Purpose: This was a prospective study conducted at Benha University hospital and National Heart Institute on one hundred patients undwent coronary artery bypass grafting (CABG) to evaluate the effect of CABG on the right ventricular (RV) function using speckle tracking echocardiography (STE). Methods: All cases were subjected to detailed medical history, full physical examination, 12 leads electrocardiogram (ECG), routine laboratory tests including (complete blood picture, liver functions, renal functions and lipid profi le) and echocardiography either conventional echocardiography or STE, all parameters obtained before and within 2 weeks after surgery. Results: By conventional echocardiography there was statistically signifi cant decrease in peak right ventricle systolic velociy (RVS´) from (12.76 ± 1.72) to (7.33 ± 1.71) and tricuspid annular plane systolic excursion (TAPSE) from (22.8 ± 3.99) to (13.77 ± 4.63) among the studied patients after CABG. While there was signifi cant increase in right ventricle fractional area change (RVFAC) from (44.69 ± 3.25) to (49.01 ± 3.36). On the other hand, there was non-signifi cant change in right ventricle end diastolic diameter (RVEDD) at mid-cavity from (26.37 ± 2.72) to (26.53 ± 2.72) and basal segment from (36.05 ± 2.98) to (36.29 ± 3.04), right ventricle stroke volume (RVSV) from (65.44 ± 7.02) to (65.85 ± 6.86) and right myocardial performance index (RMPI) from (0.491 ± 0.088) to (0.498 ± 0.086). Statistical analysis Data analysis was performed using the software SPSS (Statistical Package for the Social Sciences) version 20.

Background: After an acute coronary syndrome (ACS), patients remain at risk of major adverse cardiovascular events (MACE), despite contemporary treatment including aspirin and clopidogrel. The risk of MACE may be secondary to thrombin, which remains elevated after ACS. Objectives: This study aimed to evaluate the safety and indicators of efficacy of the novel oral direct factor Xa inhibitor (rivaroxaban). Patients and Methods: In our study, we randomly assigned 100 patients with a recent ACS to receive the oncedaily dose of 2.5mg of rivaroxaban or placebo in addition to dual antiplatelet therapy for six months. The primary efficacy endpoint was a composite of death from cardiovascular events, myocardial infarction, and stroke. The secondary endpoint was death from cardiovascular events, myocardial infarction, or stroke and the incidence of bleeding at six months. Results: Rivaroxaban significantly reduced the primary efficacy endpoint, as compared with placebo, with respective rates of 4% and 22% (P=0.007). Regarding secondary endpoint, the 2.5mg dose of rivaroxaban reduced the rates of death from cardiovascular causes (0% versus 8%, P=0.041). As compared with placebo, rivaroxaban increased the rates of minor bleeding (12% vs. 2%, P=0.049), with no major or fatal bleeding had been recorded. Conclusions: In patients with a recent acute coronary syndrome, rivaroxaban reduced the risk of the composite endpoint of death from cardiovascular causes, myocardial infarction, or stroke. Rivaroxaban increased the risk of minor bleeding but not the risk of major or fatal bleeding.

Background: After an acute coronary syndrome(ACS), patients continue to be at risk of major adverse cardiovascular events (MACE) despite the standard treatment. The risk of MACE may be secondary to thrombin, which remains elevated after ACS.We evaluated the safety and efficacy of the novel oral anticoagulant (NOAC), factor Xa inhibitor rivaroxaban. Methods: In our study, we randomly assigned 100 patients with a recent ACS to receive the once-daily dose of 2.5mg of rivaroxaban or placebo in addition to dual antiplatelet therapy for six months. The primary efficacy endpoint was a composite of death from cardiovascular events, myocardial infarction, and stroke, the secondary endpoint was death from cardiovascular events, myocardial infarction, or stroke with assessing the safety (risk of bleeding). Results: Rivaroxaban significantly reduced the primary efficacy endpoint, as compared with placebo, with respective rates of 4% and 22% (P=0.007). Regarding secondary endpoint, the 2.5mg dose of rivaroxaban reduced the rates of death from cardiovascular causes (0% versus 8%, P=0.041). As compared with placebo, rivaroxaban increased the rates of minor bleeding (12% vs. 2%, P=0.049), with no major or fatal bleeding had been recorded. Conclusion: In patients with a recent acute coronary syndrome, rivaroxaban reduced the risk of the composite endpoint of death from cardiovascular causes, myocardial infarction, or stroke. Rivaroxaban increased the risk of minor bleeding but not the risk of major or fatal bleeding.

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