Objective: To study various risk factors associated with Acute Myocardial Infarction , to define independent predictors of mortality and morbidity in AMI and to compare our mortality rate with those published from centre having PCI/CABG facilities.

Method: This was a prospective study on 200 consecutive patients of acute myocardial infarction admitted to intensive cardiac care unit of PGIMS Rohtak for one year duration. Clinical and demographic profile, risk factors, morbidity and mortality of AMI patients were studied, analyzed and compared to results from centers having PCI/CABG facilities.

Results: Factors associated with increased morbidity are age>70 years, female gender, >10 hours duration of chest pain, tachycardia (>100bpm), hypotension (systolic BP 100mmHg), hypertension, socioeconomic status (class III, IV, V), diabetes, obesity, sedentary life style, LDL cholesterol<140mg%, S. homocystine >12umol/L, S. cholesterol>240mg/dl, presence of multiple risk factors. Independent predictors of mortality include age>70 years, female gender, duration of chest pain >10 hours, tachycardia, hypotension, not receiving treatment outside hospital, previous history of MI, history of diabetes, physical inactivity, S. total cholesterol >240mg%, LDL cholesterol >130mg%, HDL cholesterol <40mg%, S. homocystine >12umol/L and presence of multiple risk factors. On follow up, most common complication was LVF and post MI angina. Total mortality rate in this one year study was 3%.Total mortality rate of last 5 years data was 4.49%.Centers having PCI facilities had 6.4% mortality in AMI patients.

Keywords: Acute myocardial infarction, risk factors, mortality, morbidity.

1. WHO 2003. Shaping the Future. The World Health Report 2003.
2. Valentin F, Wayur RA, Robert AD, Roule O. ST segment elevation, Myocardial infarction: Clinical presentation, diagnostic evaluation and medical management. In: Hurst’s The Heart.11^thp.1333.
3. Hedayati HA, Farivar S. The role of coronary care unit in reduction in mortality rate and sudden death in acute myocardial infarction. Pahlavi Med J 1977; 8(2):198-207.
4. Maynard C, Weaver D, Litwin PE, Martin JS, Kudenchuk PJ, Dewhurst TA et al. Hospital mortality in acute myocardial infarction in the era of reperfusion therapy (the myocardial infarction triage and intervention project). Am J Cardiol 1993; 72: 877-82.
5. Pair P, Xavier D, Gupta R. Treatment and outcome of acute coronary syndromes: Does the hospital make a difference. Indian Heart J 2002; 54: 477-82.
6. Parisi AF, Folland ED, Hartigan P. A comparison of angioplasty with medical therapy in treatment of single- vessel coronary artery disease. N Eng J Med 1992; 326(1): 10-6.
7. Schomig A, Ndrepepa G, Mehilli J. Therapy dependent influence of time of treatment interval on myocardial salvage in patients with acute myocardial infarction treated with coronary artery stenting or thrombolysis. Circulation 2003; 108: 1084-8.
8. Park CK. Epidemiology of chronic non- communicable diseases and conditions. In: Park’s text book of preventive and social medicine. 17^th Jabalpur; Banarsidas Bhanot; 2002; 272-307.
9. Barbash GI, Harvey DW, Michaela M. Significance of smoking in patients receiving thrombolytic therapy for acute myocardial infarction. Circulation 1993;87: 53-7.
10. Stig J, Kober L, Ottensen MM. The prognostic importance of smoking status at the time of acute myocardial infarction in 6676 patients. J Cardiovasc Risk 1999; 6: 23-7.
11. Lundberg V, Stegmayr B, Asplund K. Diabetes as a risk factor for myocardial infarction: population and gender perspectives. J Int Med 1997; 241: 485-92.
12. Daniel ES, Moulton AV, David MN. Interaction of diabetes with other preinfarction risk factors. Diabetes 1989; 38: 350-57.
13. Zahn R, Schiele R, Schneider S. Primary angioplasty versus intravenous thrombolysis in acute myocardial infarction: can define subgroups of patients of patients benefiting most from primary angioplasty? Results from pooled data of the Maximal Individual Therapy in Acute Myocardial Infarction Registry and MI Registry. J Am Coll Cardio 2001; 37(7): 1827-35.
14. Goliasch G, Orarce S, Blessberger H. Relative importance of different lipid risk factors for the development of myocardial infarction at a very young age (≤40 years of age). Eur J Clin Invest 2012; 42(6): 631-6.
15. Canto JG, kiefe CI, Rogers WJ. Number of coronary heart disease risk factors and mortality in patients with first myocardial infarction. Jama 2011;30(19):2120-27.
16. Gili M, Sala J, Lopez J. Impact of co-morbidities on in-hospital mortality from acute myocardial infarction 2003-2009. Rev Esp Cardiol 2011;64(12):1130-37.
17. Mun KJ, knudson AD, Klug MG. In hospital mortality among rural medicare patients with acute myocardial infarction: the influence of demographics, transfer and health risk factors. J Rural Health 2011;27(4):394-400.

Viral Sangwan
PGIMS Rohtak
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