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Coronary Artery Disease: HELP
Articles from Miscellaneous cities in Egypt
Based on 158 articles published since 2010
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These are the 158 published articles about Coronary Artery Disease that originated from Miscellaneous cities in Egypt during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Editorial Cochrane corner: is it better to access the coronary circulation via the radial or the femoral artery? 2019

Kolkailah, Ahmed A / Alreshq, Rabah S / Muhammed, Ahmed M / Zahran, Mohamed E / Anas El-Wegoud, Marwah / Nabhan, Ashraf F. ·Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA. · Department of Medicine, Albany Medical Center, Albany, New York, USA. · Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. · Egyptian Center for Evidence Based Medicine, Cairo, Egypt. · Department of Obstetrics and Gynaecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. ·Heart · Pubmed #30700521.

ABSTRACT: -- No abstract --

2 Review Effect of Percutaneous Coronary Intervention on Heart Rate Variability in Coronary Artery Disease Patients. 2018

H Abdelnaby, Mahmoud. ·Medical Research Institute, Alexandria University Alexandria, Egypt. ·Eur Cardiol · Pubmed #30310473.

ABSTRACT: Patients with coronary artery disease (CAD) have a state of autonomic imbalance with a sympathetic predominance. Autonomic dysfunction has been linked to an increased risk of cardiovascular morbidity and mortality. Heart rate variability (HRV) analysis is one of the most encouraging non-invasive diagnostic models and is increasingly used for the assessment of autonomic dysfunction. Percutaneous coronary intervention (PCI) is considered the gold standard in CAD treatment. Revascularisation through PCI eliminates the state of sympathetic hyperactivity, restores the normal cardiac autonomic modulation that can be assessed by HRV measurement.

3 Review Impact of fractional flow reserve on decision-making in daily clinical practice: A single center experience in Egypt. 2018

Elfaramawy, Amr / Hassan, Mohamed / Nagy, Michael / ElGuindy, Ahmed / Elmahdy, Mahmoud F. ·Cardiology Department, Cairo University, Cairo, Egypt. · Cardiology Department, Aswan Heart Center, Aswan, Egypt. · National Heart and Lung Institute, Imperial College London, UK. ·Egypt Heart J · Pubmed #30190641.

ABSTRACT: Background: Fractional flow reserve (FFR) is the reference standard for the assessment of the functional significance of coronary artery stenoses, but remains underutilized. Our aims were to study whether FFR changed the decision for treatment of intermediate coronary lesions and to assess the clinical outcome in the deferred and intervention groups. Methods: In this retrospective study, coronary angiograms of patients with moderately stenotic lesions (40-70%) for which FFR was performed were re-analyzed by three experienced interventional cardiologists (blinded to FFR results) to determine its angiographic significance and whether to defer or perform an intervention. Results: We revised 156 equivocal lesions of 151 patients. The clinical presentation were stable angina (65.6%) and acute coronary syndrome in (34.4%). All reviewers had concordant agreement to do PCI in 59 (37.8%) lesions based on angiographic assessment. Interestingly 23 (39%) of these lesions were functionally non-significant by FFR. The reviewers agreed to defer 97 (62.2%) lesions, however, 32 (33%) of these lesions were functionally significant by FFR and necessitated PCI. MACE were similar in both groups (1.5% vs 2.4%, p = 1.0). Conclusion: Mismatches between visually- and FFR- estimated significance of intermediate coronary stenosis are frequently encountered across a wide spectrum of clinical presentations. FFR leads to a change in decision for coronary intervention. The clinical and cost implications of such changes-in areas with limited resources- needs further evaluation.

4 Review Amiodarone-Induced Thyroid Dysfunction: A Clinical Update. 2018

Elnaggar, Mohamed Nabil / Jbeili, Kahtan / Nik-Hussin, Nik / Kozhippally, Mohandas / Pappachan, Joseph M. ·Department of Endocrinology, Diabetes & Metabolism, University Hospitals of Morecambe Bay NHS Foundation Trust, United Kingdom, LA1 4RP. · Internal Medicine Department, Faculty of Medicine, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt. · Department of Radiology and Nuclear Imaging Services, University Hospitals of Morecambe Bay NHS Foundation Trust, United Kingdom, LA1 4RP. · Department of Medicine, Good Hope Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom, B75 7RR. ·Exp Clin Endocrinol Diabetes · Pubmed #29558786.

ABSTRACT: Amiodarone is one of the most commonly prescribed antiarrhythmic agents in clinical practice owing to its efficacy, even with high toxicity profile. The high iodine content and the prolonged biological half-life of the drug can result in thyroid dysfunction in a high proportion of patients treated with amiodarone even after cessation of amiodarone. Both hypothyroidism and hyperthyroidism are common side effects that mandate regular monitoring of patients with thyroid function tests. Amiodarone-induced hypothyroidism (AIH) is diagnosed and managed in the same way as a usual case of hypothyroidism. However, differential diagnosis and clinical management of amiodarone-induced thyrotoxicosis (AIT) subtypes can be challenging. With the aid of a case snippet, we update the current evidence for the diagnostic work up and management of patients with amiodarone-induced thyroid dysfunction in this article.

5 Review Treatment of coronary bifurcation lesions: current knowledge and future perspectives. 2018

Elwany, Mostafa / Palma, Gaetano Di / Cortese, Bernardo. ·Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy. · Faculty of Medicine, University of Alexandria, Alexandria, Egypt. · Department of Cardiothoracic Sciences, Second University of Napoli, Naples, Italy. · Cardiac Department, Fondazione G Monasterio CNR-Regione Toscana, Pisa, Massa, Italy. ·Future Cardiol · Pubmed #29372810.

