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1.
Viveka Kumar Vivek Kumar Kajal Kumari K.K. Talwar Divya Prasad Sunil Agarwal M.S. Yadav Hamed Bashir Suman Jatain S.K. Gupta 《The Egyptian Heart Journal》2018,70(4):375-378
Introduction
Dual antiplatelet treatment is recommended by current clinical practice guidelines for patients undergoing PCI. The PLATO trial showed superiority of ticagrelor to clopidogrel in reducing the rate of death from vascular causes, myocardial infarction and stroke without increase in the rate of overall major bleeding in ACS patients. However, real world evidence in Indian patients is limited. The objective of this study is to compare safety profile of ticagrelor with clopidogrel in real world settings.Methodology
In this single centered retrospective observational study, a total of 1208 serial patient records undergoing PCI (ACS and stable angina patients as well) treated with Ticagrelor or Clopidogrel were collected and analyzed to look into in hospital outcomes. We excluded the patient’s data that were incomplete.Results
In total of 1208 patients, 604 patients received ticagrelor and similarly 604 patient received clopidogrel. No significant differences in the rates of major life threatening bleeding and any major bleeding were observed between ticagrelor and clopidogrel group (0.2% (n?=?1) vs. 0.7% (n?=?4), p?=?0.18 and 2.8% (n?=?17) vs. 3% (n?=?18), p?=?0.86 respectively). There was increase in minor bleeding rate with ticagrelor compared to clopidogrel (21.4% & 13.6%, p?=?0.00).Conclusion
In the real world settings, patients undergoing PCI treated with ticagrelor showed similar safety profile compared to clopidogrel but with increase in minor bleeding rate. The observed results were in alignment with PLATO clinical trial. 相似文献2.
Manal Abd El Baky Mahmoud Menat Allah Ali Shaaban Ali Ali Ramzy 《The Egyptian Heart Journal》2018,70(3):155-159
Objective
To assess the role of Copeptin in diagnosis of acute myocardial infarction in troponin-blind period.Subjects and methods
This study was conducted on 40 patients who presented to emergency department complaining of chest pain and were highly suspicious to have acute cardiac ischemia, in addition to 10 subjects serving as a healthy control group. Blood samples were collected for determination of CK-MB, cTnI and Copeptin. These were measured twice (in patients’ group); at 3 h and then at 6–9 h from admission time.Results
The first sample revealed a non-significant difference between UA group and AMI group as regards CKMB and troponin, however, high significant difference was found as regards Copeptin (Z?=?5.29, P?<?0.001). Moreover, ROC curve analysis of serum Copeptin for discriminating AMI group from UA group in the first sample showed diagnostic sensitivity and specificity of 100%.In conclusion
Determination of copeptin in early diagnosis of AMI has diagnostic value being superior to a conventional cTn-I within the first three hours after acute chest pain. 相似文献3.
Samia Salah-El-Din Mahmoud Doaa Ghaith Yomna Farag Bishoy Ibrahim 《The Egyptian Rheumatologist》2018,40(4):273-276
Introduction
Ferritin is an acute-phase reactant that is elevated in several autoimmune disorders. Serum ferritin levels have been correlated with disease activity scores of juvenile systemic lupus erythematosus (JSLE). Furthermore, enhanced levels of ferritin have also been described in lupus nephritis (LN).Aim of the work
To evaluate serum ferritin as a cheap and available marker of disease activity and renal involvement in Egyptian children with JSLE.Patients and methods
Forty-eight JSLE cases recruited from the Pediatric Rheumatology Clinic in Cairo University Specialized Children’s Hospital and 43 matched healthy children were enrolled in the study. SLE disease activity score-2000 (SLEDAI-2K) and renal activity score were assessed. Serum levels of ferritin, was quantified by enzyme-linked immunosorbent assay.Results
The mean age of the patients was 12.6?±?3.02?years and disease duration 3.4?±?2.5?years. Serum ferritin significantly higher in patients (416.1?±?1022.9?ng/ml) compared with control (36.1?±?18.2?ng/ml) (p?<?0.001). Serum ferritin was significantly higher in active (n?=?20) (890.4?±?1474.8?ng/ml) compared to inactive (n?=?28) (77.4?±?74.1?ng/ml) patients (p?<?0.001). A significant correlation was found between serum ferritin with SLEDAI-2K (r?=?0.35, p?=?0.014), renal-SLEDAI-2K (r?=?0.49, p?<?0.001) and with renal activity score (r?=?0.38, p?=?0.008). A significant correlation was found between serum ferritin and anti-double stranded-DNA (r?=?0.44, p?=?0.002) and complement 3 (r?=??0.42, p?=?0.003).Conclusion
Serum ferritin level can be considered a reliable biomarker for monitoring disease and renal activity in children with JSLE and LN. This may lead to improvement of management and consequently prognosis of JSLE patients as serum ferritin is an available and relatively cheap marker. 相似文献4.
