Impact of primary percutaneous coronary intervention on ST-segment elevation myocardial infarction patients: A comprehensive analysis

BACKGROUND

Myocardial infarction, particularly ST-segment elevation myocardial infarction (STEMI), is a key global mortality cause. Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center. Multiple factors were identified influencing in-hospital mortality. Significantly, time from symptom onset to hospital arrival emerged as a decisive factor. Consequently, our study hypothesis is: "Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."

AIM

To determine the key factors influencing mortality rates in STEMI patients.

METHODS

We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention (PPCI) at the Erbil Cardiac Center. Their clinical histories were compiled, and coronary evaluations were performed via angiography on admission. Data included comorbid conditions, onset of cardiogenic shock, complications during PPCI, and more. Post-discharge, one-month follow-up assessments were completed. Statistical significance was set at P < 0.05.

RESULTS

Our results unearthed several significant findings. The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2% and 2.3% respectively. On the investigation of independent predictors of in-hospital mortality, we identified atypical presentation, onset of cardiogenic shock, presence of chronic kidney disease, Thrombolysis In Myocardial Infarction grades 0/1/2, triple vessel disease, ventricular tachycardia/ventricular fibrillation, coronary dissection, and the no-reflow phenomenon. Specifically, the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer (6.92 ± 3.86 h) compared to those who survived (3.61 ± 1.67 h), P < 0.001. These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.

CONCLUSION

Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients, highlighting the critical need for prompt intervention.

Failure of ciprofloxacin to eradicate brucellosis in experimental animals

Ciprofloxacin is a quinolone that penetrates well intracellularly. It was shown to be active against Brucella melitensis in vitro. In this study, ciprofloxacin and tetracycline were used to treat B. melitensis and B. abortus infections in mice. The drugs were given for 7, 14, 21 and 28 days. Tetracycline reduced spleen and liver weight and splenic bacterial counts and eliminated the infection in 70% of mice treated for 3 or 4 weeks. Ciprofloxacin, on the other hand, did not affect liver or spleen weight or bacterial counts after 3-4 weeks of therapy. It failed to eradicate the organism from any of the mice treated. It is concluded that ciprofloxacin is probably not suitable for the treatment of brucellosis.

Immunoperoxidase staining in the recognition of Aspergillus infections

This study concerns the use of the indirect immunoperoxidase technique for labelling Aspergillus species in infected human and animal tissues in smears taken from cultures. Specific labelling without serious cross-reactivity with Candida species or Zygomycete fungi was demonstrated using antiserum to Aspergillus. However, it was not possible to distinguish between two Aspergillus species. A fumigatus and A. flavus with this technique. Pretreatment of sections with sodium azide and normal swine serum was effective in eliminating background staining. The method can be used to produce permanently stained sections and has applications in the recognition of hyphal fragments in tissue from infected patients.