ABSTRACT: Coronary lesions at bifurcation sites are frequent and still remain a challenging subset for the interventional cardiologist. Although in the last years the provisional stenting technique has shown more consistent results, coronary bifurcation interventions still share a worse procedural success rate and increased rates of mid- and long-term cardiac events. Most of the dedicated devices proposed in the last few years have failed to show improved results when compared with standard devices. The broader use of imaging techniques, such as intravascular ultrasound and optical coherence tomography, lead to a better understanding of the real anatomy of bifurcations and has shown to be a great tool for percutaneous coronary intervention optimization. Preliminary results come from drug-coated balloons and bioresorbable vascular scaffolds, especially for the 'leave nothing behind' concept, particularly interesting in this setting of lesions.

6 Review Optimal percutaneous coronary intervention in patients with ST-elevation myocardial infarction and multivessel disease: An updated, large-scale systematic review and meta-analysis. 2017

Nguyen, An Vu / Thanh, Le Van / Kamel, Mohamed Gomaa / Abdelrahman, Sara Attia Mahmoud / El-Mekawy, Mohamed / Mokhtar, Mohamed Ashraf / Ali, Aya Ashraf / Hoang, Nam Nguyen Nho / Vuong, Nguyen Lam / Abd-Elhay, Fatma Abd-Elshahed / Omer, Omer Abdelbagi / Mohamed, Ahmed Abdou / Hirayama, Kenji / Huy, Nguyen Tien. ·Pham Ngoc Thach University of Medicine, Ho Chi Minh City, 70000, Viet Nam. · University of Medicine and Pharmacy, Ho Chi Minh City, 70000, Viet Nam. · Faculty of Medicine, Minia University, Minia 61519, Egypt. · Faculty of Medicine, Alexandria University, Beheira 22762, Egypt. · Faculty of Medicine, Cairo University, Cairo 13719, Egypt. · Faculty of Medicine, Sohag University, Sohag 82738, Egypt. · Faculty of Medicine, Gezira University, 20, Wad Madani, Sudan. · Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. · Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Viet Nam; Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. Electronic address: nguyentienhuy@tdt.edu.vn. ·Int J Cardiol · Pubmed #28647440.

ABSTRACT: BACKGROUND: Our study aimed to compare three different percutaneous coronary intervention (PCI) approaches: culprit-only (COR) and complete (CR) revascularization - categorizing into immediate (ICR) or staged (SCR). METHODS: We searched 13 databases for randomized controlled trials. Articles were included if they compared at least two strategies. To have more studies in each analysis, an adjusted analysis was performed using person-years to incorporate follow-up durations and obtain pooled rate ratios (RR), with their corresponding 95% confidence interval. RESULTS: Thirteen trials were included with a population of 2830 patients. COR significantly increased major adverse cardiac event (MACE) (adjusted RR 1.67, 95% CI: 1.27-2.19) and repeat revascularization (2.12, 1.67-2.69), which was driven by repeat PCI, without any difference in all-cause mortality and myocardial infarction (MI) compared to CR. When categorizing CR into SCR and ICR, the trend repeated with COR increased MACE (1.99, 1.53-2.6 for ICR), cardiovascular mortality (2.06, 1.07-3.96 for ICR), MI for ICR (1.72, 1.04-2.86), repeat revascularization and repeat PCI for both ICR and SCR. Non-cardiovascular mortality, stroke, nephropathy, re-hospitalization, stent thrombosis and bleeding were similar among all approaches. CONCLUSIONS: In MVD-STEMI patients, CR is better than COR in terms of MACE, cardiovascular mortality, repeat revascularization with no difference in safety outcomes. There was a trend towards to a reduction of cardiovascular mortality and MI in ICR compared to SCR when each matched with COR; even though there is no statistically significant difference between ICR and SCR when compared together.

7 Review Aspirin Use Prior to Coronary Artery Bypass Grafting Surgery: a Systematic Review. 2017

Elbadawi, Ayman / Saad, Marwan / Nairooz, Ramez. ·Department of Medicine, Rochester General Hospital, Rochester, NY, USA. · Department of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt. · Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205,, USA. · Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205,, USA. ramez.nairooz@gmail.com. ·Curr Cardiol Rep · Pubmed #28213669.

ABSTRACT: PURPOSE OF REVIEW: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies. RECENT FINDINGS: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk. A recent large randomized controlled trial did not find a significant difference in bleeding risk or post-operative mortality with pre-CABG aspirin use. The results of available studies showed a beneficial effect with pre-CABG aspirin use by decreasing thrombotic complications and perioperative myocardial infarction, with an associated adverse risk of bleeding that did not affect mortality rates. Given overall benefit-risk assessment, we are in favor of pre-operative aspirin use in CABG patients.

8 Review Is atherosclerosis fundamental to human aging? Lessons from ancient mummies. 2014

Clarke, Emily M / Thompson, Randall C / Allam, Adel H / Wann, L Samuel / Lombardi, Guido P / Sutherland, M Linda / Sutherland, James D / Cox, Samantha L / Soliman, Muhammad Al-Tohamy / Abd el-Maksoud, Gomaa / Badr, Ibrahem / Miyamoto, Michael I / Frohlich, Bruno / Nur el-din, Abdel-Halim / Stewart, Alexandre F R / Narula, Jagat / Zink, Albert R / Finch, Caleb E / Michalik, David E / Thomas, Gregory S. ·University of California, Los Angeles, CA, USA. · Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. · Al Azhar Medical School, Cairo, Egypt. · Columbia St Mary's Healthcare, Milwaukee, WI, USA. · Laboratorio de Paleopatologia, Catedra Pedro Weiss, Universidad Peruana Cayetano Heredia, Lima, Peru. · Newport Diagnostic Center, Newport Beach, CA, USA. · Saddleback Memorial, Laguna Hills, CA, USA. · University of Cambridge, Cambridge, UK. · National Research Center, Giza, Egypt. · Cairo University, Cairo, Egypt. · Institute of Restoration, Alexandria, Egypt. · Mission Internal Medical Group, Mission Viejo, CA, USA. · Smithsonian Institution, National Museum of Natural History, Washington, DC, USA. · University for Science and Technology, 6th of October City, Egypt. · University of Ottawa Heart Institute, Ottawa, Ontairo, Canada. · Mount Sinai, New York, NY, USA. · Institute for Mummies and the Iceman, European Academy, Bolzano, Italy. · University of Southern California, Los Angeles, CA, USA. · Miller Children's Hospital, Long Beach, CA, USA; University of California, Irvine, CA, USA. · MemorialCare Heart & Vascular Institute, Long Beach Memorial, Long Beach, CA, USA; University of California, Irvine, CA, USA. Electronic address: gthomas1@memorialcare.org. ·J Cardiol · Pubmed #24582386.

