Background: The metabolic syndrome is linked to several conventional and rising pro-thrombotic and pro-inflammatory cardiac risks. Most patients with cardiovascular disease have metabolic syndrome; however, the occurrence and connection of its various elements aren't obvious. There isn't any research regarding the occurrence of Metabolic Syndrome in young patients with acute STEMI. Objective: The purpose of this study was to figure out the occurrence of metabolic syndrome (MS) in young patients shown ST-Elevation Myocardial Infarction (STEMI) at a tertiary care hospital in Karachi, Pakistan. Material and Methods: The research was conducted on 170 patients with STEMI. Body mass index was measured. Smoking level, metabolic syndrome (MS), and aspects of the metabolic syndrome (BMI >23 kg meter per square, high blood pressure, hypertriglyceridemia, low-plasma HDLc, and affected fasting plasma glucose) were noted. Descriptive statistics were used, and stratification was done in the study. Fisher exact test and post-stratification by square test were used during the research study. P-value ≤0.05 was regarded as significant. Results: There were 42.2% women and 57.6% men with a mean age of 29.84±7.96 years. Metabolic syndrome (MS) was positive in 64.7 per cent of sufferers. BMI >23 kg meter per square was noticed in 97.1 per cent of patients. High blood pressure in 72.4 per cent of patients. Hypertriglyceridemia in 77.65 per cent of patients, Low plasma HDLc in 44.1 per cent of individuals, and affected fasting plasma glucose in 47.1 per cent of patients. Conclusion: It had been determined by research findings that the occurrence of metabolic syndrome in young patients having STEMI was higher. The common element was BMI >23 kg/m2, Hypertension, and Hypertriglyceridemia. Keywords: Prevalence, Young Patients, Metabolic Syndrome (MS), STEMI, Aspects of MS
Introduction: Acute coronary syndrome(ACS) is associated with activation ofplateletsand thecoagulationsystem which could influence the incidence of early stentthrombosis(EST).Stent thrombosis is a relatively uncommon phenomenon, yet it is a serious complication which often presents as an ST-segment elevation myocardial infarction (STEMI) and/or sudden cardiac death1,2.Stent thrombosis (ST) is an uncommon but life-threatening complication after percutaneous coronary intervention (PCI), frequently manifesting as acute coronary syndrome (ACS) or even cardiac death.Platelet activation and the heightening of the coagulation system play a major role in the pathogenesis of acute coronary syndrome (ACS) and might impact the occurrence of stent thrombosis in those patients who undergo stenting during ACS. Unfortunately, stent thrombosis (ST) is more frequent after stenting for STEMI than after elective stenting with both drug-eluting stents (DES) and baremetal stents (BMS). Objective: To determine the frequency of early subacute stent thrombosis after primary percutaneous coronary intervention in patients with STsegment elevation myocardial infarction Methodology: Study Design: Descriptive Case Series Setting: This study was conducted in NICVD Hospital, Karachi Subjects and Methods: Study was approved by hospital ethical review committee. All patients who fulfilled the inclusion criteria were included in the study. Pre-operatively a written consent was taken from each patient by the primary investigator of this study. All these patients were undergone primary PCI and stent either drug-eluting stents (coated with medication) or bare-metal stent was placed. These patients were observed for 24 hours for early subacute stent thrombosis. All the collected data were entered into the proforma attached at the end. Results: Mean ± SD of age was 55.56±12.24 with C.I (53.52------57.59) years. Mean ± SD duration of surgery was 33.48±9.26 with C.I (31.90------35.05) minutes. Out of 142 patients 103 (72.53%) were male and 39 (27.4%) were female. Frequency of early subacute stent thrombosis was found to be 4(2.82%). Conclusion: It is to be concluded that frequency of early acute stent thrombosis after primary PCI was found to be 2.82%.Patients presenting with STEMI who are hemodynamically unstable and have multivessel coronary disease undergoing coronary stenting during ACS, are at increased risk of EST. Keywords: Acute myocardial Infarction, Primary PCI, Early Subacute Stent, Thrombosis, STEMI
