<b><i>Background:</i></b> Coronary artery disease remains the greatest cause of morbidity and mortality worldwide despite the growing access to percutaneous coronary intervention (PCI). Data regarding the factors predicting the development of major adverse cardiac events (MACE) in patients undergoing PCI are, however, lacking in the gulf region. In this study, we analyze demographics and risk profile of all patients undergoing PCI in a tertiary cardiovascular center located in Dubai – UAE. In our study, we aimed to analyze the risk profile of all patients undergoing PCI and determine the independent predictors of MACE. <b><i>Methods:</i></b> Data were collected prospectively on all patients who underwent PCI in our hospital between September 2017 and September 2018. Patients aged 18 years and above were included in the study and there were no exclusion criteria. The definition of MACE was a composite of death, in-hospital recurrent myocardial infarction (MI), in-hospital target vessel revascularization (TVR), and stroke. The patients’ characteristics, risk factor, and demographics were analyzed to identify the predictors of MACE using logistic regression model which is presented in odds ratio. <b><i>Results:</i></b> Data were available for 789 patients. Of these, 741 (94%) were male. The mean age was 52 ± 11 years. Twenty-two (3%) patients died, 7 (1%) had an in-hospital recurrent MI, 6 (1%) had in-hospital TVR, and 1 (0.1%) had a stroke. Of the patients who died, 16 (73%) patients presented with cardiogenic shock. Major adverse cardiovascular events occurred in 29 (3.7%) patients. In the multivariable regression model, only cardiogenic shock (odds ratio [OR] = 32.43) and the presence of diabetes mellitus (OR = 3.36) were predictors of MACE. <b><i>Conclusion:</i></b> Our study showed that cardiogenic shock and diabetes mellitus are the independent predictors of MACE in patients undergoing PCI.
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic due to ‘coronavirus disease 2019’ (COVID-19) that has led to millions of deaths. This may have resulted in a change in the rate of admissions for other potentially life-threatening conditions such as acute coronary syndromes (ACS). Therefore, we investigated the incidence of ACS admissions during the current pandemic and compared it to a similar period the year before. Methods: This was a retrospective analysis of all patients admitted to a tertiary cardiology centre with ACS between February 2019 and the end of April 2019 (pre-COVID) that was compared with admissions between the same three months in 2020 (post-COVID). The main outcomes of interest were to evaluate any potential reduction of ACS admissions during the pandemic or change in mortality. In addition, we evaluated the rate of patients proceeding to coronary angiography (CAG). Results: During the post-COVID period, only 200 patients were admitted with ACS as compared to 331 patients during the pre-COVID period (39.6% reduction; 95% confidence interval (CI): 34% - 44%; p<0.01). A reduction in the percentage of patients proceeding to CAG was also noted (253 patients during the pre-COVID period compared to only 134 patients in the post-COVID period (76.4% vs 67.0%; p = 0.02)) but no associated reduction of primary percutaneous coronary intervention was noted. No increase in in-hospital mortality was noted between the pre-COVID and post-COVID groups (1.5% vs 1% respectively; p = 0.62). Conclusion: There was a significant reduction in admissions for ACS in the post-COVID period compared to a similar period prior. There was also a reduction in the overall invasive management of ACS, with less CAG performed but no associated reduction in the rate of PPCI. The in-hospital mortality rate was similar in the two groups.
We describe a case of 52-year-old female who presented with heart failure, uncontrolled hypertension and worsening renal function with progression of heart failure on starting an Angiotensin Converting Enzyme Inhibitor (ACE-I). Magnetic Resonance Angiography (MRA) revealed significant stenosis of the right renal artery. Her symptoms and blood pressure improved after renal artery stenting.
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