Egyptian Heart Journal最新文献

{"title":"Clinical role of serum Copeptin in acute coronary syndrome","authors":"Manal Abd El Baky Mahmoud ,&nbsp;Menat Allah Ali Shaaban ,&nbsp;Ali Ali Ramzy","doi":"10.1016/j.ehj.2018.04.008","DOIUrl":"10.1016/j.ehj.2018.04.008","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the role of Copeptin in diagnosis of acute myocardial infarction in troponin-blind period.</p></div><div><h3>Subjects and methods</h3><p>This study was conducted on 40 patients who presented to emergency department complaining of chest pain and were highly suspicious to have acute cardiac ischemia, in addition to 10 subjects serving as a healthy control group. Blood samples were collected for determination of CK-MB, cTnI and Copeptin. These were measured twice (in patients’ group); at 3 h and then at 6–9 h from admission time.</p></div><div><h3>Results</h3><p>The first sample revealed a non-significant difference between UA group and AMI group as regards CKMB and troponin, however, high significant difference was found as regards Copeptin (Z = 5.29, P &lt; 0.001). Moreover, ROC curve analysis of serum Copeptin for discriminating AMI group from UA group in the first sample showed diagnostic sensitivity and specificity of 100%.</p></div><div><h3>In conclusion</h3><p>Determination of copeptin in early diagnosis of AMI has diagnostic value being superior to a conventional cTn-I within the first three hours after acute chest pain.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 3","pages":"Pages 155-159"},"PeriodicalIF":1.1,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2018.04.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36465574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of fractional flow reserve on decision-making in daily clinical practice: A single center experience in Egypt","authors":"Amr Elfaramawy ,&nbsp;Mohamed Hassan ,&nbsp;Michael Nagy ,&nbsp;Ahmed ElGuindy ,&nbsp;Mahmoud F. Elmahdy","doi":"10.1016/j.ehj.2017.12.007","DOIUrl":"10.1016/j.ehj.2017.12.007","url":null,"abstract":"<div><h3>Background</h3><p>Fractional flow reserve (FFR) is the reference standard for the assessment of the functional significance of coronary artery stenoses, but remains underutilized. Our aims were to study whether FFR changed the decision for treatment of intermediate coronary lesions and to assess the clinical outcome in the deferred and intervention groups.</p></div><div><h3>Methods</h3><p>In this retrospective study, coronary angiograms of patients with moderately stenotic lesions (40–70%) for which FFR was performed were re-analyzed by three experienced interventional cardiologists (blinded to FFR results) to determine its angiographic significance and whether to defer or perform an intervention.</p></div><div><h3>Results</h3><p>We revised 156 equivocal lesions of 151 patients. The clinical presentation were stable angina (65.6%) and acute coronary syndrome in (34.4%). All reviewers had concordant agreement to do PCI in 59 (37.8%) lesions based on angiographic assessment. Interestingly 23 (39%) of these lesions were functionally non-significant by FFR. The reviewers agreed to defer 97 (62.2%) lesions, however, 32 (33%) of these lesions were functionally significant by FFR and necessitated PCI. MACE were similar in both groups (1.5% vs 2.4%, p = 1.0).</p></div><div><h3>Conclusion</h3><p>Mismatches between visually- and FFR- estimated significance of intermediate coronary stenosis are frequently encountered across a wide spectrum of clinical presentations. FFR leads to a change in decision for coronary intervention. The clinical and cost implications of such changes-in areas with limited resources- needs further evaluation.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 3","pages":"Pages 161-165"},"PeriodicalIF":1.1,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2017.12.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36465575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral leaflet separation index. An easy two dimensional echocardiography technique for assessment of mitral valve area before and after percutaneous balloon mitral valvuloplasty","authors":"Sameh S. Raafat ,&nbsp;Ali A. Ramzy ,&nbsp;Amr F. El-Hadidy ,&nbsp;Mohamed A. Abd Allah ,&nbsp;Hany F. Hanna","doi":"10.1016/j.ehj.2018.04.006","DOIUrl":"10.1016/j.ehj.2018.04.006","url":null,"abstract":"<div><h3>Aim</h3><p>To evaluate the reliability of the mitral leaflet separation (MLS) index against the traditional echocardiographic methods in measuring mitral valve area (MVA) pre and post percutaneous balloon mitral valvuloplasty (PBMV).