الفهرس 
Non ST segment elevated myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
Despite impressive advances in diagnosis and management over the last decades, ACS continues to be a major public health problem in the industrialized world and is becoming an increasingly important problem in developing countries.
This study was conducted at Benha University Hospital and was done as a part of Euro heart snapshot registry of acute coronary syndromes which is a large survey of acute coronary syndromes in Europe and the Mediterranean basin.
The current study included 100 patients with acute myocardial infarction from attendants of coronary care unit. They were enrolled in non randomized manner; patients with myocardial infarction as a complication of procedures like PCI or CABG (e.g. side branch occlusion) were excluded from the study.
The patients were observed for initial presentation and management; in-hospital outcome and complications.
The present study included 100 patients of whom; there were 80 males (80%) and 20 females (20%).
There were 74 patients (74%) with STEMI and 26 patients (26%) with NSTEMI.
The ages of the patients ranged from 33 to 82 years, with mean age(57.59±10)years of whom 56patients were younger than 60 years (56%) and 44 patients were older than 60 years(44%).
Regarding mortality, nine patients died during hospital course. Seven patients were diagnosed STEMI (9.5%) and two patients were diagnosed NSTEMI (7.7%).
There were three statistically significant factors associated with increased mortality which were age > 60 years, heart failure and major bleeding.
Mortality was higher among patients more than 60 years old (15.9%) as compared with those patients under 60 years (3.6%), p value <0.05.
Mortality was also higher among patients with heart failure (32.1%) versus (0.0%) who had not heart failure. It was also higher in patients who were complicated by major bleeding (100%) versus (0.0%) who had not major bleeding, p value <0.05.
28 patients (28%) developed heart failure during and shortly after their first presentation.
Two statistically significant factors were associated with increased incidence of heart failure prior history of CAD and impaired LVEF. 44.4% in patients with prior history of CAD versus 21.9% for those with no prior history of CAD (P value <0.05) and 41.9% had LVEF <50% versus 7.8% had LVEF >50% p value < 0.001.
There was a slight increase in the incidence of heart failure in male patients (28.8%) versus females (25%), those with age > 60 years (29.5%) versus those with age < 60 years (26.8%), diabetic patients (35.6%) versus non diabetic (21.8%), obese patients (36.8%) versus non obese (25.9%), non smokers (32.6%) versus smokers (24.1%), hypertensives (35.1%) versus non hypertensives (23.8%) and dyslipidemics (32.4%) versus non dyslipidemics (25.8%) but all these differences were statistically insignificant (p value >0.05).
Two factors were associated with increased incidence of coronary angiography age and obesity.
Coronary angiography was done in 26.8% in patients younger than 60 years, versus 11.4% for those who were more than 60 years. The difference was statistically significant (P value <0.05).
Also Coronary angiography was done in 47.4% of the obese patients, versus 13.6% for non obese patients (P value <0.001).
Concerning reperfusion in STEMI patients Fifty eight patients (78.4%) received streptokinase, while 16 patients (21.6%) didn’t receive streptokinase in whom 10 patients (13.5%) had late presentation & 6 patients (8.1%) had primary PCI.
While in NSTEMI patients five patients (19.2%) had coronary angiography, while 21 patients (80.8%) didn’t have coronary angiography.
Regarding location of STEMI Seven patients (9.5%) had inferior MI, while 16 patients (21.6%) had inferior & Right MI, 7 patients (9.5%) had inferior& lateral MI.
Thirty patients (40.5%) had anterior MI, while 14 patients (18.9%) had anterior & lateral MI.