Background Suboptimal myocardial perfusion in primary PCI is associated with increased infarct size, left ventricular (LV) dysfunction and higher mortality rates as compared as those with optimal myocardial perfusion. We identified clinical and procedural predictors of suboptimal myocardial reperfusion as judged by myocardial plush grade (MBG) in primary PCI. Methods and Results 100 patients with acute STEMI who underwent primary PCI were prospectively subjected to clinical, ECG, laboratory and angiographic evaluation. Patients were classified into: Optimal myocardial reperfusion group: (n=73) who had final MBG=3. Suboptimal myocardial reperfusion group: (n=27) who had persistent final MBG ≤ 2. Suboptimal myocardial reperfusion group had statistically significant little history of angina prior to MI 5 (18.5%) vs 44 (60.3%), little current aspirin intake 6(22%) vs 38 (52% ), increased blood sugar on admission (240 ± 101 mg/dl vs 171 ± 72 mg/dl), increased total leucocytic count on admission (12.1 ± 3.6 vs 10.2 ± 3.3) 103/mm3, longer reperfusion time (6.1 ± 2.8 vs 4.3 ± 2.1 h ), higher thrombus burden 12 (44.4 % ) vs 13 (17.8 %), higher predilatation pressure (16 ± 2.3 vs 14 ± 1.8 ATM), repeated balloon inflation during predilatation 24 (92.3 % ) vs 46 (69.7%) as compared optimal myocardial reperfusion group, (P < 0.05 for all). Conclusion Longer reperfusion time, repeated balloon inflations, high predilatation pressure> 15 ATM , high thrombus burden, neither history of angina nor aspirin intake prior to AMI, high total leucocytic count > 10103/mm3 and high blood glucose level > 160mg/dl were predictors for persistent suboptimal myocardial reperfusion in primary PCI.

BackgroundPatent ductus arteriosus is generally associated with hyperdynamic status. Given the vascular shunt between the aorta and pulmonary artery, intrinsic aortic changes occur (aortic stiffness). In the present study, we attempted to assess the impact of PDA on aortic stiffness and its connection with cardiovascular function before and after transcatheter closure of PDA.Patient and methodsOur study consisted of 60 children who were preparing for transcatheter closure of PDA and 60 healthy controls. All patients had clinical and echocardiographic proof of hemodynamically significant PDA.ResultsPatients with PDA exhibited significantly higher ASI than controls before closure (p-value < 0.05). After closure, ASI was significantly reduced (p-value < 0.05), but still higher than that of controls (p-value < 0.05) at the six-month follow-up assessment. Patients with PDA had significantly lower LVEF than controls before closure (p-value < 0.05). After closure, LVEF was significantly enhanced (p-value < 0.05), and no significant difference was noted amongst patients and controls (p-value < 0.05) at the six-month follow-up assessment.ConclusionAortic stiffness is significantly increased in patients with PDA regardless of PDA size. Aortic stiffness is related to reduced heart function. ASI may be valuable for observing the course of patients with PDA before and after intervention.

Background: Hyperglycemia doubles the risk of recurrent myocardial infarction, heart failure, cardiogenic shock, and death. Control of hyperglycemia is important to prevent complications. Aim: Evaluate the effect of implementing nursing guidelines on controlling hyperglycemia in patients with acute myocardial infarction. Design: Aquasi experimental research design. Setting: Coronary care unit at El-Minia University Hospital. Subjects and method: Sixty basically sick grown-up patients who satisfied the consideration criteria and gave intense myocardial infarction with hyperglycemia. Patients were partitioned into two equivalent groups 30 patients for each, (study and control groups). Study Tools: Three tools were utilized to collect data in the present study (Patient assessment tool, Cardiac assessment tool, and Hyperglycemia assessment sheet).Results: We discovered significantly less inconveniences was identified with Myocardial infarction and diabetes in the study group than in the control group, and additionally measurably critical change in the examination assemble regarding to all items of knowledge (P= 0.0001*). Conclusion: Implementation of nursing guidelines results an improvement on outcomes of hyperglycemic patients in the setting of intense myocardial infarction. Recommendation: Glucose levels should be monitored closely in patients admitted to a coronary care unit with acute myocardial infarction as long as hypoglycemia is avoided.