title: Short-term outcome of acute inferior wall myocardial infarction with emphasis on conduction blocks: a prospective observational study in Indian population.
abstract: OBJECTIVE
  The primary aim of the present study was to evaluate the complications, particularly conduction blocks, subsequent morbidity and mortality, and effect of thrombolytic therapy in Indian patients with inferior wall myocardial infarction (IWMI).
  
  
  METHODS
  This was a prospective, observational, single-center study conducted at LPS Institute of Cardiology, Kanpur, from December 2011 to May 2014. Patients who presented with typical chest pain and were subsequently diagnosed by standardized diagnostic criteria as having IWMI were enrolled. Patients were grouped on basis of conduction abnormalities, right ventricular (RV) infarction and thrombolytic treatment. Each group was analyzed for comparison of complication profile and mortality.
  
  
  RESULTS
  Of 573 patients with IWMI enrolled in the study (mean age: 58.90±12.3 years), 81.2% were male, 225 (39.3%) had conduction blocks, and 189 (32.9%) had RV infarction. In patients with conduction blocks, mortality occurred in 27 patients (12.0%) in contrast to 3.4% of patients without conduction block (p<0.03). Also, there were 27 cases of in-hospital mortality in patients with RV infarction compared with 9 cases in patients without RV infarction (p<0.01). Thrombolytic therapy significantly reduced mortality in patients with IWMI (p<0.001). A significant reduction was observed in cardiogenic shock (p=0.002), severe mitral regurgitation (p=0.007), and left ventricular failure (p<0.001) in patients undergoing thrombolytic therapy.
  
  
  CONCLUSIONS
  In Indian patients with IWMI, incidence of conduction blocks was higher than previously reported studies. Major complications such as atrioventricular block and RV infarction are associated with increased mortality and poor clinical outcomes. Thrombolytic therapy has a beneficial role in reduction of mortality rate and other complications.
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India. drvarun_gupta@yahoo.co.in.
authors.forename: Varun
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Prakash
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Razi
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Chandra Mohan
authors.initials: CM
authors.lastname: Verma
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Thakur
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Umeshwar
authors.initials: U
authors.lastname: Pandey
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Rajpal Singh
authors.initials: RS
authors.lastname: Bhardwaj
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ahmad
authors.affiliation: Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College; Rawatpur, Kanpur-India.
authors.forename: R K
authors.initials: RK
authors.lastname: Bansal
authors.affiliation: Institute of Medical Sciences, Banaras Hindu University; Varanasi-India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Gupta
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D007194:India; D056989:Inferior Wall Myocardial Infarction / Q000188:drug therapy / Q000208:ethnology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015912:Thrombolytic Therapy