共查询到20条相似文献，搜索用时 109 毫秒
1.
Rabi Malla Chandra Mani Adhikari Binay Rauniyar Deepak Limbu 《The Egyptian Heart Journal》2017,69(1):81-84
Background
Renovascular hypertension due to fibromuscular dysplasia is an uncommon cause of secondary hypertension and is more common in females. This entity is an important treatable cause of secondary hypertension.Case presentation
We report the case of a 21-year-old asymptomatic male found to have high blood pressure on routine checkup. Renal angiogram revealed fibromuscular dysplasia involving the right renal artery. He underwent percutaneous angioplasty with complete recovery. The single antihypertensive which he was on was stopped next month.Conclusion
Fibromuscular dysplasia causing stenosis of renal artery is uncommon. High degree of suspicion is required for the timely diagnosis and treatment of this potentially treatable cause of secondary hypertension. 相似文献2.
M. Jukić L. Pavić I. Bitunjac T. Jukić M. Milošević D. Lovrić M. Lovrić Benčić 《The Egyptian Heart Journal》2017,69(4):235-239
Introduction
Myocardial bridging is congenital anomaly which usually has benign prognosis but there are also reports suggesting that it can be associated with ischemic clinical syndromes presenting with chest pain. Coronary computed tomography angiography is a well-established method for detecting myocardial bridging. However, clinical significance of this anomaly still remains unclear.Methods
We studied 977 patients who presented with recurrent typical or atypical chest pain in outpatient clinic. All patients have undergone detailed clinical examination, ECG stress testing and coronary computed tomography angiography.Results
Highest positive prediction for having myocardial bridging was for patients presenting with atypical chest pain with negative ECG stress test and who were younger women.Conclusion
Coronary computed tomography angiography may be preferable method for evaluation of chest pain in younger women presenting with atypical chest pain. 相似文献3.
Mohamed Abdel Kader Abdel Wahab 《The Egyptian Heart Journal》2017,69(3):183-190
Background
Management of patients with a suspected ACS and LBBB is a challenge to the clinician.Aim
To detect the ability of IMA to exclude myocardial ischemia in suspected patients with ACS and LBBB.Material and methods
A total of 68 patients with suspected ACS and LBBB (group I) and another twenty patients age and sex matched known to have LBBB with normal coronary angiography (group II) were included in this study and subjected to: routine laboratory tests, 12 lead ECG, echocardiography, and measurement of serum troponin I (TnI) and IMA (measured by ELISA). Diagnostic coronary angiography was performed on all patients and scored by severity and modified Gensini scores.Results
IMA and TnI levels are significantly increased in group I compared to group II (P value <0.001). IMA with a cutoff value >95 could predict significant CAD (lesions >50%) with AUC of 0.923, sensitivity of 88%, specificity of 83.33%, PPV of 93.6%, NPV of 71.4% and accuracy 86.76%. Moreover, by using both simple and multiple logistic regression analyses IMA could also independently detect significant CAD. The combined use of IMA and TnI significantly improved the sensitivity and the negative predictive value to 98% and 90.9% respectively.Conclusion
There was a distinct advantage of measuring IMA in patients presenting to the emergency department with acute chest pain and LBBB to rule out a final diagnosis of ACS. 相似文献4.
Osama A. Smettei Sawsan Sayed Rami M. Abazid 《Journal of the Saudi Heart Association》2017,29(2):84-89
Background
Coronary artery anomalies (CAAs) affect about 1% of the general population based on invasive coronary angiography (ICA) data, computed tomography angiography (CTA) enables better visualization of the origin, course, relation to the adjacent structures, and termination of CAAs compared to ICA.Objective
The aim of our work is to estimate the frequency of CAAs in Qassim province among patients underwent cardiac CTA at Prince Sultan Cardiac Center.Methods
Retrospective analysis of the CTA data of 2235 patients between 2009 and 2015.Results
The prevalence of CAAs in our study was 1.029%. Among the 2235 patients, 241 (10.78%) had CAAs or coronary variants, 198 (8.85%) had myocardial bridging, 34 (1.52%) had a variable location of the Coronary Ostia, Twenty two (0.98%) had a separate origin of left anterior descending (LAD) and left circumflex coronary (LCX) arteries, ten (0.447%) had a separate origin of the RCA and the Conus artery. Seventeen (0.76%) had an anomalous origin of the coronaries. Six (0.268%) had a coronary artery fistula, which is connected mainly to the right heart chambers, one of these fistulas was complicated by acute myocardial infarction.Conclusions
The incidence of CAAs in our patient population was similar to the former studies, CTA is an excellent tool for diagnosis and guiding the management of the CAAs. 相似文献5.