ABSTRACT: Case reports from Johan Czermak, Marc Ruffer, and others a century or more ago demonstrated ancient Egyptians had atherosclerosis three millennia ago. The Horus study team extended their findings, demonstrating that atherosclerosis was prevalent among 76 ancient Egyptian mummies and among 61 mummies from each of the ancient cultures of Peru, the American Southwest, and the Aleutian Islands. These findings challenge the assumption that atherosclerosis is a modern disease caused by present day risk factors. An extensive autopsy of an ancient Egyptian teenage male weaver named Nakht found that he was infected with four parasites: Schistosoma haematobium, Taenia species, Trichinella spiralis, and Plasmodium falciparum. Modern day patients with chronic inflammatory disease such as rheumatoid arthritis, systemic lupus erythematosus, and human immunodeficiency virus experience premature atherosclerosis. Could the burden of chronic inflammatory disease have been a risk factor for atherosclerosis in these ancient cultures? The prevalence of atherosclerosis in four diverse ancient cultures is consistent with atherosclerosis being fundamental to aging. The impact of risk factors in modern times, and potentially in ancient times, suggests a strong gene-environmental interplay: human genes provide a vulnerability to atherosclerosis, the environment determines when and if atherosclerosis becomes manifest clinically.

9 Clinical Trial Role of Proximal Optimization Technique Guided by Intravascular Ultrasound on Stent Expansion, Stent Symmetry Index, and Side-Branch Hemodynamics in Patients With Coronary Bifurcation Lesions. 2017

Hakim, Diaa / Chatterjee, Arka / Alli, Olusuen / Turner, Joshua / Sattar, Assad / Foin, Nicolas / Leesar, Massoud A. ·From the Division of Cardiology, University of Alabama at Birmingham (D.H., A.C., O.A., J.T., A.S., M.A.L.) · Suez Canal University, Ismailia, Egypt (D.H.) · and Medtech Research Theme, National Heart Centre Singapore and Duke-NUS Medical School (N.F.). ·Circ Cardiovasc Interv · Pubmed #29038225.

ABSTRACT: BACKGROUND: Bench models of coronary bifurcation lesions demonstrated that the proximal optimization technique (POT) expanded the stent and opened the side branch (SB). We investigated the role of POT guided by intravascular ultrasound on the main vessel (MV) stent expansion and SB fractional flow reserve (FFR) in patients with coronary bifurcation lesion. METHODS AND RESULTS: In 40 patients with coronary bifurcation lesion, 120 intravascular ultrasound examinations of the MV were performed at baseline, after MV stenting, and POT followed by 95 FFR measurements of the SB. In the proximal stent segment, stent volume index and minimum stent area were larger after POT versus MV stenting (9.2±3.4 versus 7.40±2.0 mm CONCLUSIONS: This is the first study of POT guided by intravascular ultrasound in patients with coronary bifurcation lesion, demonstrating that POT symmetrically expanded the proximal and bifurcation segments of the stent. After POT, SB FFR was <0.75 in a third of patients, which improved to >0.75 after SB dilation or SB stenting+final POT.

10 Clinical Trial Patients with end-stage renal disease: optimal diagnostic and prognostic performance of myocardial gated-SPECT, initial results. 2013

Amin, Amr / Younis, Gehan / El-Khatib, Mohamed / Ali, Ismail. ·Departments of Nuclear Medicine, Faculty of Medicine, Cairo University, Egypt. amramin67@gmail.com ·Nucl Med Commun · Pubmed #23407369.

ABSTRACT: PURPOSE: We investigated the role of Tc-99m sestamibi myocardial perfusion gated single photon emission computed tomography (GSPECT) in identifying those patients with end-stage renal disease (ESRD) in whom optimal diagnosis of coronary artery disease and prediction of cardiac events (CEs) could be achieved. METHODS: This was a prospective study that included 41 asymptomatic ESRD patients who had been undergoing hemodialysis for 12 months or less (22 men and 19 women) with restricted selection criteria (asymptomatic traditional risk). Tc-99m sestamibi GSPECT was carried out for all patients, whereas coronary angiography (Cath) was carried out only for abnormal GSPECT patients, with a 2-year follow-up for CEs. Twenty individuals matched for age, sex, and BMI formed the control group. RESULTS: Of the 41 ESRD patients, 13 showed abnormal GSPECT [11/13 with myocardial perfusion defects and left ventricular dysfunction in concordance with Cath and 2/13 with only left ventricular dysfunction (i.e. stunning)] compared with 1/20 in the control group. None of the patients with negative results experienced CEs (negative predictive value 100%); these patients had a 2-year CE-free survival rate of 100% compared with 46% for patients with positive results on GSPECT (P<0.0001; seven GSPECT-positive patients developed CEs during their follow-up). Patients with positive results were more frequently male (P<0.001), were significantly older (P=0.01), and had highly sensitive C-reactive protein levels (P=0.002). Abnormal GSPECT was the only independent predictor of CEs (95% confidence interval, 7.1-46.7; hazard ratio, 46.1; P<0.001). CONCLUSION: GSPECT exhibited optimum performance for coronary artery disease detection and risk stratification in asymptomatic ESRD patients during their first year of regular hemodialysis who were selected according to our modification of the traditional risk category. This may help in selecting suitable candidates for Cath, revascularization, and future renal transplantation.

