Transradial Approach versus Anatomical Snuff Box Distal Radial Access for Coronary Procedures

Background: Radial artery catheterization is a fundamental approach that is used as a procedural access in the different catheterization laboratories so our study is a comparison between distal radial artery approach and convential traditional transradial approach to explore the fesibility and safety of coronary angiography and percutanous coronary. Aim of the Work: The purpose of our study is a comparison between the conventional transradial approach versus distal transradial approach for diagnostic and interventional coronary procedures. Materials and Methods: This is a prospective study that included 60 patients who presented to the Cardiology departments in Ahmed Maher Teaching Hospital from December 2018 until October 2019 to perform planned Transradial Coronary Angiography and/or coronary intervention. The study is divided into two groups, group (A) included 30 patients who undergone the procedure through the distal radial approach (The Anatomical Snuffbox)and group (B) included 30 patients who undergone the procedure through the traditional Transradial approach. Results: Thrombosis and hospital stay are higher significant in radial group than distal radial group and patient satisfaction is higher significant in distal radial group than traditional Transradial while there is no significant difference between both groups as regard Success and failure rate of cannulation, bleeding, infection and duration of the procedure. Conclusion: coronary procedures by distal radial approach have minor access complication versus the conventional Transradial approach.

Assessment of Right Ventricular Function Using Strain and Strain Rate in Patient with Acute Anterior ST Segment Elevation Myocardial Infarction

Introduction: Anterior ST-segment elevation myocardial infarctions (STEMI) are those involving the anterior ECG leads of the heart as a result of transmural ischaemia. They can be subdivided according to their extension into anteroseptal and anterolateral infarctions. Objective: The aim of this study is assessment of right ventricular function using strain and strain rate imaging in patients with anterior ST segment elevated myocardial infarction (STEMI). Methods: This prospective study was conducted on 35 patients with anterior ST segment elevated myocardial infarction (STEMI) who were admitted to ER and CCU department in National Heart Institute from May 2018 to May 2019. Results: Comparison between groups regarding longitudinal strain showed that there is highly statistically significant difference between them in lateral wall (all segments), septum (all segments) and global LS of right ventricle. Comparison between studied groups regarding circumferential strain revealed that there is highly statistically significant difference between them in all segments of right ventricle. Conclusions:Strain and strain rate imaging are feasible and reproducible tools in assessment of right ventricular function in patients with anterior ST segment elevated myocardial infarction (STEMI).

Predictive Value of Neutrophil-to-Lymphocyte Ratio in Outcomes of Patients with Acute Coronary Syndrome

Objectives: Previous studies have demonstrated the role of inflammation in acute coronary syndrome (ACS). The neutrophil-to-lymphocyte ratio (NLR) was found to be a useful inflammatory marker for predicting adverse outcomes. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would be associated with increased mortality in patients with acute coronary syndrome. Methods: The study consisted of 40 patients with acute coronary syndrome who were admitted to Cardiology Department—Menoufia University Hospitals. The primary endpoint was all-cause in-hospital as well as 30-day mortality, and the patients were divided into three tertiles according to their admission NLR results. Results: All-cause 30-day mortality in the three groups based on NLR was 0.0%, 7.7% and 28.6%, in the low-, middle- and high-NLR groups, respectively (P χ2 test). In a logistic regression analysis, including baseline demographic, clinical, and biochemical covariates, the neutrophil-to-lymphocyte ratio was an independent predictor of mortality (OR = 2.44, 95% CI = 1.185 - 5.007, P Conclusion: An elevated neutrophil-to-lymphocyte ratio (NLR), a simple, relatively inexpensive and universally available inflammatory marker, seems to be a predictor of 30-day mortality in patients with acute coronary syndrome.