Yasser Emad Yasser Ragab Osama Ibrahim Maher Khalifa Ahmed Dawood Johannes J. Rasker 《The Egyptian Rheumatologist》2017,39(3):195-198
Aim of the work
The objective of this clinical report is to describe the detailed magnetic resonance imaging (MRI) findings of the spine, knee and hip joints in two young sisters with Camptodactyly Arthropathy Coxa-vara Pericarditis (CACP) syndrome.Cases report
In two young sisters, both had normal levels of inflammatory markers and typical features of the CACP syndrome with camptodactyly, symmetric joint swelling of both hand joints, knees, ankles and both feet. The affected joints were not tender on palpation with no overlying redness or hotness. Coxa vara on plain X-ray and all cases have evidence of pericarditis. The MRI studies showed the typical rim pattern enhancement of the synovial membrane in the knee and hip joints in both, with no evidence of pannus formation, yet a sizable amount of joint effusion. Both had protrusio acetabuli and one had a unilateral synovial cyst of the hip. MRI studies of the lumbar spine showed evidence of facet joint arthropathy and facet joint effusion, a synovial cyst in both cases and synovial enhancement in post-contrast images with no associated facet joint ankylosis.Conclusion
The findings of the two cases confirm the possible axial affection in the CACP syndrome in the form of facet joint disease as a new finding in this rare syndrome. Spinal involvement should be screened in all cases, as it may have consequences for diagnosis and treatment. 相似文献6.
Mohamed Abdel Kader Abdel Wahab Mohamed Mohamed Saad Khaled Abdel Ghany Baraka 《Journal of the Saudi Heart Association》2017,29(1):30-36
Background
Microalbuminuria (MA) is a marker of vascular damage. However, many studies have observed an increased risk at lower levels of albuminuria than are currently used to define MA.Aim
To verify early cardiovascular changes occurring before MA in hypertensive patients.Materials and methods
One hundred and fifty hypertensive patients and 60 normotensive individuals were divided into normotensive individuals with normal left ventricular (LV) geometry (Group I), hypertensive patients with normal LV geometry (Group II), and hypertensive patients with abnormal LV geometry (Group III). The LV mass index, ambulatory arterial stiffness index, flow-mediated dilatation of the brachial artery, and intima-media thickness (IMT) of the common carotid were assessed. Urinary albumin/creatinine ratio was determined using a morning spot-urine sample.Results
Compared with Group I, ambulatory arterial stiffness index and IMT were significantly increased and flow-mediated dilatation was significantly decreased in Group II; however, MA did not differ between both groups. These changes were augmented when Group III was compared with Group II. MA significantly increased in Group III compared with Group II. Receiver operating characteristic analysis revealed that MA, with a cut-off value of 19.25 mg/g, predicted increased IMT, and abnormal LV geometry in a statistically significant manner.Conclusion
Many vascular changes, in the form of increased IMT, reduced vasodilator capacity, and increased arterial stiffness, preceded MA and any change in LV geometry. The results presented here strengthen the usefulness of adopting a lower cut-off to define MA. 相似文献7.
