جستجوی مقالات مرتبط با کلیدواژه « Myocardial infarction » در نشریات گروه « پزشکی »

The concurrence of acute myocardial infarction (AMI) with COVID-19 can complicate the clinical conditions of patients and affect the patterns of hospital resource utilization. This study aimed to investigate and analyze the direct treatment costs of AMI patients with concurrent COVID-19.

This cross-sectional study collected and analyzed clinical data, including symptoms, readmission, and interventions, and treatment cost data for all patients at Tehran Heart Center using SPSS26 software. The mean medical costs of patients from January through May 2022 were also calculated.

The COVID-19 group was composed of 72.9% male and 27.1% female patients, whereas the non-COVID-19 group consisted of 67.3% male and 32.7% female patients. Most of the patients in the COVID-19 group (60%) were in the elderly age group (>65 y). The length of stay was 8.70±5.84 days for the COVID-19 group and 6.31±4.42 days for the non-COVID-19 group. The mortality rate in the COVID-19 group was 24%, higher than the 5% rate in the other group. Additionally, the average total treatment costs were $6384.54±$6760.13 in the COVID-19 group and $6362.49±$4343.07 in the non-COVID-19 group (P>0.78 and P>0.050).

The study found that the COVID-19 group had a significantly higher in-hospital mortality rate than the non-COVID-19 group. During the follow-up period, the incidence of complications (chest pain and heart failure) was higher in the non-COVID-19 group. It also showed that longer hospital stays resulted in higher treatment costs.

Hospital outcomes for myocardial infarction are among the clinical conditions influenced by the spread of COVID-19. Patients with COVID-19 frequently experience cardiovascular complications, with challenges encountered in acute management. We assessed clinical presentation, incidence, clinical outcomes and angiographic findings of myocardial infarction in COVID-19 patients.

This  study is a observational retrospective multicenter, medical diagram study was conducted on successive patients hospitalized with diagnosis of Covid-19 and myocardial infarction ,in two large referral hospitals with catheterization equipment and laboratories.COVID-19 infection was confirmed with reverse transcription–polymerase chain reaction assays of a nasopharyngeal sample or pattern of pulmonary parenchymal involvement in lung HRCT (approved by an expert respiratory or infection disease specialist). Data collected included patient demographics, comorbidities, electrocardiogram(ECG) and echocardiography results ,inpatient medication, treatment (fibrinolytic therapy, percutaneous coronary intervention  (PCI) ,coronary artery bypass graft (CABG), vasopressor use, invasive mechanical ventilation),laboratory test results (leucocyte count, C-reactive protein , D dimer, BUN, Cr, and ferritin)and outcome(duration of hospitalization, revascularization success, in-hospital reinfarction and mortality).

The most common comorbidities were hypertension (29, 58%), diabetes mellitus (21, 42%), dyslipidemia (14, 28%) and smoking (5, 10%). Fourteen patients (44.4%) were treated with PCI and 8 (19.5%) patients with fibrinolytic therapy as the initial reperfusion strategy. Revascularization was successful in 62% of patients.  The median CRP level of patients died was 96, which was significantly more than the level (46) in discharged cases (p<0.001). Creatinine levels were also significantly higher in patients who died compared to those who were discharged (p=0.008).

The results of this study demonstrate upper mortality rate in patients with diabetes, kidney injury and high-level CRP, denoting the baseline clinical and laboratory data could be defined as prognostic markers in COVID-19 patients, especially while managing myocardial infarction with concurrent COVID-19 infection.

Myocardial infarction is one of the leading causes of death in the world and accounts for 23% of mortalities. Self-care for senior patients with myocardial infarction can reduce complications, multiple hospitalizations, and financial costs.

This clinical trial was performed on 128 older adults with myocardial infarction. Available sampling was done via block random sampling among patients at the Heart Clinic of Booali Hospital, Qazvin, Iran. Data were collected through interviews and demographic and self-care questionnaires regarding heart disease. Data analysis was conducted using R software, version 4.1.0, and via the mixed-effects model method and post hoc and contrast tests.