Objectives: Post-dilatation with non-compliant (NC) balloons is a commonly used strategy to improve inadequate stent expansion but this strategy carries an increased risk of slow flow/no-reflow (SF/NR) due to distal embolization. Therefore, our objective was to evaluate the demographic, clinical, angiographic, and procedure characteristics among patients undergoing primary percutaneous coronary intervention (PCI) who developed slow flow/no-reflow (SF/NR) after post-dilatation with non-compliant (NC) balloons. Methodology: In this cross-sectional observational study, we included consecutive patients with SF/NR after post-dilatation using NC balloon post stent deployment during primary PCI. The demographic, clinical, angiographic, and procedure characteristics were evaluated. Results: In the sample of 107 patients, male were 77.6% (83) and mean age was 56.94 ± 10.47 years. The median chest pain to ER (emergency room) arrival time was 292 [180-394] minutes. A majority of the patients (66.4%) had multi-vessel disease. Mean length NC balloon was 10.57±1.98 mm and diameter was 3.5±0.26 mm. The mean number of inflation were 3.62±1.08, at mean maximal pressure of 20.43±2.49 mmHg, proximal edge pressure of 19.25±2.74 mmHg, and distal edge pressure of 14.64±2.01 mmHg. A total of 5.6% (6) patients developed adverse events and final TIMI (thrombolysis in myocardial infarction) III flow was achieved in 89.7% (96) of the patients. Conclusion: SF/NR after post-dilatation during primary PCI is associated with a significant rate of adverse events and sub-optimal (<III) final TIMI flow. The detrimental effects of high pressure, short length, and increased number of inflations on post NC SF/NR need further investigations.
Objective: To determine the frequency of anemia among the patients presented with myocardial infarction (MI) at a tertiary care hospital of Karachi, Pakistan. Study Design: A cross-sectional study. Place and Duration: Adult Cardiology Department of National Institute of Cardiovascular Disease (NICVD), Karachi from February 2022 to July 2022. Methodology: A total of 253 patients diagnosed with MI were included. Demographic and clinical characteristics of the patients were recorded. Hemoglobin level was obtained at the time of admission. Results: In a total of 253 patients, the mean age was 54.36±8.21 years. There were 187 (73.9%) male and 66 (26.1%) female. Frequency of anemia among the patients presented with myocardial infarction was found to be in 72 (28.5%). Frequency of anemia among patients presenting with MI was noted. Practical Implications: Anemia in myocardial infarction patients has affected the patency of vessel so this single most essentially and easily treatable component should be corrected in these patients.. Conclusion: High prevalence of anemia in patients presenting with MI was noted. Keywords: Anemia, hemoglobin, ischemic heart disease, myocardial infarction
Objectives: To determine the frequency of pre-hospital aspirin use in patients presenting with ST- segment elevation myocardial infarction and to assess the demographic and clinical characteristics of the patients taken pre-hospital aspirin. Methodology: It was a prospective study conducted at tertiary care hospital for the duration of six months. About 657 patients aged between 18-80 years, of either gender and diagnosed with ST-elevation myocardial infraction were included in the study. Use of pre-hospital aspirin after symptoms was assessed in all patients, then followed and outcomes such as discharge status and length of hospital in days were evaluated. Results: Overall mean age was 54.60±12.06 years and most of them were males (79.1%). About 254 patients (38.7%) received aspirin before transfer to hospital and 403 patients (61.3%) received aspirin after arrival in hospital. Frequency of pre-hospital use of aspirin was significantly associated with gender (p=0.001), educational status (p=0.006), and monthly income (p=0.003). The mean rank of length of hospital stay was similar significantly lower in STEMI patients who received pre-hospital aspirin as compared to those who did not receive pre-hospital aspirin (p=0.001). Moreover, the death rate was lower in patients with pre-hospital aspirin administration as compared to those who did not receive pre-hospital aspirin (1.2%vs2%). However, the difference between pre-hospital aspirin use and discharge status was not statistically significant (p=0.434). Conclusion: Frequency of pre-hospital aspirin use was lower in patients with STEMI. Gender, educational status, and socio-economic status were the significant factors for pre-hospital aspirin use.
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