</p></div><div><h3>Methods</h3><p>Ninety patients suffering symptomatic moderate to severe MS underwent PBMV at Ain Shams University Hospital in cardiology department. Seventy of the patients were females representing 77.8% and 20 were males representing 22.2%. Their age ranged from 22 to 56 years. All patients were subjected to full transthoracic echocardiography (TTE) examination pre and post PBMV. MLS index was introduced as a comparative parameter with traditional echocardiographic methods for assessment of MVA, measuring average of distance between tips of MV leaflets in parasternal long axis and four chamber two dimensional echocardiographic views.</p></div><div><h3>Results</h3><p>MVA increased <strong>from 0.95 ± 0.28 to 2.21 ± 0.41 cm² (P=0.001)</strong> using 2D planimetry; and increased <strong>from 0.93 ± 0.23 to 2.21 ± 0.46 cm² (P= 0.0011)</strong> by pressure half time method (PHT). MLS index was correlated with MVA by 2D planimetry pre and post PBMV (r=0.453) and (r=0.668) respectively (p=0.0001) and strongly correlated with MVA using PHT post PBMV (r=0.768) (p=0.0001). Post PBMV 14 patients suffered significant mitral regurgitation 3 of them were transferred to surgery. MLS index above 11.75 mm and below 9.15 mm had excellent positive predictive value for detecting mild and severe MS respectively.</p></div><div><h3>Conclusion</h3><p>The MLS index it is a simple and effective method for assessment of the MVA, it has an excellent correlation with MVA with an excellent sensitivity and specificity for the prediction of effective MVA. The MLS index cannot evaluate outcome of PBMV because it is an anatomical parameter and not flow dependent thus does not correlate with grades of mitral regurgitation.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 3","pages":"Pages 195-201"},"PeriodicalIF":1.1,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2018.04.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36465580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waist height ratio and waist circumference in relation to hypertension, Framingham risk score in hospitalized elderly Egyptians","authors":"Heba M. Tawfik","doi":"10.1016/j.ehj.2017.12.008","DOIUrl":"10.1016/j.ehj.2017.12.008","url":null,"abstract":"<div><h3>Background</h3><p>Hypertension is a public health problem and obesity is becoming an epidemic, increasing the risk of hypertension. Both are risk factors for cardiovascular diseases (CVD).</p></div><div><h3>Methods</h3><p>A case control study recruiting 102 patients aged ≥60 years, divided into 55 cases with hypertension and 47 controls without. Body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR) were measured as well as lipid profile then Framingham risk score (FRS) was calculated.</p></div><div><h3>Results</h3><p>Odds ratio (OR) for hypertension and medium to high risk cardiovascular events was the same in female patients using WC and WHtR. In male patients, only WHtR increased the risk for hypertension and for cardiovascular events, OR significantly increased with higher WHtR compared to WC.</p></div><div><h3>Conclusion</h3><p>WHtR and WC are strong risk factors for hypertension and cardiovascular events in Egyptian elderly female patients. WHtR is the best anthropometric predictor for hypertension and cardiovascular events in male patients.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 3","pages":"Pages 213-216"},"PeriodicalIF":1.1,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2017.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36469730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter intervention for abnormal pulmonary venous drainage","authors":"Sedigheh Saedi,&nbsp;Tahereh Saedi","doi":"10.1016/j.ehj.2018.01.003","DOIUrl":"10.1016/j.ehj.2018.01.003","url":null,"abstract":"<div><p>Transcatheter interventions for congenital heart anomalies are constantly improving. Although correction of anomalous pulmonary venous connection is routinely achieved through surgery, there are rare instances where the abnormal pulmonary vein has dual connections to both left atrium and the major systemic veins. Under these circumstances catheter based treatment might become a feasible option. We report a case of dual supply vertical vein connected to left upper pulmonary vein and innominate vein which was successfully obstructed by an occluder device leading to improvements in patient’s condition.