Correlation of Clinical, Electrocardiographic, Echocardiographic and Coronary Angiographic Profile with Outcome in Acute Inferior Wall ST Segment Elevation Myocardial Infarction: A Hospital Based Prospective Observational Study
Creators
- 1. Department of Cardiology, Silchar Medical College and Hospital, Silchar-15, Assam
- 2. Professor, Department of General Medicine, Silchar Medical College and Hospital, Silchar-15, Assam
Description
Background: Acute myocardial infarction is the most common type of coronary artery disease with variable prognosis. This study sought to determine the clinical, electrocardiographic, echocardiographic, and coronary angiographic profile in patients with inferior wall ST-elevation myocardial infarction to establish the correlation of these parameters with the observed outcomes. Material and Methods: This observational, prospective study was conducted in 102 patients admitted with inferior wall ST-elevation myocardial infarction (STEMI) at Silchar Medical College, Silchar within 12 hours of onset of symptom. The data for all the patients were collected and eligible patients were assessed for electrocardiography, echocardiography, coronary angiography and clinical profile to correlate them with in-hospital and one-month follow-up outcomes. Results: The mean age of the study population was found to be 57.98 ± 9.02 years and majority were male (80.4%). The outcomes noted in patients during hospitalization were requirement of temporary pacemaker implantation (18.63%), cardiogenic shock (12.75%), hemodynamically significant ventricular tachycardia/ventricular fibrillation (9.8%), heart failure (5.88%) while the outcomes observed after follow-up were post MI angina in 15.22% of patients, heart-failure readmission (5.43%) and few patients developed reinfarction and other mortality (2.17%). In the study population, lower rate of mortality was observed in patients with single vessel disease (SVD) than multi vessel disease (MVD)(p=0.013); similarly, lower rate of post MI angina was observed in patients with SVD than MVD (p=0.02). Conclusion: To take rational therapeutic decisions in the management of inferior wall STEMI, it is paramount to identify the risks and outcomes using indicators such as clinical profile, electrocardiography, echocardiography, and coronary angiography parameters.
Abstract (English)
Background: Acute myocardial infarction is the most common type of coronary artery disease with variable prognosis. This study sought to determine the clinical, electrocardiographic, echocardiographic, and coronary angiographic profile in patients with inferior wall ST-elevation myocardial infarction to establish the correlation of these parameters with the observed outcomes. Material and Methods: This observational, prospective study was conducted in 102 patients admitted with inferior wall ST-elevation myocardial infarction (STEMI) at Silchar Medical College, Silchar within 12 hours of onset of symptom. The data for all the patients were collected and eligible patients were assessed for electrocardiography, echocardiography, coronary angiography and clinical profile to correlate them with in-hospital and one-month follow-up outcomes. Results: The mean age of the study population was found to be 57.98 ± 9.02 years and majority were male (80.4%). The outcomes noted in patients during hospitalization were requirement of temporary pacemaker implantation (18.63%), cardiogenic shock (12.75%), hemodynamically significant ventricular tachycardia/ventricular fibrillation (9.8%), heart failure (5.88%) while the outcomes observed after follow-up were post MI angina in 15.22% of patients, heart-failure readmission (5.43%) and few patients developed reinfarction and other mortality (2.17%). In the study population, lower rate of mortality was observed in patients with single vessel disease (SVD) than multi vessel disease (MVD)(p=0.013); similarly, lower rate of post MI angina was observed in patients with SVD than MVD (p=0.02). Conclusion: To take rational therapeutic decisions in the management of inferior wall STEMI, it is paramount to identify the risks and outcomes using indicators such as clinical profile, electrocardiography, echocardiography, and coronary angiography parameters.
Files
IJPCR,Vol16,Issue7,Article70.pdf
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Additional details
Dates
- Accepted
-
2024-06-25
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue7,Article70.pdf
- Development Status
- Active
References
- 1. Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. Lancet.2017;389(10065):1 97-210. 2. Ali H, Sarfraz S, Fawad M, Shafique Z. Frequency of Right Ventricular Infarction in Inferior Wall Myocardial Infarction. Cureus. 2020; 12(5):e8238. 3. Heusch G, Gersh BJ. The pathophysiology of acute myocardial infarction and strategies of protection beyond reperfusion: a continual challenge. Eur Heart J. 2017;38(11):774-84. 4. Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico (GISSI). Lancet. 1986;1(8478):397-402. 5. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet. 1988;2(8607):349-60. 6. Rasoul S, de Boer MJ, Suryapranata H, Hoorntje JC, Gosselink AT, Zijlstra F, et al. Circumflex artery-related acute myocardial infarction: limited ECG abnormalities but poor outcome. Neth Heart J. 2007;15(9):286-90. 7. Chen YL, Hang CL, Fang HY, Tsai TH, Sun CK, Chen CJ, et al. Comparison of prognostic outcome between left circumflex artery-related and right coronary artery-related acute inferior wall myocardial infarction undergoing primary percutaneous coronary intervention. Clin Cardiol. 2011;34(4):249-53. 8. Hlatky MA, Califf RM, Lee KL, Pryor DB,Wagner GS, Rosati RA. Prognostic significance of precordial ST-segment depression during inferior acute my ocardialin farction. Am J Cardiol. 1985;55(4):325-9. 9. Berger PB,RyanTJ. Inferior myocardial infarction. High-risk subgroups. Circulation. 1990; 8 1(2):401-11. 10. Zehender M, Kasper W, Kauder E, Schönthaler M, Geibel A, Olschewski M, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med. 1993;328(14):981-8. 11. Yip HK, Chen MC, Wu CJ, Chang HW, Yu TH, Yeh KH, et al. Acute myocardial infarction with simultaneous ST-segment elevation in the precordial and inferior leads: evaluation of anatomic lesions and clinical implications. Chest. 2003;123(4):1170-80. 12. Mehta SR, Eikelboom JW, Natarajan MK, Diaz R,Yi C, Gibbons RJ, et al. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol. 2001;37(1):37-43. 13. Fiol M, Cygankiewicz I, Carrillo A, BayésGenis A, Santoyo O, Gómez A, et al. Value of electrocardiographic algorithm based on "ups and downs" of ST in assessment of a culprit artery in evolving inferior wall acute myocardial infarction. Am J Cardiol. 2004;94(6):709-14. 14. Sohrabi B, Separham A, Madadi R, Toufan M, Mohammadi N, Aslanabadi N, et al. Difference between Outcome of Left Circumflex Artery and Right Coronary Artery Related Acute Inferior Wall Myocardial Infarction in Patients Undergoing Adjunctive Angioplasty after Fibrinolysis. J Cardiovasc Thorac Res. 2014;6 (2):101-4. 15. Peterson ED, Hathaway WR, Zabel KM, Pieper KS, Granger CB, Wagner GS, et al. Prognostic significance of precordial ST segment depression during inferior myocardial infarction in the thrombolytic era: results in 16,521 patients. J Am Coll Cardiol. 1996;28(2):305- 12. 16. Grigioni F, DetaintD, Avierinos JF, Scott C,TajikJ, Enriquez-SaranoM.Contribution of ischemic mitral regurgitation to congestive heart failure after myocardial infarction. JAm Coll Cardiol. 2005;45(2):260-7. 17. Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation. 2001;103(13):1759-64. 18. Ali M, Tabl M, Rashid HK, Abosrea A. Clinical Outcome of Patients with Acute InferiorWall Myocardial Infarction: Comparative Study between Left Circumflex Artery and Right Coronary Artery as culpritArtery. Benha Journal of Applied Sciences. 2020;5(8 part (1)- (2)):79-85.