Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: - Early primary percutaneous coronary intervention (PPCI) is established to be superior to thrombolytic therapy in the management of patients presented with STEMI. Door to wire crossing time is the duration elapsed between the patients with acute STEMI arrivals to the emergency department (ED) to catheter guide wire crossing the culprit lesion in catheter lab. Aim: - To calculate door to wire crossing time in patients presented with ST segment elevation myocardial infarction at Cairo University Hospitals and studying its relation to outcome. Methods: - Our study included 150 patients with STEMI at Cairo University Hospitals managed by PPCI from April 2018 to November 2018. Patients{u2019} demographics, co-morbidities, laboratory values at ED, ECG at ED, PPCI results and outcome and one-month mortality were analyzed. Time intervals from door to wire crossing were calculated and analyzed. Results: The study included 150 patients 99; (66%) of them were male, 27(84.7%) of them attended to Kars Al- Ainy Teaching Hospital (KATH) ED and 23(15.3%) of patients attended New Kasr Al- Ainy Teaching Hospital (NKATH). The overall door to wire crossing mean time was 121.73±44.93 min and was shorter in KATH compared to NKATH (117.79± 44.3 6 vs. 141.17 ± 43.73, P 0.012). The TIMI flow also was affected by the shorter door to wire crossing time in patients with TIMI 3 (P 0.06). Post-MI decompensated heart failure was developed in 23 (15.3%) of patients and 13 (8.7%) developed reperfusion arrhythmia and 22 (14.7%) patients had cardiac arrest during the hospital stay. The risk of post-MI heart failure was higher with prolonged door to wire crossing time (p {u02C2} 0.001) and the longer in hospital pre-cath time (P 0.000). After one-month follow up 7 patients died due to sudden cardiac death

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