Serum Uric Acid Level in Patients with Acute Coronary Syndrome and Its Significance

Thirumurugan, S (2012) Serum Uric Acid Level in Patients with Acute Coronary Syndrome and Its Significance. Masters thesis, Chengalpattu Medical College, Chengalpattu.


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INTRODUCTION: Acute coronary syndromes represent a global epidemic. As the leading cause of morbidity and mortality, ACS is a major public health problem Acute coronary syndromes results in significant morbidity and mortality, accounting for half of all deaths due to cardiovascular disease. Factors contributing to death following Acute Myocardial Infarction are electrical disturbances in the form of Arrhythmia (Carmeliet E,Thompson CA) and mechanical disturbances in the form of pump failure. Most sudden deaths in Acute Coronary Syndromes occur within one hour due to ventricular fibrillation and also due to left ventricular failure when there is an extensive injury. The risk of sudden death is highest in the first 30 days after myocardial infarction among patients with left ventricular dysfunction. AIMS OF THE STUDY: 1. To note levels of serum uric acid in Acute coronary syndromes. 2. To assess the relationship between Quantitative serum Uric acid Level on admission and killip classification. 3. To correlate levels of Uric acid in terms of short term mortality 4. To correlate serum Uric acid levels with cardiac failure. 5. To know whether the incidence of Arrhythmias bears a relation with serum Uric acid level in acute coronary syndromes. 6. To correlate serum Uric acid levels with echocardiographic changes in patients with acute coronary syndromes. MATERIALS AND METHODS: PLACE OF STUDY: This study was conducted in the department of medicine in Chengalpattu Medical College, Chengalpattu. PERIOD OF STUDY: November 2010 to November 2011. STUDY DESIGN: This study is an observational prospective cohort study aimed to assess the significance of Serum uric acid level in patients with acute coronary syndrome. A total of 95 patients included in the study. INCLUSION CRITERIA: Patients with 1. A History of typical retrosternal compressive chest pain lasting for more than 30 minutes, not relieved by rest 2. Typical ECG changes of New or presumably new, transient ST segment deviation (≥0.05 mV) in two contiguous leads Above patients are included in the study only if they come to our hospital within 24 hours since uric acid level tends to fall subsequently. EXCLUSION CRITERIA: Patients with 1. Elevated renal parameters, 2. History of chronic alcoholism, 3. Gout, 4. Previous History of Ischemic Heart Disease on Aspirin therapy, 5. Diuretic therapy, 6. Diabetes mellitus, 7. Stroke, 8. Hypertension, 9. Lymphoproliferative disorders. CONCLUSION: 1. High concentration of serum uric acid is closely associated with acute coronary syndrome. Serum uric acid could be used as a predictor of acute coronary syndrome. 2. Serum uric acid levels are correlated with Killip class; patients in higher Killip class have higher serum uric acid levels. 3. Serum uric acid level is a good marker to predict occurrence of cardiac failure in patients with acute coronary syndrome. 4. There is an association between serum uric acid levels and development of arrhythmia in acute coronary syndrome. Further studies require to confirm this. 5. High serum uric acid levels, increases the severity of left ventricular dysfunction assessed by echocardiogram but further studies are needed to confirm. 6. High serum uric acid levels associated with higher short-term mortality. 7. Our data suggest that increased serum uric acid levels are independently and significantly associated with risk of cardiovascular morbidity and mortality in patients with acute coronary syndrome.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Serum Uric Acid Level, Patients, Acute Coronary Syndrome, Significance.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 12 Sep 2020 16:24
Last Modified: 12 Sep 2020 16:24

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