Background: Although High body mass index is associated with many cardiovascular diseases including coronary artery disease. Its effect on in-hospital death in patients with acute ST-segment elevation myocardial infarction (STEMI) is still a subject of controversy. Objective: To determine the correlation between body mass index (BMI) and in-hospital mortality in those patients. Patients and Methods: In this cross-sectional study, 180 adult patients with acute STEMI were enrolled and their BMI was measured. The participants were classified according to BMI into three groups as normal, overweight, and obese. A correlation between in-hospital mortality due to STEMI and BMI was evaluated. Results: Of the total participants, 62 (34.4%) were normally weighted, 61(33.8%) were over-weighted, and 57(31.6%) were obese. There was a significant difference (p= <0.001) between the groups concerning troponin I, hs-CRP, GRACE score, and the probability of in-hospital death. There were 16 (8.8%) in-hospital deaths during the study distributed as follows; 1(1.6%) in the normal-weight group, 5(8.1%) in the overweight group, and 10 (17.5%) in the obese group. In-hospital death showed a significant difference (p=0.04) between the study groups. In addition, a significant positive correlation(r=0.9) was found between BMI and in-hospital death. Conclusion: A robust positive correlation was detected between BMI and in-hospital mortality due to acute STEMI. When BMI increases, the number of deaths also increases exponentially. Keywords: Body mass index, ST-segment elevation myocardial infarction, mortality
Background: The correlation of cardiac troponin I with early in-hospital outcomes in acute myocardial infarction is not well established. Objective: To assess the role of troponin I in predicting in-hospital outcomes and early left ventricular systolic dysfunction in patients with ST-segment elevation myocardial infarction. Patients and Methods: A prospective study which consist of 116 patients (74 were males and 42 were females), with ST-segment elevation myocardial infarction who had been admitted to the Coronary Care Unit from March 2015 to September 2015 were enrolled. Patients were divided according to the level of troponin I on admission into 3 groups (low, medium and high elevation). Results: The mean age (+ SD) of the patients was 60+11.4 years. The troponin level of 66.2% of males was high compared with 52.4% of females (p=0.002). The incidence of acute pulmonary edema (21.1%), cardiogenic shock (7%) and early left ventricular systolic dysfunction (49.3%) was significantly higher among patients with high troponin level compared with (0%, 0% and 16%, respectively) among patients with low troponin level. All deaths and cardiac arrest were of high troponin level. Conclusion: High admission troponin I in ST-segment elevation myocardial infarction permits early identification of patients at increased risk of major cardiac complications and death.
Background: The effects of diabetes mellitus and gender on left ventricular structure in hypertension are still controversial. Objective: To evaluate the effects of diabetes mellitus and gender on left ventricular structure in a sample of hypertensive patients in Erbil-Iraq. Patients and Methods: This cross sectional study was conducted in Rizgary hospital, Erbil-Iraq, between April 2015 and April 2016. A convenient sample of 200 patients (100 males and 100 females), aged ≥18 years were enrolled. Half of the sample (Group I) had diabetes in addition to hypertension, while the other half (Group II) had hypertension only. The effects of diabetes mellitus and gender on left ventricular structure were evaluated in both groups. Results: In Group I, left ventricular diastolic and systolic dimensions were significantly higher among male patients (P=0.023, 0.022 respectively) than female patients. In group II , the mean thickness of posterior wall , left ventricular mass , left ventricular mass index and relative wall thickness was significantly higher among male patients (P=0.004, 0.016, 0.035 and 0.045 respectively) than female patients. The mean thickness of interventricular septum, posterior wall and relative wall thickness (P=0.0013, 0.007 and 0.003 respectively) was significantly higher in diabetic females than non-diabetic females. No significant differences were found between diabetic and non-diabetic males. Conclusion: There is an obvious effect of gender and diabetes on left ventricular structure. In the hypertensive non-diabetic group, the left ventricular structural changes were significantly seen among male patients than females. In contrary, these changes were significantly seen in diabetic females than non-diabetic females.
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