The mean age of the study population was 65.54±4.50 years. Before the intervention, self-care maintenance was not significantly different between the 2 groups. After the intervention, a statistically significant difference was observed between the groups (P=0.001). No statistically meaningful difference concerning self-care monitoring existed between the 2 groups at the beginning of the study (P=0.03); however, a significant difference emerged after the intervention (P=0.001). A difference existed between the groups regarding self-care confidence study commencement in that the self-care confidence level in the control group was higher (P=0.013), but no difference was observed following the intervention. Nonetheless, after 1 month, the groups were significantly statistically different (P=0.003) in that the self-care confidence level in the intervention group increased.

Mobile health could improve self-care in older adults with myocardial infarction.

An intramyocardial dissection hematoma is a rare event usually caused by hemorrhagic dissection among the spiral myocardial. Herein, we reported a senile man with Intramyocardial dissection hematoma who presented with neglected myocardial infarction

It has recently been suggested that acid-base imbalances may play a role in some types of cardiovascular diseases and metabolic disorders. The aim of this study is to investigate the association between dietary acid load and common non-communicable diseases (NCDs).

In this cross-sectional study, 1800 participants were enrolled in a cohort study in Shahrekord. Data were collected using a Food Frequency Questionnaire (FFQ). The potential renal acid load (PRAL) was calculated using the intestinal absorption of five nutrients including protein, potassium, phosphorus, magnesium, and calcium. The association of dietary acid load with NCDs was investigated in two models. Then, the raw model was adjusted by including calorie intake and age; after adjusting the effect of the two variables, the association between dietary acid load and the studied NCDs was not statistically significant.

The mean age of the participants was 51.49±9.27 years, and 941 (52.27%) of them were female. Mean±SD acid load score was -6.88±23.23. The results showed that there was a significant association between dietary acid load and age (P=0.005), weight (P=0.0001), waist circumference (P=0.016), hip circumference (P=0.0001), waist-to-hip ratio (P=0.01), body mass index (P=0.004), and triglyceride (P=0.012). In the raw model, a significant association was observed between dietary acid load and hypertension (OR=0.57, 0.39-0.8).

In this study, no significant association was observed between dietary acid load and NCDs, but the variable was associated with weight and body mass index as the most important risk factors for NCDs.

 Identifying reliable predictors for ventricular recovery at the outset is crucial for patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).

 This study aimed to evaluate the role of baseline global longitudinal strain (GLS) in predicting myocardial recovery following an acute infarction.

 We enrolled 60 consecutive patients diagnosed with STEMI and admitted to Al-Zahra Hospital for PCI from March 2022 to March 2023. Echocardiography was performed on all patients within 48 hours after revascularization to measure baseline parameters, including left ventricular ejection fraction (LVEF) and GLS. Follow-up echocardiography was conducted 6 months later to reassess LVEF.

 At the 6-month follow-up, 38 (63.3%) patients showed a ≥ 5% improvement in LVEF, indicating ventricular recovery. The change in GLS was significantly different between the groups (recovered: - 4.72 ± 2.00, not recovered: - 2.41 ± 2.15, P < 0.001). A baseline GLS ≤ - 4.5 and > -14.8 was predictive of either failure to recover or successful recovery of LVEF with 100% negative and positive predictive values, respectively. Baseline GLS values > - 9.2 were predictive of LV recovery with 50% sensitivity and 83.3% specificity (P = 0.0002, AUC (95% confidence interval) = 0.697 (0.594, 0.799)). The type of revascularization was linked to better prediction outcomes, with patients undergoing primary and rescue PCIs more likely to recover during the follow-up period compared to those receiving deferred PCI after 24 hours (P = 0.032).

