RESUMEN
Development of heart failure is always secondary to presence of risk factors like diabetes mellitus, hypertension, age, smoking and underlying coronary artery disease. The objective of this study was to find the frequency of risk factors and coronary artery involvement in patients of heart failure after myocardial infarction. A non-randomized cross sectional study. Gulab Devi Chest Hospital. Six months. 100 patients was done. Using non probability [purposive] sampling technique; all patients with ages between 20 to 80 years, irrespective of gender, diagnosed with heart failure [with ejection fraction = 40%] secondary to STEMI were included in the study. Patients that were not having heart failure secondary to STEMI and those that hadn't their coronary angiography done were excluded from the study. The data were analyzed using SPSS Version 20. Descriptive statistics was used to see analyze the data. Mean age of patients was 52.61 +/- 10.2years. There was an overall male predominance [81%]. Common risk factors that we observed were smoking [65%], hypertension [62%], diabetes [58%] and positive family history [38%]. In this study 51% patients had triple vessels disease, 15% patients had double vessels disease and 34% patients had single vessel disease. Most common lesion was of LAD following LCX, RCA and LMS. Our study conclude that coronary artery disease is the main causative factor for the development of heart failure in patients of myocardial infarction and even a single vessel disease can lead to heart failure with severe systolic dysfunction. Most common associated risk factor was smoking, hypertension being the second most common following diabetes and positive family history
RESUMEN
Objective: the aim of the study is to see the effect of aortic cross clamp time on renal function post operatively
Material and Methods: in a prospective study 90 patients were selected for CABG first time with normal renal function. A questionnaire was made to see the effect of aortic cross clamp time on post-operative renal function. Demographic factors, pre-operative, intra operative and post-operative variables were evaluated. The patient were divided into two groups according to aortic cross clamp time, patient with aortic cross clamp time 50 minutes and patients with aortic cross clamp time > 50 minutes ultimately they were evaluated to see the occurrence of acute kidney injury [AKI]
Results: AKI was observed in 6 patients with aortic cross clamp time = 50 minutes and 36 patients with aortic cross clamp time > 50 minutes. The aortic cross clamp time was highly associated with blood urea post operatively at day 1 [p value 0.002], day 2 [p-value 0.000] and day 3 [p-value 0.000]. It had significant effects on serum creatinine postoperatively day 1 [p-value 0.000], day 2 [p-value 0.005] and day 3 [p-value 0.001]. It also had significant effect on reduction of GFR postoperatively day 1 [p-value 0.011], day 2 [p-value 0.003] and day 3 [p-value 0.001]
Conclusion: the greatest likelihood of developing acute kidney injury [AKI] after CABG was observed with prolonged aortic cross clamp time. The levels of blood urea and serum creatinine was increased in patients with aortic cross clamp time> 50 minutes. Glomerular filtration rate [GFR] was reduced with aortic cross clamp time> 50 minutes
RESUMEN
Objective: to see the effect of aortic cross clamp time on renal function in patients undergoing CABG post operatively
Material and Methods: in a prospective study 90 patients were selected for CABG first time with normal renal function. A questionnaire was made to see the effect of aortic cross clamp time on post-operative renal function. Demographic factors, pre-operative, intra-operative and post-operative variables were evaluated. The patient were divided into two groups according to aortic cross clamp time, patient with aortic cross clamp time 50 minutes and patients with aortic cross clamp time > 50 minutes; ultimately they were evaluated to see the occurrence of acute kidney injury [AKI]
Results: AKI was observed in 6 patients with aortic cross clamp time = 50 minutes and 36 patients with aortic cross clamp time > 50 minutes. The aortic cross clamp time was highly associated with blood urea post operatively at day 1 [p = 0.002], day 2 [p=0.000] and day 3 [p=0.000]. It had significant effects on serum creatinine postoperatively day 1 [p=0.000], day 2 [p=0.005] and day 3 [p=0.001]. It also had significant effect on reduction of GFR post operatively day1 [p=0.011], day2 [p=0.003] andday3 [p=0.001]
Conclusion: the greatest likelihood of developing acute kidney injury [AKI] after CABG was observed with prolonged aortic cross clamp time. The levels of blood urea and serum creatinine were increased in patients with aortic cross clamp time > 50 minutes. Glomerular filtration rate [GFR] was reduced with aortic cross clamp time of more than 50 minutes