Background: COVID-19 can cause a wide range of thrombotic diseases, including acute coronary syndromes (ACS). While these thrombotic diseases occur during acute infection, evidence on the long-term thrombotic consequences of COVID-19 remain unknown. Objective: The aim of the current study was to establish the particular coronary angiographic findings, as well as the procedural and clinical effectiveness of revascularization in post COVID-19 patients presenting with STEMI. Patients and methods: A total 100 patients presented to Ain Shams University Hospitals with ST Segment Elevation Myocardial Infarction (STEMI) managed by primary percutaneous coronary intervention (PCI). Participants were divided into two groups: Group (A) included 50 patients who developed COVID-19 infection in the previous 6 months, and Group (B) included 50 patients who deny COVID-19 infection in the previous 6 months. Group (A) was divided into two subgroups: the Early Post-COVID subgroup, which included 16 patients who developed STEMI within 8 weeks of infection, and the Late Post-COVID subgroup, which included 34 patients who developed STEMI >8-24 weeks after infection. Results: The Early Post-COVID subgroup had a statistically significant high thrombus load on angiography, with 81.3% versus 48% in the control group. This resulted in a statistically significant increase in the utilization of predilatation (56.2% versus 24%) and thrombus aspiration (43.8% versus 4%) in the Early Post-COVID grouping (Pvalues 0.015 and 0.001, respectively). Coronary no-reflow was a substantially more common in the Early post-COVID subgroup (62.5%) than in the control group (22%). This translated into a higher Major Adverse Cardiovascular Events (MACE) among Early Post-COVID patients, at 31.3% versus 6% in the control group. Conclusion:The thrombogenic impact of COVID-19 on STEMI outcomes continues even after infection clearance being greatest during the first 8 weeks following infection and thereafter diminishes. It has an impact on the angiographic, procedural, and overall clinical success of in-hospital revascularization.

Background: The phenomenon of no-reflow is defined as the occurrence of areas with very low tissue flow after the target vessel has reopened. Current knowledge suggests that the no-reflow phenomenon is caused by the damage to microvascular integrity established both during ischemia and during reperfusion. D-dimer is the end product of fibrin degradation by plasmin, as plasma concentrations increase in people with persistent or recent thrombosis. Its levels reflect the rate of fibrin turnover and give an indirect estimate of the size of the coagulant mass available for fibrinolysis and the severity of the hypercoagulable condition. Objective: To investigate the Clinical and laboratory predictors of no-reflow on admission after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients. Patients and methods: A prospective single group observational study. A total of 100 patients presented with STEMI and eligible for primary PCI to the cardiology department in Ain Shams University hospital. Results: Coronary angiography showed that (74%) had normal flow while (26%) showed no re-flow. Renal impairment, DM and delayed reperfusion (> 4 hr) were significantly associated with no reflow(P-values = 0.018,0.023,0.005) respectively. ROC curve showed that the best cut off point for D-dimer to predict cases with no reflow was found ≥ 560 with sensitivity of 96.15%, specificity of 79.73% and area under curve (AUC) of 86.5% where as the best cut off point for CRP was > 41 with sensitivity of 76.92%, specificity of 64.86% and area under curve (AUC) of 69.8. Conclusion: Assessment of D-dimer and CRP levels on admission in STEMI patients might independently predicts no-reflow after primary PCI.

Background Coronary artery disease is the most important cause of death in industrialized countries. Diabetes mellitus is one of the most important modifiable risk factors of coronary artery disease. It increases the risk of coronary artery disease by 2 to 4-fold. Interestingly, this increased risk is not confined to patients with DM, but non-diabetic patients with impaired glucose tolerance (IGT) also may have an increased incidence of cardiovascular complications. Moreover, increased admission glucose levels may be related to a higher mortality rates in patients with acute myocardial infarction (AMI), regardless of diabetic status. Objective To assess the prognostic impact of admission HbA1c in patients without known diabetes mellitus who were admitted with acute ST elevation myocardial infarction, on outcome of 1ry PCI and short-term outcome of adverse cardiac events. Material and Methods This is an observational, this study was conducted at Coronary care unit & coronary catheterization lab unit of cardiology department in Ain Shams University & specialized hospitals. The study period was 6 months (From 1-9-2018 till 1-3-2019). Results 100 patients without prior diagnosis of DM were included in our study population Three categories of patients were created according to HbA1c level: Group 1 (< 5.7%): 46 patients (46%); Group 2 (5.5 to 6.4%): 38patients (38%); Group 3 (>6.5%): 16 patients (16%). Baseline characteristics of the study population are shown in Table 1. The mean age of our sample was 55.06 ± 11.73 years and 96% were males. There was highly statistically significant difference found between DM groups regarding SYNTAX score with P-value (0.002) & another highly significant difference in EF between the 3 groups. Conclusion The present study showed that admission higher HbA1c level in non-diabetic patients presented by acute STEMI is associated with more severe CAD, lower rate of complete revascularization TIMI 3, and higher incidence of adverse cardiac events and mortality. Introducing measurement of HbA1c in the CCU seems to be a simple method to obtain important information on mortality risk.