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Article
Primary Percutaneous Coronary Intervention in Acute ST Elevation Myocardial Infarction: A Single Centre Experience

Authors: Ahmed Hussein AL- Mayali --- Mushtaq T. Al-Hassnawi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2018 Volume: 11 Issue: 2 Pages: 3978-3987
Publisher: Kerbala University جامعة كربلاء

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Abstract

background Early revascularization is critically important in the management of patients presenting with acute myocardial infarction.Aim To assess the benefit of early primary percutaneous coronary intervention in patients with acute ST elevation myocardial infarction.Methods This study include 51 patients with acute STEMI they were selected from those who were admitted to the coronary care unit of Karbala cardiac center in Karbala-Iraq during a period between January 2017 and February 2018. Detailed history and thorough physical examination was done. Investigations done for each patient in form of ECG, cardiac troponin, blood urea, serum creatinine, and complete blood picture.Results & discussion percutaneous coronary intervention only, using one stent, two stent, three stent, aspiration catheter, CABG & medical treatment, 7 (13.7%),25(49%), 8(15.6%), none , 4(7.8%), 4(7.8%), 4(7.8%), 3(5.8%) respectively).Infarct related artery, LAD, LCX, RCA & LMS (30(58.8%), 4(7.8%), 6(11.7%), 2(3,9%) respectively, and the number of diseased vessels , single vessel, two vessels, three vessels & LMS which was (20(39.2%), 13(25.4%), 14(27.4%) respectively.Inhospital outcome, which include the following:- favorable outcome, period of hospitalization, access site bleeding, contrast induced nephropathy, death, respectively. Which were (96%, ˂ 1day 38(74.5%), ˃1day 13(25.5), 3.9%, 5.8%, 3.9% respectively)Conclusion in case of ST elevation myocardial infarction, left anterior descending artery is most culprit vessel to be involved, one quarter of patient needs one stent & carry favorable out comes in form of less complications and also decrease the period of hospitalization.

Keywords

primary PCI --- acute MI


Article
Incidence and in-hospital complications of acute mitral regurgitation in the early phase of acute myocardial infarction in Erbil teaching hospital
نسبة ومضاعفات في المستشفى من قلس التاجي الحاد في المرحلة المبكرة من احتشاء عضلة القلب الحاد في مستشفى أربيل التعليمي

Authors: Abdulkareem A. Al-Othman --- Firaz Muhammad Mawlood
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2012 Volume: 16 Issue: 2 Pages: 84-89
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Acute mitral regurgitation is one of the mechanical complications of acute myocardial infarction. The aim of the study was to detect the incidence of ischemic mitral regurgitation and its effect on in-hospital complications in early phase of acute myocardial infarction.Method: The study sample consisted of 100 patients with first attack of acute myocardial infarction admitted to Coronary Care Unit in Erbil Teaching Hospital from October 2009 to May 2010.The patients categorized into: group-I which represent those without mitral regurgitation; group-II represent those with mitral regurgitation and the latter categorized patients with mild mitral regurgitation (group-IIA) and those with moderate-severe mitral regurgitation (group-IIB).Results: The incidence of acute mitral regurgitation among patients with acute myocardial infarction was 33%. Fourteen patient (42.42%) had mild and 19 (57.58%) had moderate-severe mitral regurgitation. Group-II patients were older (mean age: 65.4±10.76 years) than group-I (mean age 56±11), p value=0.01. Left ventricular systolic dysfunction among group-IIA, 9 patients (64.28%) and group-IIB, 16 patients (84.21%) were higher than group-I, 12 patients (17.91%), p=<0.001.Conclusion: Acute mitral regurgitation is common in early phase of acute myocardial infarction and it is strongly associated with left ventricular systolic dysfunction.

