Comparison of carbon ion implanted stent with bare metal stent in patients with coronary artery disease

This study was conducted to evaluate the role of the inert stents in decreasing the incidence of stent restenosis after percutaneous coronary intervention [PCI] and to assess the clinical outcome of these stents. The study comprised 57 patients [49 males and 8 females, mean age 53.3 +/- 0.9 years] with angiographically documented CAD. They were admitted to the Coronary care unit at Benha University Hospital and underwent stent implantation in 57 de novo lesions. Patients were categorized into two groups; group I for whom the traditional bare metal Stainless-steel stents were deployed [30 lesions in 30 pts; 26 M and 4 F with a mean age of 50 yrs], group II for whom Inert stents [carbon [on implanted stents] were deployed [27 lesions in 27 pts; 23 M and 4 F with a mean age of 51 yrs]. Procedural success: was defined as 30% residual stenosis post procedure. Clinical success: was defined as procedural success without the occurrence of MACE [Major Acquired Coronary Events] namely, death, myocardial infarction, or Target vessel revascularization].Clinical follow-up for the occurrence of MACE was performed one and six months after the procedure. Angiographic follow-up was done after six months or after the occurrence of any of the clinical endpoints. Procedural and clinical success were documented in 100% of patients during hospital stay, there was no MACE in both groups. None of patients developed MACE during the 30-days follow-up period. Also, at 6-months follow-up, there was no statistically significant difference between the 2 groups regarding the occurrence of MACE as 4 patients [13.3%] of group I and 3 patients [11.1%] of group II developed MACE. Re-stenosis rate showed also statistically insignificant difference between the 2 groups [5 patients [16.7%] in; group I and 5 [18.5%] patients in group II, [P= > 0.05]. The implantation of Inert stent is safe and feasible, with a high acute procedural success. These stents proved also favorable short term results regarding the thrombotic complication. Inert stent did not add any beneficial effect to the bare metal uncoated stainless-steel stents regarding 6-months in-stent restenosis

Impact of doppler tissue imaging in the assessment of regional wall motion abnormalities in patients with old myocardial infarction

Doppler Tissue Imaging [DTI] is an emerging non-invasive ultrasound technique, which allows measuring velocities at any point of the ventricular wall during the cardiac cycle.To evaluate the clinical feasibility of DTI as a new method for detection and quantification of regional Wall Motion Abnormalities [WMA] in patients with old Myocardial Infarction [MI].Fourty patients with old MI who had angiographically-documented significant stenotic lesion in the infarct-related artery and WMA in the infarcted area were evaluated in addition to twenty healthy subjects[control group].Regional wall motion of each of the anterior and inferior wall segments of the left ventricle was assessed by conventional 2-D echocardiography and pulsed wave DTI. The later includes the measurement of Peak Myocardial Velocity [PMV] and Myocardial Velocity Gradient [MVG].The peak MV and MVG in the studied myocardial segments of control subjects ranged between 4 to 15 cm/s and 1 to 3.85 cms.[-l] respectively. In patients group, Myocardial segments supplied by diseased coronary vessel in the infarcted area were found to have highly significant reduction of both MV and MVG compared to the same segments in control subjects [p<0.001]. The sensitivity for detection of WMA was markedly improved by DTI studies [92.5% for MV and 100% for MVG versus 52.5% for 2-D echo] with retaining the high specificity inherited by conventional echocardiography .Compared to conventional 2-D echo, pulsed wave DTI is an accurate, highly sensitive non-invasive method to detect and quantify regional WMA induced by coronary artery disease. It is almost as accurate as contrast ventriculography in this regard, so it may be the best imaging technique for detection of WMA at rest and with different cardiovascular stresses

Correlation between plasma angiotensin II and coronary angiographic findings in patients with essential hypertension

The aim of this work,was to evaluate plasma Ang II level in essential hypertensive patients and to verify its relation to the presence and severity of coronary artery disease. Fifty eight patients with essential hypertension and ischaemic chest pain [group A] together with twelve healthy normotensive volunteers [group B] were included in this study.Thorough clinical examination, resting ECG, plain chest X ray, routine laboratory investigations, angiotensin II [Ang II] serum level and echo-Doppler were done for all individuals. Coronary angiography was done fore the group A patients only. The statistical analysis of the results pointed out, a sign higher level of Ang II in group A [38.3 +/- 2 pmol/L] than in group B [24.9 +/- 9 pmol/L] and that its level in group A patients were positively correlated sign to left ventricular mass index and left ventricular wall motion score index but negatively to E/A ratio. Ang II level was significantly higher in hypertensive patients with coronary artery disease [group AII] [59.1 +/- 2 pmol/L] than those with normal coronaries [groupAI] [31.9 +/- 1 pmol/L]. Group All patients with three vessels disease had a sign higher Ang II level than those with two or one vessel coronary artery disease. Ang II level was sign higher in group All patients with LAD coronary artery lesion than those without. Concluston:Patients with essential hypertension had a significantly higher Ang II level than normotensives. Ang II Level was positively correlated significantly to the presence, number and severity of coronary artery lesion in hypertensive patients. Patients with LAD lesion sign had a higher Ang II level than those without