Viola William Keddeas Salwa Mohammed Swelim Ghada Kamel Selim 《The Egyptian Heart Journal》2017,69(2):103-110
Background
A substantial fraction of patients with non ST-elevation acute coronary syndrome have an occluded culprit vessel on coronary angiography. Acute coronary occlusion often results in myocardial infarction and loss of systolic function. Identification of these patients may have considerable impact on treatment and prognosis.Aim
The study aims at investigating role of 2D speckle tracking echocardiography as a non-invasive predictor of acute coronary artery occlusion in patients with non ST-segment elevation myocardial infarction.Patients
This study was carried on 60 patients with first attack non ST segment elevation myocardial infarction who were admitted to coronary care unit of Ain Shams University Hospitals. All patients underwent thorough history taking, full clinical examination, 12 leads surface ECG, full 2D, M-mode and Doppler echocardiographic study, two-dimensional speckle tracking strain study and coronary angiography.Results
2D derived peak global longitudinal strain had a highly significant relationship in prediction of the presence of total occlusion, and also number of segments with reduced strain (functional risk area by strain) had a highly significant relationship in prediction of the presence of total occlusion. In this study, 2D derived peak longitudinal strain sensitivity and specificity were 68.9% and 77.7% respectively at a cutoff value of ?15.5 while number of segments with reduced longitudinal strain sensitivity and specificity were 63.6% and 77.7% respectively at a cutoff value of 5 segments.Conclusion
Both global and regional peak longitudinal systolic strain can offer accurate, feasible, and non-invasive predictor for acute coronary artery occlusion in patients with non ST elevation myocardial infarction who may benefit from early revascularization. 相似文献8.
Background
The diagnosis of coronary artery disease (CAD) in patients with LBBB represents a clinical challenge. The presence of fragmented QRS (fQRS) complex on surface ECG may be related to myocardial ischemia, scarring or fibrosis.Objectives
To investigate the relation between fQRS and the presence and severity of CAD in patients with LBBB.Patients and methods
56 patients with symptoms suggesting CAD and complete LBBB were submitted to full history taking and clinical examination, complete 12-leads electrocardiography (ECG) to confirm the diagnosis of LBBB and to diagnose the fragmented wide QRS (f-wQRS) complex, echocardiography, and coronary angiography; lesions with ?70% narrowing in major epicardial artery or ?50% narrowing in the left main coronary artery were considered significant; and Gensini score was calculated. Patients were classified into two groups according to the presence or absence of f-wQRS.Results
There were significantly more patients with obstructive CAD among patients with f-wQRS (p = 0.000053). Gensini score was significantly higher in patients with than in patients without fwQRS (p < 0.00001). f-wQRS was the only significant independent predictor of obstructive CAD. Sensitivity of f-wQRS in predicting obstructive CAD was 80.1%, specificity was 73.3%, positive predictive value was 72.4%, negative predictive value was 81.5%, and overall accuracy was 76.8%, p = 0.0022.Conclusion
Seeking for f-wQRS in patients with LBBB and suspected CAD is a simple, easy, available, method that may be helpful in noninvasive prediction of obstructive CAD. 相似文献9.
10.
Raja Alaya Imen Zouche Dhia Kaffel Hend Riahi Wafa Hamdi Mohamed Montacer Kchir 《The Egyptian Rheumatologist》2017,39(4):255-258
Introduction
The association of silicosis and RA is rare compared to pulmonary manifestations of rheumatoid arthritis (RA). A history of lung disease or a long exposure at work to silica and typical radiographic lesions on chest X-ray suggest the diagnosis of Caplan’s syndrome. We describe the case of an elderly Tunisian male RA patient with the Caplan’s syndrome diagnosed after prolonged exposure to silica.Case report
A 62-year old patient was referred for exploration of a chronic symmetrical polyarthritis for 2 years involving the hands, elbows, forefeet, and knees and accompanied by prolonged morning stiffness. He had no history of lung disease but had worked in a ceramic plant for 20 years. He presented with arthritis of the wrists and knees with a rheumatoid nodule of the left elbow. Joint destruction was present in both hands and feet. Rheumatoid factor and anti-cyclic citrullinated peptide antibodies were highly positive (135 UI/L and 363 UI/L respectively). The patient was diagnosed as RA and the disease activity score (DAS-28) was up for 6.87. His breathing was normal, pulmonary auscultation and spirometry were normal. Chest X-rays revealed a multiple micro-nodules distributed throughout the lungs but predominantly in the upper and middle zones. Bronchoalveolar lavage showed a pauci-cellular liquid and chest CT scan showed bilateral, round, well-delimited small centri-lobular nodules which predominate the upper lobes. There was infra-centimetrical adenopathy with mediastinal calcification.Conclusion
Prolonged exposure to silica dust has a remarkable influence on the development of RA with a suggested intricacy in to its pathogenesis. 相似文献11.
