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Objective: There is little information on the incidence and prognostic significance of hypertension in ST segment elevation myocardial infarction (STEMI) patients, especially in Bangladeshi population. The study aimed to compare the demographic & clinical characteristics and in-hospital outcome of hypertensive versus non-hypertensive patients with STEMI. Design and method: This prospective observational study was conducted from January 2015 to December 2022 at National Heart Foundation Hospital & Research Institute. Patients were divided into two groups: hypertensive and non-hypertensive groups. Results: A total of 10378 patients were enrolled in this study. Of them 65.6% (6813) patients were hypertensive, and 34.4% (3565) patients were non-hypertensive. Mean age of the hypertensive group was 55.89 ± 11.18 years and the non-hypertensive group was 53.49 ± 12.25 years (p = 0.001). In hypertensive group, 84.1% patients were male and 15.9% were female & in non-hypertensive group, 90.4% patients were male and 9.6% were female (p = 0.001). Compared to non-hypertensive patients, hypertensive patients were predominantly non-smoker (49.1% vs 39.9%; p = 0.001), diabetic (68.3% vs 32.1%; p = 0.001), dyslipidemic (80.7% vs 77.3%; p = 0.001), obese (37.8% vs 32%; p = 0.001), have positive family history of ischemic heart disease (IHD) (29% vs 22.4%; p = 0.001), prior history of percutaneous coronary angioplasty (3.7% vs 2.1%; p = 0.001), prior history of myocardial infarction (5.8% vs 4.6%; p = 0.007), and chronic kidney disease (48.2% vs 40.2%; p = 0.001). Hypertensive patients had more multi-vessel disease (49.3% vs 42.6%; p = 0.001), higher in-hospital complications (acute left ventricular failure-24.4% vs 21.9%; p = 0.005) and in-hospital death (4.8% vs 4%; 0.04). Conclusions: Hypertensive patients with STEMI were predominantly non-smoker, diabetic, dyslipidemic, obese, have positive family history of IHD, chronic kidney disease and had higher in-hospital complications & in-hospital death.

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Background: ST segment elevation myocardial infarction (STEMI) is associated with ventricular dysfunction due to ischemic myocardial damage, decrease ventricular compliance and increase filling pressure resulting in left atrial stretching, dilatation, increase left atrial volume and subsequently increase secretion of atrial natriuretic peptides. This study is aimed to determine the association between increase left atrial volume index (LAVI) and in-hospital outcome and to explore the correlation between LAVI and NT-proBNP in patients suffered from acute ST segment elevation myocardial infarction (STEMI). Methods: This cross sectional analytic study include 92 patients with acute STEMI admitted for reperfusion therapy. 2D Echocardiography was done and based on LAVI, study population were grouped as Group A:LAVI >34 ml/m2 (n=48) & Group B:LAVI d”34 ml/m2(n=44). Results: In-hospital outcome, plasma level of NT-proBNP and echcardiographic evaluation was done successfully. Mean NT-proBNP was significantly high in Group A than Group B (1234.6±738.77 vs 689.52±721.04). Statistically significant association was present between LAVI and adverse in-hospital outcome. Persistent chest pain, hypotension, acute LVF, arrhythmia, acute kidney injury were higher in Group A than Group B and acute LVF occurred significantly (p<0.05) more in Group A than Group B (38.3% vs. 9.1%). Statistically significant correlation was present between LAVI and NT-proBNP (r=0.453; p=0.001). According to receiver-operating characteristic curve (ROC) analysis, LAVI with a cut off value of 33.75 ml/m2 can predict adverse in-hospital outcome in patients of acute STEMI underwent reperfusion therapy with sensitivity 66.2% and specificity 75% and better than NT-proBNP with more sensitivity (66.2% vs 50.0%). Conclusion: Significant association present between increase LAVI and adverse in-hospital outcome and it can predict adverse in-hospital outcome better than NTproBNP. There is also positive correlation between LAVI and NT-proBNP in acute STEMI. Bangladesh Heart Journal 2023; 38(1): 46-57

Background: Most countries in the world faced two waves of Corona virus disease-19 (COVID-19). But there is a lack of data regarding the wave-wise comparison of epidemiological and clinical characteristics of the COVID-19 outbreak. This study aimed to compare the demographics, clinical characteristics, and in-hospital outcomes of two waves of the COVID-19 pandemic in Bangladesh. Methods: This prospective cross-sectional study was carried out at the National Heart Foundation Hospital & Research Institute. From April 3, 2020, to January 28, 2021, was considered the first wave, and from February 27, 2021, to September 25, 2021, was considered the second wave. COVID-positive patients and all admitted patients who became COVID-19 positive during these periods were included in this study for comparison. Results: The first wave included 727 patients, and the second wave included 858 patients. The mean age of the patients in the first wave was 48.11 15.75 years, and in the second wave it was 50.65 16.63 years. Males were predominant in both waves. Healthcare personnel were less affected during the second wave (11.9% vs. 30.7%; p=0.001). Hypertension, chronic kidney disease, and cardiovascular disease were more prevalent in the second wave (p 0.05), and dyslipidemia and obesity in the first wave (p<0.05). During the second wave, 80.5% of patients were unvaccinated. Asymptomatic patients were predominant in the second wave (26.9% vs. 17.5%; p=0.001). COVID-19-related symptoms (fever, body ache, headache, anosmia, sore throat, shortness of breath, and diarrhea) were less prominent during the second wave (p<0.05). Oxygen requirements and IV antibiotic use were higher during the second wave (p<0.05). Asymptomatic & severe disease form were prevalent in second wave (p<0.05). Mortality rate was more during second wave (5.1% vs 3.4%; p=0.1). Age > 50 years, severe left ventricular dysfunction, severe and critically ill patients were the independent predictor of mortality. Conclusion: In comparison to the first wave, during the second wave symptoms were less prominent, asymptomatic and severe disease forms were more prevalent & mortality rate was high. Unvaccinated persons are more prone to affected by COVID-19. Bangladesh Heart Journal 2023; 38(1): 13-21