Keywords

Acute MI --- MR


Article
Factor XII level in patients with acute Myocardial Infarction
مستوى العامل الثاني عشر عند مرضى احتشاء العضلة القلبية الحاد

Author: Aladdin Mudhafar Zubair Al-Qasim د.علاء الدين مظفر زبير القاسم
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 1 Pages: 25-29
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Acute myocardial infarction (AMI) is one of the most common diagnoses in hospitalized patients in industrialized countries. Factor XII is one of the contact activation factors. Hageman factor (FXII) activates coagulation through the intrinsic pathway. It concurrently activates the fibrinolytic system. This mechanism exists to limit clotting by cleaving fibrin, thereby solubilizing the fibrin clot.Aims of the study: To study the level of intrinsic coagulation factor (FXII: C) in patients with acute myocardial infarction.Subjects, Materials and Methods: Thirty patients were included in this study (9 female, 21 male) that were just admitted to the Coronary Care Unit in Al-Yermouk Teaching Hospital and diagnosed as having acute myocardial infarction. Blood samples were taken from these patients. Their age range is 48-68 years. Thirty healthy subjects (9 female, 21 male) age and sex matched with the patients were included as a control group. FXII: C activity was assayed for both patients and control groups. Statistical Methods: The student T-test and correlation study were used for statistical tests. Results Mean FXII: C (71.03±11.46) is significantly (P value <0.001) lower in acute myocardial infarction group than control group (119.00%±8.52). Conclusion FXII: C level was significantly lower in patients with acute myocardial infarction than control group.Key words: acute MI, factor XII assay

خلفية البحث: يعد إحتشاء عضلة القلب الحاد من الحالات المشخصة الشائعة لدى المرضى الراقدين في المستشفيات. لقد لوحظت زيادة في العلامات الخثرية في حالة إحتشاء عضلة القلب الحاد مما يدل على تنشيط جهاز التخثر لدى هؤلاء المرضى.الهدف من الدراسة: قياس مستوى العامل الثاني عشر عند مرضى إحتشاء عضلة القلب الحاد.العينات وطرق العمل:أجريت هذه الدراسة في مستشفى اليرموك التعليمي للفترة مابين تشرين الاول 2008 وآذار 2009 وخلال هذه الفترة جمعت ثلاثون حالة من المرضى المصابين بإحتشاء عضلة القلب الحاد في وحدة إنعاش القلب وسحبت عينات دم من هؤلاء المرضى وفحصت في مختبرات المستشفى المذكورة أعلاه وقد تضمنت الفحوصات المجراة قياس مستوى عامل التخثر الثاني عشر في بلازما الدم.سحبت عينات دم لعشرين من الاشخاص الاصحاء بأعمار وأجناس متوافقة مع المرضى كمجموعة سيطرة لأغراض المقارنة وأجريت عليها نفس الفحوصات المختبرية المجراة على عينات دم المرضى.النتائج:ان هناك نقصان ملحوظ (P value 0.0001) في نسبة عامل التخثرالثاني شر(71.03±11.46) لدى مرضى احتشاء عضلة القلب الحاد وبين المجموعة السيطرة(119.00%±8.52).

Keywords

acute MI --- factor XII assay


Article
Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in Ibn Alnafees Hospital, Baghdad

Authors: Majid Abdul Muhsin Falih --- Alaa AbdulHussein Allawi --- Raed Sabri Al Abboodi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 310-312
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUD:Primary percutaneous coronary intervention (PCI) provides outcomes superior to fibrinolytic therapy in acute myocardial infarction (AMI), but no registry or study in Iraq has demonstrated its use in hospital.OBJECTIVE: To evaluate using of primary PCI for acute MI in Ibn Alnafees hospital –Baghdad.METHODS: Patients between 2010 and march 2013 having symptom onset within 12 hours and either ST-segment elevation of - 1 mm in - 2 contiguous leads or presumed new left bundle branch block (LBBB) in electrocardiogram (ECG) who were treated with primary PCI were included in this study. Two patient had cardiogenic shock treated within 16 hours.RESULTS:A total of 76 patient included in this study having primary PCI for acute MI. successful result reported in 71 of cases, while death reported in 2 cases, slow flow in 2 cases, no re flow in one case and stent thrombus formation in one case. No need for urgent or elective CABG.CONCLUSION: Primary PCI for patients with AMI having ST-elevation or new LBBB is a safe and effective strategy