Jamila Es-Souiri Amina Mounir Irene Kona Fatima Ezzahra Abourazzak Taoufik Harzy 《The Egyptian Rheumatologist》2017,39(3):183-185
Background
Poncet’s disease is a reactive polyarthritis associated to active tuberculosis with excluded presence of mycobacterium in the joints and bones affected; it is an infrequent form of tuberculosis and challenging diagnosis condition with unknown pathogenesis. We report a case of Poncet’s disease in Moroccan patient to contribute data which could result in a consensus of clinical criteria.Case report
A 38-year-old female was admitted to the Rheumatology Department, Hassan II University Hospital as she presented with morning stiffness, arthralgias, symmetric arthritis of the wrists, ankles, bilateral sacroiliitis, enthesitis and inflammatory back pain. The patient had cervical lymphadenopathy with fever and erythema nodosum. Laboratory results were as follows: ESR 25 mm/h and C-reactive protein 13 mg/L while anti-nuclear antibodies, rheumatoid factor, human immunodeficiency virus and angiotensin converting enzyme were negative. The intradermal skin test for tuberculosis reading was 20 mm which is considered strongly positive. Histological report of cervical node tissue revealed granulomatous lesions compatible with tuberculosis. No alteration was observed in the radiographies of chest and the affected joints. MRI of sacroiliac joint and spine was normal. Spondyloarthritis and rheumatoid arthritis were ruled out. Therapy with pyrazinamide, isoniazide and rifampicin was started after which the arthritis resolved in a few days. The diagnosis of Poncet’s disease was confirmed.Conclusion
The differential diagnosis between Poncet’s disease and autoimmune inflammatory joint diseases is a clinical challenge. However, Poncet’s disease should be considered as a differential diagnosis for patients with fever and arthritis of unknown cause, particularly if active tuberculosis is suspected. 相似文献12.
M.A. Duarte-Millán D. Bernal-Bello J.A. Rueda-Camino S. Martín-Barón J. Canora-Lebrato A. Zapatero-Gaviria 《The Egyptian Rheumatologist》2017,39(3):187-189
Introduction
Sjögren’s syndrome (SS) is a chronic autoimmune multisystemic disease. Respiratory manifestations of SS are polymorphic and vary in severity. Among the possible manifestations, organizing pneumonia (OP) is a rare entity. Reversed halo sign (RHS) is an unusual radiological finding classically related to OP but it is also reported in other forms of interstitial pneumonitis (IP).Case presentation
We report a case of a 65-year-old woman with dyspnoea and persistent-cough of 2-month duration. She presented with RHS as an initial manifestation of IP related to SS. Chest radiography and computer tomography showed multiple well defined lesions with a central ground glass area and peripheral rim of consolidation. No pathological lymph nodes were found. After investigations, the associated diagnosis of SS was confirmed. The patient started steroids (0.5 mg/kg/day) and after 10 weeks of steroid tapering a significant clinical improvement was observed, with radiological resolution of lung lesions. We make some general considerations about differential diagnosis, conditions related to RHS and different patterns of lung involvement in SS. A report of the literature emphasizes this case as an exceptional way of presentation.Conclusion
To the best of our knowledge this is the second reported OP case associated with SS manifesting as RHS. RSH as an expression of IP related to SS is exceptional, either in the pattern of OP or non-specific IP. 相似文献13.
