الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Ischaemic heart disease is a leading cause of death in the developed countries. In the developing countries it eU1Crges a.s a public health problem. It affects mainly men at the prime of life when their productivity and social responsibilities are greate st. The morbidity and mortality of IHD have been fOUlill to be highly infleul1ced by a wide range of genetic, habit ual, psychosoctal, and behavioural risk factors such as a0d, sex, smoking, type A behaviour, diabetes ... etc. The relationship between trace metals and CHD arose from the observations of the associations of CVDs with soft water; kishan disease with hyposelenemia ; and hyperlipidemie. with decreased serum Mg, Zn, Cu, and Fe levels.. ;joreover alterations in the serum concentrations of some trace metals after myocardial infarction have been docum ented. This study was desig~ed to investigate the possible changes of serum levels of Zn, Mg, Cu, and Fe in CHD. The study was carried out at the Medical Research Institute - Alex. Un:Lversi ty. It comprised 200 individuals; 100 patients with acute IHD and 100 control subjects (selected from relatives, friends, and visitors of our patients). The subjects of the study were submitted to the following invest igations: 1. Personal data (age, sex, education... .(-etc), psycho social indicators, ” ” attack s . history of the cardiac 2. Full clinical examination of the cardiovascular, respiratory, nervous and gastrointestinal systems. J. Electrocardiogram and QRS scoring of the irdarc t ion. 4. Laboratory investigations including: Urine analysis and stool examination. Serum glucose, uric acid, lipids (triglycerides, cholesterol, LDL-ch, and HDL-ch), as well as enzymes (CPK, SGOT, and LDH) concentrations. Serum levels of Mg, Zn, Cu, and Fe. The studies of the present work were carried out on the firs~ day of examination, on the 101£ day, and after J months. The data collected were analysed using the formulae of Z test, mean, standard deviation, two paired t-test, analysis of the variance and the simple correlation coefficient. The analysis of the data revealed that: 1. Age, smoking, physical inactivity, hypertension, NIDDM and positive family history of coronary attacks were the most frequent risk factors, whereas hyperlipidemia was of low prevalence. 2. Most of the patients were married, of lower socioeconomic classes and of type ”A” behaviour characteristics. These, besides the moderate prevalence of the social conflicts and life dissatisfaction might relfect the possible association between these psychosocial indicators and the life style and CHD development. These risk factors were more prevalent among males than females. At least 3 risk factors (mainly age, physical inactivity, and hypertension) were found in either patient. J. The prevalence of CHD was higher among males than females. Also CHD occured in males at younger age than in females. 4. Serum copper_and iron levels did not show any significant relation to the development, severity, or prediction of the complications of the CHD. 5. Sertun magnesium level decreased markedly among cases of CHD in comparison to the control group. The drop in serum magnesium level was found to be more with ~ocardial infarction than angina pectoris (in comparison to the con trol group),and to correlate significantly with cardiac arrhythmia and death. Moreover serum magnesium level took a long time (more than 10 days) to increase markedly. It seems that th~ decrease in serum 1~ levels might have a po~sible aetiological role in CHD development as well as an important pro gnostic value. 6. Serum zinc level was found to decrease mark edly only with ~ocardial infarction and to show a significant elevation within 10 days from the infarction. Also it was found to be lower among cases with extensive than non-extensive infarction. This might reflect the possible diagnostic values of decreased serum zinc level in cases of acute myocardial infarction. 7. Serum CPK, SGOT and LDH activities seemed to have no prognostic values. However, QRS scor ing system was found to correlate significantly with the extent of the infarction as well as development of heart failure and death. This might reflect its possible significant pro gnostic value.^leng