11 Article Testing Real-World Application of Appropriateness Criteria of Single Photon Emission Computed Tomography (SPECT) In Two Egyptian Hospitals. 2020

Abdeltawab, Adham / Mansour, Hazem / Rayan, Mona. ·Cardiology Department, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, P.O. 11381, Egypt. Adham_abdeltawab@med.asu.edu.eg. · Cardiology Department, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, P.O. 11381, Egypt. ·Egypt Heart J · Pubmed #31925577.

ABSTRACT: BACKGROUND: The American College of Cardiology pioneered appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging in 2005 to account for evidence-based clinical relevance of stress perfusion imaging. Our aim was to assess and compare appropriateness use criteria in in Kobry al Kobba military hospital and Ain Shams University hospitals. METHODS: All patients were subjected to thorough history taking, calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria and stress-rest Tc 99m imaging to detect the presence of ischemia and one day Tc 99m imaging to detect viability. RESULTS: The study included 442 patients with mean age of 56.5 years, with male predominance (77%), 38% were diabetics and 58% had hypertension. Seventy-eight percent of patients had appropriate tests, uncertain tests in 12% and 10% inappropriate studies. 47% of appropriate tests show positive results of SPECT. CONCLUSION: We concluded that appropriateness criteria are effective in identifying appropriateness of SPECT in a diverse patient population.

12 Article Correlation between prediabetes and coronary artery disease severity in patients undergoing elective coronary angiography. 2019

Muhammed, Ahmed / Zaki, Mohamed Tarek / Elserafy, Ahmed Shawky / Amin, Sameh Attia. ·Department of Cardiology, Ain Shams University, Cairo, Egypt. · Department of Cardiology, Ain Shams University, Cairo, Egypt. Ahmedshawkyelserafy@gmail.com. ·Egypt Heart J · Pubmed #31883041.

ABSTRACT: BACKGROUND: Diabetes is a chronic disease that is responsible for a high rate of morbidity and mortality which can be attributed to atherosclerosis and cardiovascular disease. Diabetes is heralded by prediabetes which not only indicates a higher risk of developing diabetes but also increases the burden of cardiovascular disease. The objective was to observe the effect of prediabetes on the severity of coronary artery disease in patients undergoing elective coronary angiography. Seven hundred and thirty-one patients were admitted for elective coronary angiography and/or PCI starting from September 2017 to August 2018. Patients were divided into group A (normoglycemic group, N = 228), group B (prediabetes group, N = 177), and group C (diabetic group, N = 326). Coronary artery disease (CAD) severity including number of vessels affected and atherosclerotic burden by Gensini score were compared among different groups. RESULTS: The number of vessels affected as well as left main (LM) disease was higher in the prediabetes group when compared to the normoglycemic group (P,=0.001, P = 0.009, respectively) and was comparable to the diabetes group (P = 0.4, P = 0.6, respectively). Prediabetes showed a Gensini score higher than the normoglycemic group (P = 0.0001) with no significant difference when compared to the diabetic group (P = 0.9). CONCLUSION: Prediabetes is associated with high atherosclerotic burden and coronary artery disease complexity that is similar to diabetic than normoglycemic individuals.

13 Article Glycated hemoglobin predicts coronary artery disease in non-diabetic adults. 2019

Ewid, Mohammed / Sherif, Hossam / Billah, Syed Muhammad Baqui / Saquib, Nazmus / AlEnazy, Wael / Ragab, Omer / Enabi, Saed / Rajab, Tawfik / Awad, Zaki / Abazid, Rami. ·College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia. drmohammedowid@yahoo.com. · Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt. drmohammedowid@yahoo.com. · College of Medicine, Sulaiman Al Rajhi Colleges, P.O. Box 777, Al Bukayriah, Qassim 51941, Saudi Arabia. · Critical Care Medicine Department, Faculty of Medicine, Cairo University, Critical Care, Kasr A. Ainy St, Cairo, 11562, Egypt. · Prince Sultan Cardiac Center, Ministry of Health, Al Qassim, Qassim 52366, Buraydah, 7430 An Naziyah, Saudi Arabia. · Department of Nuclear Medicine, London Health Sciences Center, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada. ·BMC Cardiovasc Disord · Pubmed #31864310.

ABSTRACT: BACKGROUND: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Due to increased CAD risk factors in Saudi Arabia, research on more feasible and predictive biomarkers is needed. We aimed to evaluate glycated hemoglobin (HbA1c) as a predictor of CAD in low-risk profile non-diabetic patients living in the Al Qassim region of Saudi Arabia. METHODS: Thirty-eight patients with no history of CAD were enrolled in this cross-sectional study. They provided demographic data, and their HbA1c estimation followed the National Glycohemoglobin Standardization Program parameters. All patients underwent coronary computed tomography angiography (CCTA) for evaluation of chest pain. The extent of coronary artery stenosis (CAS) was quantified as percentage for each patient based on plaques detected in CCTA. RESULTS: Mean blood pressure of the patients was (91.2 ± 11.9 mmHg), BMI (28.3 ± 5.8 kg/m CONCLUSION: Glycated hemoglobin can be used as a predictive biomarker for CAD in non-diabetic low-risk patients.

14 Article The validity and applicability of CAD-RADS in the management of patients with coronary artery disease. 2019

Basha, Mohammad Abd Alkhalik / Aly, Sameh Abdelaziz / Ismail, Ahmad Abdel Azim / Bahaaeldin, Hanan A / Shehata, Samar Mohamad. ·Department of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt. Mohammad_basha76@yahoo.com. · Department of Radio-diagnosis, Benha University, Benha, Egypt. · Department of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt. ·Insights Imaging · Pubmed #31802266.