Ayman K.M. Hassan Hatem Abd–El Rahman Safaa Gomaa Hassan Tarek A.N. Ahmed Amr Ahmed Aly Youssef 《The Egyptian Heart Journal》2018,70(4):381-387
Background
Coronary tortuosity (CT) had different definitions and scores in literature with unclear pathophysiological impact.Objectives
To study degree of CT and it's relation to ischemic changes in patients with angina but normal coronary angiography (CA).Methods
We conducted a prospective study at University hospitals between May 2016 and January 2017. We included 200 consecutive patients who underwent CA due to chest pain assumed to be of cardiac origin, and their CA was normal (no diameter stenosis >30%, nor myocardial bridging). Patients were prospectively divided into 2 groups based on the presence (n?=?113) or absence (n?=?87) of ischemic changes during stress study and compared for clinical, echocardiographic and CA characteristics. A newly proposed Tortuosity Severity Index (TSI) was developed into significant (mild/moderate CT with more than 4 curvatures in total, or severe/extreme CT with any number of curvatures) or not significant TSI (mild CT with curvatures less than or equal to 4 curvatures in total).Results
Patients with ischemic changes had the highest rate of CT (76.5 vs 18%, p?=?0.004) compared to those without. CT mostly affects the left anterior descending (LAD) coronary artery in mid and distal segments. Females, elderly, and hypertensives with left ventricular hypertrophy were strongly related to CT. Multivariate logistic regression analysis identified CT with significant TSI as the only predictor of ischemic changes in these patients (OR?=?6.2, CI?=?2.5–15.3, P?=?<0.001).Conclusions
Coronary tortuosity is a strong predictor of anginal pain among patients with normal CA, despite positive stress study. This finding is more pronounced among elderly, hypertensive female patients. 相似文献5.
Ehsen Ben Brahim Imen Ayari Raja Jouini Salsabil Atafi Wafa Koubaa Hela Elloumi Aschraf Chadli 《Arab Journal Of Gastroenterology》2018,19(3):121-124
Background and study aim
The epidermal growth factor receptor (EGFR) plays an important role in tumourigenesis and tumour progression of colorectal cancer (CRC) and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with metastatic CRC. Today, the clinical utility of immunohistochemistry has remained somewhat inconclusive. It is based on EGFR screening methods using paraffin-embedded tumour specimen to select patients eligible for treatment. There is still lack of agreement on reproducible scoring criteria for EGFR immunohistochemistry has in various clinical trials.Patients and methods
We retrospectively reviewed 36 CRC patients who underwent surgeries during 2011 in Habib Thameur hospital in Tunis. We analyzed the immunohistochemical overexpression of EGFR using a score based on immunostaining intensity. In addition, we analyzed the correlation between this overexpression and patients' clinicopathologic parameters.Results
The positive expression rate of EGFR was 78% (28/36). Using the immunoreactivity score, 21 cases were considered low grade expression and 15 tumours were high grade. Immunohistochemical expression of EGFR showed a significant difference with tumour’s location (p?=?0.034) and vascular invasion (p?=?0.03). This expression was not significantly associated with age, gender, tumour size, histological type, grade, TNM staging and perineural invasion.Conclusions
EGFR expression by immunohistochemistry in CRC is variably correlated with clinicopathological parameters. Its assessment by this method has still not proved its predictive value. 相似文献6.
