source routing (DSR) to efficiently collect data on an IoT healthcare platform. The second stage involves the classification of ECG images using hybrid-based deep features. Our classification system utilizes the "ECG Images dataset of Cardiac Patients", comprising 12-lead ECG images with four distinct categories: abnormal heartbeat, myocardial infarction (MI), previous history of MI, and normal ECG. For feature extraction, we employed a lightweight CNN, which automatically extracts relevant ECG features. These features were further optimized through an attention module, which is the method's main focus. The model achieved a remarkable accuracy of 98.39%. Our findings suggest that this system can effectively aid in the identification of cardiac disorders. The proposed approach combines IoT, deep learning, and efficient routing protocols, showcasing its potential for improving CVD diagnosis and management.

Fibroblast Growth Factor 23: Potential Marker of Invisible Heart Damage in Diabetic Population.

Two-dimensional speckle-tracking echocardiography (2DSTE) detects myocardial dysfunction despite a preserved left ventricular ejection fraction. Fibroblast growth factor 23 (FGF23) has become a promising biomarker of cardiovascular risk. This study aimed to determine whether FGF23 may be used as a marker of myocardial damage among patients with diabetes mellitus type 2 (T2DM) and no previous history of myocardial infarction. The study enrolled 71 patients with a median age of 70 years. Laboratory data were analyzed retrospectively. Serum FGF23 levels were determined using a sandwich enzyme-linked immunosorbent assay. All patients underwent conventional echocardiography and 2DSTE. Baseline characteristics indicated that the median time elapsed since diagnosis with T2DM was 19 years. All subjects were divided into two groups according to left ventricular diastolic function. Individuals with confirmed left ventricular diastolic dysfunction had significantly lower levels of estimated glomerular filtration rate and higher values of hemoglobin A1c. Global circumferential strain (GCS) was reduced in the majority of patients. Only an epicardial GCS correlated significantly with the FGF23 concentration in all patients. The study indicates that a cardiac strain is a reliable tool for a subtle myocardial damage assessment. It is possible that FGF23 may become an early diagnostic marker of myocardial damage in patients with T2DM.

Depression and Anxiety in Heart Transplant Recipients: Prevalence and Impact on Post-Transplant Outcomes.

Depression and anxiety (DA) are common mental disorders in patients with chronic diseases, but the research regarding their prevalence in heart transplantation (HTx) is still limited. We performed an analysis of the prevalence and prognostic relevance of DA in patients who underwent HTx between 2010 and 2018 in Germany. Data were obtained from Allgemeine Ortskrankenkasse (AOK), which is the largest public health insurance provider. Overall, 694 patients were identified. More than a third of them were diagnosed with DA before undergoing HTx (n = 260, 37.5%). Patients with DA more often had an ischaemic cardiomyopathy (p < 0.001) and a history of previous myocardial infarction (p = 0.001) or stroke (p = 0.002). The prevalence of hypertension (p < 0.001), diabetes (p = 0.004), dyslipidaemia (p < 0.001) and chronic kidney disease (p = 0.003) was higher amongst transplant recipients with DA. Patients with DA were more likely to suffer an ischaemic stroke (p < 0.001) or haemorrhagic stroke (p = 0.032), or develop septicaemia (p = 0.050) during hospitalisation for HTx. Our analysis found no significant differences between the groups with respect to in-hospital mortality. The female sex and mechanical circulatory support were associated with an inferior prognosis. Pretransplant non-ischaemic cardiomyopathy was related to a favourable outcome. DA affect up to a third of the population undergoing HTx, with a greater prevalence in patients with comorbidities. DA are associated with a higher incidence of stroke and septicaemia after HTx.

