ABSTRACT
Background: Congestive heart failure, has high morbidity and mortality outcomes
Objective: To evaluate the association between the risk factors and congestive heart failure in patients admitted for CABG surgery
Subjects and Methods: This comparative cross sectional study includes 102 consecutive patients aged >50 years, admitted for CABG surgery and were classified as with and without congestive heart failure. They were selected from cardiac surgery department of Punjab Institute of Cardiology, Lahore over a period of 6 months from 1[st] January 2014 to 31[st] June 2014. Pre-operative risk factors were recorded while, the data was analyzed by using SPSS Version 20. P-value < 0.05 was taken as significant
Results: Out of 102 patients, 48 were males and 54 were females. Females were older than males. Risk factors i.e. AF, raised creatinine [>1.4 mg/dl], impaired LV function, renal disease, valvular heart disease [VHD], COPD, smoking and hypertension were found to be comparatively higher in heart failure group than non- HF group. [P<0.05]
Conclusion: CHF in patients admitted for CABG surgery leading to increased morbidity. Male gender, age, hypertension, smoking, renal disease, VHD, raised creatinine [mg/dl], impaired LV function, chronic obstructive pulmonary disease [COPD] and artial fibrillation were independently associated with CHF
ABSTRACT
Effective risk stratification is integral to management of acute coronary syndromes [ACS]. The Thrombolysis in Myocardial Infarction [TIMI] risk score for ST-segment elevation myocardial infarction [STEMI] is a simple integer score based on 8 high-risk parameters that can be used at the bedside for risk stratification of patients at presentation with STEMI. To evaluate the prognostic significance of TIMI risk score in a local population group of acute STEMI. The study included 160 cases of STEMI eligible for thrombolysis. TIMI risk score was calculated for each case at the time of presentation and were then followed during their hospital stay for the occurrence of electrical and mechanical complications as well as mortality. The patients were divided into three risk groups, namely 'lowrisk', 'moderate-risk' and 'high-risk' based on their TIMI scores [0-4 low-risk, 5-8 moderate-risk, 9-14 high risk]. The frequencies of complications and deaths were compared among the three risk groups. Post MI arrhythmias were noted in 2.2%, 16% and 50%; cardiogenic shock in 6.7%, 16% and 60%; pulmonary edema in 6.7%, 20% and 80%; mechanical complications of MI in 0%, 8% and 30%; death in 4.4%, 8%, and 60% of patients belonging to low-risk, moderate-risk and high-risk groups respectively. Frequency of complications and death correlated well with TIMI risk score [p=0.001]. TIMI risk score correlates well with the frequency of electrical or mechanical complications and death after STEMI
ABSTRACT
A number of researchers have used different electrocardiographical criteria to predict the culprit vessel in acute inferior wall myocardial infarction [MI] cases. Therefore, the determination of infarct related artery in AMI is extremely important with regard to prediction of potential complications, furthermore, predicting the probable site of occlusion within RCA is worthwhile because proximal occlusions are likely to cause greater myocardial damage and an early invasive strategy may be planned in such cases. Our study aimed at evaluating the ECG criteria to predict the proximity of lesion in the right coronary artery [RCA] in acute inferior wall MI cases. The Objectives were to predict the presence of a proximal lesion in right coronary artery by severity of ST segment elevation in inferior ECG leads. This cross-sectional study carried out at the department of cardiology and cardiac catheterization at Jinnah Hospital, Lahore from April 2008 to September 2008. A total of 60 patients who suffered from inferior wall MI were included in the study who underwent coronary angiography in the first week. The ECGs of these patients were then compared with the angiographic findings to correlate the proximity of culprit lesion in RCA with the degree of ST segment elevation in inferior limb leads. Out of 60 patients, 29 [48.4%] had the culprit lesion in proximal, 23 [38.5%] in mid and 8 [13.4%] in distal RCA. Patients with proximal RCA disease showed a mean ST segment elevation of 12.55 +/- 1.38 mm, with mid RCA disease 8.39 +/- 0.89 mm and with distal RCA disease 6.0 +/- 0.54 mm. This study demonstrated that the severity of ST segment elevation was correlated with proximity of RCA lesion