Margaret Cupit-Link Karen L. Syrjala Shahrukh K. Hashmi 《Hematology/oncology and stem cell therapy》2018,11(3):129-134
Objective/Background
Improvements in curative treatments for many types of cancer have emerged over the past several decades, resulting in a growing population of long-term cancer survivors – of both adult and childhood cancers. Despite this incredible medical achievement, long-term survivors of cancer face a unique fear: the fear of relapse.Methods
We conducted a review of the literature for data on fear of relapse among cancer survivors.Results
The fear of cancer recurrence is present in survivors of childhood and adult cancers as well as family members and often leads to psychological sequelae.Conclusion
Literature on the fear of cancer recurrence has begun to emerge. However, herein we provide a unique approach through the use of a metaphor: Cicero’s story of Damocles’ sword. We aim to outline the many fear-related and emotional challenges faced by cancer survivors with an extensive review of studies demonstrating such challenges. 相似文献7.
Amira A. Shahin Hania S. Zayed Rasha M. Elrefai Heba Taher Ahmed Elsaie Soha H. Senara Hanan M. Fathi Gihan Omar Mervat I. Abd Elazeem 《The Egyptian Rheumatologist》2018,40(4):243-248
Aim of the work.
Studies describing the epidemiology of vasculitis in the Middle East and Africa are limited. The aim of this multi-centre study is to describe the distribution and outcome of vasculitic syndromes among Egyptian vasculitis patients seen by rheumatologists.Patients and Methods
The files of patients diagnosed with vasculitis between January 2002 and December 2016 were reviewed and were classified according to The Chapel Hill Consensus Conference on the Nomenclature of Systemic Vasculitis CHCC 2012 and disease- specific criteria. The vasculitis damage index (VDI) was calculated for all patients at the last visit.Results
Six hundred and thirty patients with ages ranging from of 9?months-74?years, including 264 (41.9%) males and 366 (58.1%) females were studied. Vasculitis associated with hepatitis C virus (HCV) infection was detected in 151 (24%), Behçet’s disease in 148 (23.5%), Immunoglobulin A vasculitis in 101 (16%), vasculitis associated with systemic lupus erythematosus in 93 (14.8%), Takayasu’s arteritis in 33 (5.2%), Kawasaki’s disease in 22 (3.5%) patients, respectively. Other vasculitic syndromes were uncommon and each accounted for?less than?2% of the studied cases. The VDI ranged from 0 to 13. Only 109/630 (17.3%) patients had no vasculitis-related damage (VDI?=?0). Mortality was recorded in 36 (5.7%) patients; out of these, 27 deaths were vasculitis-related.Conclusion
HCV-associated vasculitis and Behçet’s disease were the most frequently diagnosed vasculitic syndromes. 相似文献8.
Yomna K. Eissa Hend N. Ellithy Sherif M. Yousry Zakaria Ismail 《Hematology/oncology and stem cell therapy》2018,11(4):219-224
Background
The genetic background plays an important role in thrombosis and pregnancy morbidities. Low levels of protein Z is associated with increased risk of thrombosis. The G79A polymorphism in the protein Z gene may be a genetic risk factor for thrombosis.Aim of the study
To investigate the prevalence and clinical significance of the protein Z-79 G/A gene polymorphism in Egyptian patients with antiphospholipid syndrome (APS).Methods
We genotyped 60 APS patients and 41 controls, for protein Z-79 G/A gene polymorphism using the PCR-restriction fragment length. The polymorphism was then analyzed in relation to thrombosis and pregnancy morbidities in APS patients.Results
We observed a higher prevalence of the A allele in the controls when compared to the APS patients (P Value?=?<0.001). In our studied sample, the G79A polymorphism, as well as its minor A allele, were not associated with an increased risk of thrombosis or pregnancy morbidities in APS.Conclusion
Protein Z-79 G/A gene polymorphism may be of a protective value against thrombosis in APS. The G79A polymorphism of protein Z was not found to be an independent risk factor of thrombosis in APS. 相似文献9.