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 2","pages":"Pages 125-127"},"PeriodicalIF":1.1,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2018.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and characteristics of tricuspid valve endocarditis among patients presented to Ain Shams Hospital echocardiography lab; one year study","authors":"Haitham Galal,&nbsp;Osama Rifaei,&nbsp;Mohammed Abdel Rahman,&nbsp;Hussein El-Sayed","doi":"10.1016/j.ehj.2017.12.009","DOIUrl":"10.1016/j.ehj.2017.12.009","url":null,"abstract":"<div><h3>Background</h3><p>Isolated Tricuspid valve infective endocarditis is an infrequent diagnosis, the incidence of Tricuspid valve infective endocarditis accounts for 5% and up to 15% of IE cases.</p></div><div><h3>Aim</h3><p>To assess the prevalence and the echocardiographic characteristics of tricuspid valve endocarditis among patients presented to the echo lab of Ain Shams hospital from 1-1-2016 to 1-1-2017.</p></div><div><h3>Methods</h3><p>This is a retrospective study which included all patients presented to the echo lab of Ain Shams university hospital from 1st January 2016 to 1st January 2017, the total number of patients were 8376, patients with infective endocarditis were 278, and patients with tricuspid valve endocarditis were 51 patients respectively. Complete transthoracic echocardiography was done for all patients and data was retrieved from a locally designed electronic database of cardiology department at Ain shams hospitals.</p></div><div><h3>Results</h3><p>The incidence of TVIE was (17.7%) of all cases of IE, and (0.67%) of all cases attending the echo lab during the study period. The mean age group in our study was (31.1 ± 7.8) and about 84.3% of patient’s age was between 20 and 40 years. Higher incidence of IE was in males (90.2%) than in females (9.8%) with a ratio of 9:1. The vegetations were detected in one leaflet in 33 patients (64.7%), two leaflets in 9 patients (17.6%) and in the three TV leaflets in 7 patients (13.7). The most affected leaflet was the anterior leaflet that was affected in 38 patients constituting about 74.5% of patients. The size of vegetations was large &gt;15 mm in 40 patients (78.4%).</p><p>The most encountered echocardiographic complication was severe TR, detected in 40 patients (78.4%) and abscess formation was the least present, detected in only 2 patients (3.9%).</p></div><div><h3>Conclusion</h3><p>The incidence of TV IE is increasing with male gender predominance, and affects mainly young age groups. TV IE represented 0.6% of all patients, and 17.7% of IE cases. The main echocardiographic feature of TV IE is vegetations which were characterized by being large, highly mobile, and affecting mainly anterior TV leaflet. The main echocardiographic complication is severe TR, but abscess formation was infrequent.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 2","pages":"Pages 59-63"},"PeriodicalIF":1.1,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2017.12.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of left and right atrial geometrical changes in patients with stable coronary artery disease: Left and right atrial strain and strain rate imaging study","authors":"Lamiaa khedr ,&nbsp;Abdelfatah Elasfar ,&nbsp;Soha Hekal ,&nbsp;Ehab ElGendy ,&nbsp;Mohamed Abdulaal ,&nbsp;Hatem Elsokkary ,&nbsp;Medhat Ashmawy","doi":"10.1016/j.ehj.2018.02.003","DOIUrl":"10.1016/j.ehj.2018.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>In patients with coronary artery disease (CAD), there are several studies that assessed the left ventricular (LV) function by strain (S) and strain rate (SR) imaging. The aim of this study is to evaluate the function of both atria in patients with CAD using strain and strain rate imaging, and to correlate this with the severity of CAD.</p></div><div><h3>Methods</h3><p>We conducted a prospective, single center case control study for 40 consecutive patients who presented to our department with chronic stable angina and were candidates for invasive coronary angiography. We enrolled patients from December 2013 to May 2014 and each patient was subjected to echocardiographic assessment of E/e′ of mitral valve, left atrial volume index (LAVI), right atrial volume index (RAVI), and peak atrial longitudinal strain (es) and strain rate (SR) during LV systole. This was followed by invasive coronary angiography for assessment of the severity of CAD using Gensini score. Patients were classified according to angiographic results into 3 groups: Group I (Gensini score = zero), Group II (Gensini score &gt; 0 and &lt; 20) and Group III (Gensini score ≥ 20).