RESUMO
To explore the prognostic value of baseline estimated glomerular filtration rate [eGFR] in Saudi patients presenting with ST elevation myocardial infarction [STEMI], and its impact on hospital therapies. The STEMI patients with a baseline serum Creatinine enrolled in the SPACE [Saudi Project for Assessment of Coronary Events] registry were analyzed. This study was performed in several regions in Saudi Arabia between December 2005 to December 2007. Based on eGFR levels, patients were classified into: more than 90.1 ml/min [normal renal function], 90-60.1 [borderline/mildly impaired renal function], 60-30 [moderate renal dysfunction], and less than 30 ml/ min/1.73 m[2] [severe renal dysfunction]. Two thousand and fifty eight patients qualified for this study. Of these, 1058 patients had renal dysfunction. Patients with renal dysfunction were older, and had a higher prevalence of risk factors for atherosclerosis. Patients with moderate or severe renal dysfunction were less likely to be treated with beta blockers, angiotensin converting enzymes inhibitors, statins, or reperfusion therapies. Significantly worse outcomes were seen with lower eGFR in a stepwise fashion. The adjusted odds ratio of in-hospital death in patients with eGFR less than 30ml/min was 5.3 [95% CI, 1.15-25.51,p=0.0383]. A low baseline eGFR in STEMI patients is an independent predictor of all major adverse cardiovascular outcomes, and a marker for less aggressive in-hospital therapy
RESUMO
Sarcoidosis is prevalent worldwide with significant heterogeneity across different ethnic groups. We aimed to describe the clinical characteristics and computed tomography findings among Arab patients with pulmonary sarcoidosis. A retrospective study of patient demographics, symptoms, co-morbid illness, sarcoidosis stage, treatment, pulmonary function and CT results. Of 104 patients, most [77%] were 40 years of age or older at diagnosis, and females in this category [>/= 40 years] significantly outnumbered male patients [69/104 [66.3%] vs. 35/104 [33.7%], P=.003]. The most common complaints were dyspnea [76%], cough [72.1%] and weight loss [32.7%]. The majority of patients displayed impairment in lung function parameters at presentation. However, significant impairment in forced vital capacity, percentage predicted [FVC%] [<50%] was present in only 17% of patients. The most frequent CT finding was mediastinal lymph node enlargement in 49 patients [73.1%]. Parenchymal abnormalities indicating lung fibrosis were noted in 31 patients [46.3%], and traction bronchiectasis was the most common [35.8%] fibrotic pattern detected on CT scans. At presentation, clinical manifestations of sarcoidosis among this sample of Arab patients were similar to reports from other nations. Further studies are needed to explore the effects of race and ethnicity on disease severity in the Middle East