Article
SMALL DENSE, LOW-DENSITY LIPOPROTEINS OF YOUNG ADULTS WITH FAMILY HISTORY OF ACUTE MYOCARDIAL INFARCTION: PREDECTIVE VALUE AND RELATED RISK FACTORS
القيمة التخمينية والعوامل ذات العلاقة لبروتينات الشحمية الصغيرة و القليلة الكثافة, عند الشباب الذين لدى الوالدين احتشاء العضلة القلبية المبكر

Authors: BAHEAJ Y. KHALIL بهيج خليل --- DHIA M. SULAIMAN ضياء سليمان --- DHIA J. AL-TIMIMI ضياء التميمي
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2009 Volume: 3 Issue: 2 Pages: 67-78
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background Although growing evidence suggests that small, low density lipoprotein-cholesterol (Sd, LDL-ch) is strong predictors of coronary artery disease in the general population, epidemiological data among young adults with family history of acute myocardial infarction are limitedObjective To evaluate the Sd, LDL-ch and related risk factors of young adults with a positive family history of acute myocardial infarction and compared them with controls in order to identify risk indicators for atherosclerosis.Subjects and methods A group of 200 young adults aged 20-40 years with a positive family history of acute myocardial infarction were evaluated for serum concentrations of total cholesterol (Tch), low-density lipoprotein cholesterol (LDL-ch), high density lipoprotein cholesterol (HDL-ch), small dense, low density lipoprotein cholesterol (Sd, LDL-ch), triglycerides (TG), oxidized lipoproteins, C-reactive protein(C-RP) and malonyldialdehyde (MDA).These values were compared with the levels of a control group of 100 adults of comparable age. Results In young adults with positive family history of acute myocardial infarction, increased serum Sd, LDL-ch was more frequent than in controls (65.5 versus 10.0%, p<0.001). Among these young adults, 66(33%), 68(34%), and 63(31.5%) had hypercholesterolemia, hypertriglyceridemia and metabolic syndrome. In addition, those young adults had significantly higher concentrations of Tch, TG, LDL-ch, Sd, LDL-ch, oxidized lipoproteins, MDA, C-RP and glucose and lower concentrations of HDL-ch compared with controls. Significant differences were also noted in the values of waist circumference, and blood pressure between positive family history group and controls. The serum Sd, LDL-ch and related risk factors being frequently positively correlated. In a ROC curve analysis, the area under curve was 0.894(95% CI 0.802-0.886), suggesting a good discrimination between the young adults with and without family history for myocardial infarction. Conclusions In young adults, positive family history group is characterized by a higher prevalence of increased Sd, LDL-ch and metabolic abnormalities. This finding may have clinical implications due to the increased risk of future coronary artery disease.