</p></div><div><h3>Results</h3><p>There was no statistically significant difference between the three groups in either LA volumes (V_min, V_max) and distensibility with p value of 0.272, 0.126, and 0.243 respectively or RA volumes and distensibility with a p value of 0.671, 0.183, and 0.259 respectively. On the other hand, LA &amp; RA systolic S and SR were significantly lower among CAD patients in comparison with the group of normal coronaries. Mean LA S and SR was decreased in group III than group II (15.97 ± 3.73, 21.8 ± 6.75 % and 1.11 ± 0.30, 1.81 ± 1.23 s⁻¹) with p value of 0.005&amp;0.041 respectively. RA systolic S and SR were significantly lower in the 2 groups with CAD than the group with normal coronaries with a p value of 0.001 and 0.002 respectively.</p></div><div><h3>Conclusion</h3><p>In patients with CAD and normal EF, borderline E/e′ ratio and normal atrial size, there are decreased LA and RA systolic S and SR parameters with no effect on atrial volumes or distensibility. Accordingly, this could prove that atrial wall deformation occurs early in CAD even before any changes in atrial volumes or dimensions.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 2","pages":"Pages 101-106"},"PeriodicalIF":1.1,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2018.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of elective percutaneous coronary intervention of left anterior descending coronary artery on regional myocardial function using strain imaging","authors":"Gehan Magdy,&nbsp;Mohammed Sadaka,&nbsp;Tarek Elzawawy,&nbsp;Abdallah Elmaghraby","doi":"10.1016/j.ehj.2017.12.003","DOIUrl":"10.1016/j.ehj.2017.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Percutaneous coronary intervention (PCI) is a commonly used procedure for revascularization, however the impairment of regional myocardial function in patients with stable coronary artery disease (CAD) has not been well characterized, our study aimed to assess the improvement of left ventricular (LV) systolic function after elective PCI of the left anterior descending artery (LAD) using strain and strain rate imaging techniques.</p></div><div><h3>Materials and methods</h3><p>The study included 30 patients (aged 56.8 ± 6.6 years, 66.7% males) presented with stable CAD on optimal medical therapy, and recommended for elective PCI to LAD, all patients included in the study had a normal LV wall motions, and normal LV systolic function. Tissue Doppler imaging (TDI) was done before PCI, immediately, and three months post PCI. The peak systolic longitudinal strain (PSLS), and peak systolic strain rate (PSSR) were measured and averaged for the 6 LAD segments (the basal, mid, and apical segments of the anterior wall, the basal, mid anteroseptal, and the apicoseptal segments), 15 healthy control subjects were included as a control group.</p></div><div><h3>Results</h3><p>The average PSLS and PSSR of the ischemic segments were significantly lower in patients compared to control in the ischemic segments, and significantly increased 3 months post PCI but not immediately post PCI. Using the ROC curve a cutoff value of −13.69% for PSLS can detect regional ischemia with a sensitivity 93.3% and a specificity of 80%.</p></div><div><h3>Conclusions</h3><p>TDI derived strain and strain rate can detect resting regional myocardial dysfunction in presence of preserved LV systolic function, and can assess the improvement of regional myocardial function after successful elective PCI in patients with stable CAD.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 2","pages":"Pages 83-88"},"PeriodicalIF":1.1,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2017.12.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short term outcome of thoracic endovascular aortic repair in patients with thoracic aortic diseases","authors":"Hamdy Soliman ,&nbsp;Mohammed N. El-Ganainy ,&nbsp;Reham M. Darweesh ,&nbsp;Sameh Bakhoum ,&nbsp;Mohammed Abdel-Ghany","doi":"10.1016/j.ehj.2018.02.001","DOIUrl":"10.1016/j.ehj.2018.02.001","url":null,"abstract":"<div><h3>Aim and background</h3><p>Open surgical repair for thoracic aortic diseases is associated with a high perioperative mortality and morbidity. Most of type B aortic dissections are uncomplicated and are medically treated which carries a high mortality rate. Thoracic endovascular aortic repair is the first-line therapy for isolated aneurysms of the descending aorta and complicated type B aortic dissection. The aim of this study is to test the safety of early thoracic endovascular aortic repair in patients with uncomplicated type B aortic dissection and patients with thoracic aortic aneurysms.