Background: Acute coronary syndrome (ACS) is a medical emergency requiring prompt diagnosis and care. Percutaneous coronary intervention (PCI) has become integral part of management of coronary artery disease (CAD) and become lifesaving in acute STEMI patients. Microalbuminuria (MA) is a common phenomenon in patients with cardiovascular disease. Objective: To assess importance of microalbuminuria as a predictor of outcome in non-diabetic patients undergoing PCI for ACS. Subjects and methods: This study was conducted on 123 patients admitted with ACS and were divided equally into three groups [unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI) and STEMI). The patients were then divided into patients with negative and positive microalbuminuria (MA). Echocardiography, coronary angiography and estimation of microalbuminuria level were done to all patients. Results: Mean age of patients 54.94 ± 9.86 years. There were 28 females (22.8%) and 95 males (77.2%). MA was more common in smokers than non-smokers were. There was statistically significant decrease in EF% and increase in WMSI in patients with positive MA than those with negative MA. There was statistically significant increase in the complications and mortality rate in patients with positive MA than those with negative MA. The univariate logistic regression analysis showed statistically significant association between presence of MA and wall motion score index (WMSI) >1.25, amount of dye > 160 ml, no reflow, occurrence of complications, EF pre ≤ 55%, and EF post ≤ 59%. Conclusion: Albuminuria was a strong predictor of outcome in non-diabetic patients underwent PCI for ACS.
Background: Despite the importance of early defibrillation in shockable cardiac arrest management that can affect the outcome, our Egyptian studies are very little in comparison with European and American updated studies. Aim: to improve Cardio pulmonary resuscitation protocols quality to give high rate of success of resuscitation protocols influencing ultimate outcome. Patients and Methods: Randomly selected 81 patients who are diagnosed as cardiac arrest either in hospital or out of hospital were included. They received advanced life support (ALS) protocol, and the effect of defibrillation time was assessed. Results: our study scope on the relation between early defibrillated shockable patients and time when first shock delivered, 25 patients received shock around 5 minutes (recorded by timer) from the beginning of resuscitation of confirmed cardiac arrest. The outcome as well as survival rate were the highest among patients who defibrillated early (n= 25). Of them, 23 patient got Return of Spontaneous Circulation (ROSC). However, among patients who defibrillated late (after 5 minutes, n=35), only 20 patients got ROSC. Conclusion: Our study showed that early defibrillation is the most important key to a successful outcome of inhospital patients with cardiac arrest who need defibrillation.
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