Mohammad A. Sadaka Eman M. El-Sharkawy Mohamed A. Sobhy Basma A. Hammad 《The Egyptian Heart Journal》2017,69(1):63-70
Objectives
We aimed to determine the role of multi-detector computed tomography (MDCT) in prognosis of patients with known or suspected coronary artery disease (CAD) by applying plaque characterization and whether obstructive versus non-obstructive plaque volume is a predictor of future cardiac events.Background
Vulnerable plaques may occur across the full spectrum of severity of stenosis, underlining that also non-obstructive lesions may contribute to coronary events.Methods
We included 1000 consecutive patients with intermediate pretest likelihood of CAD who were evaluated by 64-MDCT. Coronary artery calcium scoring, assessment of degree of coronary stenosis and quantitative assessment of plaque composition and volume were performed. The end point was cardiac death, acute coronary syndrome, or symptom-driven revascularization.Results
After a median follow-up of 16 months, 190 patients had suffered cardiac events. In a multivariate regression analysis for events, the total amount of non-calcified plaque (NCP) in non-obstructive lesions was independently associated with an increased hazard ratio for non-fatal MI (1.01–1.9/100-mm3 plaque volume increase, p = 0.039), total amount of obstructive plaque was independently associated with symptoms driven revascularization (p = 0.04) and coronary artery calcium scoring (CACS) was independently associated with cardiac deaths (p = 0.001).Conclusion
MDCT is a non-invasive imaging modality with a prognostic utility in patients with known or suspected coronary artery disease by applying plaque characterization and it could identify vulnerable plaques by measuring the total amount of NCP in non-obstructive lesions which could be useful for detecting patients at risk of acute coronary syndrome (ACS) and guide further preventive therapeutic strategies. CACS was shown to be an independent predictor of mortality, while total amount of obstructive volume was shown to be an independent predictor of symptoms driven revascularization. 相似文献14.
Aim of the work
To detect the frequency of hepatitis C virus (HCV) infection among patients admitted to a rheumatology ward in northern Cyprus.Patients and methods
154 patients admitted to the rheumatology department of Near East University Hospital. The demographic data, examination findings and the medical cause of admission together with clinical manifestations of their disease was recorded. All patients were screened for HCV antibodies and cryoglobulins.Results
The mean age of the patients was 46.6±15.8 years. The diagnosis amongst the 154 patients included rheumatoid arthritis in 24 (15.6%), arthralgia in 15 (9.7%), ankylosing spondylitis in 12 (7.8%), fibromyalgia syndrome in 11 (7.1%), osteoarthritis in 10 (6.5%), palindromic rheumatism in 10 (6.5%), systemic lupus erythematosus in 7 (4.5%), sjogren’s syndrome in 7 (4.5%),psoriatic arthritis in 17 (11.0%), vasculitis in 5 (3.2%), raynaud phenomenon in 5 (3.2%), scleroderma in 4 (2.6%), enteropathic arthritis in 4 (2.6%), familial mediterranean fever in 4 (2.6%), gout diseases in 3 (1.9%), reactive arthritis in 7 (4.5%), behcet’s disease in 1 (0.6%) and retroperitoneal fibrosis in 1 (0.6%) patients. HCV antibodies were negative in all the patients and only 1 male tested positive for cryoglobulins. Almost a quarter of the patients were receiving non-steroidal ant-inflammatory drugs (NSAIDs) and 7.1% received colchicine.Conclusions
Although rheumatic diseases are noted at a high rate in north Cyprus, there is no associated HCV infection. 相似文献15.