Sherif Arafa Sherehan Abdelsalam Abdel-Hady El-Gilany Youssef Mohamed Mosaad Adel Abdel-Ghaffar 《The Egyptian Heart Journal》2018,70(4):393-401
In Egypt, The prevalence of chronic heart disease (CHD) is 8.3%. It is the principal cause of death and is responsible for 22% of total mortality. The age-adjusted mortality rate is 174 per 100,000 of population. There are many studies on traditional risk factors and CHD in Egypt but the study of novel risk factors is deficient.
Objectives
The aim of the present case control study was to investigate the relation between CHD susceptibility and Endothelial Nitric Oxide Synthase (eNOS) Glu 298 Asp (G894T) and Apolipoprotein E (ApoE) gene polymorphism in a cohort of Egyptian individuals.Methods
Genotyping of eNOS (Glu298Asp) and Apo E genes polymorphisms were done using polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) method for 100 CHD cases and 100 age and sex matched healthy controls.Results
A statistically significant association was observed between GT and TT genotypes of endothelial nitric oxide synthase gene with CHD with OR?=?2.03 and 3.5; respectively. Also, carriers of E4 allele and especially E3/E4 genotype were at higher risk of CHD with OR?=?3.3 for both. Significant association was also observed between the presence of combined GTE3E4 genotype and CHD with OR?=?6.6.Conclusion
GT and TT genotypes of endothelial nitric oxide synthase gene, E3/E4 genotype of Apo E gene polymorphism and combined GTE3E4 genotype can be considered risk factors for the development of CHD among Egyptians. 相似文献10.
Anne Keats Dane Moran Siobhan Rothwell Timothy Woodcock Tammy Williams Nishi Rawat 《Journal of the Saudi Heart Association》2018,30(3):180-187
Objective
To improve compliance with a target door-to-electrocardiogram (EKG) time of 10?minutes or less in patients presenting with symptoms concerning for acute coronary syndrome.Methods
A pre-post study was performed between January 2014 and May 2016 at five emergency departments (EDs) in Saudi Arabia. Patients who presented to ED with symptoms concerning for acute coronary syndrome were included in the study. The primary outcome of interest was whether EKG was completed within 10?minutes after the patient arrival to ED. Quality improvement interventions consisted of human resources adjustments, education, technological improvements, and improved interdepartmental collaboration. Multivariate analysis was used to model the percentage of EKGs that were completed within the targeted time.Results
During the study period, 11,518 patients received EKGs. Prior to the intervention, compliance with a door-to-EKG time of 10?minutes or less was found to be 62.6%. Post intervention, compliance improved to 87.7%. On multivariate analysis, male patients were significantly more likely to receive EKG within 10?minutes than female patients (odds ratio?=?1.231, 95% confidence interval?=?1.113–1.361; p?<?0.001).Conclusion
A quality improvement project can successfully increase the percentage of patients receiving EKG within 10?minutes of presentation to ED. Further research is required to demonstrate the clinical significance of improved door-to-EKG times. 相似文献11.
Background
Acute coronary syndrome (ACS) refers to a spectrum of symptoms compatible with acute myocardial ischemia. Plasma markers of inflammation have been recently identified as diagnostic aid and risk predictors. The present study, conducted in Slemani Cardiac Hospital (SCH), Sulaimaniyah, Iraq aimed to recognize some risk factors for ACS in Iraqi adults younger than 40.Methodology
This is a prospective case-control study of 100 patients with ACS vs. a control group of 100 healthy volunteers. The study began at 1st January 2014 and ended at 31st December 2016. All patients were subjected to full history taking, clinical examination including measurement of waist circumference and body mass index (BMI). Investigations included electrocardiography (ECG), echocardiography, full blood count, measurement of lipid profile and C-reactive protein (CRP). The patients were managed by percutaneous coronary intervention (PCI).Results
The mean age of the patients was 36?years (range 28–40). Eighty-five% of patients were male. The mean BMI (29?kg/m2) and waist circumference (98?cm) of the patients were higher than the controls (24?kg/m2 and 72?cm respectively). The leukocytes, lymphocytes and neutrophil counts as well as CRP in both groups were within the normal range. The most prevalent risk factor was obesity (n?=?86). Other risk factors were smoking (n?=?62), hypertension (n?=?26), diabetes mellitus (n?=?22) and positive family history of ACS (n?=?24). Most patients (n?=?83) had multi-vessel coronary artery disease (2–3 vessels).Conclusion
ACS in young adults is an increasing health problem. Obesity was found to be the most prevalent risk factor. 相似文献12.
