Risk factors for ST- Elevation Myocardial Infarction in a tertiary hospital in central Nepal

Abstract

Background & Objectives: Coronary artery disease is the common cardiac disease in Nepal. The objective of the study is to explore different risk factors for coronary artery disease.Materials & Methods: This was cross sectional hospital based study studying the baseline clinical and angiographic characters in ST Myocardial infarction who had Primary Percutaneous coronary intervention (PPCI) in College of Medical Science Teaching Hospital (CMSTH).Results: There were 95 cases with male 77 (82.1%) and female 18 (17.9%). The mean age overall was 60.05 ± 12.2. The mean age of male was 59.9 ± 12.5 and of female was 60.5 ± 11.2 years. Apart from chest pain, common clinical symptoms were sweating in 60 (63.2%) cases, dyspnea in 41 (43.2%), nausea/vomiting in 38 (40%), dizziness in 17 (17.9%) and epigastric pain in nine (9.5%) cases. Common risk factors were smoking in 83 (87.7%) cases, hypertension 59 in (51.6 %), diabetes in 24 (25.3%), dyslipidemia in 24 (25.3%) and family history in six (6.3%) cases. Common angiographic variables were single vessel disease (SVD) in 45 (47.4%), double vessel disease (DVD) in 20 (21.1%) and triple vessel disease (TVD) in 30 (31.6%) cases. Infarct related artery were Right coronary artery (RCA) in 43 (45.3%), Left circumflex artery (LCx) in seven (7.4 %) and Left anterior descending artery (LAD) in 45 (47.4 %) cases.Conclusion: Patients visiting CMSTH had classical symptoms and risk factors of myocardial infarction. Single vessel disease and Left anterior descending infarction was the most common vessel involved.

A Study of Clinical Profile and Complications In Patients with ST-Elevation Myocardial Infarction Attending In College of Medical Sciences Teaching Hospital, Bharatpur (Chitwan), Nepal.

“…10 The incidence of acute myocardial infarction was found to be highest in age group of 51-60 years (29.1%) while lowest among age group of 31-40 (6.4%) and above 80 (1.8%) years while 7.1% were less than 45 years. The mean age of presentation was 59.31 years which is consistent with many other studies, Dhungel et al (60.05±12.2 years), 11 SGNHC-STEMI-registry (60.8±13.4 years) 10 and Hafeez et al (58±11 years). 12 The incidence of MI in young patients (<45 years) ranges from 6%-10%.…”

“…SGNHC-STEMI-registry showed smoking as the most common risk factor (54%) followed by hypertension (36.6%). Hypertension was found in 65% of patients in study done by Adhikari et al 14 Smoking was present as a most common risk factor as seen in studies done by Dhungel et al 11 (87.7%), Gautam et al 15 (50.8%) and Shrestha et al 16 (60%). Findings were also similar to study done by Misiriya et al 17 in India in which most common risk factor was smoking 46.6%, followed by hypertension 29.02%, dyslipidemia 26.15%, diabetes mellitus 23.95%.…”

Angiographic profile among patients with acute coronary syndrome in tertiary care centre: A retrospective cross-sectional study

“…[8][9][10] In our study, the mean age of presentation was 61.29 years which was comparable to studies done in Nepal, India, and USA. [11][12][13][14][15][16] The incidence of ACS in young (<45 years) ranges from 5-10%. [17][18][19] Among 192 patients, young patients (<45 years) comprises 16 (8.33%) which was similar to another study done in Nepal.…”

Challenges in Managing Acute ST Myocardial Infarction in Community Heart Hospital

“…High percentage of young MI have been described in other literature. 6,7,8 Avoiding tobacco, promoting regular exercises, attending training on coping and releasing stress and living healthy life style can help reduce burden of STMI in young. In comparisons to Adhikari et al the patient undergoing CAG in our study was 38.6% vs 26.8% , thrombolysis 8.8% vs 5.6%, Primary angioplasty with stenting 77% vs 87% and POBA 12% vs 6 In 9569 STMI patients in Kerala multicenter CAD registry thrombo-lysis was done in 18.8% and CAG was done in 19.6% of which 65.9% did primary PCI.…”