الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study aimed at characterizing the presentation, predictors, and processes of care and outcomes of patients with acute myocardial infarction undergone primary percutaneous coronary intervention with a focus on procedural and angiographic characteristics and in hospital mortality. This project is a prospective registry of 945 patients presented with STEMI and treated with Primary Percutaneous Intervention between November 2019 and November 2021 at primary percutaneous intervention capable centers in Tanta for example ( Tanta University Educational Hospital and Cardiology Department at Tanta University Hospitals ) . In this study we extracted data from Cath. Lab. Data base. The patients included are those who were admitted to the cardiac intensive care unit with acute STEMI and underwent primary PCI according to recent ESC guidelines.2 Patients were allocated according to catheterization lab availability or the presence of any contraindications to thrombolytic therapy, where as those with contraindications to primary PCI or those who received thrombolytic therapy were excluded . The study involved two phases : Baseline measurement of process of care and health care services through a registry form will be filled out on cath lab. data base for each patient on admission and over a period of 6 months. Then Follow up assessment at 1 month , 3 months , 6 months after the index procedure. It was shown that most of the patients were males and with median age around 60 years old . The most prevalent risk factors were diabetes dyslipidemia and smoking . As regard clinical presentation , most of patients were presenting within 8 hours of onset of symptoms with mean door to reperfusion time about 120 minutes , most of them were Anterior STEMI with Killip class 1 with LAD is more prevalent as culprit vessel . As regard procedural aspects , recently radial access is more widely used than usual, pre-dilatation was done in baseline TIMI 0 flow where as thrombus aspiration was done in heavily thrombotic burden vessels in whom post dilatation was restricted and in most of them we used deferred stenting strategy with the use of intracoronary and intravenous Glycoprotein IIb IIIa inhibitors . Most of our patients discharged from cath lab with TIMI III flow with higher success rates of coronary patency Regarding MACE during hospital admission, it was found that the most common was heart failure , contrast induced nephropathy , bleeding complications which may be attributed more to old age fragile patients and low ejection fraction as most of our patients presented with anterior STEMI as well as late presentation of the patients . Also concomitant diagnosis of COVID -19 was significantly associated with higher rates of in hospital mortality compared with patients without a diagnosis of COVID-19. where as regarding MACE during follow up , there was relatively lower mortality rates than during admission , but there was significant increase in incidence of mortality between follow up periods , also most of patients presented with stent thrombosis , reinfarction and repeated hospitalization mostly due to medication non compliance after improvement of symptoms .