No abstract

No abstract

No abstract

No abstract

Background: Any kind of stress, physical or emotional leads to increased production of ACTH, thus leading to increased glucocorticoid release and hence, hyperglycemia. Various studies suggest that the treatment of Stress Hyperglycemia has tremendous potential to reduce the morbidity and mortality among hospitalized patients with Stress Hyperglycemia. Aims: To study the prevalence and prognostic value of stress hyperglycemia in determining the cardiovascular outcome in non-diabetic acute coronary syndrome patients. Material and Methods: This study was conducted in 100 patients with no previous history of diabetes with Acute Coronary Syndrome over a period of 18 months. Stress Hyperglycemia in the acute phase of Acute Coronary Syndrome was defined as random blood glucose levels greater than or equal to 140 mg/dl. Patients were divided into two groups A and B on the basis of random blood sugar as normoglycemics and those with Stress Hyperglycemia, respectively. These groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular outcome of heart failure, arrhythmias, cardiogenic shock or death. The data was collected and statistically analysed. Results: Out of 100 patients of acute coronary syndrome with no previous history of diabetes, 38 % were found to be having stress hyperglycemia. Heart failure, arrhythmia, shock and death occurred in 57.89%,13.16 % 13.16 %, 21.05% of Stress Hyperglycemic patients as compared to only 16.12%,4.83%, 8.06 %, 6.45 % in normoglycemic patients, respectively. Summary and Conclusion: There is high prevalence (38%) of Stress Hyperglycemia in Acute coronary syndrome patients and is associated with adverse outcomes such as heart failure, arrhythmia, cardiogenic shock and death.

Background: An Acute Myocardial Infarction (AMI) is a subset of a spectrum of IHD that includes unstable angina and AMI with or without ST elevation. Ischemic heart disease (IHD) places a massive health burden on humanity. Sodium (Na

Background: Leukocytosis, predominantly neutrophilia has previously been described following ST elevation myocardial infarction (STEMI). The exact contribution of this phenomenon to the clinical outcome of STEMI is yet to be shown. We examined cellular inflammatory response to STEMI in the blood by assessing total neutrophil count (TNC), neutrophil to lymphocyte ratio (NLR) and Left ventricular ejection fraction (LVEF) post myocardial infarction and their association with inhospital mortality and/or adverse clinical events. Methods: In this cross-sectional study, 50 patients who were admitted with the diagnosis of acute STEMI at Government medical college and Hospital, Amritsar were studied. The complete blood cell count (CBC) was done in all patients within12-24 hours of the onset of symptoms. Total leukocyte count and differential leukocyte count were performed and neutrophil/lymphocyte ratio (NLR) was calculated. Left ventricular ejection fraction was assessed within one week of MI. Association of cellular response and ejection fraction with the incidence of post-MI mortality/complications like pulmonary edema, cardiogenic shock, arrhythmias and blocks were assessed by using ROC curve analysis and chi square test. Results: In-hospital mortality and post-STEMI complication rate were 8% and 42%, respectively. Total neutrophil count (P=0.029) and Neutrophil to lymphocyte ratio (P=0.001) were predictors of mortality. High NLR (P<0.001) and lower LVEF (P<0.001) were predictors of total complications and cardiogenic shock. Pump failure in the form of acute pulmonary edema (6%) or cardiogenic shock (8%) occurred in 7 (14%) patients. Higher total neutrophil counts (P=0.009), higher NLR (P<0.001) and lower ejection fraction (P<0.001) were predictors of pulmonary edema. The frequency of ventricular tachyarrhythmias (VT/VF) at the first day was associated with higher NLR level (P=0.029).High TNC and low LVEF were predictors for first degree heart block and high NLR was predictor for third degree heart bock and left bundle branch block. Conclusion: A single CBC analysis along with routinely assessed parameter i.e. ejection fraction may help to identify STEMI patients at risk for mortality and heart failure, while neutrophil to lymphocyte ratio is the most valuable in predicting both.