Vascular cell adhesion molecule‑1 levels in patients with coronary artery disease with type 2 diabetes mellitus

Chronic systemic inflammation is a key component of the pathogenesis of both type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD). Soluble vascular cell adhesion molecule‑1 (sVCAM‑1) is considered as the indicator of vascular inflammation and endothelial activation. The aim of our study was to investigate sVCAM‑1 levels in patients with CAD with T2DM and to determine their dependence on a previous history of myocardial infarction (MI). The study included 52 patients with stable CAD with T2DM, 20 CAD patients without diabetes and 14 control group persons. sVCAM-1 levels were measured in serum by the enzyme-linked immunosorbent assay. sVCAM‑1 levels in patients with CAD with T2DM and patients with CAD without diabetes were higher than in the control group (p&lt;0,001 and p&lt;0,001, respectively). The difference in sVCAM‑1 levels between CAD patients with T2DM and without diabetes was not significant (p=0,355). There were no significant correlations of sVCAM‑1 levels with glucometabolic indices in any group. Only in patients with CAD with T2DM sVCAM‑1 level negatively correlated with high-density lipoprotein cholesterol. CAD patients with and without T2DM with a history of myocardial infarction (MI) had higher sVCAM‑1 levels than patients without previous MI (p=0,038, р=0,043, respectively). Only in diabetic CAD patients sVCAM‑1 levels were increased in those without a history of MI (р=0,036, in comparison with the controls). There were no correlations between sVCAM‑1 levels and left ventricular remodeling indices in patients either with or without MI. Conclusions. In patients with CAD with T2DM and patients with CAD without T2DM, sVCAM‑1 levels increased in comparison with the controls. However, in patients without diabetes sVCAM‑1 level was increased only in those with previous MI. In patients with T2DM, sVCAM‑1 level increased in the absence of previous MI and there was the further significant increase of its level in postinfarction cardiosclerosis.

Incidence and predictors of left ventricular function change following ST-segment elevation myocardial infarction.

The purpose of the study was to assess the incidence and predictors of left ventricular function change in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. 312 patients with STEMI who received primary percutaneous coronary intervention (PCI) between January 2015 and December 2016 were consecutively enrolled in this study. Multiple logistic regression analysis was used to evaluate independent predictors of left ventricular ejection fraction (LVEF) improvement after long-term follow-up. We finally analyzed the LVEF change in 186 patients from baseline to follow-up. The mean age was 61.3 ± 12.5 years, with 78.5% being male. The median duration of follow-up after STEMI was 1,021 (389-1,947) days. 54.3% had a decrease in LVEF and 45.7% experienced an improvement in LV function after primary PCI through long-term follow-up. Logistic regression analysis showed lower peak troponin I, non-anterior STEMI, lower baseline LVEF, and no previous myocardial infarction history were independently associated with LVEF improvement. 54.3% of patients with STEMI undergoing primary PCI had a decrease in LVEF during long-term follow-up. LVEF recovery can be predicted by baseline characteristics.

Angina After Percutaneous Coronary Intervention: Patient and Procedural Predictors.

Twenty percent to 40% of patients are affected by angina after percutaneous coronary intervention (PCI), which is associated with anxiety, depression, impaired physical function, and reduced quality of life. Understanding patient and procedural factors associated with post-PCI angina may inform alternative approaches to treatment. Two hundred thirty patients undergoing PCI completed the Seattle Angina Questionnaire (SAQ-7) and European quality of life-5 dimension-5 level (EQ-5D-5L) questionnaires at baseline and 3 months post-PCI. Patients received blinded intracoronary physiology assessments before and after stenting. A post hoc analysis was performed to compare clinical and procedural characteristics among patients with and without post-PCI angina (defined by follow-up SAQ-angina frequency score <100). Eighty-eight of 230 patients (38.3%) reported angina 3 months post-PCI and had a higher incidence of active smoking, atrial fibrillation, and history of previous myocardial infarction or PCI. Compared with patients with no angina at follow-up, they had lower baseline SAQ summary scores (69.48±24.12 versus 50.20±22.59, P<0.001) and EQ-5D-5L health index scores (0.84±0.15 versus 0.69±0.22, P<0.001). Pre-PCI fractional flow reserve (FFR) was lower among patients who had no post-PCI angina (0.56±0.15 versus 0.62±0.13, P=0.003). Percentage change in FFR after PCI had a moderate correlation with angina frequency score at follow-up (r=0.36, P<0.0001). Patients with post-PCI angina had less improvement in FFR (43.1±33.5% versus 67.0±50.7%, P<0.001). There were no between-group differences in post-PCI FFR, coronary flow reserve, or corrected index of microcirculatory resistance. Patients with post-PCI angina had lower SAQ-summary scores (64.01±22 versus 95.16±8.72, P≤0.001) and EQ-5D-5L index scores (0.69±0.26 versus 0.91±0.17, P≤0.001) at follow-up. Larger improvements in FFR following PCI were associated with less angina and better quality of life at follow-up. In patients with stable symptoms, intracoronary physiology assessment can inform expectations of angina relief and quality of life improvement after stenting and thereby help to determine the appropriateness of PCI. URL: https://www. gov; Unique identifier: NCT03259815.

