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Current Trends in Cardiology | Volume: 03
10th WORLD HEART CONGRESS
&
6 th International Congress on
CARDIOLOGY AND CARDIAC SURGERY
December 02-03, Dubai, UAE
Joint event on
Curr Trend Cardiol, Volume: 03
Syntax score as a predictor of no reflow in patients presented with STEMI treated by
primary PCI
Ibrahim Mahmoud Mohamed
Cairo University Hospital, Egypt
Objectives: The SYNTAX score (SXscore) has emerged as
a reproducible angiographic tool to quantify the extent
of coronary artery disease based on the location and
complex-ity of each lesion. The aim of this study was to
evaluate whether the SXscore is an independent predictor
of no-reflow phenomenom and long-term cardiovascular
outcomes in patients presented with acute ST-segment
elevation myocardial infarction (STEMI) treated with
primary percutaneous coronary intervention (pPCI).
Methods : A total of 760 patients with acute STEMI
who were subjected to pPCI. Patients were categorized
according to their TIMI flow grade into: normal flow (TIMI
3) 657 patients (86.4%) and noreflow (TIMI 0,1,2) 103
patients (13.6%) and according to Syntax scores into: mild
(0-22) ➔ 292 patients who constituted 38.4% of the study
group, moderate (23-32) ➔ 338 patients who constituted
44.5% of the study group, severe (>32) ➔ 130 patients who
constituted 17.1% of the study group.
Results: There were significant differences among the
normal flow and noreflow groups with respect to age, basal
glucose levels, and the incidences of diabetes mellitus,
Killip class, onset of presentation, TIMI risk score and
previous use of statins. There were increasing rates of
culprit left anterior descending lesion (P < .001). No-reflow
phenomenon was correlated to SYNTAX score, (r value .682,
P value <.001). At longterm follow-up, all-cause mortality,
non-fatal myocardial infarction, stroke, rehospitalization
due to heart failure, and the need of revascularization
were significantly more frequent among the patients in
the noreflow group and highest SXscore. In multi-variate
analysis, after including the SXscore as a numerical variable
into the model, every point of increase was determined as
an independent predictor for long-term mortality (hazard
ratio [HR] 1.8, 95% confidence interval [CI] 1.139-2.95, P
.013) and for overall major adverse cardiac events (MACEs;
HR 1.44, 95% CI 1.33-1.56, P < .001).
Conclusion: The SXscore is an independent predictor
of noreflow and MACE in patients with acute STEMI
undergoing pPCI.
Biography
Ibrahim Mahmoud Mohamed is recently working at Critical Care
Department, Cairo University Hospital, Egypt. He completed his Bachelor
of Medicine & Surgery (MBBCh), (Excellent with Honors) from Cairo
University 2007 Cairo, Egypt. After that he completed his master’s degree
and M.D. Degree in Critical Care Medicine from Cairo University 2016
Cairo, Egypt. Recently working in Critical care department, Cairo University.
Provided clinical care to patients at the Critical Care Centre (52 beds),
including on-call commitment. Weekly follow-up clinic for critical care
patients post-discharge. Weekly educational meetings included: Joint
Critical Care and Cardiothoracic Surgery Conference; Critical Care Journal
Club. Comprehensive Critical Care Training Program. Covered Emergency
Department on-call team for physiologically unstable patients. It consists
of a 3-year program; residents acquire clinical, procedural, and decision-
making skills from senior residents and staff members through attending
daily clinical rounds and CME program. Every year he is evaluated by
a written, oral, and clinical exam. By the end of the program, resident
becomes responsible of the admission and management of patients,
conducting evening clinical rounds, supervision and education of junior
staff, and directly involved in scientific and clinical activities. Previously he
worked in Elsalam International Hospital in medical and surgical ICU for
3 years from 2012 to 2015. Observership for one-month duration from
01/09/2014 to 30/10/2014 in Royal Free Hospital in London. UK. Saudi
German Hospital in Cairo for 2 years from 2015 to 2017 and still working
there as senior registrar.
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