الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 130 |  |  |
| | | from | 130 | | |
Abstract
Platelets play an important role in pathogenesis of acute coronary syndromes. It has been shown that platelet size, measured as mean platelet volume (MPV), correlates with their reactivity. Mean platelet volume is positively associated with indicators of platelet activity including expression of glycoprotein Ib and glycoprotein IIb/IIIa
receptors. Elevated MPV has been recognized as an independent risk factor for myocardial infarction and stroke. An elevated MPV is associated with poor clinical outcome among survivors of myocardial infarction. Lately, it has also been proved that there is a positive
relationship between MPV and the severity of acute ischemic
cerebrovascular events.
In our study we sought to determine whether MPV, measured on admission, can be used in determining the risk of impaired reperfusion measured by TIMI-Flow grading & Myocardial Blushing (MBG) , and assessing the incidence of Major Adverse Cardiac Event (MACE) in sixmonth follow up in STEMI patients treated with primary PCI.
The current study was conducted in El-Agouza Police Central Hospital CCU in time period from January 2015 to October 2016,The
study enrolled 130 consecutive patients with a significant single vessel disease/lesion which is infarction related artery. admitted with acute
STEMI treated by primary PCI within maximum 6 hours from onset”.
All patients have been subjected to:
Thorough history taking.
Clinical examination.
Standard 12-lead electrocardiogram(ECG):
Laboratory Investigation including assessment of MPV
Transthoracic Echocardiography
Angiographic Analysis and DES stenting to culprit vessel (Primary PCI)
Reperfusion assessment after stenting. Using TIMI Score &
Myocardial Blush score (MBG)
Adjunctive Pharmacotherapy:
Follow up to the patients for 6 months:
Aiming at detecting any Major Adverse Cardiovascular events or
mortality related to cardiac causes.
Patients have been classified according to on admission MPV into group Iwith high MPV (>11.5fl) , and group II with normal MPV (7.5-
11-5fl)
The study demonstrated that There was significant increase of
incidence of slow flow (TIMI II) & Impaired Myocardial Blushing (MBG 0,1)in group I compared to group II. Also There is significant increase in incidence of major adverse cardiac events (MACE) in Group
I compared to group II. While there was No statistical difference
regarding Age, Risk factor, culprit artery lesion nor the site of MI
between both groups.
Regarding incidence of MACE we found in our study that ;MPV
is the most independent risk factor in predicting MACE/ mortality with MPV Cut off value >11.6 flis predictor of occurance of MACE /
mortality than those with low MPV
While regarding TIMI Flow Score we found in our study that ;
MPV ia the most independent predictor of immediate reperfusion result,
with cut off value of MPV of<10.8 flare more likely to have excellent reperfusion in form of TIMI 3score after treating patients with primary PCI.
We also tried in our study to find the relation between MPV level and the Myocardial Blushing MBG outcome and we found that there is negative correlation between MPV & MBG but it failed to stand as an independent predictor for it in linear regression model.