Abdulaziz U. Joury Ahmed S. Hersi Hussam Alfaleh Khalid F. Alhabib Tarek Seifaw Kashour 《Journal of the Saudi Heart Association》2018,30(3):233-239
Background and objectives
Limited data are available highlighting the different clinical aspects of acute coronary syndrome (ACS) patients, especially in Gulf countries. In this study, we aimed to compare patients who presented with acute myocardial infarction (AMI) as the first presentation of patients who have a history of ACS in terms of initial presentation, medical history, laboratory findings, and overall mortality.Methods
We used the Second Gulf Registry of Acute Coronary Events (Gulf RACE-II), which is a multinational observational study of 7930 ACS patients.Results
Among all patients, 4723 (59.6%) patients presented with AMI. First presentation AMI patients were older (mean age, 55?years vs. 53?years; p?<?0.001) and had lower risk factors than patients with a history of ACS. Higher laboratory readings of cardiac markers and all aspects of mortality were significantly higher among patients with first presentation AMI. After adjustments for baseline variables, congestive heart failure [odds ratio (OR)?=?1.08; 95% confidence interval (CI), 0.73–1.57], reinfarction (OR?=?1.16; 95% CI, 0.58–2.30), cardiogenic shock (OR?=?1.51; 95% CI, 0.74–3.08), stroke (OR?=?2.30; 95% CI, 0.29–17.99), and overall mortality (OR?=?1.16; 95% CI?=?0.74–1.83) were independent predictive factors for first presentation AMI.Conclusions
First presentation AMI patients tend to be older and to have lower rates of risk factors. Adverse clinical outcomes such as congestive heart failure, reinfarction, cardiogenic shock, and stroke were higher among patients with first presentation AMI compared to patients with a history of ACS. 相似文献13.
Reem Waziry Asmaa Gomaa Imam Waked Gregory J. Dore 《Arab Journal Of Gastroenterology》2018,19(1):26-32
Background and Study Aims
In this study we assessed rates and determinants of survival in people with untreated chronic HCV infection and hepatocellular carcinoma (HCC) in an Egyptian liver clinic setting.Patients and Methods
This is a prospective cohort study of patients diagnosed with HCV-related HCC and undergoing HCC management at a national liver centre in Egypt in 2013–2014 and with a follow-up through 2016.Results
A total of 345 patients diagnosed with HCV-related liver cirrhosis complicated by HCC were included. Median age at diagnosis was 57?years (IQR?=?52, 62), the majority were male (78%) and Child-Turcotte-Pugh (CTP) class A (64%). At diagnosis Barcelona Clinic Liver Cancer staging (BCLC) was 0 (8%), A (48%), B (20%), C (17%), and D (7%). Most common HCC management modalities were transarterial chemoembolization (TACE) (42%), and radiofrequency ablation (RFA) (21%). Median survival following HCC was 22.8?months. Factors associated with poorer survival in adjusted analyses were INR (HR?=?1.81, p?=?0.01), alpha-foeto protein (AFP) ≥200 (HR?=?1.41, p?=?0.02), higher CTP score (HR?=?2.48, p?<?0.01), and advanced BCLC stage (HR?=?1.85, p?<?0.01). One year survival in patients with CTP A, B, and C was 85%, 71% and 32%, respectively. One year survival following RFA, TACE, combination RFA/TACE, and sorafenib was 93%, 79%, 80% and 60%, respectively.Conclusion
Survival following HCV-HCC in Egyptian patients undergoing HCC management in a specialised clinic setting is poor, although similar to high income country settings. CTP score is a key determinant of survival, even following adjustment for BCLC stage and HCC management. 相似文献14.
15.
