Association Of Degree Of St Segment Depression With Inhospital Mortality In Patients With Non-St Elevation Myocardial Infarction.

BACKGROUND: Ischemic heart disease is responsible for approximately 1/3 of all global deaths, making it a leading cause of cardiovascular mortality. Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) which is an acute event in spectrum of coronary artery disease is a potentially lifethreatening emergency, makes up for the majority of admissions to a cardiac unit with one-year mortality rate of 23.5%. The objective of this study was to determine the association of degree of ST segment depression on hospital mortality in patients presenting with Non-ST segment elevation myocardial infarction (NSTEMI). METHODS: This descriptive case-series was carried out in the department of Cardiology, Punjab Institute of Cardiology Lahore. Using Non-probability purposive sampling technique, a total of 250 patients of age between 30-75 years of either gender, who reported during the study period, with NSTEMI were inducted in this study.. RESULTS: In our study, 33.2% (n=83) patients were between 30-50 years and 66.8% (n=167) patients were between 51-75 years of the age. Mean age was 54.64±9.69 years. 43.2% (n=108) patients were male and 56.8% (n=142) were females. Frequency of in-hospital mortality was 4.4% (n=11). Mortality increased with increasing degree of ST segment depression on admission Electrocardiogram (ECG).. CONCLUSIONS: In patients admitted with Non-ST segment elevation myocardial infarction (NSTEMI), degree of ST segment depression on admission ECG predicts In-Hospital mortality.

Usefulness Of Neutrophils To Lymphocytes Ratio For Predicting Troponin-I Elevation In Patients Presenting With Suspected Nste-Acute Coronary Syndrome.

BACKGROUND: Most of the admissions to the coronary care unit are patients who are having Non- ST-segment elevation acute coronary syndrome (NSTE-ACS). Inflammation has an important role in the pathogenesis of the acute coronary syndrome. Inflammatory marker such as Leukocyte counts & most importantly Neutrophils to Lymphocyte Ratio (NLR) has been found an important predictor of cardiovascular events. Few studies show the diagnostic role of Neutrophils to Lymphocyte ratio in the patient presenting with NSTE-ACS. The objective of this study was to determine the diagnostic role of Neutrophils to Lymphocytes ratio to predict the elevation of Troponin-I in patients presenting with suspected NSTE-acute coronary syndrome. METHODS: This was a Descriptive Case Series study, conducted in Cardiology department Ayub Teaching Hospital/Ayub Medical College Abbottabad, from 15th May 2017 to30th December 2018. A total of 203 patients with suspected NSTE-ACS were inducted in the study by non-probability, consecutive sampling. RESULTS: Results of this study shown a strong correlation between Neutrophils to Lymphocyte ratio (NLR) & rise in Troponin-I levels. Furthermore, results shown that at 4th quartile of Neutrophils to Lymphocyte ratio (NLR) there is high Specificity (97.8%) and very high positive predictive of value 96.7% for predicting the rise in Troponin-I levels. CONCLUSION: We concluded that there is a strong correlation between rising Neutrophils to Lymphocyte ratio (NLR) and cardiac Troponin-I elevation in patients presenting with suspected NSTE-acute coronary syndrome. Therefore, this parameter can be used to predict the rise in troponin level in patients presenting with suspected NSTE-ACS.