A rsenic is currently one of the most important environmental global contaminants and toxicants, particularly in the developing countries. The main route of arsenic exposure in these countries is drinking water; some rocks of earth's crust contain this element and the use of herbicides and insecticides increases the concentration of arsenic in ground water (Garcia et al., 2013). Arsenic exposure occurs from inhalation, absorption through the skin and primarily, by ingestion of contaminated food and drinking water. As-induced toxicity depends on its oxidation state and chemical form. Inorganic form of As is more toxic than organic form (Manna et al., 2008). Arsenic exposure causes obvious damage in various organs. Total tissue arsenic accumulation was greatest in kidney, lung, urinary bladder, skin, blood and liver (Kenyon et al., 2008). Chronic exposure to inorganic arsenic has been associated with loss of body weight, cancer of the skin, liver fibrosis, and chronic lung disease. Moreover, it causes metabolic disorders such as diabetes and dysfunction of the endocrine system, nervous system, cardiovascular diseases and reproductive system (Elshawarby et al., 2014; Ma et al., 2015). Arsenic binds to sulfhydryl groups on proteins, modulates protein metabolism, and generates reactive ox
Introduction: Cardiogenic shock of patients with myocardial infarction still affects between 3-10% of patients, and the in-hospital death rate is <30%. One of the challenges is the left main (LM) coronary intervention. Objective: The aim of the current study is to investigate the short-term outcome of emergency LM coronary intervention. Patients and methods: A total of 80 patients who underwent percutaneous coronary intervention (PCI) of LM in the setting of cardiogenic shock in our hospital were retrospectively studied. Short-term clinical outcomes and PCI characteristics were evaluated. Results: LM was the culprit artery in ]about 62.8% of the patients. The remaining cases were treated due to persistence of cardiogenic shock after successful PCI of the culprit vessel. About 43.6% of the patients had Syntax scores more than 32, and the majority of them had complicated coronary stenosis. Second stent method at the LM bifurcation was employed in 12.8% of cases, complete revascularization in 34.6%, and intra-aortic balloon pump (IABP) in 13.1%. Mortality in hospitals was 48.7%. Half of the patients had no differences between 1 or 2 stent LM bifurcation procedures at 90 days' follow-up. Patients with incomplete revascularization with a residual Syntax score of 15 or more and those with thrombolysis in myocardial infarction (TIMI) flow.
Conclusion:Neither the use of IABP nor the 2-stent approach in the LM showed a decreased short-term mortality in patients who first presented with cardiogenic shock and LM illness. However, in our study, patients with ultimate TIMI flow
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