Kai-Hsiang Wu Hsin-An Shih Ming-Szu Hung Cheng-Ting Hsiao Yi-Chuan Chen 《Arab Journal Of Gastroenterology》2018,19(4):143-147
Background and study aims
Azotaemia is commonly identified among patients with upper gastrointestinal bleeding (UGIB) due to absorption of blood products in the small bowel. Previous studies have found blood urea nitrogen-to-creatinine (BUN/Cr) ratio to be significantly elevated among patients UGIB bleeding compared to patients with lower GI bleeding. However, no studies have explored the relationship between BUN/Cr ratio and mortality. This study is aimed at investigating how BUN/Cr ratio relates to outcomes for UGIB patients.Patients and methods
This study was conducted prospectively at a university-affiliated teaching hospital with approximate 70,000 annual emergency department (ED) visits. Data from a total of 258 adult UGIB patients were collected between March 1, 2011 and March 1, 2012. Cox regression analysis was used to identify risk factors for 30-day mortality.Results
Malignancy and Rockall score were associated with increased risk of 30-day mortality (Unadjusted hazard ratio (HR): 3.87, 95% CI: 1.59–9.41, p?=?0.0029; HR: 1.31, 95% CI: 1.02–1.71, p?=?0.0476, respectively). However, BUN/Cr?>?30 was associated with lower risk of 30-day mortality (HR: 0.32, 95% CI: 0.11–0.97, p?=?0.0441).Conclusions
A BUN/Cr ratio of >30 was found to be an independent risk factor for mortality and may be useful for pre-endoscopic assessment. Development of future risk scoring systems might warrant consideration of including BUN/Cr ratio as a parameter for estimating risk. 相似文献16.
Ahmed Bendary Mohamed El-Husseiny Tarek Aboul Azm Ahmed Abdoul Moneim 《The Egyptian Heart Journal》2018,70(4):415-419
Background
Coronary no-reflow (NR) is a dreadful complication of primary percutaneous coronary intervention (pPCI) that is seen in nearly 50% of cases. A great effort is being done to discover simple tools that could predict such a complication. We aimed primarily to study the predictive power of R-wave peak time (RWPT) on NR.Methods
From October 2017 to March 2018, we enrolled 123 patients with STEMI treated with pPCI at Benha University Hospital and National Heart Institute. We measured RWPT from infarct-related artery (IRA) leads and assessed the development of NR in all finally included 100 patients (after exclusions).Results
Based on occurrence of NR, patients were divided into 2 groups; Group I (n?=?39) with NR and group II (n?=?61) without NR. Smoking, DM, HTN, longer reperfusion times and higher thrombus burden were significantly associated with NR. Both pre- and postprocedural RWPT were significantly higher in group I than Group II. Preprocedural RWPT?>?46?ms predicted NR with a sensitivity and specificity of 79.5% and 86.9% respectively (AUC 0.891, 95% CI 0.82–0.962, P?<?0.001). In adjusted multivariate analysis, preprocedural RWPT was found to be among independent predictors for NR (OR: 26.2, 95% CI: 6.5–105.1, P?<?0.001). The predictive power of preprocedural RWPT was statistically non-inferior to ST-resolution (STR)% (difference between area under curves?=?0.029, P?=?0.595).Conclusion
RWPT is strongly associated with and significantly predicts the development of NR. This association was statistically non-inferior to the well-known association between STR% and NR. 相似文献17.
Background
The beneficial effects of atrial septal defect (ASD) device closure on electrical cardiac remodeling are well established. The timing at which these effects starts to take place has yet to be determined.Objectives
To determine the immediate and short term effects of ASD device closure on cardiac electric remodeling in children.Methods
30 pediatric patients were subjected to 12 lead Electrocardiogram immediately before ASD device closure, 24 h post procedure, 1 and 6?months after. The maximum and minimum P wave and QT durations in any of the 12 leads were recorded and P wave and QT dispersions were calculated and compared using paired T test.Results
The immediate 24?h follow up electrocardiogram showed significant decrease in P maximum (140.2?±?6 versus 130.67?±?5.4?ms), P dispersion (49.73?±?9.01 versus 41.43?±?7.65?ms), PR interval (188.7?±?6.06?ms versus 182.73?±?5.8?ms), QRS duration (134.4?±?4.97?ms versus 127.87?±?4.44), QT maximum (619.07?±?15.73?ms versus 613.43?±?11.87), and QT dispersion (67.6?±?5.31 versus 62.6?±?4.68?ms) (P?=?0.001). After 1?month all the parameters measured showed further significant decrease with P dispersion reaching 32.13?±?6 (P?=?0.001) and QT dispersion reaching 55.0?±?4.76 (P?=?0.001). These effects were maintained 6?months post device closure.Conclusion
Percutaneous ASD device closure can reverse electrical changes in atrial and ventricular myocardium as early as the first 24 h post device closure. 相似文献18.