Behnam Azizolahi Elham Rajaei Reza Taherkhani Manoochehr Makvandi 《The Egyptian Rheumatologist》2017,39(4):239-243
Background
A new form of hepatitis B virus (HBV) infection, occult hepatitis B infection (OBI), has been identified and reported among patients with rheumatic diseases.Aim of the work
To determine the incidence of HBV infection and OBI in patients with rheumatic diseases referred to major hospitals in the city of Ahvaz in Iran.Patients and methods
136 patients with rheumatic diseases were included. Serological assays for HBV markers (HBsAg, HBcAb and HBsAb) were performed by enzyme-linked immunosorbent assay. All the sera were tested for HBV DNA using nested PCR and real-time PCR. All samples were negative for anti-HCV and anti-HIV antibodies.Results
The mean age of the patients was 43.5 ± 12.02 years with a F:M 2.24:1. 2 (1.47%) cases with undifferentiated connective tissue disease tested positive for both HBsAg and HBV DNA. Quantitative HBV real-time PCR was carried out for the 134 negative HBsAg samples and only 1 (0.74%) patient was positive for OBI. The results of sequencing and alignment showed that the detected HBV DNAs belonged to the D genotype, ayw2 subtype. The nucleic acid sequence of OBI case revealed substitution changes in amino acids in the positions of the 171-4 of HBsAg gene.Conclusion
A moderate rate of HBV infection and low detection of OBI is found in patients with rheumatic diseases in southwest Iran. The amino acid substitutions and mutation have been observed at the position of 171-4 in the S gene region of HBV DNA which may affect the detection of HBsAg by commercial immunoassay methods. 相似文献16.
Muhammad O. Awiwi Zeynep Aslan Yagli Ferruh Elbir Ahmet Arif Aglar Erhan Guler Unsal Vural 《Journal of the Saudi Heart Association》2017,29(1):1-6
Introduction
Oral anticoagulation with warfarin is indicated for patients with prosthetic heart valves. The effects of religious fasting during Ramadan month (in the Islamic calendar) on anticoagulation aren’t clear.Objectives
To study the impact of Ramadan fasting on international normalized ratio (INR), quality of anticoagulation, dose of warfarin used and blood osmolarity.Methods
18 patients were followed-up prospectively for 3 months (pre- Ramadan, Ramadan and post-Ramadan months). Patients presented for weekly visits in which blood samples were obtained.Results
No significant difference in INR and warfarin dose was found between Ramadan month, and months before and after it. The post-Ramadan INR was significantly larger than pre-Ramadan (p = 0.004). Blood osmolarity was significantly lower during Ramadan compared to pre- and post-Ramadan months. A significantly better quality of anticoagulation was noticed during Ramadan (p < 0.001). A significantly larger ratio of supratherapeutic INR values occurred in the post-Ramadan month (p < 0.05). A significantly larger ratio of infra-therapeutic INR values was noticed in the pre-Ramadan month (p < 0.05).Conclusion
No significant difference in mean INR or warfarin dose was found and a better quality of anticoagulation was achieved during Ramadan. A tendency toward supra-therapeutic anticoagulation occurred after Ramadan, thus a closer follow up during this period may be reasonable. 相似文献17.
Background
Rheumatoid arthritis (RA) is an autoimmune disease characterized by increased inflammation of synovial joint. The collagen-induced arthritis (CIA) is a widely used animal model for RA. Spironolactone possesses potent anti-inflammatory and immune modifying properties that might make it an excellent medical intervention for rheumatic diseases.Aim of the work
The present study was conducted to evaluate the therapeutic effect of spironolactone (SPIR) in collagen-induced arthritis model in mice.Materials and methods
DBA/1mice were divided into eight groups and CIA mice treated with SPIR (20, 40 and 80 mg/kg/day), methotrexate (MTX) and vehicle was administered beginning on day 21 (arthritis onset) until day 42. The effects of treatment in the mice were assessed by clinical, oxidative markers, inflammatory cytokines; tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) as well as histological changes in ankle joints.Results
Mice immunized with collagen II with complete and incomplete Freund’s adjuvant developed inflammatory arthritis. Spironolactone (40 and 80 mg/kg/day) was effective in bringing significant changes on all the parameters (paw swelling, arthritis score, oxidative markers) studied. Oral administration of SPIR significantly reduced the level of TNF-α and IL-6. The protective effect of SPIR against RA was also evident from the ankle joint histopathology and its effect was found comparable to that of MTX.Conclusion
Amelioration of paw swelling, antioxidant properties, inflammatory mediators TNF-α and IL-6 and histopathological changes indicates that SPIR can be considered with MTX among the treatment armamentarium of arthritis. Spironolactone may be considered for use as a novel therapeutic treatment against human arthritis. 相似文献18.
