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Samir Alam

Publications and source records attributed to Samir Alam.

8 recordsLinked to original sources
PubMed2007

Unusual thrombotic cardiac complications of Pemphigus vulgaris: a new link?

We are reporting a case of Pemphigus vulgaris with extensive thrombosis of deep veins, pulmonary veins, and cardiac chambers complicated by myocardial infarction. The extensive skin lesions prohibited the administration of thrombolytics and coronary intervention. The patient was treated conservatively with heparin, and oral anticoagulation in addition to steroids and cyclosporine with significant resolution of thrombosis.

Adult↗
PubMed2005

Predictors of coronary artery disease in the Lebanese population.

BACKGROUND: Coronary artery disease (CAD) is one of the major causes of morbidity and mortality in the world. The disease is determined by many risk factors such as age, gender, diabetes, dyslipidemia, smoking, as well as elevated serum levels of lipoprotein (a) (Lp(a)), homocysteine, C-reactive protein (CRP) and uric acid. In this study, we evaluated the association of biologic and metabolic parameters with CAD in a group of Lebanese patients. METHODS: Three hundred patients were recruited for the study. Biologic and blood metabolic parameters were measured. Patients were then divided into 3 groups according to their catheterization result: 0% stenosis (controls), <50% stenosis and >or=50% stenosis. RESULTS: Hyperlipidemias, CRP, homocysteine and uric acid levels in CAD patients were not different from those of the controls. However, age, elevated fasting blood glucose (FBG) and elevated serum Lp(a) levels were found to be strong independent predictors of CAD in our study population. Association with CAD was also shown for gender, hypertension, diabetes and family history of CAD. CONCLUSION: We report the importance of serum Lp(a) levels and FBG in the prediction and prevention of CAD in our population.

Aged↗
PubMed2005

Prevalence of coronary artery calcium among asymptomatic men and women in a developing country: comparison with the USA data.

BACKGROUND: Coronary artery calcium score (CACS) correlates with atherosclerotic burden and predicts cardiac events. Most of the published data have been derived from the USA population. OBJECTIVE: To study the prevalence of coronary calcium in an asymptomatic population from the eastern Mediterranean region and compare it to data obtained from a large population study in the USA. RESULTS: A total of 1154 asymptomatic men and women from Lebanon underwent EBCT screening because of the presence of one or more CAD risk factors. Mean CACS as well as the percentile cut-points increased consistently with increasing age and, except for those above 74 years of age, were higher in men than women in each age stratum. Age, hypercholesterolemia, diabetes and smoking showed significant associations with CACS in men, while only age and hypercholesterolemia were significantly associated with CACS in women. Among men, the 75th and 90th percentile distributions were comparable to what is observed in developed countries such as the USA. CONCLUSION: Findings, from this first study in the region, suggest that despite a higher rate of diabetes and smokers in our study population, the CACS distribution in Lebanon is similar to that observed in the USA.

Adult↗
PubMed2004

Acute myocardial infarction: clinical characteristics, management and outcome in a university medical centre in a developing Middle Eastern country.

BACKGROUND: The management and outcome of acute myocardial infarction (AMI) have not been well studied in developing countries, although demographic data from the World Health Organization indicate that developing countries contribute a major share to the global burden of cardiovascular disease. OBJECTIVES: To analyze the clinical characteristics, management and outcome of patients hospitalized with AMI in a university medical centre in a developing Middle Eastern country. METHODS: The study population comprised all patients hospitalized with AMI at the American University of Beirut between January 1, 1997, and December 30, 1998. The medical records of the patients were reviewed to determine their clinical characteristics, the diagnostic and invasive procedures used during the hospitalization, and any in-hospital complications, including death. RESULTS: The population comprised 184 patients with a mean age of 60+/-13 years. Fifty-two per cent of the infarcts were anterior and 76% developed Q waves. Fifty-one per cent of the patients received thrombolytic therapy. At discharge, 80% of the patients were given acetylsalicylic acid, 35% were given beta-blockers, 34% were given angiotensin-converting enzyme inhibitors and 30% were given statins. Seventy-two per cent of the patients underwent coronary angiography, 23% underwent percutaneous transluminal coronary angioplasty and 13% had coronary artery bypass grafting. The in-hospital mortality was 13%. The predictors of in-hospital mortality were advanced age (over 60 years), diabetes, prior AMI, Killip class greater than I and ejection fraction less that 40%. In contrast, the predictors of coronary angiography were younger age (less than 60 years), absence of diabetes or no history of AMI, Killip class I and ejection fraction greater than 40%. CONCLUSIONS: Coronary angiography after AMI was performed more frequently than expected in a university medical centre in a developing country, and it seemed to be selectively used in the low- risk patients rather than the high-risk ones. Furthermore, the underuse of medical therapy with beta-blockers and statins was evident. These findings should prompt cardiac societies in these countries to initiate educational campaigns focusing on the cost-effectiveness of therapy in AMI to optimize the use of their limited resources.

Cardiovascular Agents↗
PubMedDate not supplied

Analysis of referral patterns, predictive accuracy, and impact on patient management of myocardial perfusion imaging in a new nuclear cardiology laboratory.

BACKGROUND: Most of the published data on myocardial perfusion imaging (MPI) come from large tertiary-referral medical centers with extensive experience in cardiac imaging as well as a large volume of procedures. Whether the results of MPI remain as reliable in new nuclear cardiology laboratories with smaller volumes of procedures is unknown. The purpose of this study was to analyze the referral patterns, predictive accuracy, and impact of MPI on clinical practice in a newly opened nuclear cardiology laboratory. METHODS AND RESULTS: We performed a prospective study on all patients referred for MPI at our nuclear cardiology laboratory during its first year of operation. Patients were followed up for 3 months after the MPI study to determine whether they underwent coronary angiography. The study population consisted of 334 patients. Their mean age was 56 +/- 10 years, and 80% were men. Of the patients, 30% were asymptomatic, 29% had angina, and only 6% had recent acute myocardial infarction or unstable angina. Fifty-one patients (fifteen percent) were subsequently referred for coronary angiography. The positive and negative predictive values of MPI were 91% and 86%, respectively. The presence of reversible perfusion defects (P =.02) and the presence of multiple perfusion defects (P =.01) on MPI were the most important determinants of subsequent referral to coronary angiography. CONCLUSIONS: MPI stress testing retains its high diagnostic accuracy in a new nuclear cardiology laboratory with a relatively small volume of procedures. Furthermore, MPI findings in this population had a strong impact on the clinical practice of the referring physicians in terms of subsequent referral to coronary angiography.

Cardiology Service, Hospital↗