ABSTRACT: BACKGROUND: The coronary artery disease reporting and data system (CAD-RADS) is designed for a uniform standardization of coronary computed tomography angiography (CCTA) reporting and further management recommendations of coronary artery disease (CAD). This study aimed to assess clinical validity, applicability, and reproducibility of CAD-RADS in the management of patients with CAD. METHODS AND RESULTS: A single-center prospective study included 287 patients with clinically suspected or operated CAD who underwent CCTA. Four reviewers evaluated the CCTA images independently and assigned a CAD-RADS category to each patient. The invasive coronary angiography (ICA) was used as the reference standard for calculating diagnostic performance of CAD-RADS for categorizing the degree of coronary artery stenosis. The intra-class correlation (ICC) was used to test the inter-reviewer agreement (IRA). Reporting was provided to referring consultants according to the CAD-RADS. Based on ICA results, we have 156 patients with non-significant CAD and 131 patients with significant CAD. On a patient-based analysis, regarding those patients classified as CAD-RADS 4 and CAD-RADS 5 for predicting significant CAD, the CAD-RADS had a sensitivity, specificity, and an accuracy of 100%, 96.8 to 98.7%, and 98.3 to 99.3%, respectively, depending on the reviewer. There was an excellent IRA for CAD-RADS categories (ICC = 0.9862). The best cutoff value for predicting significant CAD was > CAD-RADS 3. Eighty-seven percentage of referring consultants considered CAD-RADS reporting system to be "quite helpful" or "completely helpful" for clinical decision-making in CAD. CONCLUSION: CAD-RADS is valuable for improving CCTA structural reports and facilitating decision-making with high diagnostic accuracy and high reproducibility.

15 Article Molecular Dynamics Simulation Reveals Exposed Residues in the Ligand-Binding Domain of the Low-Density Lipoprotein Receptor that Interacts with Vesicular Stomatitis Virus-G Envelope. 2019

Al-Allaf, Faisal A / Abduljaleel, Zainularifeen / Taher, Mohiuddin M / Abdellatif, Ahmed A H / Athar, Mohammad / Bogari, Neda M / Al-Ahdal, Mohammed N / Al-Mohanna, Futwan / Al-Hassnan, Zuhair N / Alzabeedi, Kamal H Y / Banssir, Talib M / Bouazzaoui, Abdellatif. ·Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, P.O. Box 715, Makkah 21955, Saudi Arabia. · Science and Technology Unit, Umm Al Qura University, P.O. Box 715, Makkah 21955, Saudi Arabia. · Molecular Diagnostics Unit, Department of Laboratory and Blood Bank, King Abdullah Medical City, Makkah 21955, Saudi Arabia. · Pharmaceutics Department, College of Pharmacy, Qassim University, Qassim, 51452, Saudi Arabia. · Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt. · Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi Arabia. · Regional Laboratory, Makkah 25321, Saudi Arabia. ·Viruses · Pubmed #31731579.

ABSTRACT: Familial hypercholesterolemia (FH) is an autosomal dominant disease most often caused by mutations in the low-density lipoprotein receptor (LDLR) gene, which consists of 18 exons spanning 45 kb and codes for a precursor protein of 860 amino acids. Mutations in the LDLR gene lead to a reduced hepatic clearance of LDL as well as a high risk of coronary artery disease (CAD) and sudden cardiac death (SCD). Recently, LDLR transgenes have generated interest as potential therapeutic agents. However, LDLR packaging using a lentiviral vector (LVV) system pseudotyped with a vesicular stomatitis virus (VSV)-G envelope is not efficient. In this study, we modified the LVV system to improve transduction efficiency and investigated the LDLR regions responsible for transduction inhibition. Transduction efficiency of 293T cells with a 5'-LDLReGFP-3' fusion construct was only 1.55% compared to 42.32% for the eGFP construct. Moreover, co-expression of LDLR affected eGFP packaging. To determine the specific region of the LDLR protein responsible for packaging inhibition, we designed constructs with mutations or sequential deletions at the 3' and 5' ends of LDLR cDNA. All constructs except one without the ligand-binding domain (LBD) (pWoLBD-eGFP) resulted in low transduction efficiency, despite successful packaging of viral RNA in the VSV envelope, as confirmed through RT-PCR. When we evaluated a direct interaction between LDLR and the VSV envelope glycoprotein using MD simulation and protein-protein interactions, we uncovered Val119, Thr120, Thr67, and Thr118 as exposed residues in the LDLR receptor that interact with the VSV protein. Together, our results suggest that the LBD of LDLR interacts with the VSV-G protein during viral packaging, which significantly reduces transduction efficiency.

16 Article Cyclophilin A and matrix metalloproteinase-9: Their relationship, association with, and diagnostic relevance in stable coronary artery disease. 2019

Ebrahim, Hala F / Abdel Hamid, Fatma F / Haykal, Mohamed A / Soliman, Ahmed F. ·Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt. · Cardiovascular and Ultrasonography Unit, Research Institute of Ophthalmology, Council of Research Centers and Institutes, Giza, Egypt. ·Vascular · Pubmed #31594532.

ABSTRACT: -- No abstract --

17 Article Incidental Non-cardiac Findings in Coronary Computed Tomography Angiography: Is it Worth Reporting? 2019

Ramanathan, Subramaniyan / Ladumor, Sushila B / Francis, Willington / Allam, Abdelnasser A / Alkuwari, Maryam. ·Departments of Clinical Imaging, Al Wakra Hospital, Hamad Medical Corporation, Qatar. · Department of Radiology, Weill Cornell Medicine, Doha, Qatar. · Departments of Clinical Imaging, Hamad General Hospital, Hamad Medical Corporation, Qatar. · Departments of Clinical Imaging, Heart Hospital, Hamad Medical Corporation, Qatar. · Department of Radiology, Al Azhar Faculty of Medicine, Cairo, Egypt. ·J Clin Imaging Sci · Pubmed #31538038.

