Frequency of Heart Failure in Patients Thrombolysed for Acute Interior Wall Myocardial Infarction
DOI:
https://doi.org/10.70749/ijbr.v3i3.903Keywords:
Acute Anterior Wall Myocardial Infarction, Acute Heart Failure, Thrombolytic TherapyAbstract
Background: With inferior wall myocardial infarction (IWMI) making up a sizable percentage of cases, myocardial infarction (MI) continues to be a major cause of morbidity and mortality globally. A common treatment for ST-elevation myocardial infarction (STEMI) is thrombolytic therapy, which aims to decrease the size of the infarct and restore coronary blood flow. Methods: 200 patients with acute IWMI receiving thrombolytic treatment participated in this cross-sectional study, which was carried out at the Bolan Medical Complex Hospital in Quetta. In order to ensure representation across various demographics and comorbidities, patients were chosen through the use of purposeful sampling. Clinical case reviews, study of hospital records, and patient interviews were used to gather data. Descriptive statistics were used to examine the prevalence of heart failure, related risk factors, and treatment results. Results: According to the study, 40% of patients who had thrombolysis for IWMI went on to develop heart failure. Fatigue (45%) decreased exercise tolerance (55%), and dyspnea (60%) were the most commonly reported complaints. The three main comorbidities that were found were smoking history (45%), diabetes mellitus (40%), and hypertension (50%). 25% of patients needed to be readmitted to the hospital, and 30% of patients had recurrent symptoms even after receiving thrombolytic therapy. Nonetheless, 75% of patients said they were generally satisfied with their care. Conclusion: Heart failure is still a frequent and serious side effect of thrombolytic treatment for acute IWMI. Key risk factors included smoking, diabetes mellitus, high blood pressure, and advanced age. Although thrombolysis improves outcomes, a considerable number of patients continue to experience symptoms and require readmission. To lessen the burden of heart failure in this patient population, these findings emphasize the necessity of enhanced post-thrombolysis monitoring, early intervention, and focused management techniques.
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Amsterdam, E. A., Wenger, N. K., Brindis, R. G., Casey, D. E., Ganiats, T. G., Holmes, D. R., Jaffe, A. S., Jneid, H., Kelly, R. F., Kontos, M. C., Levine, G. N., Liebson, P. R., Mukherjee, D., Peterson, E. D., Sabatine, M. S., Smalling, R. W., & Zieman, S. J. (2014). 2014 AHA/ACC guideline for the management of patients with non–st-elevation acute coronary syndromes: Executive summary. Circulation, 130(25), 2354-2394. https://doi.org/10.1161/cir.0000000000000133
Coughlin, R. M. (2010, April 11). Attacking anterior-wall myocardial infarction in time. American Nurse. https://www.americannursetoday.com/attacking
Fibrinolytic Therapy Trialists' (FTT) Collaborative Group. (1994). Indications for fibrinolytic therapy in suspected acute myocardial infarction: Collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. The Lancet, 343(8893), 311-322. https://doi.org/10.1016/s0140-6736(94)91161-4
Filipe, M. D., Meijers, W. C., Rogier van der Velde, A., & De Boer, R. A. (2015). Galectin-3 and heart failure: Prognosis, prediction & clinical utility. Clinica Chimica Acta, 443, 48-56. https://doi.org/10.1016/j.cca.2014.10.009
per lo Studio, G. I. (1986). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet, 327(8478), 397-402.
