Abbreviations and AcronymsECG = electrocardiography or electrocardiogram QRS-c = QRS complex QTc = QT interval corrected for heart rate QTD = QT dispersion ABSTRACT INTRODUCTION: Patients with end-stage renal disease who are on long-term dialysis support have a very high mortality. Nearly half of deaths on dialysis are secondary to myocardial infarction, cardiac arrest, malignant arrhythmias, and other cardiac causes. The purpose of the present study was to compare electrocardiogram (ECG) disturbances before and after hemodialysis. METHODS:The participants were 144 patients on dialysis who met specific inclusion criteria. Their mean (SD) age was 56.27 (14.2) years. A cross-sectional study was conducted between June and December, 2009. Twelve-lead ECGs were performed in identical conditions for all patients, 10 minutes before and 10 minutes after the midweek morning hemodialysis session. Duration and amplitude of P wave and QRS complex, and duration of QTc and QTd were calculated. ECGs were analyzed by a single observer who was blind to all patient information. The Kolmogorov Smirnov, Wilcoxon signed rank, and McNemar tests were used to compare the variables before and after hemodialysis. RESULTS:The mean duration of the QRS complex and QTc were significantly higher after dialysis (P = .043 and P = .007, respectively). There were no significant differences in the mean P wave duration or mean QTd (P > .05).There was a significant increase in the mean P wave and QRS complex amplitudes after hemodialysis (P = .0001).There were no significant differences between the number of patients with normal and abnormal values before and after dialysis for the duration of QRS complex, P wave, QTc, or QTd, or the amplitude of the P wave and QRS. CONCLUSIONS:In the present study, ECG changes before and after hemodialysis presented as a significant increase in duration and amplitude of QRS, amplitude of P wave, and duration of QTc. ECG changes, especially QT intervals, should be monitored in patients with a history of hemodialysis in order to decrease cardiac complications. UroToday International Journal ® UI J
Background: The SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) score has emerged as an anatomicalbased tool that quantitatively determines the coronary vasculature due to 9 criteria such as number, location, complexity, and functional impact of angiographically obstructive lesions. Because of the fact that the same study of this scoring system has not been performed in Iran, we aimed to do this study to predict the value of SYNTAX score on in-hospital outcomes after Percutaneous Coronary Intervention (PCI) in patients referred to Heshmat Hospital, Rasht, Iran. Methods: The present cross-sectional study conducted at Heshmat Heart Center, Rasht, Iran. Patients admitted for elective or primary PCI of coronary arteries due to the acute coronary syndrome, ST segment elevation myocardial infarction and chest pain. Each patient's medical data such as clinical characteristics, procedures and adverse events collected from data bank and medical records. The SYNTAX score was calculated using SYNTAX score version 2.58 (SYNTAX SCORE I, www. syntaxscore.com). All in-hospital outcomes were entered in SPSS software version 23 and analysis was done. Results: In this study 431 patients underwent PCI. The average age of the samples was 57.10 ± 10.67 years (range 23-85 years). However, the average SYNTAX score in the samples was 15.93 ± 5.53 points. The mean SYNTAX score is significantly higher in positive cases of CVA after PCI (p=0.001), hypotension (p=0.001), arrhythmia (p=0.001), in-hospital death (p=0.002), unsuccessful PCI (p=0.001), CIN (p=0.001) and total adverse event incidence (p=0.001) but not with vascular disorders (p=0.769). ROC curve for predicting outcomes of PCI in the patients based on SYNTAX score, showed the total cutoff point of it was 19.5 and under curve area was calculated 0.79 (CI=0.716-0.865, p<0.0001). Conclusion: It seems that SYNTAX score utilization for samples with anatomic complexity, can predict the in-hospital outcomes in our setting.
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