</p></div><div><h3>Methods</h3><p>A total of 30 patients (24 men and 6 females; mean age 59 ± 8 years) with uncomplicated type B aortic dissection and descending thoracic aortic aneurysm who underwent endovascular aortic repair in National Heart Institute and Cairo University hospitals were followed up. Clinical follow-up data was done at one, three and twelve months thereafter. Clinical follow-up events included death, neurological deficits, symptoms of chronic mal-perfusion syndrome and secondary intervention. Multi-slice computed tomography was performed at three and six months after intervention.</p></div><div><h3>Results</h3><p>Of the 30 patients, 24 patients had aortic dissection, and 6 patients had an aortic aneurysm. 7 patients underwent hybrid technique and the rest underwent the basic endovascular technique in whom success rate was 100%. Two patients developed type I endoleak, however both improved after short term follow up. The total mortality rate was 10% throughout the follow-up. Both death and endoleak occurred in subacute and chronic cases, while using TEVAR in acute AD and aneurysm showed no side effects. Early thoracic endovascular aortic repair showed better results and less complications.</p></div><div><h3>Conclusion</h3><p>Along with medical treatment, early thoracic endovascular aortic repair in uncomplicated type B aortic dissections and thoracic aortic aneurysms is associated with better outcome.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 2","pages":"Pages 89-94"},"PeriodicalIF":1.1,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2018.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of elevated glycosylated hemoglobin on hospital outcome and 1 year survival of primary isolated coronary artery bypass grafting patients","authors":"Mona Ramadan ,&nbsp;Ahmed Abdelgawad ,&nbsp;Ahmed Elshemy ,&nbsp;Emad Sarawy ,&nbsp;Aly Emad ,&nbsp;Mahmoud Mazen ,&nbsp;Ahmed Abdel Aziz","doi":"10.1016/j.ehj.2017.09.002","DOIUrl":"10.1016/j.ehj.2017.09.002","url":null,"abstract":"<div><h3>Objective</h3><p>It is unknown whether adequacy of diabetic control, measured by hemoglobin A1c, is a predictor of adverse outcomes after coronary artery bypass grafting.</p></div><div><h3>Methods</h3><p>From December 2013 to November 2015, 80 consecutive patients underwent primary isolated CABG surgery at national heart institute, their data were prospectively collected and they were classified according to their HbA1c level into two groups, Group (A): Forty patients with fair glycemic control (HbA1c below or equal to 7%), Group (B): Forty patients with poor glycemic control (HbA1c above 7%). Hospital morbidity, mortality and one year survival were examined in both groups. Telephone conversation was used to call patients or their relatives to determine the one year survival and it was 100% complete. This study had gained the ethical approval from national heart institute ethical committee.</p></div><div><h3>Results</h3><p>In-hospital mortality for group A was 2.5% (one patient) and 7.5% (3 patients) for group B with no statistical significance. One year mortality was (5.13%) (2 patients for group A) and (8.11%) (3 patients) for group B with no statistical significance. As regard the morbidity there was no statistical significance between the two groups in the incidence of neurological complications whether stroke or coma, atrial fibrillation, postoperative myocardial infarction, low cardiac output syndrome, heart failure, renal failure, need for dialysis, deep sternal wound infection, and readmission. However, group B had lengthy hospital stay, lengthy ventilation hours, more respiratory complications, and more superficial wound infection with a statistical significance when compared to group A, P values were 0.003, 0.003, 0.038, 0.044 respectively.</p></div><div><h3>Conclusions</h3><p>This study showed that HbA1c is a good predictor of in-hospital morbidity. It worth devoting time and effort to decrease HbA1c level below 7% to decrease possible postoperative complications.</p></div>","PeriodicalId":44962,"journal":{"name":"Egyptian Heart Journal","volume":"70 2","pages":"Pages 113-118"},"PeriodicalIF":1.1,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehj.2017.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}