ABSTRACT: Objectives: The objectives of this study were to estimate the prevalence and significance of incidental non-cardiac findings (INCFs) in coronary computed tomography angiography (CCTA) using a dual-source multidetector computed tomography. Materials and Methods: Retrospective review of all CCTA studies performed over a time period for various indications was included in the study. After exclusions, CCTA of 1713 patients was evaluated by two experienced cardiac radiologists for non-cardiac abnormalities in the full field-of-view limited contrast chest series. The scans were acquired from the level of the carina to just below the diaphragm. INCFs were classified into three categories: Significant, indeterminate, and insignificant findings based on their clinical impact and availability of prior imaging and clinical details. Results: The study cohort consisted of 1123 males (mean age of 58 years) and 590 females (mean age of 64 years). INCFs were seen in 600 patients of 1713 patients. A total of 812 INCFs (47.5%) were found in 1713 patients. Of those, 568 (70%) were considered insignificant, 205 (25.2%) indeterminate, and 39 significant findings (4.9%). The prevalence of significant findings was 2.3%. Among the 39 significant findings, after correlating with clinical details and other imaging, nine were really significant findings (0.5%) and out of this, four turned out to be cancers (0.2%). Conclusion: Large number of INCFs can be found in CCTA with majority of them being insignificant or of minimal clinical impact. Although the proportion of significant findings is small and may not be cost beneficial, it is prudent to evaluate all the available data and to make appropriate classification of INCFs which can help in further management.

18 Article Echocardiographic association of epicardial fat with carotid intima-media thickness in patients with type 2 diabetes. 2019

Yafei, Saeed / Elsewy, Fathy / Youssef, Eman / Ayman, Mohamed / Elshafei, Mohamed / Abayazeed, Rasha. ·1 Diabetes and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt. · 2 Department of Internal Medicine, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen. · 3 Cardiology and Angiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. · 4 Department of Radiodiagnosis, Faculty of Medicine, Alexandria University, Alexandria, Egypt. ·Diab Vasc Dis Res · Pubmed #31271311.

ABSTRACT: BACKGROUND: Epicardial fat is recognized as active endocrine organ and as emerging risk factor for cardio-metabolic diseases. The aim of this study was to explore the relationship between epicardial fat and carotid intima-media thickness in type 2 diabetes patients. METHODS: Epicardial fat thickness was measured in 76 type 2 diabetes patients without clinical atherosclerotic cardiovascular disease and 30 age- and sex-matched controls. In addition to laboratory tests, all patients underwent transthoracic echocardiography for epicardial fat thickness and ultrasonographic examination of carotid intima-media thickness. RESULTS: Patients with diabetes had higher epicardial fat thickness and carotid intima-media thickness than those of the controls (6.23 ± 1.27 mm vs 4.6 ± 1.03 mm, CONCLUSION: Patients with type 2 diabetes have higher carotid intima-media thickness and epicardial fat thickness. Epicardial fat thickness was found to be a strong predictor of subclinical atherosclerosis.

19 Article Association of 584C/T polymorphism in endothelial lipase gene with risk of coronary artery disease. 2019

Elnaggar, Ismail Zaki / Hussein, Samia / Amin, Mohamed Ibrahem / Abdelaziz, Eman Ahmed. ·Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Zagazig University, Zagazig, Egypt. · Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt. ·J Cell Biochem · Pubmed #31020688.

ABSTRACT: BACKGROUND: Coronary artery disease (CAD) is one of the cardiovascular diseases, which is caused by a reduced amount of oxygen and blood that goes to the heart. CAD includes stable angina, unstable angina, myocardial infarction, and sudden cardiac death. It is a common cause of death in both men and women. The environmental and genetic factors are involved in the development of CAD. Multiple gene polymorphisms are risk factors of CAD. OBJECTIVE: To evaluate the association between EL 584C/T polymorphism, CAD risk, and lipid profile in an Egyptian population. METHODS: This is a case-control study. The patients were classified into three groups: Group A: Control group, this group included 42 apparently healthy people. Group B: included 42 subjects diagnosed with previous myocardial infarction (MI). Group C: included 42 subjects diagnosed with unstable angina (UA). RESULTS: The frequencies of TT and CT genotypes and T allele were higher in control healthy individuals than CAD patients. In addition, the risk of CAD was significantly lower in individuals carrying T allele (P = 0.001). Serum high-density lipoprotein (HDL) levels were significantly higher in healthy individuals and CAD patients (MI and UA patients) carrying EL 584 T allele compared with those carrying CC genotype (P ≤  0.001). By multiple logistic regression, we found that the protective effect of T allele remained significant (P = 0.005) and it decreased the risk of CAD independent of plasma HDL levels. CONCLUSION: There was a significant difference between 584C/T polymorphism in the EL gene and CAD and HDL level. T-allele carriers had a higher HDL level and were protected from CAD. T allele was significantly associated with the decreased risk of CAD independent of plasma HDL levels.

20 Article Predictive Value of Osteoprotegerin for Detecting Coronary Artery Calcification in Type 2 Diabetes Mellitus Patients in Correlation with Extent of Calcification Detected by Multidetector Computed Tomography. 2019

Ahmed, Sahar / Sobh, Rasha. ·Department of Internal Medicine, Kasr Ainy Cairo University, Cairo, Egypt. ·Endocr Metab Immune Disord Drug Targets · Pubmed #30747085.

ABSTRACT: BACKGROUND: Osteoprotegerin (OPG) is a tumor necrosis factor receptor super-family member. It specifically acts on bone by increasing bone mineral density and bone volume. Recent studies have evidenced its close relation to the development of atherosclerosis and plaque destabilization. Elevated OPG level has also been associated with the degree of coronary calcification in the general population and it has been considered to be a marker of coronary atherosclerosis. OBJECTIVE: The aim of this study was to determine the relation between OPG levels and Coronary Artery Calcification score (CACs) in Type 2 diabetic patients in comparison to healthy controls. METHODS: Our study included 45 type 2 diabetic patients (mean age 51.7 years; 51.1% male) without evidence of previous CVD and 45 healthy age and sex matched subjects as control. All participants were subjected to full history, full examination and lab investigations. Serum OPG concentration was measured by an enzyme-linked immunosorbent assay (ELISA) and CAC imaging was performed using non contrast Multi detector CT of the heart. RESULTS: Significant CAC (<10 Agatston units) was seen in 23 patients (51.11 %). OPG was significantly high in diabetic patients in comparison to controls with mean 12.9±5.7 pmol/l in cases, and 8.6±0.5 pmol/l in controls (P value < 0.001). The Coronary Artery Calcification Score (CACS) was positively correlated with age and duration of diabetes. The OPG was positively correlated with age, fasting blood sugar and duration of diabetes. The CACS showed a significantly positive correlation with OPG. CONCLUSION: Findings suggested that increasing in serum OPG was consistent with CAC and could be used for the early diagnosis of subclinical atherosclerosis.

