Aim: Our aim was to study the correlation between the thyroid hormones level and the coronary lesion complexity in patients with acute coronary syndrome (ACS). Patients and Methods: This is a prospective which included 100 patients with ACS who were admitted for percutaneous coronary intervention (PCI). The patients were divided according to thyroid functions into 3 groups: Euthyroid patients (90 patients), hyperthyroid patients (2 patients), and hypothyroid patients (8). Results: There was statistically significant correlation between 3 groups of thyroid hormone levels and BMI and myocardial infarction (MI). There was statistically non-significant differences between the 3 groups of thyroid functions(euthyroid, hyperthyroid and hypothyroidism) as regarded Age, Sex, Hypertension, DM, Coronary artery disease(CAD),Congestive heart failure (CHF), Blood diseases, PCI ,taking aspirin or warfarin, Ejection fraction, HbA1C, liver function tests, C-Reactive protein(CRP)level and Troponin marker. There was not a significant correlation between Syntax score and Age, International normalized ratio(INR), (Thyroid stimulating hormone)TSH level, Free Thyroxine (FT4), Ejection fraction and HbA1C.Syntax score was significantly inversely related to serum triiodothyronine (FT3) levels. In addition to its correlation with the syntax score, FT3 was shown to be a reliable predictor of CAD severity on its own. This suggests that FT3, rather than FT4 and TSH levels, may be utilized to predict the severity of CAD. Conclusion: FT3 levels below 2.65 nmol/L are a strong indicator of coronary artery lesion severity. A lower FT3 level is a continuous variable that may be utilized as a predictor of an increased risk for severe CAD.
Background: Contrast-induced nephropathy (CIN) is a serious complication of angiographic procedures and results from administration of iodinated contrast media (CM). Aim: To study the preventive and therapeutic effects of Mineralocorticoid receptor antagonist's pretreatment on contrast-induced acute kidney injury in patients undergoing coronary angioplasty. Methods: This case control study was carried out on patients admitted for coronary angioplasty in Benha University Hospitals (cardiology department), in which 100 patients were selected and divided in two groups "active & control". Group (A)(control): received placebo. Group (B) (Active): received Spironolactone 50 mg. Results: Blood Urea in Group (A) showed a significant increase during follow up when it was compared to baseline values while Group (B) showed an increase during follow up but without any statistically significant difference. Serum Creatinine in Group (A) showed a significant increase after 2 days of follow up with a mean value of 1.30±0.248 when it was compared to baseline values. While Group (B) showed a significant increase after 2 days of follow up with a mean value of 1.15±0.406 when it was compared to baseline values and also when compared to values after 7 days of follow up with a mean value of 1.19±0.384. Conclusion: The administering of Mineralocorticoid therapy prior to coronary angioplasty obtains additional benefit in terms of decrease incidence of CI-AKI in CAD patients.
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