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Background: Cardiovascular diseases are the number one cause of mortality all over the world. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease. We conducted this study to assess serum uric acid levels on admission as a potential predictor of short-term mortality (7 days) in acute myocardial infarction patients. Methodology: Total of 200 patients diagnosed with the myocardial infarction (MI) in our hospital along with 200 age and gender matched controls were selected for this study. The clinical history, examination, ECG changes and biochemical markers were evaluated on day 0, 3 and 7. Association with Killips class and mortality in STEMI / NSTEMI cases was done. Results:The study had 200 cases and 200 controls. The mean age of cases was 62.54 ± 18.24 years and controls were 61.94±17.25 years. There were majority males among both cases 114 (57%) and controls 112 (56%). The patients were classified using Killip's class. Majority belong to class I 98 (49%) followed by II 42 (21%). There were 26 (13%) of class III and 34 (17%) into class IV. There is significant difference seen between uric acid levels of cases and control on day 1, 3 and 7 (p<0.001). There was 25% mortality (50 deaths) seen among the cases. There was association seen between Killips class III & IVand mortality, there was higher mortality seen in STEMI as compared to NSTEMI (i.e. p<0.05). Conclusion:Our study concludes that the serum uric acid (SUA) levels have significant association with Killip's class and mortality in Acute Myocardial Infarction cases.
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Background: The incidence and prevalence rates of heart failure (HF) are increasing worldwide. The prevalence of HF rises exponentially with increasing age and affects 4% to 8% of people older than 65. The leading causes of HF in India include coronary artery disease (CAD), diabetes, hypertension, rheumatic valvular heart diseases and primary cardiac muscle diseases. Rheumatic heart disease (RHD) is still a common cause of HF in India. Epidemiological studies have estimated that 1.5% to 2% population experience HF and it is the main reason for hospital admission of elderly patients. The objective of this study was to establish the etiological factors of heart failureMethods: A cross sectional study of 150 patients above the age of 18 years presented with heart failure diagnosed clinically on the basis of Framingham heart failure criteria and echocardiography, done over a period of one year in department of medicine in BRD medical college Gorakhpur Uttar Pradesh.Results: A total of 150 patients were include in this analysis the majority of patients were male (57.3%). Age of patients ranged from 18 - 70 years and 84% patients were above the age of 40 years.Conclusions: Heart failure was more prevalent in elderly male above 40 years of age. Myocardial infarction, DCMP, rheumatic heart disease and hypertensive heart failure are the common etiology leading to heart failure.
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Background: Following Myocardial Infarction some proteins and enzymes, CPK-MB/ Troponin-I, T, are released into the blood from the necrotic heart muscle. Serum Uric Acid (SUA) may be a risk factor and negative prognostic marker for cardiovascular diseases. Aim of the study was to study serum uric acid levels in patients of acute Myocardial infarction with congestive heart failure, its relation with stages of congestive heart failure as per Killip classification and the role of serum uric acid levels as a marker of mortality.Methods: The case control study was conducted on 120 patients divided into two groups. Group A included 60 patients of acute Myocardial infarction. Group A was further divided into two categories. One includes 30 patients of with congestive heart failure and another includes 30 patients without congestive heart failure. Group B consists of 60 control patients. Serum uric acid levels were measured in Group A on 1st, 3rd and 7th day of hospital admission and in Group B on 1st day.Results: The study showed females have higher degree of hyperuricemia than males. SUA was significantly higher in patients of acute myocardial infarction than control group patients. SUA were also higher in patients with history of IHD, in patients with BNP >100 and it correlates with Killip class and mortality rates. Patients of acute myocardial infarction with diabetes mellitus had higher degree of hyperuricemia than nondiabetic and control group. No significant difference in SUA levels were observed with regard to age, alcohol intake, lipid profile, ejection fraction and hypertension.Conclusions: In acute myocardial infarction, patients with hyperuricemia had higher mortality and may be considered as poor prognostic biomarker.
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Background: Serum uric acid is increased in ischemic conditions and is significantly higher in patients with acute myocardial infarction. The aim of study was to correlate serum uric acid level with KILLIP class in respect of mortality and morbidity profile of patients with acute coronary syndromes..Methods: 100 patients fulfilling the standard diagnostic criteria for acute coronary syndromes on the basis of classical history, clinical signs, ECG changes and biomarkers were included in the study. Age and sex matched 50 normal healthy subjects were also included as control group after obtaining informed consent. Serum uric acid level was measured on day 0, 3 and 7 of various ACS.Results: There was statistically significant higher level of serum uric acid concentration in patients of AMI on day of admission as compared to controls and unstable angina patients. On all three days of serum uric acid estimation, the serum uric acid levels were higher in AMI patients who were in higher KILLIP class as compared to lower KILLIP class group. Smokers had significantly higher baseline serum uric acid but age, sex, dyslipidemia, hypertension and diabetes mellitus did not significantly affect serum uric acid level at any stage in various ACS patients. Five patients who died during hospital stay, had serum uric acid level more than 7.0 mg/dL and all of them were in KILLIP class III and IV.Conclusions: serum uric acid level is a strong and independent risk factor in predicting mortality and morbidity profile of patients of acute myocardial infarction. Also, serum uric acid level correlates well with KILLIP class.