 While certain baseline GLS value thresholds may serve as predictors of LVEF recovery in patients with STEMI undergoing primary PCI, further prospective studies with larger cohorts are needed to establish more precise cut-off values.

 Out-of-hospital cardiac arrest (OHCA) is a significant public health issue. Developed countries have observed an increasing number of OHCAs in the elderly population. Emergency medical technicians (EMTs) are facing a growing number of OHCA cases in elderly patients, requiring special attention and consideration. As of 2020, the latest cardiopulmonary resuscitation (CPR) guidelines prioritize chest compressions as the initial course of action in OHCA situations.

 A year-long statistical analysis (2020-2021) of elderly individuals in the pre-hospital system of Hamadan province examined 10 cases of OHCA in the elderly in 2020-21 that occurred after consuming food (postprandial myocardial infarction).

 Ten of 90 cardiac arrest cases attended by EMTs occurred in elderly individuals after eating, and despite resuscitation efforts by the EMTs, none of these cases were successful. Consequently, this complication significantly reduces the chances of successful resuscitation in these patients. Therefore, addressing the issue of aspiration in elderly individuals during resuscitation is crucial.

 Continued research, collaboration, and adaptation of resuscitation protocols will contribute to advancements in the field and enhance the life-saving potential of elderly individuals who experience cardiac arrest.

Percutaneous coronary intervention (PCI) is the gold standard approach to ST-Segment Elevation Myocardial Infarction (STEMI). Fibrinolysis followed by PCI has been recommended. The current study aims to investigate the no-reflow phenomenon incidence in patients undergoing post-thrombolytic therapy PCI. This cross-sectional study was conducted on 250 patients with STEMI who primarily received fibrinolytic therapy followed by early (3-24 hours) (n=231) or delayed (> 24 hours) (n=19) PCI. They were also subcategorized into four intervals: <6 hours (n=98), 6-12 hours (n=93), 12-24 hours (n=38), and ≥24 hours (n=21). The demographic and medical data of the patients were retrieved. The Thrombolysis in Myocardial Infarction score (TIMI) was assessed at baseline and at the end of PCI. A TIMI score other than 3 was defined as no-reflow. The incidence of the no-reflow phenomenon was not associated with any of the underlying demographic and medical characteristics of the patients (P-value>0.05). Despite the significantly higher rate of improvement in TIMI grading among those undergoing early PCI (P-value=0.04), as well as within less than 6 hours after thrombolytic therapy (P-value=0.031), the rate of the no-reflow phenomenon did not differ between the groups, neither by sorting them as early versus delayed (P-value=0.518) nor by categorizing them into four intervals (P-value=0.367). Based on the findings of the current study, early PCI after fibrinolysis led to significantly improved TIMI flow. However, the incidence of no-reflow did not differ between the groups with early versus delayed post-fibrinolysis PCI.

Myocardial Infarction (MI) refers to the destruction and death of cells in the myocardium of the heart. Its prevalence increases with age due to changes in the cardiovascular system. The aim of the present study was to combine, summarize, standardize, resolve inconsistencies in the results of studies, and investigate the impact of potential factors on the prevalence rate of MI in the elderly through a systematic review and meta-analysis.

This systematic review and meta-analysis was conducted from 1987 to March 2022. All relevant published studies were searched in PubMed, Embase, Scopus, Web of Science (WoS) databases, and Google Scholar search engine using related MeSH/Emtree and Free Text words. The heterogeneity among studies was quantified using the I2 index.

In the initial search, 35453 studies were identified. After eliminating irrelevant studies, finally, 29 articles with a sample size of 3279136 subjects were included in the meta-analysis. After combining the results of the studies included in the meta-analysis, the total prevalence of MI in the elderly was estimated to be 17.6% (95% CI: 12.8 - 23.7%), 16.1% (95% CI: 11.0 - 22.8%) in males, and 12.5% (95% CI: 9.2 - 16.8%) in females. The prevalence of MI increased with the year of publication and the mean age of the elderly (P < 0.001).

