Percutaneous Coronary Intervention Vs Coronary Artery Bypass Surgery for Unprotected Left Main Coronary Disease: G-LM Registry.

Coronary artery bypass surgery (CABG) has been the standard of care for revascularization for patients with obstructive unprotected left main coronary disease (ULMCA). There have been multiple randomized and registry data demonstrating the technical and clinical efficacy of PCI in certain patients with ULMCA. The purpose of this study is to evaluate clinical outcomes of ULMCA PCI as compared to CABG in patients requiring revascularization in three Gulf countries. All ULMCA cases treated by PCI with DES versus CABG were retrospectively identified from 14 centers in 3 Arab Gulf countries (KSA, UAE, and Bahrain) from January 2015 to December 2019. In total, 2138 patients were included: 1222 were treated with PCI versus 916 with CABG. Patients undergoing PCI were older, and had higher comorbidities and mean European System for Cardiac Operative Risk Evaluation (EuroSCORE). Aborted cardiac arrest and cardiogenic shock were reported more in the PCI group at hospital presentation. In addition, lower ejection fractions were reported in the PCI group. In hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCE) occurred more in patients undergoing CABG than PCI. At median follow-up of 15 months (interquartile range, 30), no difference was observed in freedom from revascularization, MACCE, or total mortality between those treated with PCI and CABG. While findings are similar to Western data registries, continued follow-up will be needed to ascertain whether this pattern continues into latter years.

Blood cell counts and their correlation with creatine kinase and C-reactive protein in patients with acute myocardial infarction.

This study reports differential blood cells counts and their correlations with creatine kinase (CK) and C-reactive protein (CRP) levels in acute myocardial infarction (AMI) patients and normal subjects. Peripheral blood samples were obtained from all 39 AMI patients and 35 controls for blood cell counts and CK and CRP analyses. Total WBC, WBC fractions, RBC and platelets were measured with an automated hematology analyzer. The results showed a significant increase in total WBC (8.688 × 10(9)/L versus 6.148 × 10(9)/L), monocytes (1.271 versus 0.497 × 10(9)/L), and neutrophils (8.367 versus 3.223 × 10(9)/L) counts in AMI patients than controls. The RBC count was significantly less in AMI patients (4.638 × 10(12)/L) as compared to controls (5.105 × 10(12)/L). However, there was no significant difference in lymphocytes, eosinophils, basophils and platelet counts between AMI patients and controls. Both, serum CK (215.38 ± 43.15 versus 100.82 ± 8.86 U/L) and CRP (29.49 ± 7.61 versus 3.48 ± 0.60 mg/L) were significantly higher in AMI patients as compared to controls. Age of the subjects was neither correlated with blood cell counts nor CK indicating the validity of these markers irrespective of patient age. A significant correlation was observed between WBC counts and CK (R = 0.242, P = 0.041) as well as CRP (R = 0.416, P = 0.000). In conclusion, this study clearly showed significant increase in total and differential leukocyte counts indicating a pro-inflammatory cascade in AMI patients. A significant correlation between WBC counts and CK or CRP levels suggest a possible biomarker value of WBC for a quick prediction of both myocardial necrosis and inflammation in AMI patients.