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

Role of statin in decreasing levelof hs crp short term clinicaloutcome in patients withunstable angina and nstemi

Background: Inflammation is a major contribution to pathogenesis of atherosclerosis. CRP considered a marker of inflammation, it has been found that increase CRP associated with increased cardiovascular risk,statin which have been shown to exert a variety of beneficial effects more than its anti-inflammatory effect, its role ,relation with CRP and impaction on cardiovascular system is unclear

Aim: To assess role of statin in decreasing CRP with short term clinical outcome in unstable angina and NSTEMI

Subject and methods: This study included 40 patients referred to the CCU with unstable angina and NSTAMI there were divided into [group I]20 patients received standard therapy + 40mg atorvastatin, [group II] 20patients received standard therapy + 10mg atorvastatin .all patients subjected to: - Full history taking and clinical follow up to 3 months. -ECG - Lab. Evaluation of : S.creatinine - Cardiac enzyme- pp sugar- HS CRP : on admition and after 3 month - Echocardiograms to asses EF, WMSI - coronary angio.to assess, number and severity of lesions done at one month

Results: there was no significant difference as regards age, sex, lipidprofile between the two groups on admition also in coronary angio done at one month. As regarding hs CRP there was significant difference when comparing between admition and 3 month in each group but no significant when comparing between two groups. There was significant in-crease as regards complications in group II. There was significant difference as regarding chol. LDL In group I when comparing with group II. Also in the echo parameters [Ef, WMSI] showed significant improvement in group I than group II after 3 month. Finally there was correlation between HSCRP in all patients and Left main artery disease

Conclusion: In patients with unstable angina and NSTEMI, high dosestatin had better lipid profile, clinical outcome [less complication-better Efand WMSI] and both high dose and low dose statin showed significantlowering of hs-CRP after 3 months, and they had the same anti inflamma-tory effect, only there was a correlation between HS-CRP in all patientsand lesion in left main coronary artery

Predictive value of c-reactive protein for coronary in stent restenosis

C-Reactive protein [CRP] should be measured in all patients undergoing coronary angioplasty for prognostic stratification. Preprocedural levels are of proved efficacy. CRP levels can be used as a guide to therapy in PCI. The aim of this study is to evaluate the predictive value of CRP plasma leve1 for coronary instent restenosis [ISR]. This study included 60 patients who underwent successful coronary stenting. All patients included in. this study were subjected to the following. Full history taking, thorough clinical examination, risk factors evaluation, 12 leads surface ECG, plain chest x-ray echocardiography, coronary angiography and laboratory investigations [Blood sugar level lipid profile and CRP] with follow up period for six month. Patients were classified into two groups according to ISR. Group [I] with ISR included 22 patients [43.1%] and 22 lesions treated with 25 stents [45%]. Group [II] without ISR included 29 patients [59.9%] with 29 lesions treated with 30 stents [55%]. At follow up, focal ISR [<10 mm] was detected in 5 patients [22.7%]. diffuse [>10 mm] in 7 patients [31.8%], proliferative ISR in 5 patients t22. 7%] and total occlusion in 5 patients [22.7%]. In restenotic group [I] 8 patients [36.4%] were asymptomatic, two p [9.1%] had unstable angina and 12 patients [54.5%] had stable angina. In the non restenotic group [II] 22 patients [75.9%] were asymptomatic four patients [138%] had unstable angina and three patients [102%] had stable angina. Clinical, lesional and procedural variables are not associated with in creased risk of ISR. The only variable for exclusion of ISR was a normal level of CRE in plasma [72 hours after coronary stenting]. Its specificity was [100%]

study of homocysteine level in patients with coronary artery disease

Thirty five patients were selected for this study. Twenty of them were suffering from occlusion of less than two coronary arteries as proven by coronary angiography. The remaining fifteen patients were having two or more affected coronary arteries. Fifteen control healthy persons were included in the study. All the subjects were not risky, i.e. non smoker, not diabetic, not hypertensive and with negative family history of coronry artery disease [CAD]. All subjects were investigated for plasma homocysteine and folic acid levels, also serum blood glucose, creatinine, triglycerides, total cholesterol, HDL-C and LDL-C were done. The results showed that total plasma homocysteine [Hcy] was statistically significantly higher in the patients group than in control. A non significant lower level of plasma folate in patients than control was found with negative correlation between the level of Hcy and folate. Also no significant correlation was found between the level of Hcy and the levels of F.B.S., Triglycerides, total cholesterol, HDL-c, LDL-c or serum creatinine. Results in patients group having less than 2 affected coronary arteries [group A] and patients group having 2 or more affected vessels [group B] showed that; total plasma Hcy level was non-significantly higher in group [B] than in group [A], and plasma folic acid level was non significantly lower in group B than in group A

