Yasseen Abdulruda Yasseen Altaweel

ABSTRACT Objective: To determine the prevalence of psychological disorders among patients with acute coronary syndrome (ACS) in Iraq and identify sociodemographic and clinical predictors associated with these disorders, aiming to inform future psychological and medical interventions. Methods and Materials: A descriptive cross-sectional study was conducted at the Najaf Cardiology Center from February 2023 to January 2025. The sample included 400 ACS patients aged 45–75 years. Psychological assessments were performed during hospitalization and 6–8 weeks post-discharge using validated tools: PHQ-9 (depression), GAD-7 (anxiety), and PCL-5 (PTSD). Data were analyzed with chi-square tests, Pearson correlation, and logistic regression to identify predictors. Findings: Overall, 35% of patients experienced psychological disorders post-ACS, including depression (31%), anxiety (19%), and PTSD (11%), while 50% reported general psychological symptoms. Higher prevalence was observed in females, younger patients, and those with low socioeconomic status, poor social support, or without post-crisis psychological rehabilitation (p<0.05). Severity of cardiac event (e.g., shock, STEMI) and prior psychiatric history significantly increased the risk of psychological distress. Logistic regression confirmed low economic status, lack of social support, and high clinical severity as independent predictors. Conclusion: Psychological disorders are common after ACS and are strongly influenced by both clinical and socioeconomic factors. Integrating routine psychological screening, early intervention, and tailored rehabilitation programs into cardiac care—particularly for high-risk groups—could improve both psychological and cardiovascular outcomes. Keywords: Acute coronary syndrome, psychiatric disorders, post-traumatic stress disorder, depression.

Background: Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive and effective alternative for treating severe aortic stenosis, particularly in high-risk surgical patients. However, infective endocarditis following TAVI (PTIE) represents a rare but serious complication with significant morbidity and mortality, compounded by diagnostic delays and atypical clinical presentations. Objectives: This retrospective cross-sectional study aimed to investigate the incidence, clinical features, microbiological profile, diagnostic challenges, and short-term outcomes of PTIE, as well as to identify predictors of poor prognosis. Methods: Data were collected from 599 patients who underwent TAVI between February 2021 and January 2025 at a specialised cardiovascular centre. Patients diagnosed with PTIE according to the modified Duke Criteria were analysed. Demographics, comorbidities, procedural details, microbiological findings, imaging results, and clinical outcomes were recorded. Statistical analyses included Chi-square tests, t-tests, and logistic regression to identify independent predictors of in-hospital mortality. Results: Out of 599 patients, 27 (4.5%) developed PTIE. The median time from TAVI to infection onset was 64 days. The most common pathogens were Staphylococcus aureus (37%), Enterococcus faecalis (26%), and Streptococcus species (15%). Culture-negative cases accounted for 22%. Echocardiographic findings included prosthetic valve vegetations (59%), paravalvular abscesses (15%), and valve dehiscence ( 7 % .) Short-term outcomes included in-hospital mortality (25.9%), 30-day readmission (37%), and surgical intervention in 11.1%. Independent predictors of in-hospital mortality included S. aureus infection (OR = 3.5, p = 0.01), paravalvular abscess (OR = 4.2, p = 0.01), and diagnostic delay >7 days (OR = 5.1, p = 0.002). Conclusion: Although infrequent, PTIE carries a high risk of mortality and diagnostic difficulty. Early identification of clinical warning signs, especially in high-risk patients such as those with permanent pacemakers, chronic kidney disease, and prolonged ICU stays, is crucial. Improved imaging

Abstract Objective: The Impact of Early ST-Segment Resolution in Acute ST-Elevation Myocardial Infarction after primary percutaneous coronary intervention. Methods: This was a prospective study done at Alnajaf cardiac center. Patients of ST elevation myocardial infarction, who were treated with primary percutaneous coronary intervention were recruited at the time of arrival in the emergency department. ECG was acquired at baseline and within 60 minutes post primary percutaneous coronary intervention. Patients were subsequently divided into two groups(A) Patients with ST segment resolution.(B). Patients without ST segment resolution. Results Ninety patients included in this prospective study, 74 (82%) patients showed ST resolution in their post primary percutaneous coronary intervention, ECG was taken immediately and within 60 minutes after procedure (group A), while 16 (26%) patients showed no ST resolution (group B).Twenty six patients were underwent primary percutaneous coronary intervention within 3 hours after onset of symptoms, 25 (96%) of them showed ST resolution while 1 (4%) did not show ST resolution. Among the 34 patients who underwent primary percutaneous coronary intervention within 3-6 hours after onset of symptoms, 29(85%) showed ST resolution and 5 (15%) did not show ST resolution. Thirty patients were underwent primary percutaneous coronary intervention within 6-12 hours after onset of symptoms and among them 20 (66%) showed ST resolution and 10 (34%)did not show ST resolution ,Pvalue 0.0133. Out of 90 patients, 1 died and his ECG did not show ST resolution in the post primary percutaneous coronary intervention. There was a statistically significant difference in the incidence of all the complications between the two groups Pvalue < 0.001. Conclusions: The extent of ST segment resolution after primary percutaneous coronary intervention provides a good predictor of patient clinical outcome .

Abstract Background: Inflammation plays an important role in the development of acute coronary syndromes (ACS) and post percutaneous coronary intervention (PCI) response due to vascular injury triggered by intervention procedures. During the thrombus formation, the progression of inflammation, neointimal proliferation, a lymphocyte/macrophage infiltration can occur either immediately after or in the hours following the series as an inflammatory response to coronary stent implantation. Bioresorbable vascular scaffold (BVS) thrombosis is a problem with this device in both acute to very late thrombosis. Acute and sub-acute BVS thrombosis is linked with conditions of implantation as shown in drug-eluting stent (DES). Objective: To assess the differences between the two types of coronary systems, Novolimus Bioresorbable scaffold and Novolimus eluting stent implantation associated with acute inflammatory response triggered by percutaneous coronary intervention in coronary artery disease patients. Patients and Methods: A total of forty-four diabetic patients (type II) with unstable angina (29 men and 15 women, aged 43 to 70 years old) were included in this study. All patients submitted to elective PCI at AL-Najaf center for cardiac surgery and Tran’s catheter therapy between January and July 2015. The patients were randomized into two groups in a single-blind study. (Group 1) includes Twenty diabetes patients with coronary artery stenosis undergoing Novolimus Bioresorbable coronary scaffold implantation (Group 2) includes Twenty four diabetes patients with coronary artery stenosis undergoing Novolimus eluting stent implantation. Serum blood samples were drawn from peripheral vein directly before implantation, as well as 12 and 24 hours after implantation to use for measurement of IL-6, PTX3, MMP-9, cTn-I, and C5a by sandwich ELISA method. Results: This comparison of Novolimus eluting coronary stent and Novolimus Bioresorbable coronary scaffold implantation showed a significant increase in serum levels of IL-6, PTX3 at 12 and 24 hrs. and MMP-9 at 24 hrs. (p<0.05) in group 1 as compared with group 2, while the serum levels of cTn-I and C5a were insignificantly changed between two groups of coronary systems (p>0.05). Conclusions: The Novolimus Bioresorbable scaffold with thick strut causes a more marked inflammatory response as compared with Novolimus eluting stent with a thin strut.

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