جستجوی مقالات مرتبط با کلیدواژه « آنفارکتوس حاد میوکارد » در نشریات گروه « پزشکی »

Systemic embolism can be one of the unfortunate side effects of left ventricular thrombus following acute heart infarction, and its timely diagnosis and treatment is very important. In this report, a patient with saddle embolism in the abdominal aorta due to the complete separation of the left ventricular thrombus following acute anterior infarction is presented.

Case Report: 

The patient is a 60-year-old man who referred to the emergency room complaining of severe retrosternal chest pain, nausea and cold sweats. In the ECG, he had ST segment elevation in leads V1-V5, and with the diagnosis of acute anterior infarction with ST segment elevation (acute anterior STEMI), he underwent primary angioplasty with stent placement (Primary PCI) on the left anterior descending artery. In transthoracic echocardiography three days later, a large thrombus was seen in the apex of the left ventricle. Seven days after stent implantation, the patient experienced severe pain and paraplegia of the lower limbs. In Doppler ultrasound, bilateral iliac artery occlusion was seen. Despite treatment with aspirin, clopidogrel, and anticoagulants, the left ventricular thrombus was embolized to the bifurcation of the abdominal aorta and caused bilateral acute ischemia of the lower limbs. The patient underwent emergency embolectomy and was discharged one week later with a stable condition and two antiplatelets and warfarin. Three months later, warfarin was discontinued.

According to this case report, abdominal aortic saddle embolism following acute myocardial infarction may rarely be seen. Paying attention to clinical symptoms, careful examination and quick diagnosis and treatment can improve the prognosis. In any patient with a left ventricular thrombus following an acute myocardial infarction, the possibility of systemic embolism should be considered.

Acute myocardial infarction is one of the main causes of mortality in the worldwide. The aim of the present study is to predict the Association of interleukin (IL)-17 and phagosome with acute myocardial infarction.

Methods and Materials:

Microarray data were extracted from National Center for Biotechnology Information (NCBI) and then analyzed by GEO2R and R softwares. The functional analysis of up/down regulation of genes were performed using DAVID and Enrichr data bases.

In this study, expression of 208 genes were lower in patients group compared to the controls (Log2FC<-1). In patients’ group, PAQR8, CCR2, CCR5, and ZNF137P genes significantly had lower expression. Although 528 gens, especially NR4A2, GABARAPL1, THBD, NFIL3, and MAFB significantly had more expression compared to the controls (Log2FC>+1). KEGG analysis on gens that increase expression showed that signaling pathways of IL-17 and phagosome are two pathways in patients with acute myocardial infarction.

According to our finding, after acute myocardial infarction, inflammatory pathway like IL-17 signaling recruiting matrix metalloproteinase 9 as a protein involve in repairing acute myocardial infarction damages. Also, the phagosome activity by major histocompatibility complex class-II (MHC-II) and CD36 signaling pathways, may be played a role in accelerating healing after acute myocardial infarction damages.

Recently, researchers have become more interested in the role of thyroid hormones in acute coronary syndromes. In the present study, the serum levels of thyroid hormones in STEMI patients at the time of hospital admission and the it's correlation in the success rate in primary percutaneous intervention which is depicted in the form of ST-resolution was evaluated.

In this study, 500 patients who underwent primary angioplasty in Shahid Madani Tabriz hospital within early 2016 and late 2017 were included. The participants were divided in two groups: group 1 (decrease in ST-resolution less than 50%) and group 2 (decrease in ST-RESOLUTION more than 50%). Correlations between thyroid hormones, ST resolution, mortality and Major Adverse Cardiovascular Events (MACE) were assessed.

The mean age of the patients was 57.22 ± 11.32 years old while 401 patients (80.2%) were male and 99 patients (19.8%) were female. In 152 patients (30.4%) ST resolution was 50% and less (group 1) and in 348 patients (69.6%) ST-RESOLUTION was more than 50%. No significant correlation was found between TSH and FT3 levels and ST resolution. Also, MACE and thyroid hormones didn’t have any correlation.

The finding of the present study showed there was no significant relationship between ST resolution and MACE and FT4, TSH and FT3 levels.

Vitamin D deficiency is related to acute myocardial infarction (MI) directly and indirectly. Therefore, this study evaluated serum level of vitamin D in patients with acute MI.

This is a cross-sectional and descriptive study on 84 patients with acute MI in Amiralmomenin hospital since May 2018 to May 2019. The demographic information of patients including risk factors for MI as: age, gender, body mass index, hypertension, hyperlipidemia, diabetes, cigarettes use or drugs abuse, history of cardiovascular diseases, inpatient time, and vitamin D status are gathered as questionnaires. The data was added to SPSS version 25, and the P-value of 0.05 was considered significant.

52.4% of patients were female. All the patients were 36 to 90 years old, and the mean (±standard deviation) age was 67.51±12.90 years old. 25% of the patients had vitamin D deficiency, 23.8% insufficiency, 11.9% severe deficiency, and 51.2% normal value. However, none of the risk factors were related to the vitamin D status significantly.

