Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Objectives: The major determinant of final infarct size for a given coronary occlusion is the size of the myocardial area- at-risk. We propose herein a new QCA index to predict area-at-risk in patients with myocardial infarction (MI). The aim of the study was to assess the predictive value of simple QCA index in STEMI systolic function reduction and its relation to adverse clinical outcome.Correlating it with nuclear imaging . Study design: 52 acute MI patients with their first acute coronary syndrome incident were consecutively and prospectively enrolled in to the study. QCA index was calculated by dividing the culprit segment diameter by the sum of the left anterior descending, circumflex, and right coronary arteries at their proximal segments. We evaluated the in hospital follow-up rates of major clinical endpoints, which were defined as death, non-fatal MI, stroke, and new congestive heart failure (CHF). Results: Simple QCA index showed no correlation with systolic function of the heart , WMSI ,Cardiac enzymes and in hospital clinical outcome . Conclusion: A simple index derived from coronary angiography at the time of primary percutaneous coronary intervention cannot predict LV systolic function loss and adverse clinical out- come in patients with acute MI.

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