Publications (3)9.75 Total impact
Article: Current Reperfusion Strategies for ST-Elevation Myocardial Infarction in an Academic Medical Center in a Developing Country: Efficacy of Primary Percutaneous Coronary Intervention.[show abstract] [hide abstract]
ABSTRACT: : To study the reperfusion strategies currently being used in the treatment of ST-elevation myocardial infarction (STEMI) at an academic medical center in a developing country and to analyze the door-to-balloon time (DBT) in those patients undergoing primary percutaneous coronary intervention (PCI). : The study included all patients presenting with STEMI to the emergency department at the American University of Beirut Medical Center between July 2008 and February 2010. Data were collected prospectively from the patients' medical records. : The study population consisted of 100 consecutive patients. Compared with an earlier study from American University of Beirut Medical Center done in 2002-2005, there was a significant increase in the utilization of primary PCI for reperfusion (81% vs. 2.5%; P < 0.001). However, the median DBT was 110 minutes, with only 30% of patients achieving a DBT ≤90 minutes. The predictors of delayed DBT (>90 minutes) were culprit lesions in the circumflex artery (P = 0.007) and delayed time from electrocardiogram to arrival in the catheterization laboratory (P < 0.001). : There was a significant increase in the utilization of primary PCI for reperfusion of STEMI in this academic medical center in a developing country. However, achieving a target DBT ≤90 minutes was suboptimal. Future studies are needed to analyze the logistic factors associated with delayed reperfusion to institute policies and systems that can enhance the efficacy of primary PCI as a reperfusion modality in these countries.Critical pathways in cardiology 03/2013; 12(1):24-7.
Article: Evaluation of the appropriateness criteria for coronary computed tomography angiography in an academic medical center in a developing country: comparison of the 2006 and 2010 criteria.[show abstract] [hide abstract]
ABSTRACT: The aims of this study are to analyze the risk profile and evaluate the appropriateness of patient referral to coronary CT angiography in a new MSCT laboratory in an academic medical center in a developing country. The study population consisted of 100 consecutive patients (mean age 53 ± 13 years, 83% males) who were referred to the new 64 slice MSCT laboratory at the American University of Beirut between July 2008 and July 2009. 52% of patients had chest pain and 48% were asymptomatic. By the 2006 ACCF criteria, only 8% of the referrals fitted the "Appropriate" criteria, 49% were "Inappropriate", and 43% were "Uncertain". The percentage of "Appropriate" indications increased from 8% by the 2006 criteria to 38% by the 2010 ACCF criteria. Framingham risk score (FRS) calculation showed a substantial percentage (46%) of patients to be at low risk, with 32% being at intermediate risk, and 22% at high risk. The prevalence of high calcium score (>400) (0% vs 22%, vs 27%, P < .001) and of obstructive CAD (4% vs 23% vs 40%, P < .001) increased steadily across the low, intermediate, and high FRS groups, respectively. There was a significant increase in the percentage of "Appropriate" indications for MSCT when comparing the 2010 to the 2006 ACCF appropriateness criteria. However, in spite of that, there was still significant deviation from the ACCF appropriateness criteria among patients referred for coronary CT angiography in this new MSCT laboratory in a developing country.Journal of Nuclear Cardiology 08/2011; 18(6):1053-8. · 2.67 Impact Factor
International journal of cardiology 05/2011; 154(2):e27-8. · 7.08 Impact Factor