The results showed that due to the high prevalence of myocardial infarction (MI) in the elderly, it should be addressed within healthcare systems and policy makers should pay more attention to prevention of MI. However, considering the inclusion of heterogeneous studies, the pooled estimation should be interpreted with caution.

Myocardial infarction (MI) is a major cause of death, particularly during the first year. The avoidance of potentially fatal outcomes requires expeditious preventative steps. Machine learning (ML) is a subfield of artificial intelligence science that detects the underlying patterns of available big data for modeling them. This study aimed to establish an ML model with numerous features to predict the fatal complications of MI during the first 72 hours of hospital admission.

We applied an MI complications database that contains the demographic and clinical records of patients during the 3 days of admission based on 2 output classes: dead due to the known complications of MI and alive. We utilized the recursive feature elimination (RFE) method to apply feature selection. Thus, after applying this method, we reduced the number of features to 50. The performance of 4 common ML classifier algorithms, namely logistic regression, support vector machine, random forest, and extreme gradient boosting (XGBoost), was evaluated using 8 classification metrics (sensitivity, specificity, precision, false-positive rate, false-negative rate, accuracy, F1-score, and AUC).

In this study of 1699 patients with confirmed MI, 15.94% experienced fatal complications, and the rest remained alive. The XGBoost model achieved more desirable results based on the accuracy and F1-score metrics and distinguished patients with fatal complications from surviving ones (AUC=78.65%, sensitivity=94.35%, accuracy=91.47%, and F1- score=95.14%). Cardiogenic shock was the most significant feature influencing the prediction of the XGBoost algorithm.

XGBoost algorithms can be a promising model for predicting fatal complications following MI.

Among non-communicable diseases, myocardial infarction (MI) and stroke are the most common cause of death in the world. The current study aimed to investigate the relationship between risk level and preventive behaviors of heart in people aged 30 to 60 years of Jiroft city in 2022.

This research was a cross-sectional study. The population under study is 383 middle-aged individuals (30-60 year) of Jiroft city with the combined sampling method. The data collection tools was reseacher made, included demographic questions, risk perception questionnaires, and preventive behavior questions for MI and stroke. Information was analyzed by SPSSv21 software and further analyzed with descriptive statistics tests, chi-square test, independent t-test, one-way ANOVA, and Pearson correlation test at level 0.05.

The participants' average age was 41.26 ± 8.32 years. The highest percentage (51.4%) of middle-aged individuals had a risk level between 10 and 20% for cardiovascular diseases. The study investigated a significant correlation (p < 0.01) between risk level, risk perception, and preventive behaviors for MI and stroke. Smoking and physical activity failed to reveal a significant correlation (p > 0.05), but other dimensions of preventive behaviors correlated positively and significantly with the total score of preventive behaviors (p < 0.01).

According to study findings, risk perception plays a significant role in influencing preventive behaviors for MI and stroke. It is recommended to conduct educational interventions to enhance understanding of the actual risk of MI and stroke, particularly among individuals with a high-risk assessment level. This would encourage the adoption of preventive behaviors in this population.