Attenuation of Hypocretin/Orexin Signaling Is Associated With Increased Mortality After Myocardial Infarction.

Background The hypocretin/orexin system has been shown to play a role in heart failure. Whether it also influences myocardial infarction (MI) outcomes is unknown. We evaluated the effect of the rs7767652 minor allele T associated with decreased transcription of the hypocretin/orexin receptor-2 and circulating orexin A concentrations on mortality risk after MI. Methods and Results Data from a single-center, prospectively designed registry of consecutive patients hospitalized for MI at a large tertiary cardiology center were analyzed. Patients without previous history of MI or heart failure were included. A random population sample was used to compare allele frequencies in the general population. Out of 1009 patients (aged 64±12 years, 74.6% men) after MI, 6.1% were homozygotes (TT) and 39.4% heterozygotes (CT) for minor allele. Allele frequencies in the MI group did not differ from 1953 subjects from general population (χ2 P=0.62). At index hospitalization, MI size was the same, but ventricular fibrillation and the need for cardiopulmonary resuscitation were more prevalent in the TT allele variant. Among patients with ejection fraction ≤40% at discharge, the TT variant was associated with a lower increase in left ventricular ejection fraction during follow-up (P=0.03). During the 27-month follow-up, there was a statistically significant association of the TT variant with increased mortality risk (hazard ratio [HR], 2.83; P=0.001). Higher circulating orexin A was associated with a lower mortality risk (HR, 0.41; P<0.05). Conclusions Attenuation of hypocretin/orexin signaling is associated with increased mortality risk after MI. This effect may be partially explained by the increased arrhythmic risk and the effect on the left ventricular systolic function recovery.

Coronary artery dominance in cases with IWMI

Background: Acute coronary syndrome is one of the most common life-threatening emergency and one of the leading causes of sudden death. If diagnosed in time, the patient can be saved. Angiography is the gold standard and helps in identifying the affected vessel. Aims and objective: To see the frequency of coronary artery dominance in cases presenting with inferior wall myocardial infarction. Material and Methods: This cross sectional observational study was done in the emergency department of Punjab Institute of Cardiology, Lahore from March to August 2017. All the patients between 18-60 years of age, both genders, diagnosed with IWMI and had been given thrombolytic therapy within 24 hours of MI were included in this study. Those patients having history of heart failure as determined by the past medical record, patients with renal failure (serum creatinine on admission 1.1 mg/dL), patients with a history of rheumatic heart disease, hypertension 5 years, uncontrolled diabetes (determined by HbA1C 7%), patients having history of previous myocardial infarction or concomitant involvement of other coronary artery areas like an anterior wall or septal wall and those were excluded from this study who did not give informed consent. Results: 227 patients enrolled in this study. Mean age of the patients was 45.07±8.17 years. Males were 51.98% (n=118) and females were 48.02% (n=109) of our study population. Mean BMI was 26.13 ± 3.29. The dominant left circumflex artery (LCX) was found in 25.55% of subjects Right Coronary Artery (RCA) was found to be dominant in 74.45% of our subjects. Conclusion: Presentation of IWMI with RCA as the dominant artery is three times more common as compared to LCx in our local population.

Associations between migraine and major cardiovascular events in type 2 diabetes mellitus.

