Islam Abudayyeh

Cilostazol: A Potential Therapeutic Option to Prevent In-Stent Restenosis

It was of great interest and utility to read the paper by Dangas et al. ([1][1]) pertaining to in-stent restenosis (ISR) in drug-eluting stents (DES). The authors reviewed systematically the pathophysiological, mechanical, and technical mechanisms and treatment options of ISR in DES. The proposed

COMPARISON OF OUTCOMES IN PATIENTS UNDERGOING RENAL TRANSPLANTATION WITH IMPAIRED VERSUS NORMAL LEFT VENTRICULAR EJECTION FRACTION

End-stage renal disease and dialysis are associated with poor quality of life and long term outcomes. Renal transplantation improves long term mortality, quality of life, and leads to lower healthcare costs. However, patients with impaired left ventricular ejection fraction (LVEF) are less likely to

ISCHEMIC TIME AND RISK FACTORS ASSOCIATED WITH THE INCIDENCE OF CARDIOGENIC SHOCK IN PATIENTS PRESENTING WITH ST ELEVATION MYOCARDIAL INFARCTION

INTRODUCTION Cardiogenic shock (CS) is the number one predictor of mortality in patients with STelevation myocardial infarction (STEMI). Emergent evaluation and treatment including revascularization when indicated is recommended upon arrival to hospital. There is variation in time to presentation and total ischemic time in this patient population. We sought to evaluate the impact of ischemic time on incidence of CS and variables which may influence its presentation.

GLYCEMIC CONTROL IN INSULIN AND NON-INSULIN DEPENDENT DIABETIC PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION PREDICTS TIME TO PRESENTATION

Background: Worldwide, the annual number of people diagnosed with diabetes continues to increase. Classically, Diabetes Mellitus (DM) has been associated with silent or atypical initial symptoms and increased time to presentation in patients presenting with ST elevation myocardial infarction (STEMI

IMPACT OF DEMOGRAPHICS AND SOCIOECONOMIC STATUS ON MODE OF TRANSPORTATION AND TIME TO PRESENTATION IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION

Background: National guidelines recommend the utilization of a robust network for pre-hospital care of patients who experience chest pain and other relatable symptoms subsequently classified as ST elevation myocardial infarction (STEMI). Despite the widespread use of this network, little is known

Factors Affecting Time to Presentation in ST-Elevation Myocardial Infarction(FAT STEMI)

Introduction: Advancements in ST-Elevation Myocardial Infarction (STEMI) management have led to improved outcomes and decreased mortality in recent decades. A critical factor in this improvement was developing hospital systems to decrease emergency room door to cath lab balloon times of less than 90 minutes. Continued efforts to decrease total ischemic time by reducing time to presentation are an area for further improvement. Identifying factors that affect the time from the onset of symptoms to presentation can provide hospital systems additional opportunities to improve outcomes of STEMI patients. Methods: Utilizing a single center, retrospective chart review, 604 STEMI activations were identified. After false activations were excluded, the remaining 529 patient cases were analyzed for various factors and variables affecting the time to presentation (TTP), including age, mode of transportation, race, language, and diabetic status. Results: The variables found to be statistically significant with their effect on time to presentation to the hospital included race (p=0.024), mode of transportation (p=0.021), and diabetic status (p=0.0054). Additionally for every unit increase in Hgb A1c, TTP increased 1.12 minutes (R2=0.49). Time to presentation showed no statistically significant difference based on age (p=0.60), sex (p=0.15), ethnicity (p=0.46), language (p=0.20) or religion (p=0.15). Conclusions: Mode of transportation, race, and diabetes status had a significant impact on the time from the onset of symptoms to presentation in patients with STEMI. The use of EMS decreases the time to presentation compared to self-transport. Patients, who identify themselves in the “Other” race category, including American Indians, Pacific Islanders, and Native Hawaiians, exhibited longer TTP. Diabetics took longer to present than their non-diabetic counterparts. Interestingly, no differences in TTP were found when comparing age, sex, ethnicity (Hispanic vs. non-Hispanic), language or religion.