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

Evaluation of some trace elements in patients with acute myocardial infarction

To evaluate the role of sonic trace elements in acute myocardial infarction [AMI] we studied 60 patients with AMI within the first 24 hours and 20 well matched healthy volunteers. AU were subjected to though history taking, clinical examination, plain chest x-ray, resting ECG, Echo-Doppler and laboratoy analysis .The laboratoy tests included the serum 'level of iron, copper, zinc, selenium, magnesium, eythrocytic glutathion peroxidase[EGP], cholesterol, LDL-C, HDL-C, triglycerides and risk ratio. The patients were followed up during their hospital course for development of complications. The study pointed out a statistically significant increases in serum levels of Iron and copper while statistically significant decreases in serum levels of zinc, magnesium, selenium and EGP in AMI-patients when compared to the control group. The AMI-patients showed a significant positive correlation between the level of serum copper and that of cholesterol, triglycerides, LDL-C and risk ratio, while there was a significant negative correlation to HDL-C. Also, a significant positive correlation between the serum level of zinc and that of cholesterol, LDL-C and risk ratio. However, there was no significant difference between the serum levels of the trace elements and the development of in-hospital complications. the increased serum levels of iron and copper while the decreased that of selenium and zinc play a role in the occurrence of IHD, but has no role in the development of in-hospital complications

Prevalence and determinants of late potentials in patients with unstable angina

To study the factors determining the positivety of late potentials and its prevalence in unstable angina, fifty unstable angina patients together with a sex and age matched twenty stable angina patients serving as control were included in this study. All were subjected to careful history taking and clinical examination, laboratory blood analysis; twelve leads resting surface ECG; echo-Doppler study; 24-hours Holterniortitoring and signal averaged ECG [SAECG] namely filtered QRS complex duration, root of the mean square of signal amplitude in the last 40 msec of the filtered QRS and the duration of terminal filtered low signal amplitude [LAS] with frequency amplitude<40 uv. Echo-Doppler; Holter monitoring and SAECG were repeated two weeks later for the unstable angina patients. Exercise treadmill was done to confirm the diagnosis of stable angina patients. In the present study the incidence of positive LPs was 24% on admission and was significantly reduced to 14% after 2 weeks of medical therapy in unstable angina patients. However, non of the stable angina patients had positive LPs. All the parameters of SAECG were significantly higher in the unstable angina patients. Sex and age had no effect on the incidence of LPs, inferior ischemia had significantly higher positive LPs than anterior ischemia [55% vs 33%/. Holter-reported ischaemic episodes and echo-reported regional wall motion abnormalities were significantly positively correlated with positive LPs. The presence of left ventricular systolic and diastolic dysfunction significantly increase the incidence of positive LPs and their improvement significantly reduce the incidence of positive LPs Positive LPs was recorded in 24% of patients with unstable angina Left ventricular systolic and diastolic dysfunction and the frequency of ischaemic episodes showed significant positive correlation with the incidence of positive LPs Medical therapy significantly reduced the incidence of positive LPs

Chlamydia pneumoniae infection as a risk factor for coronary heart disease

Eighty male patients were selected for this study. Forty of them were diagnosed as having coronary artery disease [CAD] as documented by coronary angiography the remaining 40 patients were confirmed to have acute myocardial infarction. Twenty control healthy persons were included in the study. All sujects were studied by history, clinical examination and investigated for blood sugar, liver and renal function, lipid profile, plasma fibrinogen and chlamydia pneumoniae IgM and IgG. The results showed that C. pneumoniae IgG was statistically significantly higher in patients than control. On the other h and the distribution of IgM in studied cases was 10% in infarction cases and 2.5% in angina cases which are all non significant. As regard patients with other risk factors for coronary heart disease [CHD] in this study as diabetes mellitus, hypertension or high blood lipids, we found that there is no correlation with IgG sero positivity to C. pneumoniae in either angina or infarction groups

Effect of hypertension on pulmonary function

Thirty hypertensives and ten normal control subjects were included in the study, all had a normal left ventricular systolic function, no clinical or radiological pulmonary disease, fifteen hypertensives had diastolic dysfunction. Echo-Doppler and ventilatory pulmonary function studies were done for all. There was a significant inverse relation between E/A ratio and both the age and level of BP in hypertensive, but a significant direct relation with EF. Hypertensives with normal diastolic function showed a significant decrease in F.E.V[1] and M.V.V. and a significant increase in F.E.V[1]/F.V.C. but still within the normal range. Hypertensives with diastolic dysfunction had a combined obstructive-restrictive ventilatory dysfunction as represented by a significant decrease in V. C, F.V. C, F.E.F and M.V.V. less than normal range. However the effect of hypertension on small airways was insignificant B.P = Blood Pressure E.F = Ejection Fraction F.E.V[1] = Forced Expiratory Volume at the first second M.V.V = Maximal Volantary Ventilation F.V.C. = Forced Vital Capacity. V.C. = Vital Capacity. P.E.F. = Peak Expiratory Flow