Migraine is one of the most common primary headache disorders and a well-known risk factor for cardiovascular disorders. We aimed to investigate the association between migraine and major cardiovascular outcomes, including myocardial infarction (MI), ischemic stroke (IS), and cardiovascular death (CVD) in people with type 2 diabetes. A total of 2,229,598 people from the nationwide Korean National Health Insurance Service database with type 2 diabetes but without a previous history of MI and IS were included in this study. We identified patients over 20years of age with migraine using the claim data of International Statistical Classification of Diseases Related Health Problems, Tenth Revision (ICD-10) code G43. The patients with migraine were divided according to their migraine aura status. Migraine was present in 6.3% of the study population. Cases observed for MI, IS, CVD, and all-cause death were 2.6%, 3.6%, 5.9%, and 7.9%, respectively. The diagnosis of migraine was significantly associated with an increased risk of MI, IS, and CVD. The results remained significant after adjusting for covariates, including age, sex, body mass index, alcohol intake, smoking habits, physical activity, economic status, hypertension history, dyslipidemia, and duration of type 2 diabetes (MI, adjusted hazard ratio [aHR]: 1.182, 95% confidence interval [CI]: 1.146-1.219; IS, aHR: 1.111, 95% CI 1.082-1.14; CVD, aHR: 1.143, 95% CI 1.12-1.167). In particular, the presence of aura was associated with a higher risk of MI development compared to the non-aura group. The difference became more prominent with progressing age. In this nationwide population-based study, people with type 2 diabetes and migraines were found to be at a significantly higher risk for major cardiovascular events, including MI, IS, and CVD. The risk of MI and CVD significantly increased with the presence of aura symptoms among patients with migraine.

A CNN and ResNet 50 Approach to Detect Cardiac Diseases using ECG Images

Abstract: The biggest cause of mortality globally is cardiac illness. If the initial diagnosis was more accurate, cardiac problems may be avoided. ECG testing is typically used as a diagnostic technique to screen for heart disorders. The electric cardiac signal is recorded by an ECG to look for various heart conditions. Utilizing a variety of datasets, a number of algorithms and methodologies have been developed to detect different heart illnesses. However, this study proposes to examine whether convolutional neural network (CNN) model and ResNet 50 can be used to identify cardiac illnesses such arrhythmia or abnormal heartbeat (AHB), myocardial infarction (MI), and previous history of MI (PMI) from electrocardiogram (ECG) trace images. A 1937 ECG image dataset from Kaggle is examined... The ECG pictures in the dataset are separated into four categories: normal, MI, AHB, and PMI. The suggested approach examined categorization of normal and various heart disorders with 99.12% accuracy (MI, AHB, and PMI)

Abstract 11802: Hypocretin/Orexin Receptor-2 Influences Mortality Risk After Myocardial Infarction

Introduction: Hypocretin/orexin system has been shown to play a role in heart failure. Whether this system also influences all-cause mortality in patients after myocardial infarction (MI) is unknown. The aim of the present study was to evaluate the effect of rs7767652 allele variants, upstream of hypocretin/orexin receptor-2, on prognosis of patients with MI. Methods: Data from a single-center prospectively designed AMBITION registry of consecutive patients hospitalized for MI at a large tertiary cardiology center were analyzed. Patients with type I MI, without previous history of MI or heart failure were included. A random population sample including 1,953 individuals was used to compare allele frequencies in the population. Results: Out of 1,593 patients in the registry, 1,009 fulfilled the inclusion criteria. In total, 6.1% patients were homozygotes and 39.4% heterozygotes for the minor allele. Allele frequencies in patients with MI did not differ from the general population (χ 2 p=0.62), suggesting no influence on the MI risk. During the median follow-up of 27 months (IQR 13-41), mortality rate was 8.4%. Homozygotes for the rs7767652 minor allele had a higher mortality risk as compared to heterozygotes (p=0.001) and homozygotes for the major allele (p=0.001) ( Figure ). After multivariate adjustment, minor allele homozygotes remained at increased mortality risk (HR 2.83, 95% CI 1.55-5.19). Minor allele homozygotes experienced more often ventricular fibrillation (12.9% vs. 4.8%, p=0.01) and required more often CPR (16.1% vs. 7.0%, p=0.02). Among patients with EF&lt;40% at hospital discharge, minor allele homozygotes had a lower increase in EF during the follow-up (2.5±11.0 vs. 8.4±9.4, p=0.04). Conclusions: Our Mendelian randomization study shows that hypocretin/orexin system influences prognosis of patients with MI. This effect may be partially explained by the increased arrhythmic risk and the effect on the left ventricular systolic function recovery.