Background
Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).Aim of work
Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients.Methodology
IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions).Results
As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p?=?0.001) with higher total cholesterol level (194.6?±?35.3 vs 174.4?±?28.5?mg/dl, p?=?0.001) and higher LDL-C (145.3?±?27.1 vs 123.2?±?31.4, p?=?0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4?±?7.4 vs 16.3?±?7.9?mm, p?=?0.002) with higher plaque burden (60.8?±?15.3 vs 54.8?±?14.0, p 0.002) and more area stenosis percentage (60.8?±?15.6 vs 55.6?±?14.1, p?=?0.008). Structurally, the diabetic group lesions had more lipid content (19.8?±?8.8 vs 16.8?±?8.7, p?=?0.008) and more necrotic core (17.6?±?7.4 vs 14.7?±?4.8, p?=?0.008) but less calcification (6.9?±?3.6 vs 11.8?±?6.3, p?=?0.001). The RI was negative in both groups, 0.95?±?0.13 in the diabetic group vs 0.98?±?0.19 in non-diabetic group (p?=?0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23.?±?5.2 vs 14.6?±?8.6, p?=?0.01) but less fibrotic component (48.6?±?4.7 vs 59.1?±?13.6%, p?=?0.01) and less calcification (10.9?±?6.8% vs 14.07?±?3.8%, p?=?0.02) as compared to the nondyslipidaemic subgroup.Conclusions
Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. 相似文献19.
Mohamed Waheed Basyouni Adel Mohamed Shabana Wael Mahmoud El Kilani 《The Egyptian Heart Journal》2018,70(4):295-299
Background
Atherosclerosis is progressive and diffuse pathological disorders which can simultaneously affect multiple vascular beds. Diagnosing Lower extremities peripheral arterial disease (PAD) in patients with Coronary artery disease (CAD) admitted to cardiac rehabilitation program can help to tailor exercise regimen to fit these patients, in addition, early treatment and/or intervention may help to control progression of the disease.Aim
The study is to search for the prevalence of undiagnosed PAD using ankle brachial index (ABI) in Egyptian patients with documented CAD undergoing cardiac rehabilitation program.Patients and Methods
The study included 200 patients with documented CAD scheduled for cardiac rehabilitation in Cardiology department, Ain Shams University, with exclusion of patients with known (diagnosed) PAD. All patients underwent ABI using Doppler ultrasonography. The patients were divided into two groups; Study group with positive ABI (≤?0.9) and Control group with negative ABI (>?0.9).Results
We found that the prevalence of undiagnosed PAD in those patients was 14.5% (29 patients). The incidence of PAD is increased in patients above 60 years (p?=?0.001) and in presence of hypertension/uncontrolled systolic blood pressure (p?=?0.002), Dyslipidemia (p?=?0.005), or family history of ischemic heart disease (p?=?0.035). PAD is associated also with impaired left ventricular systolic function and presence of segmental wall motion abnormalities at rest. Impaired eGFR increased the risk of development of PAD (p?=?0.016). PAD was associated more with patients presented by multivessel lesions by coronary angiography and in presence of ischemic ECG changes.Conclusion
This study shows that significant PAD is present in almost 15% of ischemic Egyptian patients. We recommend ABI to be done routinely in patients with significant CAD for exclusion or diagnosis of PAD to help in treatment and improving quality of life in addition to modification of cardiac rehabilitation program in presence of PAD according to its severity. 相似文献20.
Ghada Youssef Sherif Nagy Ahmed El-gengehe Amr Abdel Aal Magdy Abdel Hamid 《The Egyptian Heart Journal》2018,70(4):369-373