Secondary Prevention of Myocardial Infarction:

a study on patients with a history of MI

Scientific Coordinator: Dr. Pantis Carmen, MD PhD

Graduate: Laila Ali

Introduction

The heart is one of the most fascinating and complicated structures of the
human body that has been studied anatomically and philosophically since
ancient times. Aristotle was the first to conclude that it is the most vital
organ. A lot of research has been done on myocardial infarction since it is
one of the leading causes of death and one of the main reasons for
hospital admission from the emergency department. As a result,
secondary prevention of myocardial infarction has been the cornerstone of
cardiac rehabilitation programs.
Purpose of Study
Coronary artery disease is the cause of
myocardial infarction which originates
from several risk factors.
- Male >45 and female >55
- Smoking
- Hypertension
- Diabetes
- Hyperlipidemia
- Overweight/obese with BMI>25
- Not following a healthy diet
Although this study was conducted on a
small scale of 165 patients the aim was
to identify these risk factors in patients
with a history of MI and to emphasize the
importance of changing their lifestyle to
prevent a future ischemic event.
Post-MI patients must adhere to the
treatment plan, and adopt healthy
lifestyle choices. Understandably, it is
difficult if a network of support and post-
discharge cardiac rehabilitation programs
are underutilized by the patients.
Materials & Methods

From January 2015 to July 2017, a total of 11,823 patients were admitted
into the cardiology department from the Emergency Clinical County
Hospital of Oradea. Out of these patients a total of 1,422 patients suffered
a myocardial infarction. From the patients that suffered a myocardial
infarction 165 case files were randomly selected for this study. Other
clinical findings were gathered from these 165 patient case files to
evaluate risk factors and comorbidities that could or have led to a repeated
myocardial infarction.
 The following clinical aspects of the
1,422 patients that were admitted
Section 1: for MI was gathered:

● Gender
Patients admitted into the
cardiology department that ● Age groups

were diagnosed with MI ● Area of residence

● Deceased
Din 2015 până în 2017, 11, 823 de pacienţi au fost internaţi in sectiile de cardiologie
Din numărul acestor pacienţi, 1,422 au fost diagnosticaţi cu infarct miocardic.
 Total
1,422

Între anii 2015-2017, dintr-un total de 1,422 de pacienţi diagnosticaţi cu infarct miocardic, 836 de pacienti au fost de sex masculin,
iar 586 de sex feminin.
Între anii 2015-2017 majoritatea pacienţilor diagnosticaţi cu IM se regasesc în grupa de vârstă 65-74 de ani, având 459 de pacienţi, urmaţi de
numărul pacienţilor din grupa 75-84, 352 de pacienţi, iar 319 pacienţi au fost înregistraţi în grupa de vârstă 55-64. Cei mai puţini pacienţi, 2 la
număr, se găsesc în grupa de vârstă 15-24. Un număr de 9 pacienţi au fost înregistraţi în grupa de vârstă 25-34, iar în grupa de vârstă sub 14
ani nu s-a înregistrat niciun pacient.
 Total
1,422

Un total de 1,422 de pacienţi diagnosticaţi cu infarct miocardic au fost înregistraţi între anii 2015-2017, dintre care 744 locuiau în
mediu urban, iar 678 în mediu rural.
 Total
1,422

În perioada 2015-2017, dintre 1,422 de pacienţi diagnosticaţi cu IM, 242 au decedat.

 Of the selected 165 patients that were admitted for
MI the following clinical aspects was gathered:

● Gender
● Age groups
Section 2: ● Risk factors for MI:
- Age & gender
Selected case files of - Smoking
patients diagnosed with MI - Hypertension
- Diabetes
- Overweight/obese with BMI >25
- Doesn't follow a healthy diet
- Hyperlipidemia
- Atherosclerosis
 Total 165

From 2015-2017 out of 165 patients diagnosed with MI 88 were male and 77 were female.
From 2015-2017 out of 165 patients that majority were in the age group of 65-74 consisting of 48 patients followed
by 46 patients in the age group of 75-84 and 43 patients in the age group of 55-64. The least amount of patients
were in the age group of 25-34 consisting of 1 patient and 4 patients in the age group of 35-44.
 From 2015-2017 out of 165 patients diagnosed with MI 48 of them have the risk factor of
being M>45 and F>55. Out of these 48 patients 20 are male and 28 are female.
From the 20 male patients 19 of them are >45 and from the 28 female patients 24 of them are >55.
 Total 165

From 2015-2017 out of 165 patients diagnosed with MI 49 of them are smokers.
 Total 165

From 2015-2017 out of 165 patients diagnosed with MI 97 of them have hypertension.
 Total 165

From 2015-2017 out of 165 patients diagnosed with MI 54 of them have diabetes.
 Total 165

From 2015-2017 out of 165 patients diagnosed with MI 60 of them have hyperlipidemia.
 Total 165

From 2015-2017 out of 165 patients diagnosed with MI 65 of them have atherosclerosis.
From 2015-2017 out of 165 patients that were diagnosed with MI 68 of them are
overweight/obese with a BMI >25 and 41 of them don’t follow a healthy diet.
 The following clinical aspects of patients
with history of MI were gathered:

● Major risk factors for MI:

Section 3: - Gender & age : Male > 45
Female >55
- Smoking
Patients with a
- Hypertension
history of MI
- Hyperlipidemia
- Atherosclerosis
- Diabetes
- Overweight/obese (BMI >25)
- Doesn't follow a healthy diet
 Total 165

From 2015-2017 out of 165 selected patients diagnosed with MI 97 of them have a history of MI.
From 2015-2017 out of 97 patients with a history of MI 56 of them are male and 41 are female.
From the 56 male patients 52 of them >45 and from the 41 female patients 39 of them are >55.
 Total 97

From 2015-2017 out of 97 patients with a history of MI 34 of them are smokers.

 Total 97

From 2015-2017 out of 97 patients with a history of MI 38 of them have hypertension.

 Total 97

From 2015-2017 out of 97 patients with a history of MI 39 of them have hyperlipidemia.

 Total 97

From 2015-2017 out of 97 patients with a history of MI 49 of them have atherosclerosis.

From 2015-2017 out of 97 patients with a history of MI 31 of them are diabetic. 18 patients have type 1 diabetes and
8 of them have complications. 13 patients have type 2 diabetes and 9 of them have complications.
From 2015-2017 out of 97 patients with a history of MI 34 of them are overweight/obese with a BMI >25
and 28 of them don’t follow a healthy diet.
Conclusion

- Myocardial infarction can be a prevented with modification in lifestyle.

- This study has shown that patients with MI and those with a history of MI have several risk factors
against them.
- A large number of patients are overweight/ obese and do not follow a healthy diet which is easily
modified by following a regular exercise program and a healthy diet as recommended by physicians.
- Other risk factors such as hypertension and diabetes can be controlled with adherence to treatment
as well as with diet and exercise.
- It is understandable that making lifestyle changes for post-MI patients are difficult but with a
network of support and cardiac rehabilitation these changes can be made slowly on a day to day
basis for a better future outcome.