A CLINICAL STUDY OF PROGNOSIS OF MYOCARDIAL INFARCTION (STEMI & N-STEMI) IN PATIENTS WITH METABOLIC SYNDROME: A TERTIARY CARE STUDY

Abstract

Background: Multifaceted etiology of cardiovascular diseases (CVD), especially coronary heart disease, has been recognized for a long time. The Metabolic syndrome (METS) is a specific clustering of cardiovascular risk factors in the same person (abdominal obesity, atherogenic dyslipidemia, elevated blood pressure (BP), insulin resistance (IR), a prothrombotic and a proinflammatory state.
Aims and Objectives: To evaluate the prognosis of Myocardial Infarction (STEMI & N-STEMI) in patients with Metabolic Syndrome in our tertiary care hospital.
Materials And Methods: Total of 154 Patients have been reported for diagnosis in our hospital. A final diagnosis of Myocardial Infarction (MI) was made in the presence of serial increases in serum biochemical markers of cardiac necrosis, associated with typical electrocardiographic changes and/or typical symptoms as defined by the joint committee of the European society of cardiology
and the American college of cardiology. A detailed case history was taken including the symptoms, history of diabetes mellitus, hypertension (HT), smoking and alcohol consumption. A careful physical examination was done with special reference to resting blood pressure (BP), waist circumference (WC), height and weight.
Results and Observations: As we sampled a total of 154 Patients, 77 patients with MI and METS and 77 Patients without MI and METS into two groups 1 & 2. There were 39 (50.66%) cases of heart failure among patients of MI with METS compared to 18 (24.00%) cases of heart failure among patients of MI without METS, and the difference was statistically significant. Postoperative analgesic requirement was seen in 64 % of the patients of group 1 while it was seen in 16 % of the patients in group 2.

Conclusion: The main finding of present study was that the Metabolic Syndrome was a meaningful predictor of in-hospital death in patients with STEMI. During one week of hospital stay there were significantly more deaths and heart failure among patients of MI with METS compared to patients of MI without METS (50.66% and 25.33% vs. 24% and 14.66%). Though the number of patients who developed other complications like recurrent MI, VT (Ventricular Tachycardia),VF (Ventricular Fibrillation) and Stroke were more in patients of MI with METS when compared to patients of MI without METS, The difference was not statistically significant.