Introduction: Acute MI is a common presentation of acute coronary syndrome. All acute MI are classified as ST elevation and Non-ST-elevation MI. Acute STEMI is defined by at least two of the followings in which typical ECG changes is a must and any one either typical chest pain of cardiac origin or significantly raised troponin I level. Despite tremendous advances in the primary and secondary prevention of coronary artery disease, ST-elevation myocardial infarction (STEMI) still occurs in vast numbers. 80 percent people, who are living in developing country, die from cardiovascular disease.

Objective: The main objective of the study was to evaluate the pattern of arrhythmias in patients of acute ST elevation myocardial infarction with impaired renal function.

Methods: Prospective observational study. 100 patients of STEMI diagnosed by clinical, biochemical and ECG criteria were included in the study. After getting serum creatinine level, eGFR was calculated and if it is <60ml/min then the patient was selected for the study. Patients were followed up to hospital stay to see the outcome. Data was analyzed by computer based software SPSS-20.

Results: STEMI  hypertension was found in 61%, smoker was 52%, dyslipidemia was present in 78%, DM was in 31%, sedentary life style was found in 23% patients obesity was common among 23% of total patients  and family history of IHD was found in 24% of patients. Pattern of arrhythmias divided into two categories – Tachyarrhythmias and Brady arrhythmias. The results of the two categories mentioned in this article. From the present study it can be concluded that impaired renal function among MI patients has an adverse outcome. Early detection of renal impairment is necessary to avoid increased mortality and morbidity.

Keywords: Myocardial infarction, ST-elevation myocardial infarction, arrhythmias.

1. Wannamethee SG, Shaper AG, Perry IJ. Serum creatinine concentration and risk of cardiovascular disease: A possible marker for increased risk of stroke. Stroke 1997; 28:557–63.
2. Abbott JD, Ahmed HN, Vlachos HA, Selzer F,Williams DO. Comparison of outcome in patients with ST-elevation versus non–ST-elevation acute myocardial infarction treated with percutaneous coronary intervention.Am J Cardiol 2007;100:193–195.
3. Pahor M, Shorr RI, Somes GW. Diuretic-based treatment and cardiovascular events in patients with mild renal dysfunction enrolled in the systolic hypertension in the elderly program. Arch Intern Med 1998; 158:1340–5.
4. Culleton BF, Larson MG, Wilson PW. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int 1999; 56:2214–9.
5. Ramachandan A, Snehalata C, Satyavani K, Vijay V. Impaired fasting glucose and impaired glucose tolerance in urban population in India. Diabet Med 2003;20(3):220-4
6. Ayub M, Waseem T. Risk stratification of patients presenting with first acute myocardial infarction with serum cardiac troponin T. Pak J Card 1999; 10:54-56
7. Boucher JM. On behalf of the Quebec Acute Coronary Care Working Group Age- related differences in in-hospital mortality and the use of thrombolytic therapy for acute myocardial infarction. CMAJ 2001;164(9):1285-90
8. Peter B, Richman MD. Clinical characteristics of Diabetic Vs Nondiabetic Patients Who” Rule in” for Acute Myocardial Infarction. Academic Emergency Medicine 1999;6(7):719-23
9. Culie V. Acute myocardial infarction: Differing preinfraction and clinical features according to infarct site and gender. Int J Cardiol 2003; 90(2-3):189-96
10. McLeod, Shelley L., AllaIansavichene, and Sheldon Cheskes. "Remote Ischemic Perconditioning to Reduce Reperfusion Injury During Acute ST‐Segment–Elevation Myocardial Infarction: A Systematic Review and Meta‐Analysis." Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 6, no. 5 (2017).

Dr M. M. Abdus Shamim

Assistant Professor, Dept. of Cardiology, Gazi Medical College, Khulna