21 Article Diagnostic accuracy of dobutamine stress echocardiography in the detection of cardiac allograft vasculopathy in heart transplant recipients: A systematic review and meta-analysis study. 2019

Elkaryoni, Ahmed / Abu-Sheasha, Ghada / Altibi, Ahmed M / Hassan, Adil / Ellakany, Karim / Nanda, Navin C. ·Division of Internal Medicine, University of Missouri Kansas City, Kansas City, Missouri. · Division of Biomedical Statistics and Medical Informatics, Medical Research Institute, Alexandria University, Alexandria, Egypt. · Division of Internal Medicine, Henry Ford Allegiance Health, Jackson, Michigan. · Division of Cardiovascular Disease, University of Alexandria School of medicine, Alexandria, Egypt. · Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama. ·Echocardiography · Pubmed #30726558.

ABSTRACT: BACKGROUND: Dobutamine stress echocardiography (DSE) is a well-established imaging modality used to screen patients with mild-to-moderate risk for coronary artery disease. In heart transplantation recipients, cardiac allograft vasculopathy (CAV) is a common and lethal complication. The use of DSE to detect CAV showed promising results initially, but later studies showed limitation in its use to detect CAV. It is unclear if this cohort of patients derives benefit from DSE. METHODS: We searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Scopus from inception through March 2018 for studies examining the accuracy of DSE in correlation to coronary angiography (CA) or intravascular ultrasound (IVUS) to detect CAV. Original studies comparing the ability of DSE to detect CAV in comparison with CA or IVUS were included. Relevant data were extracted and hierarchical summary receiver operating characteristic analysis was conducted to test the overall diagnostic accuracy of DSE for patients with CAV. RESULTS: Eleven studies (749 participants) met the inclusion criteria. The sensitivity of DSE varied from 1.7% to 93.8%, and specificity, from 54.8% to 98.8%. Pooled sensitivity was 60.2% (95% confidence interval (CI), 33.0%-82.3%) and specificity 85.7% (95% CI, 73.8%-92.7%). DSE had an overall diagnostic odds ratio (OR) of 9.1 (95% CI, 4.6-17.8), positive likelihood ratio (LR+) of 4.1 (95% CI, 2.8-6.1), negative likelihood ratio (LR-) of 0.47 (95% CI: 0.23-0.73), and area under curve (AUC) of 0.73 (95% CI, 0.72-0.75). Heterogeneity among studies was not statistically significant (τ CONCLUSION: Dobutamine stress echocardiography has a limited sensitivity to detect early CAV but its specificity is much higher. There remains a need for an alternative noninvasive modality which will have both high sensitivity and high specificity for detecting CAV.

22 Article MicroRNAs 342 and 450 together with NOX-4 activity and their association with coronary artery disease in diabetes. 2019

Seleem, Mae / Shabayek, Marwa / Ewida, Heba A. ·Department of Pharmacology and Biochemistry, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt. ·Diabetes Metab Res Rev · Pubmed #30681251.

ABSTRACT: BACKGROUND: Dysregulation of miRNAs has been associated with many clinical conditions, including coronary artery disease (CAD). MiRNAs roles in patients with type 2 diabetes mellitus (T2D) with or without CAD, however, have not been clearly understood. Therefore we studied the expression of miRNAs 342 and 450 and the activity of the NADPH oxidase 4 (NOX-4), and their association with anthropometric and biochemical parameters of hyperglycaemia and dyslipidaemia. SUBJECTS AND METHODS: Blood was collected from 200 outpatient subjects, divided into four groups of 50 individuals including control, T2D, CAD, and T2D with CAD. CAD was further divided based on CAD with angina, CAD clots, and CAD ischaemia to differentiate the primary cause of CAD. We measured the miRNAs 342 and 450 expression and NOX-4 activity, in addition to routine parameters. RESULTS: The expression of miRNAs 342 and 450 and NOX-4 activity was significantly different between groups. Furthermore, they presented significant correlations with routine parameters, providing evidence of a potentially beneficial role in stratifying the risk for CAD in patients with T2D. CONCLUSION: The results of this study suggest that the expression of miRNAs 342 and 450 and NOX-4 activity may help identify those individuals with T2D at high risk for developing CAD as well as the prognosis in those with established CAD.

23 Article A genetic variant c.553G > T (rs2075291) in the apolipoprotein A5 gene is associated with altered triglycerides levels in coronary artery disease (CAD) patients with lipid lowering drug. 2019

Bogari, Neda M / Aljohani, Ashwag / Amin, Amr A / Al-Allaf, Faisal A / Dannoun, Anas / Taher, Mohiuddin M / Elsayed, Atalla / Rednah, Dareen Ibrahim / Elkhatee, Osama / Porqueddu, Massimo / Alamanni, Francesco / Khogeer, Soud Abdulraof A / Fawzy, Ahmed. ·Medical Genetics department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. nmbogari@uqu.edu.sa. · Medical Genetics department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. Asjohani@uqu.edu.sa. · Biochemistry Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. · Faculty of Medicine, AinShams University, Giza, Egypt. · Medical Genetics department, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. · Science and Technology Unit, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. · ST JAMES'S HOSPITAL-Republic of Ireland, Ireland, Dublin. · Occupational Medicine, the University of Manchester, Manchester, UK. · Orthopedic residant, Fakeeh hospital, Jeddah, Kingdom of Saudi Arabia. · Department of Cardiology, Dalhousie University Halifax, Halifax, Nova Scotia, Canada. · Department of Cardiac Surgery, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia. · Department of Cardiac Surgery, Head of Cardiac Surgery, Monzino Heart Center - University of Milan, Milan, Italy. · Division of Human Genetics and Genome Research, Department of Molecular Genetics and human Enzymology, National Research Centre, 33Bohouth St. Dokki, Giza, Egypt. afawzy1978@yahoo.com. ·BMC Cardiovasc Disord · Pubmed #30606120.

