56 patients had AST/ALT ratio greater than 2, while 59 patients had AST/ALT ratio less than 2. STEMI patients with AST/ALT ratio greater than 2 had a significantly higher prevalence of total vessel occlusion (TIMI thrombus grade 5), and there is a significant association between high AST/ALT ratio and TIMI thrombus grade 5 on both univariate and multivariate analysis. However, there is no statistically significant difference between both groups as regarding the coronary artery complexity as assessed by SYNTAX and Genseni scores.
Conclusion
Patients with AST/ALT ratio greater than 2 are strongly associated with high thrombus burden (thrombus burden of 5) on TIMI thrombus grade before primary PCI.
Objectives: Hepcidin, a major regulator of iron metabolism and homeostasis. Studies on hepcidin in rheumatoid arthritis (RA) are still inconsistent. Aim to identify if hepcidin could add to diagnosis of RA associated complications, especially atherosclerosis.
Methods: A case-control study involved measurement of serum hepcidin levels in patients and control by Enzymelinked immunosorbent assay, and assessment of Carotid intima Media thickness (CIMT) by Doppler ultrasonography. Patients’ clinical manifestations, comorbidities, and treatment were recorded. The disease activity score-28 (DAS28) was used to evaluate RA activity.
Results: This study enrolled 50 RA patients and 25 control subjects, with predominantly female participants (98%). Hepcidin is significantly increased in RA patients when compared to control (p< 0.001). Right and Left Carotid intima media thickness showed significant difference between patients and control (p= 0.016 & p= 0.006). In multivariate linear regression models hepcidin showed significant positive correlation with BMI, CRP, CIMT (p< 0.001). Hepcidin level≥ 298.5 showed significant AUC that could discriminate between patients.
Conclusion: Increased hepcidin level in RA patients was correlated with CIMT (r= 0.676). Patient Age, RA duration, cholesterol level and hepcidin level were linked to an increase in CIMT in RA patients. Therefore, serum hepcidin level could be a predictor of atherosclerosis in RA patients.
Objectives: Platelet indices, such as platelet distribution width (PDW), mean platelet volume (MPV), and plateletcrit (PCT), can provide insights into platelet activation. Large platelets are more active and have higher thrombotic potential than small platelets, suggesting that larger platelets play a role in ST-elevation myocardial infarction (STEMI). To assess PDW, MPV, and PCT and their relation to severity and validity for prediction of primary, secondary outcomes, and MACE in acute STEMI patients who underwent PPCI.
Methods: This prospective study included 115 consecutive STEMI patients who underwent PPCI. Admission blood samples were measured for MPV, PDW, and PCT. The SYNTAX and Gensini (GS) scores were used to quantify the severity of CAD. Patients were followed up for a period of 3 to 6 months with regard to primary and secondary clinical outcomes.
Results: PDW had a moderate positive correlation with SYNTAX score (r= 0.321, p< 0.001) and GS (r= 0.270, p= 0.002), and a negative correlation with TIMI Risk (r=-0.199, p= 0.017) and ejection fraction (r=-0.170, p= 0.034). Also, MPV had a significant positive correlation with SYNTAX score (r= 0.235, p= 0.006). PDW had the highest diagnostic accuracy for the prediction of the primary outcome and MACE.
Conclusion: PDW, a low-cost and easily measured laboratory test, could be used as a predictor of re-infarction and adverse outcomes in STEMI patients.