Clinical presentation and outcome of patients with acute myocardial infarction with emphasis on in-hospital mortality and 30 day mortality.

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Clinical presentation and outcome of patients with acute myocardial infarction with emphasis on in-hospital mortality and 30 day mortality.

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Title: Clinical presentation and outcome of patients with acute myocardial infarction with emphasis on in-hospital mortality and 30 day mortality.
Author: Zargar, Fayaz-u-Haq (Scholar); Khan, Khurshid Aslam (Guide)
Abstract: Background: The mortality rates from myocardial infarction (AMI) have come down considerably in last three decades. This decline has been attributed to the introduction of coronary care units, thrombolytic therapy, percutaneous coronary intervention and drugs such as Aspirin, Clopidogrel, Angiotensin converting enzyme inhibitors and Beta blockers. Objectives: To study 1) the risk factor profile of AMI; 2) Clinical presentation in AMI; 3) Level of care as per guidelines; & 4) The outcome in patients with AMI including in-hospital and 30 day mortality. Materials & Methods: Between January 2001 to October 2008, 817 patients who presented with AMI (both STEMI & NSTEMI) were included in study. Patients were assessed for risk factor profile, clinical presentation& level of care. The in hospital and 30 day mortality were analyzed. Results: The mean age of Presentation of study population was 58.8±11.4 years. There were 669 (81.9%) males and 148 (18.1%) females. 623 (76.3%) patients were smokers, 200 (24.5%) were diabetics, 694 (84.9%) hypertensive, 181 (22.2%) obese and 116 (14.2%) had hyperlipidemia. 525 (64.3%) patients presented with chest pain, 185 (22.6%) with breathlessness, 91 (11.1%) with diaphoresis, 46 (5.6%%) with palpitation and 37 (4.5%) syncope. 435 (55.4%) patients had taken Aspirin, 445 (54.5%) taken ACE inhibitors, 349 (42.7%) Betablockers, 340 (41.6%) clopidogrel and 331 (40.5%) statins prior to admission. STE MI was present in 697 (85.3%) patients and NSTEMI in 120 (14.7%) patients. Amongst the patients with ST EMI, 357 (51.2%) had Anterior wall MI, Inferior wall MI 288 (41.3%) patients, 47 (9%) had associated RV extension. Of 817 patients with AMI 121 (14.81%) died in hospital. In-hospital mortality was higher for patients with STEMI (16.4%Vs5.8%). 30 day follow up data was available for 155 patients, of which 8 (5.16%) died at 30 days. Conclusions: The in-hospital mortality rate of AMI is high, which is higher compared to west. A lot needs to be done to improve out comes in AMI. Public awareness about AMI, prompt identification and institution of standard treatment strategy is pivotal in achieving favorable outcomes in these patients.
URI: http://dspaces.uok.edu.in/handle/1/744
Date: 2009


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