Proper self-care practices play a crucial role in the well being and longevity of patientswith cardiovascular disease. To effectively engage in self-care, it is imperative for patients to receiveadequate education and training on the self-care process. This study was conducted to determine theeffect of family-oriented education (FOE) on the self-care behaviors of patients with acute myocardialinfarction (AMI). In this randomized clinical trial study, 70 patients hospitalized in two hospitals in Shirazduring November 2021-April 2022 participated after the first AMI. Patients were randomly assignedinto control (N=35) and intervention groups (N=35) based on random allocation. In the interventiongroup, an educational program was conducted for patients and active family members during threesessions of 45 to 60 minutes. The control group received routine care. Demographic information formand Self-Care Agency scale was completed by the patients before the educational intervention, onemonth, and two months after the educational intervention. Data analysis was done through SPSS 22using Chi-square test, independent t-test, Fisher’s exact, and Friedman test. P˂0.05 was considered asthe statistical significance level. There was no significant difference in self-care behaviors between the two groups before theintervention (P=0.71). The mean score of self-care behaviors in patients one month (P<0.001) and twomonths (P<0.001) after FOE in the intervention group showed a statistically significant difference withthe control group. Also, the mean score of self-care behaviors two months after the education in theintervention group was significantly higher than before and one month after the intervention (P<0.001). Given the positive effect of FOE on self-care behaviors of patients with AMI, it isrecommended that educational interventions related to the treatment plan of these patients with theparticipation of families should be conducted.Trial Registration Number: IRCT20211116053078N1

Immature Platelet Fraction (IPF) is a measure of the proportion of reticulated platelets (RPs) to all platelets in circulation. IPF may have both prognostic and diagnostic values in patients with Acute Coronary Syndrome (ACS). This study aims to comprehensively summarize the diagnostic utility of IPF levels in patients with ACS, specifically focusing on its ability to differentiate between different subtypes of ACS.

We conducted a systematic search in online databases including MEDLINE, Scopus, and Google Scholar up to March 4th 2024, to identify relevant studies. The random-effect model, employing inverse variance for mean differences (MD) and Mantel-Haenszel methods for odds ratios (OR) were utilized to combine the data. Joanna Briggs Institute (JBI) appraisal tool was employed to assess the quality of included studies.

Our systematic review contains 15 articles with a total sample size of 2,030 ACS patients. Pooled analysis revealed significant differences in IPF levels of ACS patients compared to healthy controls (MD (95%CI): 2.85 (0.86, 4.85), P-value = 0.004) and stable angina patients (MD (95%CI): 0.58 (0.23, 0.92), P-value < 0.001). Subgroup comparisons within ACS patients demonstrated higher IPF levels in myocardial infarction (MI) vs. unstable angina (UA) (MD (95%CI): 1.81 (0.41, 3.22), P-value = 0.01), ST elevation MI (STEMI) vs. non-ST elevation (NSTEMI) ACS (MD (95%CI): 0.74 (0.31, 1.17), P-value < 0.001), and NSTEMI vs. UA (MD (95% CI): 1.07 (0.24, 1.90), P-value = 0.01).

IPF levels could increase in patients with ACS, particularly during the acute phase of STEMI. This suggests that IPF may be a useful biomarker for early diagnosis of ACS. Additionally, IPF levels may help differentiate between ACS subtypes.

Reperfusion can be done through primary percutaneous coronary intervention (PPCI) and thrombolytic administration. Patients with myocardial infarction should receive antiplatelet drugs from the P2Y12 receptor inhibitor category (such as ticagrelor, prasugrel, and clopidogrel). Based on recent researches, effectiveness of ticagrelor versus clopidogrel is still debatable.

A total of 128 patients who underwent PPCI, divided into two groups (Zyllt® group (600 mg received as a loading dose, maintenance with dose of 75 mg daily)) and Ticora® group (180 mg as a loading dose, maintenance with dose of 90 mg twice). Both the groups received aspirin 80 mg daily, too. They were followed up after 3 months.

In this study, 86.9% were men, and there was no significant difference in terms of gender and age in 2 groups. Risk factors, type of myocardial infraction (MI), number of involved and infarct‑related arteries, and presence of complications and their type were not statistically different in groups (P > 0.05). Among all complications, only one person had dyspnea in the Ticora group, one patient in the Ticora group, and 3 patients in the Zyllt group had chest pain. The difference in “TIMI Score” during Time was significant (P = 0.037).

Our study shows no difference between ticagrelor and clopidogrel after PPCI in patients with MI in terms of risk factors, type of MI, number of involved and infarct‑related arteries, and presence of complications and their type, in two studied groups.