Background and objective: The association between serum uric acid and ischemic heart disease remains controversial and it has not yet been established as cardiovascular risk factor. Our objective was to study the association of serum uric acid level with angiographic severity of coronary artery disease in men with acute coronary syndrome (ACS). Methods : This cross-sectional study was conducted on 100 consecutive male patients presenting with ACS at Punjab Institute of Cardiology. Hyperuricemia was defined as serum uric acid level > 6.5 mg/dl. Severity of ischemic heart disease was assessed on the basis of Gensini score, number of diseased vessels, critical lesions and total occlusions on coronary angiogram. Results: Mean age of normouricemic group (n=59) was 52.62 ± 9.46 years and mean age of hyperuricemic group (n=41) was 50.52 ± 9.40 years (p=0.273). Mean uric acid level; normouricemic group (4.75 ± 1.05), hyperuricemic group (7.61 ± 1.24), p<0.001. Mean Gensini score; normouricemic group (22.15 ± 21.52), hyperuricemic group (35.69 ± 26.80). Mann Whitney U test was applied to compare the Gensini score of two groups and it showed statistically significant difference (p value <0.006). Critical lesions, total occlusions and multi-vessel disease were more frequent in hyperuricemic group but statistically significant difference was found only for total occlusions (p=0.013) and critical lesions (p=0.046). Conclusions : Hyeruricemia is associated with higher Gensini score and more frequent total occlusions and critical lesions in men presenting with acute coronary syndrome.

Background and Objectives: Assessment of left ventricle function is the singlemost common indication for transthoracic echocardiogram. Out of different indicators of LVfunction, ejection fraction is the most validated one. MAPSE has promised recently to be a reliableand easily obtainable indicator for LV function even in inexperienced hands but its value in caseof left ventricle hypertrophy (LVH) is questionable. Study Design: Cross-sectional comparativestudy. Setting: Rehmatul-lil-Alameen Institute of Cardiology, Lahore. Period: January 2015and March 2015. Methods: 100 consecutive patients presenting for echocardiography atRehmatul-lil-Alameen Institute of Cardiology, Lahore. Patients were divided into two groups onthe basis of presence of left ventricle hypertrophy (LVMI >115 g/m2 in males and > 95 g/m2in females) and further subdivided according to LVEF into those with preserved (EF>55%) anddepressed EF (EF<55%). EF was calculated by visual quantification (eyeballing). MAPSE wasmeasured using M-mode at all four mitral annular sites-medial, lateral, anterior and posteriorand values averaged. Results: Among 100 patients; 66(66%) were without LVH while 34(34%)were having LVH. Without LVH group had 43 (65%) patients with preserved LVEF (EF>55%)while 23 (35%) had depressed LVEF (EF>55%). In LVH group 22 (64.7%) had preservedLVEF while 12 (35.3%) had depressed LVEF. Mean EF (%), without LVH and preserved LVEF(61.6±3.6), LVH with preserved LVEF (61.9±3.6). Mean EF (%); without LVH and depressedLVEF (41.1±6.4), LVH with depressed LVEF (42.9±5.4), p=0.663. Mean MAPSE score (mm);without LVH with preserved LVEF (13.2±1.7), LVH with preserved LVEF (10.6±0.9), p<0.001.Mean MAPSE score (mm); without LVH and depressed LVEF (9.17±0.9), LVH with depressedLVEF (7.4±1.5), p=0.002. Mann Whitney U test was applied to compare the MAPSE score ofgroups and it showed statistically significant difference in MAPSE score of patients with andwithout left ventricle hypertrophy with values much lower in the presence of LVH. Conclusion:Statistically significant difference exists in values of MAPSE in patients with and without leftventricle hypertrophy irrespective of LV function.

Background: Myocardial infarction (MI) especially with ST segment elevation MI (STEMI) is a highly morbid and fatal entity and can result in various electrophysiological and mechanical complications during in hospital stay. Objective: To determine the in hospital outcomes of patients with ST segment elevation myocardial infarction, late for thrombolysis. Material and methods: This descriptive cases series was conducted at Rehmatul Lil Alameen Institute of Cardiology, PESSI, Lahore during 01-06-2018 to 31-12-2018. The cases of both genders with age 30 years or more, having ST elevation MI who were late for thrombolysis were included. The patients were looked for various outcomes like cardiogenic shock, left ventricular thrombus, heart block, death or discharge from the hospital. Results: In this study out of 105 cases, 74 (70.5%) males and 31 (29.5%) females. The mean age was 58.40 ± 11.19 years and mean duration of hospital stay was 6.77 ± 3.34 days. LV clot was seen in 7 (6.67%) of the cases, cardiogenic shock in 23 (21.9%) and complete heart block in 4 (3.81%) of the cases. Out of 105 cases, 9 (8.57%) died while rest were discharged. Regarding different types of MI, death was seen in 5 (8.1%) cases in AWMI, 4 (10%) in IWMI and none in LWMI out of their respective groups with p= 0.81. Conclusion: STEMI is a highly morbid entity in cases those are late from thrombolytic and cardiogenic shock is the most common complication observed.