Outcome of acute myocardial infarction: A retrospective analysis at a rural tertiary care centre

Himanshu Dhiman; Akhil Katna

Outcome of acute myocardial infarction: A retrospective analysis at a rural tertiary care centre

Authors
Himanshu Dhiman, Akhil Katna

Abstract
Background: Coronary Artery Disease (CAD) is the major cause of mortality as well as morbidity. Most myocardial infarctions occur due to CAD and associated with a higher mortality. Aim: To analyze outcome of the patients admitted with acute MI at a rural tertiary care centre in India Methods: A total of 490 patients admitted with MI during Jan 2016 to Dec 2016 were included in this retrospective study at Dr. Rajendra Prasad Govt. Medical College, Kangra at Tanda. Diagnosis of acute MI was classified according to World Health Organization (WHO) guidelines. The patients were included if they had a clinical history of ischemic-type chest discomfort, had changes in electrocardiographic tracings, and there was a change in serum cardiac markers. Data were analyzed using SPSS v21.0 (IBM, USA). Results: Mean age of the subjects was 62.37±13.04 years Male to female ratio was 2.58:1. Hypertension was the most common co-morbidity (23.67%) followed by diabetes (16.73%). More than half of the patients were active smokers (52.45%). Half of the patients were diagnosed with ST elevation MI (STEMI) while 38% of the patients had non-STEMI (NSTEMI). In-hospital mortality was 12.44%. Time of onset of symptoms to presentation to the final tertiary healthcare facility was significantly higher among non-survivors in comparison to survivors (P=0.037). Out of 24 patients with Killip class, 75% did not survive. In-hospital mortality was significantly associated with severity of Killip class (P<0.0001). However, we observed that type of MI was not significantly associated with in-hospital mortality (P=0.083). Conclusion: Killip class at the time of the patients’ admission and time of presentation to the tertiary care centre are important Determinants of in-hospital mortality.

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