Objective: To determine the frequency of arrhythmias in patients with acute ST-segment elevation myocardial infarction primary percutaneous coronary intervention (PPCI) till 48 hours post PPCI in admitted at national institute of cardiovascular diseases (NICVD), Karachi. Material & Methods: This was a hospital based clinical study conducted at NICVD through convenience sampling technique for the period of 6 months from 1st September 2021 to 31st March, 2022. All the adult (age more than 18 years) male and female, presented with acute ST-segment elevation myocardial infarction, and eligible for PPCI were included in this study. Cardiac arrhythmias during 48 hours post-PPCI were evaluated and documented. SPSS v. 26 was used for data entry and analysis. Results: A total of 285 patients were included for final analysis. The overall mean age ± SD was 56.56±13.07 years. Most of the patients were belongs to age group II (age ≥55 years) as compare to age group I (age <55 years), 50.87% and 49.12%, respectively. The overall incidence of arrhythmias was 16.6% among them most of the arrhythmias were observed during the first 24 hours of PPCI (72.22%). Ventricular arrhythmias were most common as compare to atrial arrhythmias (61.11%). There was an insignificant association observed in relation to gender and incidence of arrhythmias, p 0.236. Patients having age ≥55 were significantly associated with occurrence of arrhythmias, p <0.001. Conclusion: Frequency of cardiac arrhythmias is higher during early hours of after PPCI. Among them, ventricular arrhythmias were more common as compare to atrial arrhythmias. Older patients (age >55 years) were significantly associated with increased incidence of cardiac arrhythmias as compare to younger age group (age <55 years). Keywords: Cardiac arrhythmias, STEMI, primary PCI, time duration, in-hospital incidence, South Asia
Background: Cardiovascular disease specially ischemic heart disease in Pakistan has become one of the major cause of mortality. Patients with symptoms/signs of angina non obstructive CAD may be suspected where atherosclerotic epicardial CAD does not limit coronary blood flow, but other processes may disturb myocardial supply/demand relationship Objective: To determine the frequency of nonobstructive coronary artery disease in patients admitted for elective coronary angiography, at NICVD, Karachi, Pakistan Methods: This Cross sectional study was done at National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan from April 16, 2021 to October 15, 2021. we included patients fulfilling the inclusion criteria. Informed consent was taken. The data was collected on prepared proforma. Results: Mean ± SD of age was 55.4±13.2 years. Out of 151 patients, 90 (59.6%) were male while 61 (40.4%) were female, Hypertension was noted in 105 (69.5%) patients while Diabetes mellitus was documented in 71 (47%) patients and Positive family history of nonobstructive CAD was found to be in 26 (17.2%) patients , and 67 (44.4%) were smoker. Nonobstructive CAD was found to be in 35 (23.2%) patients. Conclusion: It is to be concluded that nonobstructive coronary artery disease was documented in considerable number of patients admitted for elective coronary angiography. Further large-scale work is recommended for validation of current findings. Keywords: Coronary Artery Disease, Elective Coronary Angiography.
Introduction: Higher levels of troponins >10 folds of upper normal limits (UNL) are considered as high-risk patients on coronary angiography sufferers having high levels of troponin-I (>10 folds upper limit normal level) had extra three-vessel coronary artery disease involvement. Objectives: To determine the frequency of degree of cardiovascular disease with Troponin-I level >10 folds ULN in NSTEMI patients at tertiary care hospital. Methodology: It is a cross-sectional study comprising of a total 800 patients recruited from the Department of Cardiology, National Institute of Coronary Disease, Karachi Pakistan based on Exclusion/Inclusion criteria. Results: There are 678 male as well as 122 female patients. The mean troponin-I level was 15.00±6.82 ng/ml. Single vessel disease found in 25.25% cases, two vessel diseases were observed in 37.75% cases, and three vessel diseases were observed in 20% cases. 83% were found with extent of CAD findings on angiography. There have been 678 male and also 122 female patients. The mean troponin-I level was 15.00±6.82 ng/ml. Single vessel disease found in 25.25% cases, two vessel diseases were observed in 37.75% cases, and three vessel diseases were observed in 20% cases. 83% were found with extent of CAD findings on angiography. Conclusion: The higher troponin level found significantly associated with extent of CAD and three vessel disease. To understand the cardiovascular troponin condition of the sufferer as soon as feasible is crucial. Keywords: Extent of Coronary Artery Disease, NSTEMI, Troponin-I Level >10 Folds ULN
Objective: To determine the frequency of hyponatremia and itsassociation of with associated factors and its impact on in-hospital outcome in patients with acute ST elevated myocardial infarction. Study Design:AnalyticalStudy. Study Setting: Study was conducted at Aga Khan University Hospital, Karachi (AKUH). Subjects and Methods: This is an analytical study conducted at Aga Khan University Hospital, Karachi (AKUH) between the period of 2016 to 2017.Informed consent to enroll and use data of patients was obtained from all the 225 patients before commencing the study. All patients of age between 20 to 75 years of either gender diagnosed with ST elevation acute myocardial infarction in emergency or outpatient department were enrolled in the study.Hyponatremia was labelled as serum sodium level less than 135mEq/L (Normal is 135-145mEq/L).A detailed history was taken followed by complete examination at admission.In hospital outcomes were measured within 72 hours of admission. Report was collected and findings were noted in the Performa.Data was analyzed on SPSS Version 16. Results:A total of 225 patients admitted in Department of Cardiology, Aga Khan University Hospital, Karachi were included in this study. Mean age in our study was 56.80±7.56 years.135 (60%) were male and 90 (40%) were female. Out of 225 patients, 43 (19.1%) had hyponatremia and 182 (80.9%) did not have hyponatremia. In-hospital mortality was 22 (100%) who had hyponatremia. Conclusion:The results showed that hyponatremia has very strongly association with in-hospital mortality. Cardiovascular mortality among patients with acute STElevationmyocardial infarction. Plasma sodium levels may serve as a simple marker to identify patients at risk. Key Words: Acute ST elevated myocardial infarction,Hyponatremia, in-hospital mortality, associated factors.
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