000			03158cam a2200349 a 4500
003			EG-GiCUC
005			20250223031800.0
008			170823s2017 ua d f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aM.Sc
099			_aCai01.11.09.M.Sc.2017.Ho.R
100	0		_aHossam Ali Abdelhamid
245	1	0	_aRisk stratification of STEMI patients using arterial blood lactate in relation with coronary angiography and echocardiography / _cHossam Ali Abdelhamid ; Supervised Ahmed Abdelrahman Battah , Rania Mustafa Alhussiny , Alaa Ashour Heikl
246	1	5	_aتحديد الخطورة فى مرضى جلطات القلب باستخدام مستوى حمض اللاكتيك فى الدم مقارنة بنتائج القسطرة القلبية و الموجات فوق الصوتية على القلب
260			_aCairo : _bHossam Ali Abdelhamid , _c2017
300			_a143 P. : _bcharts ; _c25cm
502			_aThesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine
520			_aIntroduction. Serum lactate level as a marker of organ hypoperfusion is an important prognostic marker. however, its rule in acute ST elevation myocardial infarction (STEMI) need further evaluation. Objectives. To assess the rule of serum lactate level as a method for risk stratification of patients admitted with acute STEMI. Methods. 50 consecutive patients with acute STEMI were enrolled in the study. After exclusion of patients with any known cause for elevated lactate level, arterial blood lactate was measured immediately on admission. In-hospital, 30 days and 3 months mortality were the study endpoints. Results. 50 patients with mean age of 65.6±6.13years, with 78% are males. The distribution of risk factors was: Smoking 58%, diabetes mellitus 56%, hypertension 54%, and dyslipidemia 50% and previous history of ischemic heart disease 44%. Patients were managed according to the latest guidelines. The in-hospital mortality was 6% during the hospital stay, 10% after 30 days and 22% after 3 months. 19 patients (38%) had lactate level above 4 mmol/l. They showed the highest incidence of complications (acute mitral regurge 14%, acute heart failure 14%or cardiogenic shock 12%), and highest rate of mortality (in-hospital mortality 6%, 30 days 10%and 3 months 22%). Admission lactate with a cutoff value of 4 had a sensitivity of 90% and a specificity of 89 % for prediction of 3 months mortality, with the area under the curve of 0.79. Conclusions. Measurement of arterial lactate at presentation in patients with STEMI has the potential to improve acute risk stratification, and can be used as a prognostic tool in this group of patients
530			_aIssued also as CD
653		4	_aCoronary angiography
653		4	_aEchocardiography
653		4	_aLactate
700	0		_aAhmed Abdelrahman Battah , _eSupervisor
700	0		_aAlaa Ashour Heikl , _eSupervisor
700	0		_aRania Mustafa Alhussiny , _eSupervisor
856			_uhttp://172.23.153.220/th.pdf
905			_aNazla _eRevisor
905			_aSamia _eCataloger
942			_2ddc _cTH
999			_c62112 _d62112