One of the common negative impacts in the management of acute myocardial infarction is cognitive decline. Using the rat model of isoproterenol (ISO)-induced myocardial infarction, we assessed the cardioprotective effect of sodium thiosulfate (STS) and its influence on cognition. STS treatment reduced the cardiac infarct size
The above results suggest that mitochondrial changes associated with diabetes and cardiomyopathy significantly contribute to the adverse outcome of I/R injury.
BACKGROUND Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality worldwide. The prevalence of CAD and the incidence of Acute Coronary Syndrome (ACS) are very high among Indians. ST Elevation Myocardial Infarction (STEMI) is one of the major presentations of Acute Coronary Syndrome. The data regarding the clinical presentations of STEMI is still lacking in the majority rural population of INDIA. MATERIALS AND METHODS All patients who were admitted with features of Acute ST Elevation myocardial infarction (STEMI) from 1 st January to 30 th September 2018 were included and analysed retrospectively in this study. The demographic features, Cardiovascular risk factors, Clinical presentation, Serial E.C.G findings & the 2-D Echocardiographic features were analysed and correlated with the clinical and E.C.G findings. RESULTS Out of 236 patients admitted with features of Acute STEMI 184 (77.97%) patients were male and 52(22.03%) were female. The commonly affected age group was 40-60years of age (51.27%). The female patients with STEMI increased with advancing age. Type II diabetes mellitus was the most common modifiable risk factor (36.01%). Smoking (9.75%) and alcoholism (7.63%) contributed as significant risk factors for male. Chest pain was the most common presenting symptom (72.88%). Majority of patients 98(41.53%) presented between 12-24hours after the onset of chest pain. AWMI (51.27%) was more common than IWMI (46.19%). RV infarction occurred in 33% of patients with Acute IWMI. There were more patients with LVEF <40% in AWMI group (64.46%) and in non-thrombolysed patients (66.67%). CONCLUSION Most of the patients with STEMI were male in the 40-60years of age. There were more female patients with STEMI with advancing age (>65years). Diabetes mellitus and systemic hypertension were the most common risk factors for STEMI. AWMI was more common than IWMI. 33% of patients with IWMI had RVMI. LV dysfunction with LVEF < 40% was more common in AWMI and in non-thrombolysed patients. The mortality is high among elderly female with multiple risk factors and more extensive STEMI.
BACKGROUND Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality among elderly. The clinical features of Acute ST Elevation Myocardial Infarction (STEMI) in elderly are different from those in young patients in many aspects. The elderly STEMI patients are often less aggressively treated than younger ones due to advanced age, co-morbidities and delayed admission to the hospital. The epidemiological data regarding STEMI in elderly in India are mainly from urban centres. Hence, we conducted a study on the clinical presentation, risk factors and complications of elderly STEMI (> 60 years) patients admitted in the ICCU of Department of Cardiology, Thanjavur Medical College, Tamilnadu which caters to the needs of largely rural population. MATERIALS AND METHODS Our retrospective descriptive study was conducted on patients > 60 years of age, who were admitted with the features of acute STEMI from 1 st January 2018 to 30 th September 2018. The demographic features, cardiovascular risk factors, clinical presentations, serial ECG changes and 2D-Echo features were analysed and correlated. RESULTS Out of 87 patients studied, 58 (66.67%) were Male and 29 (33.33%) were Female with Male-to-Female ratio of 2:1. However, above 80 years of age, there were more Females (20.69%) than Males (1.72%). Majority of the patients belonged to 60-70 years' age group (66.67%). Type II Diabetes Mellitus (28.74%) and Systemic Hypertension (25.29%) were the common risk factors. Though 50.57% of patients presented with chest pain, atypical symptoms were present in significant number of patients. Majority were in Killip's class II (47.13%) on admission. IWMI occurred slightly more (49.42%) than AWMI (48.28%). RVMI occurred in 37.21% of patients with acute IWMI. LVEF < 40% was more common in AWMI (64.28%) group and in non-thrombolysed (50%) patients. Mitral regurgitation was present in 57 (65.52%) cases, while cardiogenic shock was present in 14.95% of cases. 5 patients (5.74%) died during their hospital stay. CONCLUSION STEMI in the elderly presented commonly between 60-70 years of age. Female patients with STEMI increased with increasing age (>70 yrs.). Diabetes Mellitus and Systemic Hypertension were the common risk factors. More patients presented with atypical symptoms and in Killip's class II. IWMI was more common than AWMI. 37.21% of patients with IWMI had RVMI. LV systolic dysfunction with LVEF < 40% was more common in AWMI and in non-thrombolysed patients. Advanced age, female gender, multiple risk factors, co-morbid conditions, extensive infarction and severe LV systolic dysfunction were the major contributors of in-hospital mortality.
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