الفهرس 
ST Segment elevation myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
ST-elevation acute myocardial infarction (STEMI) is a clinical syndrome defined as symptoms of myocardial ischemia in association with persistent electrocardiographic ST elevation and subsequent release by characteristic ease of biomarkers of myocardial necrosis.
Notably, STEMI comprised 25-40% of myocardial infarction presentations. Recently, early reperfusion by mechanical or pharmacological means and adjunctive antithrombotic treatment has been proven to report lower mortality. Therefore, several generations of international and national guidelines have been presented to support that the standard treatment for patients with STEMI is primary percutaneous coronary intervention (PCI).
Notably, primary PCI in patients with STEMI can limit the infarct size and preserves left ventricular (LV) systolic function. However, a problem with this approach is that not all patients with STEMI reported improvement or maintenance of heart function following PCI.
As congestive heart failure (CHF) after PCI in STEMI is known as a major cause of morbidity and mortality, which may lead to hospitalization and consumption of heart-care resources.
The aim of this work is to investigate to the predictors of left ventricular dysfunction after percutaneous coronary intervention for anterior myocardial infarction (AMI) using different parameters:
1. Biomarkers (Troponin, CK-MB)
2. Echocardiography
3. Tissue Doppler imaging (TDI).The present study included 50 patients admitted at Tanta University hospital, department of Cardiology presented with acute anterior myocardial infarction and treated with primary PCI,these patients followed up for 3 months to predict the left ventricular function with Echocardiography.Transthoracic echocardiography was performed at Baseline before PCI, and repeated 24 h and 3-6 months after PCI.
The main results of the study revealed that:
There was 26 patients were hypertensive with percentage of 52%, 25 patients were diabetic with percentage of 50%, 26 patients were smokers with percentage of 52%.
Cardiac examination was unremarkable in all patients. Regarding vital signs, systolic blood pressure ranged from 90-180 mmHg with mean of 130.98 mmHg, diastolic blood pressure ranged from 60-110 mmHg with mean of 83.14 mmHg. The pulse ranged from 82 – 140 bpm with mean of 104.43 bpm.
Regarding to urea level it range from 20-87mg/dl with mean 41.82 ±15.73mg/dl. Regarding to creatinine level 0.9-2.5mg/dl with mean 1.29±0.36mg/dl. Regarding to hemoglobin level it range from 10-15g/dl with mean 11.82±1.5. Regarding to total leukocyte count (TLC) it range from 8-19 with mean 10.98±2.64. Regarding to platelet it range from 134-350 with mean of 214.72±49.74. Regarding to random blood sugar it range from 80-400g/dl with mean 197.28±100.54g/dl. Regarding to cardiac enzymes (troponin and CKMP) all patients was positive.
Regarding to ECG all patients diagnosed as anterior myocardial infarction with some patients add another wall as inferior, right or lateral infarction as following. Patients who had ST elevation V1-V6 (anterior myocardial infarction) were 40 patients with percentage 80%, patients who had anterior MI plus lateral MI were 14 patients with percentage 28%, the patients who had anterior MI plus inferior MI were 3 patients with percentage 6%, patients who were right bundle branch block 8 patients with percentage 16% and patients who were left bundle branch block 2 patients with percentage 4%.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.