In this study, none of the risk factors were related to vitamin D status in MI patients, yet cohort studies with major samples are required because there are several studies confirm that vitamin D status has an important role in development of acute MI.

Cardiovascular Disease (CVD) is the leading cause of death in developing countries. Inflammation significantly contributes to the process of atherosclerosis. Therefore, evaluating White Blood Cells (WBC) and platelet counts as markers of inflammatory as well as hematocrit as a marker of blood viscosity may predict coronary events. The present study aimed to evaluate the relationship between hematological indices and the incidence of cardiovascular events.

This study was based on the results of the Isfahan Cohort Study (ICS) which was a long-term, population-based study of 6504 adults over the age of 35 years with no history of CVD who were followed up for any incidence of CVD from 2001 to 2015. Basic levels of hematological indices were measured by entering the study.

About 49.5% of the population were male. The mean age of the population and individuals with CVD were about 51 and 57.6 years, respectively. Significant relationships were observed between systolic and diastolic blood pressures, fasting blood glucose, triglyceride, cholesterol, Low-Density Lipoprotein (LDL) levels, and waist circumference with the incidence of cardiovascular events (P<0.001 for all). Hematocrit, hemoglobin, RBC, and WBC measures were significantly associated with the incidence of cardiovascular events (P=0.002 for all). There was no significant relationship between platelet levels and the incidence of cardiovascular events.

Hematological indices including WBC and RBC counts as well as hemoglobin and hematocrit levels can predict the incidence of cardiovascular events.

The aim of this study was to examine the effect of functional analytical psychotherapy on treatment adherence and self-care behaviors in female patients with acute myocardial infarction.

The severity of cardiovascular disease is affected by cognitive and behavioral function in people experiencing acute myocardial infarction. Therefore, with effective and modern treatments for this problem, effective results could be expected.

The research method was quasi-experimental pre-test post-test and follow-up design with control group. A sample of 30 women with a history of acute myocardial infarction who had been admitted to Seyed Al-Shohada Heart Hospital in Urmia, Iran, in 2021, were selected based on inclusion and exclusion criteria and randomly assigned to experimental (N=15) and control (N=15) group. Tsai et al. (2010) Functional Analytical Psychotherapy Package was implemented for experimental group in 10 sessions of 45 minutes duration. Before and after the sessions, and also, 3 months after intervention, both members of experimental and control groups completed Treatment Adherence Questionnaire and Self-Care Behavior Questionnaire as pre-test, post-test and follow-up measurements. Data were analyzed using mixed model analysis of covariance in SPSS Version 18.

The results showed that there was a statistically significant difference between experimental and control groups in term of the means of treatment adherence and self-care behaviors in pre-test, post-test and follow-up. Functional analytical psychotherapy had a greater effect on improving self-care behaviors (0.912) than treatment adherence (0.897) in female patients with acute myocardial infarction (P≥0.0001).

These results emphasize the effect of functional analytical psychotherapy in cognitive and behavioral domains in the treatment of female patients with acute myocardial infarction.

 The present study was conducted to determine the factors affecting the survival of myocardial infarction (MI) patients hospitalized in the cardiac care unite (CCU) at the 5-year period (2013-2018).

 By knowing the factors affecting survival, it is possible to focus more on prevention and treatment protocols.

  This is a retrospective cohort study investigating the data from the records of 277 patients with acute myocardial infarction (MI) hospitalized in the CCU ward of Shahid Sayad Shirazi Teaching and Medical Hospital affiliated to Golestan University of Medical Sciences, Iran, over a 5-year period from 2013 to 2018. The convenience sampling method was used, and the inclusion criteria encompassed those with diagnosed MI based on the report of cardiologist, disease history, signs in electrocardiogram (ECG), and cardiac enzyme marker tests. The instrument used for data collection included a list of clinical information, laboratory parameters, and demographic information. The data were analyzed in SPSS-16, using descriptive and inferential statistics.

This study revealed that 187 patients (67. percent) were males, and the mean age of expired patients was significantly higher than the recovered ones (P=0.002). Moreover, the mean cholesterol and blood sugar values in the expired patients were significantly higher than the recovered ones (P=0.033, P=0.015, respectively). Correspondingly, there were a statistically significant differences in the mean value of hemoglobin and red blood cells between the two groups (P=0.002, P=0.047, respectively). MI patients who didn’t use drugs, cigarettes, and water pipe and had no systemic diseases were more likely to survive compared to those with a history of addiction and systemic diseases (P=0.04, P=0.029). Finally, the survival graph showed that 50 percent of the patients were alive until the 11th day of hospitalization (median survival time, 11 days).

 Determining the factors affecting the survival rate of patients after MI can be the focus of prevention and screening programs for high-risk groups of patients with acute myocardial infarction.  Hence, increasing the survival of patients with acute MI requires health policymakers to take comprehensive actions at prevention levels.

 The aim of this review study was to explain the consequences of pre-hospital delay in patients with acute myocardial infarction.