Efficient-ECGNet framework for COVID-19 classification and correlation prediction with the cardio disease through electrocardiogram medical imaging

In the last 2 years, we have witnessed multiple waves of coronavirus that affected millions of people around the globe. The proper cure for COVID-19 has not been diagnosed as vaccinated people also got infected with this disease. Precise and timely detection of COVID-19 can save human lives and protect them from complicated treatment procedures. Researchers have employed several medical imaging modalities like CT-Scan and X-ray for COVID-19 detection, however, little concentration is invested in the ECG imaging analysis. ECGs are quickly available image modality in comparison to CT-Scan and X-ray, therefore, we use them for diagnosing COVID-19. Efficient and effective detection of COVID-19 from the ECG signal is a complex and time-taking task, as researchers usually convert them into numeric values before applying any method which ultimately increases the computational burden. In this work, we tried to overcome these challenges by directly employing the ECG images in a deep-learning (DL)-based approach. More specifically, we introduce an Efficient-ECGNet method that presents an improved version of the EfficientNetV2-B4 model with additional dense layers and is capable of accurately classifying the ECG images into healthy, COVID-19, myocardial infarction (MI), abnormal heartbeats (AHB), and patients with Previous History of Myocardial Infarction (PMI) classes. Moreover, we introduce a module to measure the similarity of COVID-19-affected ECG images with the rest of the diseases. To the best of our knowledge, this is the first effort to approximate the correlation of COVID-19 patients with those having any previous or current history of cardio or respiratory disease. Further, we generate the heatmaps to demonstrate the accurate key-points computation ability of our method. We have performed extensive experimentation on a publicly available dataset to show the robustness of the proposed approach and confirmed that the Efficient-ECGNet framework is reliable to classify the ECG-based COVID-19 samples.

Association of metabolic comorbidity with myocardial infarction in individuals with a family history of cardiovascular disease: a prospective cohort study

BackgroundThe association between metabolic comorbidity and myocardial infarction (MI) among individuals with a family history of cardiovascular disease (CVD) is yet to be elucidated. We aimed to examine the combined effects of metabolic comorbidities, including diabetes mellitus, hypertension, and dyslipidemia, with a family history of CVD in first-degree on the risk of incident MI.MethodsThis cohort study consisted of 81,803 participants aged 40–89 years without a previous history of MI at baseline from the Korean Genome and Epidemiology Study. We performed Cox proportional hazard regression analysis to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for MI and early-onset MI risk associated with metabolic comorbidity in individuals with a family history of CVD.ResultsDuring a median follow-up of 5 years, 1,075 and 479 cases of total and early-onset MI were reported, respectively. According to the disease score, among individuals who had a positive family history of CVD, the HRs for MI were 1.92 (95% CI: 1.47–2.51) in individuals with one disease, 2.75 (95% CI: 2.09–3.61) in those with two diseases, and 3.74 (95% CI: 2.45–5.71) in those with three diseases at baseline compared to individuals without a family history of CVD and metabolic diseases. Similarly, an increase of the disease score among individuals with a positive family history of CVD was associated with an increase in early-onset MI risk.ConclusionMetabolic comorbidity was significantly associated with an increased risk of MI among individuals with a family history of CVD.