G.S. Youssef H.H. Kassem O.A. Ameen H.S. Al Taaban H.H. Rizk 《The Egyptian Heart Journal》2017,69(3):177-181
Background
Early presentation is desirable in all cases of acute prolonged chest pain. Causes of delayed presentation vary widely across geographic regions because of different patients' profile and different healthcare capabilities.Objectives
To detect causes of delay of Non-ST elevation acute coronary syndrome (NSTE-ACS) patients in our country.Methods
Patients admitted with NSTE-ACS were included. We recorded the time delay between the onsets of acute severe symptoms till their arrival to the hospital (Pre-hospital delay). We also recorded the time delay between the arrival to hospital and the institution of definitive therapy (hospital delay). Causes of pre-hospital delay are either patient- or transportation-related, while hospital delay causes are either staff- or system-related.Results
We recruited 315 patients, 200 (63.5%) were males, 194 (61.6%) hypertensives, 180 (57.1%) diabetics, 106 (33.7%) current smokers and 196 (62.2%) patients had prior history of cardiac diseases. The mean pre-hospital delay time was 8.7 ± 9.7 h. Sixty-six percent of this time was due to patient-related causes and 34% of pre-hospital delay time was spent in transportation. The mean hospital delay time was 2.3 ± 0.95 h. In 89.8% of cases, the hospital delay was system-related while in 10.2% the reason was staff-related. The mean total delay time to definitive therapy was 11.0 ± 9.8 h.Conclusion
Pre-hospital delay was mainly patient-related. Hospital delay was mainly related to healthcare resources. Governmental measures to promote ambulance emergency services may reduce the pre-hospital delay, while improving the utilization of healthcare resources may reduce hospital delay. 相似文献19.
Introduction
Coronary artery disease is the leading cause of death worldwide. Although there are a number of algorithms in use for determining the risk of coronary artery disease and thus predicting future cardiovascular events, the data available regarding their validity among the Saudi population are insufficient.Objective
We studied the validity of three clinical score systems in predicting a high risk population defined as having excessive coronary calcification: the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Risk Equation, the Framingham Risk Score, and the European Systematic Coronary Risk Evaluation.Methods
We analyzed data from 462 patients aged ?40 years. High-risk features were if the Coronary Calcium Score was either >400 or in the ?75th percentile using Multi-Ethnic Study of Atherosclerosis (MESA) score. The scores for the three algorithms were then calculated using the participants’ clinical data.Results
A total of 87 (18.8%) patients were positive for coronary calcification. Among them, 60 (13%) were classified as being at high risk according to the MESA score. Analyzing these patients by the ACC/AHA Pooled Cohort Risk Equation resulted in nine (15%) as being at low risk, 12 (20%) at intermediate risk, and 39 (65%) at high risk. The Framingham Risk classification resulted in 14 (23%) being at low risk, 13 (22%) at intermediate risk, and 33 (55%) at high risk. The European Systematic Coronary Risk Evaluation risk classification showed 24 (40%) at low risk, 12 (20%) at intermediate risk, and 24 (40%) at high risk, with p < 0.0001.Conclusion
The ACC/AHA Pooled Cohort Risk Equation has superior risk ? calibration compared to the other two risk-score algorithms in a Saudi population. 相似文献20.
Tarig Yousif Mohamed Eltayeb Malik Suliman Mohamed Abubaker Ibrahim Elbur Ahmed Sayed Ahmed Elsayed 《Journal of the Saudi Heart Association》2017,29(3):169-175