Peripheral vascular complications after percutaneous coronary interventions: incidence, profile and predictors

The objectives of this study were to estimate the incidence of peripheral vascular complications and to determine the predictors of these complications after percutaneous coronary interventions. The study included 100 consecutive patients who underwent percutaneous coronary interventions in the period from December 1998 to May 1999; the mean age of these patients was 52.46 +/- 7.76 years and 85% of the patients were males. Duplex scan was done for all patients suspected to have peripheral vascular complications. Age, gender, cardiovascular risk factors, duration and nature of the procedure, sheath size, platelets count, dose of heparin, ACT and aPTT were examined to determine their power to predict peripheral vascular complications. Peripheral vascular complications occurred in ten patients including hematoma formation in three patients [large in one patient, moderate in one patient and small in one patient], pseudoaneurysms in three patients, arterial dissection in three patients and thrombotic occlusion of the external iliac artery in one patient. Three patients underwent surgical repair of these complications. Only thrombocytopenia and aPTT were found to increase the risk of these peripheral vascular complications

Prevalence and coorelates of hypertensive complications in Egyptians

The Egyptian National Hypertension Project is a nation-wide survey conducted in the period 1991-1994. All hypertensive individuals as well as a sex and residence matched group of normotensive individuals were included in the study. The 2313 individuals included were subjected to clinical evaluation, laboratory testing, ECG recording and echocardiographic study. Left ventricular mass index estimated by echo was used to diagnose left ventricular hypertrophy [LVH]. The diagnosis of heart failure was based upon the clinical findings plus left ventricular systolic and/or diastolic dysfunction. Plasma creatinine more than 1.6 mg/dl was used to diagnose renal failure. LVH was present in 5% and 20% of the normotensive and hypertensive individuals. Age and systolic blood pressure had an important effect on the prevalence of LVH. The prevalence of coronary heart disease was 11.6% in normotensives and 19.5% in hypertensives. Heart failure was present in 5.8% of the normotensives and 13.3% of the hypertensives. Renal failure was present in 5.3% and 1.9% of the hypertensives and normotensives

Major adverse cardiac events in patients undergoing percutaneous transluminal coronary angioplasty: incidence, profile and predictors

The aim of this study was to estimate the incidence of the major adverse cardiac events [MACE] in patients undergoing percutaneous transluminal coronary angioplasty [PTCA] and detect the possible predictors of these events. The study included 11 patients underwent PTCA. Seventy-three patients were presented with unstable angina, 37 patients with stable angina and one patient had post-infarction angina. MACE included death, myocardial infarction and emergency bypass surgery during or within 24 hours of the procedure. A procedural success was achieved in 80.2% of the patients. Failed PTCA occurred in 11.7% of the patients. MACE occurred in nine patients. Three patients died, four developed myocardial infarction and two patients were referred for emergency bypass surgery. MACE occurred in 12.3% of the patients with unstable angina versus 0.0% of those with stable angina. The lesion class was the best predictor of MACE in this study by univariate analysis. Balloon to artery ratio in patients with and without MACE was 1.36 +/- 0.52 and 1.01 +/- 0.18

Left ventricular hypertrophy, remodeling and function in isolated systolic hypertension

This study included 50 patients with isolated systolic hypertension [ISH] [a blood pressure >/160 mmHg systolic and <90 mmHg diastolic] and 30 age and sex matched control subjects. Left ventricular hypertrophy [LVH] was defined as a left ventricular mass index [LVMI], estimated by echocardiography, of more than 110 g/M2 in females and 125 g/M2 in males. Left ventricular [LV] geometry was classified into four categories [normal, concentric remodeling, concentric hypertrophy and eccentric hypertrophy]. Ejection fraction [EF] and percentage of fractional shortening [% FS] were used to assess the systolic function and the A/E ratio was used to assess the diastolic function of the LV. Normal LV geometry, concentric remodeling, concentric hypertrophy and eccentric hypertrophy were present in 20% 16%, 30% and 34% of patients with ISH as well as in 70%, 20%, 0.0% and 10% of the control subjects. There were no statistically significant differences between patients with ISH and the control subjects, respectively. The level of systolic blood pressure did not have a significant effect on LVMI nor on systolic or diastolic functions of the left ventricle