Early-term outcomes of simultaneous carotid endarterectomy and coronary revascularization

Objectives: This study was designed to evaluate the early-term results of the safety and effectiveness of simultaneous applications of coronary revascularization and carotid endarterectomy. Patients and methods: In the sectional descriptive study conducted between December 2010 and December 2014, 32 patients (22 males, 10 females; mean age: 66±1.6 years; range, 49 to 85 years) with coronary artery disease and carotid artery stenosis were evaluated. All patients underwent simultaneous carotid endarterectomy and coronary artery bypass grafting. They were followed at the median for three months. Demographic characteristics of the patients and a history of previous myocardial infarction, hypertension, diabetes mellitus, hyperlipidemia, renal disease, peripheral arterial disease, and smoking were recorded. Results: Hospital mortality was encountered in two (6.3%) patients. One (3.1%) patient had a postoperative major stroke, whereas two patients had a transient ischemic attack. Postoperative myocardial infarction was observed in one patient. Conclusion: Synchronous carotid endarterectomy and coronary artery bypass grafting may be safe and effective in the management of patients with concomitant carotid artery stenosis and coronary artery disease.

Impact of SGLT2 inhibitor on mortality and cardiovascular outcomes in patients with type 2 diabetes mellitus with left main or multivessel coronary artery disease

Abstract Background Sodium-glucose Cotransporter 2 inhibitors (SGLT2-i) have shown improved cardiovascular outcomes in type 2 diabetes mellitus (T2DM) that surpass their hypoglycaemic power. However, the inclusion criteria in the pivotal studies were broad in terms of cardiovascular disease, and there are no specific studies on patients with coronary artery disease (CAD). Purpose To compare, in patients with T2DM and extensive CAD, the hazard ratio (HR) of all-cause death in patients treated with or without SLGT2-I, adjusted by IPTW and treatment (revascularization) strategy. Secondary: To compare the adjusted HR of cardiovascular (CV) death, myocardial infarction (MI), stroke, or heart failure admission (HF) in patients treated with or without SLGT-I. Methods A single-centre retrospective observational study in patients with T2DM, with the first diagnosis of extensive CAD defined by &amp;gt;50% stenosis in LM or 3-vessels, and alive at discharge. The study was approved by the research ethics committee and recruited consecutive patients from 2015 (year of first SLGT2-I approval) to 2020. Patients with prior revascularization, severe renal failure (filtration rate &amp;lt;30 ml/min), less than 6 months of SLGT2-I treatment and less than 1 year of follow-up were excluded. Results We recruited 420 patients with a mean age of 71.2±11.1 years; 78.6% were male, 82.6% had hypertension, 72% hyperlipemia, 50.2% were smokers or former smokers, 52.9% had a history of previous myocardial infarction and 10.7% of stroke. Mean LVEF (%) was 51.5±1.5, creatinine clearance 73.94±22 ml/min and glycated haemoglobin (%) 7.3±1.2. The presentation was acute coronary syndrome in 44.3% (27% ST elevation/73% non-ST elevation). LM was affected in 29%; 3-vessel CAD was found in 86.7%; 2-vessel in 8.3%; 1-vessel in 3.8%, and 1.2% exclusively in the LM. Treatment strategy was PCI + OMT in 48.3%, CABG + OMT 39.8% and OMT only in 21.9%. T2DM treatment, secondary prevention treatment and metabolic control at follow up are presented in Table 1. A total of 104 patients (24.8%) started treatment with SGLT2-I during a mean of 1.6±1 years. At a mean follow-up of 3±1.6 years, mortality was 16.4%, CV mortality was 9.5%, 6.9% had a MI,3.3% had a stroke, and 11.4% had HF admission. Patients treated with SLGT2-I had a lower risk of all-cause death, cardiovascular death and the composite of CV death or HF (Table 2). After IPTW, the risk of all-cause death was persistently lower in the SLGT-I group Conclusion This real-life study found that in T2DM patients with LM or MVD only 1 out of 4 patients was treated with SGLT2-I as a part of their secondary prevention treatment. Those with SGLT2-I had a reduced risk of all-cause death (HR 0.34 [0.12–0.91], p=0,033) after IPTW and treatment (revascularization) strategy adjustment. Funding Acknowledgement Type of funding sources: None.