Aspirin and clopidogrel are the mainstay oral antiplatelet regimens, yet a substantial number of major adverse cardiac events (MACE) still occur. Herein, we investigated genetic and nongenetic factors associated with clopidogrel response in Egyptians. In all, 190 Egyptians with acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI), treated with clopidogrel (75 mg/day) for at least a month, were genotyped for CYP2C19 *2, *3, *6, *8, *10, and *17, CES1 G143E and ABCB1*6 and *8. These variants along with nongenetic factors were tested for association with the risk of having MACE in clopidogrel‐treated patients. CYP2C19 loss‐of‐function (LOF) alleles carriers had increased risk of MACE vs. noncarriers (odds ratio 2.52; 95% confidence interval 1.23–5.15, P = 0.011). In a logistic regression, CYP2C19 LOF variants (P = 0.011), age (P = 0.032), and body mass index (BMI, P = 0.039) were significantly associated with the incidence of MACE in patients taking clopidogrel. CYP2C19 genetic variants, age, and BMI are potential predictors associated with variability to clopidogrel response in Egyptians.

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These results highlight that CYP2C19*2, along with diabetes, and use of proton pump inhibitor and statin are important factors jointly associated with variability in clinical response to DAPT following ACS in Egyptians.

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Background: Critically ill patients admitted to ICUs need to be transported according to their condition through hospital departments. Such transport is known as intra-hospital transportation (IHT) and classified as temporary or permanent. A nurse has a great role in this procedure especially in assessment of IHT risk factors, to prevent further complications. Aim: to assess risk factors associated with IHT among critically ill patients. Design: A descriptive exploratory study was utilized. Setting: Intensive care units in Tanta university hospitals. Study subject: A convenience sample of all available nurses (n=60). Tools for data collections: tool I: self-administration questionnaire including: demographic characteristics of nurses, nurses knowledge, nurses awareness, and the nurses risk factor expectations, tool II: nurses practice observational checklist used to assess nurses practice regarding IHT of critically ill patient. Results: The majority of the studied nurses (93.3%) had unsatisfactory level of knowledge about IHT of critically ill patient, 70% had low cognitive awareness about IHT of critically ill patients, the expected risk factors of the studied nurses were related to patients (78.3%), tool & equipment risk factors (64.4%), environmental risk factors (60.7%) and finally medical team risk factors (49.3%). 50% of studied nurses disagreed with the expectation of risk factors associated with IHT of critically ill patient, 75% had incompetent practice before, during, and after IHT of critically ill patients. Conclusion: according to this study patient related risk factor is the main risk factor associated with IHT. This study recommended that: nurses should use standardized systems of care (including checklists, staffing and equipment) when transferring critically ill patients within hospital.