الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Ischemic heart disease (IHD) is the most common form of heart disease and the single most important cause of premature death worldwide.
Primary PCI is the preferred reperfusion strategy in patients with STEMI within 12 hours of symptom onset, provided it can be performed expeditiously
Contrast-induced nephropathy (CIN) is one of the important complications occurring after primary percutaneous coronary intervention (PCI) and associated with increased mortality and morbidity.Therefore, early identification and intervention for patients with ACS who are at a high risk of CIN is very important to allow protective measures and improve clinical outcomes.
Vasoconstriction, oxidative stress, free radical damage, endothelial dysfunction and inflammation have been proposed as pathophysiological mechanisms of CIN.
Many risk factors for the development of CIN have been demonstrated such as chronic kidney disease (CKD), diabetes mellitus (DM), reduced left ventricular systolic function, nephrotoxic drugs and age over 70 years.
Many risk score models have been developed for the prediction of CIN. However, such models generally use variables that are not known at admission. There is a need for additional objective measures to improve early identification of patients at risk of CIN.
Monocyte to HDL-cholesterol ratio (MHR) is a novel laboratory parameter which is correlated with inflammation and has a prognostic value in patients with renal and cardiovascular diseases.
So this study was conducted to explore correlation between monocyte to HDL ratio and CIN after primary PCI in patients presented with STEMI.
Eighty patients with acute STEMI were included. Patients were differentiated into two groups according to development of contrast induced nephropathy; group (A) Patients who developed contrast induced nephropathy and group (B) Patients did not develop contrast induced nephropathy. CIN was defined as either a 25% increase in serum creatinine from baseline or 0.5 mg/dL increase in absolute value, within 48-72 h of intravenous administration of contrast medium.
Sixteen patients developed CIN (20%). MHR was significantly higher in CIN (+) group [0.0202 (0.009-0.0633) 108/mg] than nonCIN group [0.0129 (0.0031-0.0307) 108/mg] with P-value = 0.003. MHR was also significantly correlated with creatinine levels 48 hours after PCI (rs:0.322, p:0.004). ROC statistical analysis showed that MHR > 0.0131 was the best cutoff values for predicting contrast induced nephropathy with sensitivity 76 % & specificity 71.2 %.
Our study also demonstrated that age, Monocytes count, amount of contrast & Mehran risk score were significantly higher in CIN group
Also, Diabetic and hypertensive patients were significantly more in CIN group.
However, HDL level, hemoglobin level, EF, systolic and diastolic Blood Pressure were significantly lower in CIN group.