ABSTRACT: BACKGROUND: Elevated plasma triglycerides (TGs) are widely used as a major cardiovascular risk predictor and are thought to play an important role in the progression of coronary heart disease (CHD). It has been demonstrated that lipid lowering was associated with lower mortality in patients with CHD. The present study therefore aimed to investigate the consequences of the genetic variant c.553G > T (rs2075291) in apolipoprotein A5 gene to determination of triglycerides levels in CAD patients receiving, atorvastatin, lipid lowering drug. METHODS: We here report that a recently identified genetic variant, c.553G > T in the APOA5 gene which causes a substitution of a cysteine for a glycine residue at amino acid residue 185(G185C) is also associated with increased TG levels. To investigate theses effects, a case-control study compressing 608 subjects from the same area was performed. RESULTS: TG levels in T allele patients were significantly lower than the control GT allele patient (χ CONCLUSION: Nevertheless, T allele is found to reduce TG levels in CAD patients who are on the cholesterol medication, atorvastatin. Thus, c.553G > T variant can be considered as a significant predicator of hypertriglyceridemia. In addition, it could be used as a hallmark for the diagnosis and prognosis of CAD.

24 Article Association of Vitamin D Deficiency with Chronic Stable Angina: A Case Control Study. 2019

Raslan, Eman / Soliman, Saeed S Abduljalil / Nour, Zeinab A / Ahmed, Dalia / Saad, Nagwa Eid Sobhy. ·Faculty of Medicine, Cairo University, Giza, Egypt. · Faculty of Medicine, Cairo University, Giza, Egypt. saeed.salah@medicine.cu.edu.eg. ·High Blood Press Cardiovasc Prev · Pubmed #30588571.

ABSTRACT: INTRODUCTION: Coronary heart disease is a major cause of death worldwide. Although the relationship between vitamin D status and cardiovascular diseases is not clearly understood, vitamin D deficiency could be a potentially modifiable and underestimated risk factor for ischemic heart diseases. This study aims to assess and compare vitamin D status between patient group with chronic stable angina and matched control group. METHODS: A case-control study was conducted on chronic stable angina patients and matched controls attending family medicine/internal medicine clinics at Cairo University Hospitals. Forty two adult patients with chronic stable angina and forty two matched controls were studied. Detailed medical history, examination, and laboratory tests (vitamin D, fasting lipid profile, and blood sugar) were collected from study participants of both groups. RESULTS: Severe vitamin D deficiency was found in 78.6% and 7.1% of cases and controls, respectively. Vitamin D level was found to be a significant predictor of chronic stable angina. Every unit (ng/ml) increase in vitamin D level decreases the chance of the subject to have chronic stable angina by 0.30 times. CONCLUSION: There is a significant association between vitamin D deficiency and the occurrence of chronic stable angina.

25 Article Effect of Dexmedetomidine Infusion on Sublingual Microcirculation in Patients Undergoing On-Pump Coronary Artery Bypass Graft Surgery: A Prospective Randomized Trial. 2019

Mohamed, Hassan / Hosny, Hisham / Tawadros Md, Pierre / Elayashy Md Desa Fcai, Mohamed / El-Ashmawi Md, Hossam. ·Department of Anesthesia and Intensive Care, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt. · Department of Anesthesia and Intensive Care, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.; Department of Anaesthesia, Royal Brompton Hospital, Royal Brompton and Harefield Foundation Trust, London, United Kingdom. Electronic address: hishamhosny@kasralainy.edu.eg. ·J Cardiothorac Vasc Anesth · Pubmed #30075898.

ABSTRACT: OBJECTIVES: Cardiac surgery is characterized by attenuation of microcirculatory perfusion. Dexmedetomidine has been proved to attenuate the microcirculatory derangements evoked by experimental sepsis. The authors investigated the effects of dexmedetomidine infusion on sublingual microcirculation in patients undergoing on-pump coronary artery bypass graft (CABG) surgery. DESIGN: Prospective, randomized blinded study. SETTINGS: Tertiary university hospital. PARTICIPANTS: A total of 70 adults undergoing elective on-pump CABG surgery. INTERVENTION: After a standard general anesthesia, participants were allocated randomly to receive either propofol continuous intravenous infusion, 50 to 70 µg/kg/min, or propofol infusion, 50 to 70 µg/kg/min plus dexmedetomidine infusion, 0.5 µg/kg/h, during cardiopulmonary bypass. Microcirculation was studied with side-stream dark field imaging at 3 times: immediately before starting bypass (T0), 30 minutes after initiation of bypass (T1), and 30 minutes after weaning from bypass (T2). MEASUREMENTS AND MAIN RESULTS: Microvascular flow index was significantly higher in the dexmedetomidine group at T2 compared to the control group (2.20 ± 0.29 and 1.47 ± 0.30, respectively; p = 0.001). The perfused vessel density was significantly higher in the dexmedetomidine group at T2 compared to the control group (6.1 [3-8.9] mm/mm² and 3.3 [2.2-4.3] mm/mm², respectively; p = 0.01). The total vascular density was significantly higher in the dexmedetomidine group compared to the control group at T1 and T2 (9.9 [7.8-12.6] mm/mm² v 7.4 [6.1-9] mm/mm², p = 0.005; and 9.27 ± 2.27 mm/mm² v 7.24 ± 1.66 mm/mm², p = 0.003, respectively). CONCLUSION: This trial demonstrated that dexmedetomidine infusion improved sublingual microcirculation indices in patients undergoing on-pump CABG surgery.

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