FREQUENCY OF HEART FAILURE AND ITS CLINICAL OUTCOME AMONG PATIENTS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Background: Cardiovascular disease has a major impact on global health. Among the cardiovascular diseases acute myocardial infarction is the leading cause of mortality and morbidity in the western world. Heart failure significantly worsens the prognosis of patients with acute myocardial infarction. Methods: This descriptive cross sectional study of 264 patients was conducted at Coronary Care Unit, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from August 2011 to January 2012. All patients fulfilling the inclusion criteria admitted to CCU were included. Every patient was screened for the presence or absence of heart failure on history and clinical examination and stratified into different classes according to severity. Common clinical outcomes like death, ventricular tachycardia, and ventricular fibrillation were recorded. Results: Mean age of the patients was 60±1.28 years, 58% were male and 42% were female. Fifty-two percent patients had STEMI and 48% had NSTEMI, 37% patients had heart failure while 63% didn’t have heart failure. Among 98 heart failure patients, 45% were in Killip Class II, 35% were in Killip Class III, and 15% patients were in Killip Class IV. Twenty-four percent patients died, 6% had ventricular tachycardia, and 4.5% patients had ventricular fibrillation. Conclusion: Quite significant proportions of patients develop heart failure after acute MI. In STEMI, Percutaneous Coronary Intervention (PCI) should be the first line management in PCI capable centres, while early thrombolysis should be employed where PCI is not available. In non-STEMI patients proper anticoagulation, anti-platelets and revascularisation are recommended.