 Studies have shown that patients with acute myocardial infarction who refer to medical centers late, experience adverse mechanical and electrical consequences of acute myocardial infarction.

 In this review study, the keywords Outcome, Myocardial infarction, Delay, and Survival were used to search out the relevant papers published between 2000 and 2020, in databases, Up-to-date, Scopus, PubMed, Science Direct, Web of Science, SID, and Magiran. A total of 14 articles were reviewed.

 The review of the articles showed the consequences of pre-hospital delay in patients with acute myocardial infarction as the following: acute heart failure, cardiac arrest, stroke, mortality, decreased cardiac ejection fraction, long-term hospitalization, decreased long-term survival, increased in-hospital mortality, and increased treatment costs.

 Pre-hospital delay in patients with acute myocardial infarction is associated with complications and adverse consequences for patients. Health care team should educate patients and their families about the signs and symptoms of cardiovascular disease and the importance of timely treatment.

Patients with acute myocardial infarction (MI) need care due to the complications of the disease. This study aimed to evaluate the effect of the family-centered intervention on the quality of life of patients with acute MI.

A randomized clinical trial study was conducted on 80 patients with acute myocardial infarction, who were hospitalized in Hajar and Kashani hospitals in Shahrekord, Iran and one of their family members. The subjects were randomly divided into two groups of control (N=40) and test (N=40) using statistical software. In the test group, four short messages were sent weekly for three months about necessary care after MI. On the other hand, subjects in the control group received routine intervention. After that, the quality of life of subjects was assessed before and immediately after the termination of intervention in both groups. In addition, data were collected using demographic characteristics questionnaire and McNeigh's quality of life inventory. Furthermore, data analysis was performed in SPSS version 23 using descriptive statistics (mean and standard deviation), as well independent and paired t-tests.

The findings were indicative of no significant difference between the test and control groups regarding the mean score of quality of life. However, a significant difference was found between the groups after the intervention in this regard. Moreover, the mean scores of changes in the quality of life of subjects in the test and control group were significantly different before and after the intervention. The results of the independent t-test demonstrated a significant difference between mean changes in the quality of life of the study groups.

According to the results of the study, SMS intervention as a distance learning method improved the quality of life in patients. Therefore, it is recommended that the intervention be applied to improve the quality of life in patients after acute MI.

Aim:

This review study was conducted to explain the causes of prehospital delay in Iranian people experiencing myocardial infarction.

Background:

While rapid diagnosis and treatment of myocardial infarction reduces mortality, improves heart function and most importantly, improves the patientchr('39')s prognosis, studies show that some people experiencing the symptoms of myocardial infarction return to medical centers with delay.

Method:

 In this review study, SID database was used to search out articles published from 2001 to 2019. The keywords “acute myocardial infarction” and prehospital delay” was uysed to searching out the articles. Articles with accessible full text were reviewed in this study.

Findings :

The review of articles related to the factors of prehospital delay in Iranian people experiencing  acute myocardial infarction included expecting spontaneous recovery, attributing the disease to non-cardiovascular causes, unawareness of the symptoms of cardiovascular disease, not paying attention to the symptoms of the disease and taking medication arbitrarily, having an underlying disease such as diabetes, low level of pain in the onset, sex, old age, low education, low income, place of residence, insignificance of pain, being alone at the time of acute myocardial infarction, onset of symptoms from midnight to early morning, negative history of heart disease, and the gradual onset of symptoms.

Conclusion:

The results of this review showed that the most important factors in prehospital delay of Iranian people experiencing myocardial infarction individual factors and misunderstanding of the disease. Health care team should work to improve public awareness of the signs and symptoms of cardiovascular disease.

This review study was conducted to explain the causes of prehospital delay in Iranian people experiencing myocardial infarction.

While rapid diagnosis and treatment of myocardial infarction reduces mortality, improves heart function and most importantly, improves the patientchr('39')s prognosis, studies show that some people experiencing the symptoms of myocardial infarction return to medical centers with delay.

In this review study, SID database was used to search out articles published from 2001 to 2019. The keywords “acute myocardial infarction” and prehospital delay” was uysed to searching out the articles. Articles with accessible full text were reviewed in this study.

The review of articles related to the factors of prehospital delay in Iranian people experiencing  acute myocardial infarction included expecting spontaneous recovery, attributing the disease to non-cardiovascular causes, unawareness of the symptoms of cardiovascular disease, not paying attention to the symptoms of the disease and taking medication arbitrarily, having an underlying disease such as diabetes, low level of pain in the onset, sex, old age, low education, low income, place of residence, insignificance of pain, being alone at the time of acute myocardial infarction, onset of symptoms from midnight to early morning, negative history of heart disease, and the gradual onset of symptoms.

The results of this review showed that the most important factors in prehospital delay of Iranian people experiencing myocardial infarction individual factors and misunderstanding of the disease. Health care team should work to improve public awareness of the signs and symptoms of cardiovascular disease.