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Background: India has shown a rising trend in the prevalence of coronary artery disease (CAD) in urban as well as in rural population. Acute coronary syndrome (ACS) is the main reason for the mortality in India. Study of risk factors and biomarkers is important to catch the diagnosis early in order to decrease the mortality. Objective was to study risk factors and brain natriuretic peptide (BNP), troponine I, and CKMB and their effect on outcome in ACS patients in tertiary hospital.Methods: One hundred and fifty ACS patients were studied in Emergency Department of Medicine, Nehru Hospital, BRD Medical College, Gorakhpur from January 2017 to December 2017. Data on age sex socioeconomic status, medical history, baseline clinical characteristics, time to reach hospital and treatment in hospital, along with biomarkers including BNP, Troponin Iand CKMB was estimated. Baseline ECG was obtained at admission and repeated at 12 -24 hours and every 24 hours thereafter. A 2D Echocardiogram was performed within initial 48-72 hours for analysis of LVEF and wall motion abnormalities.Results: Male (58.7%) preponderance was observed with mean age of 60.12±10.58 years. Most of the patients were from rural areas (87.3%) and had hypertension (44.7%). Chest pain was most common symptom (56%). Most of them had duration of symptoms for 6-12 hours (56%). NSTEMI, STEMI and unstable angina were equally distributed between the genders (p>0.05). Out of 150 patients, 15 (10%) were thrombolysed, 78.52% had RWMA. In-hospital mortality was higher; among the patients of age >75 years (38.5%) (p=0.008), male patient (12.5%) (p>0.05), rural patient (10.7%) (p>0.05), hypertensive patient (17.3%) (p>0.05), patients of Killip class IV (48.3%)(p=0.0001) and patients having severe LVD (33.3%) (p=0.0001). In-hospital mortality was 1.2% and 1.1% among those in whom beta blocker and ACE inhibitors was present (p>0.0001). BNP and CKMB was significantly higher among expired patients (1762.62±1444.89 vs 840.76±1294.82; p=0.001) similarly troponin I was significantly higher among expired patients (67.29±45.63 vs 43.99±41.73; p=0.006) than alive.Conclusions: ACS was more prevalent in male, living in fifth to sixth decade of life, had hypertension. STEMI was more common. Patients on ACE inhibitors and beta-blocker had better outcome. Mortality was higher in patients with Killip’s class IV, higher value of troponin I, age more than 75 years and had hypertension and dyslipidemia
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Background: The study was conducted to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with ST elevation myocardial infarction (STEMI) and to assess any influence of serum uric acid levels on in-hospital mortality in STEMI patients.Methods: Authors evaluated 250 consecutive (STEMI) patients who were hospitalized within 24 hours of symptom onset from September 2015 to august 2017. Detailed history, physical examination was done as per a structured proforma and necessary laboratory investigations were done.Results: There was significant difference in mean serum uric acid level between diabetic and non-diabetic population. There was significant difference in mean uric acid level between hypertensive and non-hypertensive population. Serum uric acid level was high among STEMI patients with Killip class III and IV and low among patients with Killip class I and II. The higher the uric acid level was, the higher was the percentage of mortality during 5 days hospital course.Conclusions: Patients of higher Killip class had higher levels of serum uric acid as compared to patients of lower Killip class. Serum uric acid level when combined with Killip class is a good predictor of severity of heart failure and short-term mortality after STEMI.
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Background: We evaluated Correlation of Serum Uric Acid level in patients with acute coronary syndromes with severity and extent of coronary disease Materials and methods: Fifty-one patients with acute coronary syndromes between 25-60 years were included into the study. Patients with chronic kidney disease, gout, hematological malignancy, hypothyroidism, chronic alcoholism, receiving diuretic therapy, more than 2 grams per day of salicylate therapy, ethambutol, pyrazinamide, were excluded. Data regarding history, ECG, cardiac enzymes, serum uric acid, and angiographic details were recorded. Results: The mean age of the study population was in 55.68± 5.83 years. The age, gender BMI, and co morbidities such as smoking, obesity, diabetes, hypertension and family history were not statistically significant across types of ACS, such as CSA, USA and MI. We noticed that uric acid levels were not significantly (P>0.05) across types of ACS. We also found significant correlations between uric acid levels at admission with age, hypertension and family history. However, there was no significant correlation of uric acid with the type of a number of vessels involved and Killip classification. Conclusion: In the current study, serum UA level in patients with acute coronary syndromes is not associated with Killip class and extent of coronary vessels involved.
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Background: Hyperuricemia and micro albuminuria are known to occur independently in diabetes and hypertension. Of late the cardiovascular implication of Hyperuricemia and microalbuminuria in the non-diabetic, non-hypertensive patients has received focus. Hyperuricemia and microalbuminuria are independent risk indicators of ischemic heart disease, also indicates severity of the disease and has been considered as important prognostic indicator. Objectives: To measure and compare serum uric acid levels and microalbuminuria in either of patient and control groups and to identify the association of hyperuricemia and microalbuminuria in acute myocardial infarction in non-diabetic and non-hypertensive patients in a tertiary hospital. Materials and methods: A prospective study was conducted for a period of 8 months from February 2011-September 2011. We included 32 MI patients (diagnosed based on the clinical history and ECG changes) along with 32 age and sex matched healthy controls. A p-value of <0.05 was considered to be statistically significant. Serum uric acid and micro albuminuria were measured in these patients by colorimetric and immunoturbidimetric methods respectively. Results: The study group consisted of 50 patients, among them 32 participants were selected for our study. Our results showed significant change in serum uric acid levels and microalbuminuria when compared to healthy volunteers. In addition to that we observed positive association between serum uric acid and microalbuminuria; serum uric acid and body mass index in AMI patients. Combination NL Varun Mai, Mudumala Issac Abhilash, Chandra Shekhar. Association of hyperuricemia and microalbuminuria in acute myocardial infarction in non-diabetic and non-hypertensive patients. IAIM, 2017; 4(10): 40-51. Page 41 of Killip class and serum uric acid level after acute myocardial infarction was a good predictor of mortality after AMI. Conclusion: These results indicate that assessment of these novel markers should be undertaken so that effective treatment and appropriate life-style changes can be implemented early to prevent morbidity and mortality.