خلفية الموضوع: زيادة كوليسترول البروتينات الشحمية الصغيرة والقليلة الكثافة Sd,LDL-Ch)) اصبحت الان عامل خطر بازغ ويمكن اعتبارة ضرورة طبية, خا صة عندما يكون للشخص تاريخ مرضي عائلي لحدوث امراض القلب و الشراين المبكر.القليل معرف عن استعمالة كعامل خطورة لدى الشباب البالغين الذين بدو انهم اصحاء ولكن لديهم خطورة عالية في المستقبل لحدوث امراض القلب و الشراين.الهدف: تقييم الاهمية السريرية لكوليسترول البروتينات الشحمية الصغيرة والقليلة الكثافة و لبعض عوامل الخطورة الاخرى لدى الشباب البالغين الذين بدو انهم اصحاء ولكن لدى واليدهم تاريخ مرضي لحدوث احتشاء العضلة القلبية المبكر.طريقة العمل: تم تقييم 200 من الشباب البالغين الذين بدو اصحاء ولكن لدى والديهم تاريخ مرضي لحدوث احتشاء العضلة القلبية المبكر. تم تقييم تركيز الكوليسترول الكلي, كوليسترول البروتينات الشحمية القليلة الكثافة و, كوليسترول البروتينات الشحمية العالية الكثافة, كوليسترول البروتينات الشحمية الصغيرة والقليلة الكثافة,الدهن الثلاثي, كوليسترول البروتينات المؤكسدة,بروتين Cالنشط ,ونواتج المؤكسدات في المصل , ثم مقارنة القيم الناتجة مع مجموعة المسيطرة العمرية والبالغة 100شاب.النتائج: اظهرت النتائج البحث فرق احصائي في تركيزنسبة كوليسترول البروتينات الشحمية الصغيرة والقليلة الكثافة بين الشباب البالغين الذين بدو انهم اصحاء ولكن لدى والديهم تاريخ مرضي لحدوث احتشاء العضلة القلبية المبكرمقارنة بالشباب الذين ليس لدى والديهم تاريخ مرضي لحدوث احتشاء العضلة القلبية المبكرة وان معدل التكرار للاعلى نسبة كانت % 65.5 لدى الذين لديهم تاريخ مرضي موجب مقارنة ب % 10 للذين لديهم تاريخ مرضي سالب للاحتشاء عضلة القلب .اضافة الى ذللك يوجد فرق احصائي واضح بالنسبة لجميع الدهنيات الاخرى والعوامل التي تم تقييمها بين المجموعتين.الاستنتاج: نستنج من هذا البحث ان نسبة عالية من الشباب البالغين الذين بدو انهم اصحاء ولكن لدى واليدهم تاريخ مرضي لحدوث احتشاء العضلة القلبية المبكرة.لديهم زيادة في مستوى كوليسترول البروتينات الصغيرة والقليلة الكثافة وهذا دليل على زيادة الخطورة من امراض القلب و الشراين.


Article
Evaluation of the Intrinsic Pathway of Coagulation in a Sample of Iraqi Patients with Acute Myocardial Infarction

Author: *Maysem Mouayad Alwash F.I.B.M.S , *Alauldeen Mudhafar Zubair Alqasim F.I.B.M.S, **Salim R. Hammodi Ph.D.
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2016 Volume: 12 Issue: 1 Pages: 31-37
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Acute myocardial infarction (AMI) is one of the most common diagnoses in hospitalized patients. Increased plasma hemostatic markers were noted in acute myocardial infarction, indicating that the blood coagulation system is highly activated in those patients. Aims of the study: To study the level of intrinsic coagulation factors including (FVIII:C, FIX:C ,FXI:C ,FXII:C ) in patients with acute myocardial infarction. Type of the study: Cross –sectional study. Methods: Thirty patients (their age range is 48-68 years) were included in this study (9 female, 21 male) who were just admitted to the coronary care unit in AL-Yarmouk Teaching Hospital and diagnosed as having acute myocardial infarction patients, blood samples were taken from those patients . Twenty healthy subjects (6 female, 14 male) age and sex matched with the patients were included as a control group. The following investigations were done for both groups: 1.Packed cell volume(PCV%) .by microhaematocrit method. 2.FVIII:C assay. [ by parallel line bioassay of coagulationfactors]. 3.FIX:C assay. 4.FXI:C assay. 5.FXII:C assay. Results Mean FVIII:C (162.63%±17.22)was significantly (P value< 0.05)higher in patients with acute myocardial infarction than control group(94.70%±9.34).1-Mean FIX:C (151.20%±14.20) was significantly (P value <0.05) higher in acute myocardial infarction group than control group(94.10±8.51). 2-Mean FXI:C (146.30%±7.87) was significantly (P value <0.05) higher in acute myocardial infarction group than control group (102.00%±7.91). 3-Mean FXII:C(71.03±11.46) was significantly (P value <0.05) lower in acute myocardial infarction group than control group (119.00%±8.52). 4-There is inverse relationship between FXI:C and FXII:C in acute myocardial infarction group(P value -0.736). Conclusions Patients with acute myocardial infarction had significantly higher levels of FVIII:C,FIX:C,FXI:C than controls. FXII:C level was significantly lower in patients with acute myocardial infarction than control group. There is an inverse relationship between FXI:C and F XII:C in patients with acute myocardial infarction.

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