Gustafsson, F. (1998). Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. European Heart Journal, 19(4), 588-594. https://doi.org/10.1053/euhj.1997.0822
Haddad, H., Mielniczuk, L., & Davies, R. A. (2012). Recent advances in the management of chronic heart failure. Current Opinion in Cardiology, 27(2), 161-168. https://doi.org/10.1097/hco.0b013e32834fdc98
Hasdai, D., Holmes Jr, D. R., Califf, R. M., Thompson, T. D., Hochman, J. S., Pfisterer, M., ... & Gusto-I Investigators. (1999). Cardiogenic shock complicating acute myocardial infarction: predictors of death. American heart journal, 138(1), 21-31. https://doi.org/10.1016/S0002-8703(99)70241-3
Hellermann, J. P., Jacobsen, S. J., Gersh, B. J., Rodeheffer, R. J., Reeder, G. S., & Roger, V. L. (2002). Heart failure after myocardial infarction: A review. The American Journal of Medicine, 113(4), 324-330. https://doi.org/10.1016/s0002-9343(02)01185-3
Hellermann, J. P., Jacobsen, S. J., Gersh, B. J., Rodeheffer, R. J., Reeder, G. S., & Roger, V. L. (2002). Heart failure after myocardial infarction: A review. The American Journal of Medicine, 113(4), 324-330. https://doi.org/10.1016/s0002-9343(02)01185-3
Kostis, W. J., Deng, Y., Pantazopoulos, J. S., Moreyra, A. E., & Kostis, J. B. (2010). Trends in mortality of acute myocardial infarction after discharge from the hospital. Circulation: Cardiovascular Quality and Outcomes, 3(6), 581-589. https://doi.org/10.1161/circoutcomes.110.957803
Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA, et al. 2016 ACC/AHA Guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American college of Cardiology/American heart association task force on clinical practice guidelines: An Update of the 2011. Circulation 2016; 134(10):e123-e55. https://doi.org/10.1161/cir.0000000000000453
Maggioni, A. P., Dahlström, U., Filippatos, G., Chioncel, O., Leiro, M. C., Drozdz, J., Fruhwald, F., Gullestad, L., Logeart, D., Fabbri, G., Urso, R., Metra, M., Parissis, J., Persson, H., Ponikowski, P., Rauchhaus, M., Voors, A. A., Nielsen, O. W., & Zannad, F. (2013). EURObservational research programme: Regional differences and 1‐year follow‐up results of the heart failure pilot survey (ESC‐HF pilot). European Journal of Heart Failure, 15(7), 808-817. https://doi.org/10.1093/eurjhf/hft050
Maggioni, A. A., Maseri, A., Fresco, C., Franzosi, M. G., Mauri, F., Santoro, E., & Tognoni, G. (1993). Age-related increase in mortality among patients with first myocardial infarctions treated with thrombolysis. New England Journal of Medicine, 329(20), 1442-1448. https://doi.org/10.1056/nejm199311113292002
Mehta, S. R., Eikelboom, J. W., Natarajan, M. K., Diaz, R., Yi, C., Gibbons, R. J., & Yusuf, S. (2001). Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction11Drs. Mehta and Eikelboom were recipients of Heart and Stroke Foundation of Canada research fellowship awards. Professor Yusuf is the recipient of a medical research Council of Canada senior scientist award and holds a Heart and Stroke Foundation of Ontario research chair. Journal of the American College of Cardiology, 37(1), 37-43. https://doi.org/10.1016/s0735-1097(00)01089-5
Mehta, S. R., Eikelboom, J. W., Natarajan, M. K., Diaz, R., Yi, C., Gibbons, R. J., & Yusuf, S. (2001). Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction11Drs. Mehta and Eikelboom were recipients of Heart and Stroke Foundation of Canada research fellowship awards. Professor Yusuf is the recipient of a medical research Council of Canada senior scientist award and holds a Heart and Stroke Foundation of Ontario research chair. Journal of the American College of Cardiology, 37(1), 37-43. https://doi.org/10.1016/s0735-1097(00)01089-5
Mueed, A., Rathi, N., Kazi, S., Sachdewani, R. K., Shahzad, .., & Ashraf, J. (2021). In hospital frequency of heart failure in STEMI after thrombolysis in patient with diabetes. Journal of Pharmaceutical Research International, 66-71. https://doi.org/10.9734/jpri/2021/v33i1131245
Sutton, J. M., Ellis, S. G., Roubin, G. S., Pinkerton, C. A., King, S. B., & Topol, E. J. (1994). Long-term clinical outcome after percutaneous transluminal coronary angioplasty: the Cleveland Clinic experience. American Heart Journal, 127(1), 7-13.
Topol, E. J. (1996). Early myocardial reperfusion: An assessment of current strategies in acute myocardial infarction. European Heart Journal, 17(suppl E), 42-48. https://doi.org/10.1093/eurheartj/17.suppl_e.42
Bin, W., Ya-Ling, H., Yi, L., Quan-Min, J., Shou-Li, W., Ying-Yan, M., Geng, W., Bo, L., & Xiao-Zeng, W. (2011). Coronary collateral circulation: Effects on outcomes of acute anterior myocardial infarction after primary percutaneous coronary intervention. Journal of Geriatric Cardiology, 8(2), 93-98. https://doi.org/10.3724/sp.j.1263.2011.00093
Welsh, R. C., Ornato, J., & Armstrong, P. W. (2003). Prehospital management of acute ST-elevation myocardial infarction: A time for reappraisal in North America. American Heart Journal, 145(1), 1-8. https://doi.org/10.1067/mhj.2003.47
Williams, K. (2007). New pathophysiological concept in myocardial infarction. Can Med Assoc J, 11, 156–509.
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