A Study of the Clinical Profile of Patients with Myocardial Infarction

Saravanan, E (2015) A Study of the Clinical Profile of Patients with Myocardial Infarction. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

BACKGROUND: Cardiovascular Diseases (CVD) is a leading cause of non communicable morbidity and mortality in India. By the year 2030 CVD is projected to be the leading cause of death worldwide. One of the most important advances in cardiovascular research was the identification of risk factors associated with cardiovascular diseases with subsequent treatments developed and rigorously tested to modify the risk factors with the goal of preventing CVD. Although 80% of global burden of cardiovascular diseases occurs in low and middle income countries, knowledge of importance of risk factors is largely derived from developed countries. The effect of factors on risk of coronary artery disease in most regions of the world including developing countries like India remains largely unknown. Various studies have been conducted to identify risk factors associated with Cardiovascular Diseases. AIM OF THE STUDY: To study the symptoms, clinical profile, risk factors, complications and outcome in predominantly rural Indian population. MATERIALS AND METHODS: An observational cross sectional study involving 200 patients admitted with a diagnosis of ST Elevation Myocardial Infarction in Tirunelveli Medical College between August 2013 and August 2014. Data was collected based on Inclusion and Exclusion criteria. INCLUSION CRITERIA: All patients admitted to our hospital with a diagnosis of MI. The final diagnosis of MI will be based on the following criteria: 1. Ischemic chest pain for atleast 30 minutes. 2. ECG evidence of myocardial injury: 0.1 mv or more ST segment elevation in 2 contiguous limb leads or Development of pathological Q waves. 3. An increase in serial CPK-MB or serial Troponin T or I. EXCLUSION CRITERIA: Patients admitted with MI who refused to give consent for the study. Patients who are known cases of CKD, OLD MI, post angioplasty, post CABG patients. The outcome of the patients at the end of one week was studied using TIMI (Thrombolysis In Myocardial Infarction) Risk Score calculated at the time of admission. The information collected regarding all the selected cases were recorded in a Master Chart. Data analysis was done with the help of computer using Epidemiological Information Package (EPI 2010) developed by Centre for Disease Control, Atlanta, USA. RESULTS: Among the 200 patients, 91% were discharged alive and 9% expired. The most common cause of death was cardiogenic shock. Among the 18 patients who expired, 14 patients had a Thrombolysis in Myocardial Infarction (TIMI) risk score of 9 and above and the remaining four had a TIMI score of 5 to 8. Mortality was not seen in those with a TIMI risk score of below five. The association was statistically significant (p < 0.0001). In a subgroup analysis, In Young MI (< 45 years), 91.7% were smokers, 88.9% consumed alcohol, around 50% had positive family history; 47% were leading a sedentary life style and everyone 100% had low HDL. The percentage of smoking and alcoholism were higher in young MI group compared to overall study group and all the patients in the young MI group were male. CONCLUSION: Cardiovascular Diseases affect mainly economically productive age group in our country and has become a major public health burden. Smoking, Alcoholism, Diabetes, Hypertension and Dyslipidemia remain the most important modifiable risk factors. Patients with a higher TIMI Risk Score have a greater mortality.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cardiovascular diseases ; Myocardial Infarction ; Thrombolysis in Myocardial Infarction.
Subjects: MEDICAL > General Medicine
Depositing User: Punitha K
Date Deposited: 18 May 2018 18:57
Last Modified: 18 May 2018 18:57
URI: http://repository-tnmgrmu.ac.in/id/eprint/7951

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