الفهرس 
Introduction
ST segment Elevation Myocardial Infarction (STEMI)Only 14 pages are availabe for public view
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Abstract
Coronary artery disease (CAD) and acute coronary syndromes still represent the leading cause of death worldwide (Allender et al. 2008). The improvement in pharmacological therapies and percutaneous revascularization procedures have greatly contributed to the relevant reduction in mortality observed in the last decades for coronary artery disease, particularly in the setting of acute myocardial infarction (De Luca et al. 2011). Presentation of a patient with ST-elevation myocardial infarction (STEMI) to an emergency department (ED) represents an acute medical emergency requiring immediate complex care coordination to achieve narrow timeliness guidelines for myocardial reperfusion (O’Gara et al. 2013). Despite the application of various risk stratification schemes, ACS remain poorly characterized in terms of riskprediction (de Araújo Gonçalves et al. 2005) Uric acid is the end product of purine catabolism in humans and is readily tested in routine clinical practice, as well as being an independent risk factor for the development of CAD (Niskanen et al. 2004). SUA levels have been correlated with all major forms of death from cardiovascular disease, including acute, sub-acute, and chronic forms of CAD, heart failure, and stroke (Lazzeri et al. 2012). The current study is a prospective cross-sectional study performed at Cardiovascular Medicine Department in period between March and December 2017. The study aimed to assess the predictive role of serum uric acid level on admission and short term (in hospital and three months follow up) major adverse cardiovascular events as well as its relation to Killip classification, TIMI flow and LV function in patients with acute STEMI undergoing PPCI.
The study included 150 Patients who were diagnosed with acute STEMI and therefor they underwent primary PCI. They were divided into tertiles based on the basal serum uric acid level. Patients with high SUA (n= 72) was defined as a value in the third tertile ( 6.4 mg/dl) and a low SUA group (n = 78) was set as a value in the lower two tertiles (<6.4 mg/dl) We found that on admission SUA level carries a significant predictive value regarding the prognosis in patients with STEMI undergoing primary PCI as the low uric acid group had a better KILLIP class, better TIMI flow after stenting, higher ejection fraction and better survival besides lower incidence of other MACE during the hospital stay and three months follow up in comparison to the high uric acid group. Kaplan Meier survival analysis showed that median and mean survival of patients with low SUA was significantly longer than median and mean of patients with high SUA. Age, SUA> 6 mg/dl, TIMI flow, Killip class and EF< 40% were found to be independent predictors for MACE in such patients where SUA more than 6 mg/dl showed 71.4% sensitivity and 70.3 Specificity in prediction of MACE in our population.