الفهرس 
Outcome of primary percutaneous coronary intervention in correlation to coronary arterial dominance
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Abstract
Background : The pattern of coronary arterial dominance varies in different populations and the knowledge of dominant pattern has clinical significance. Limited information is available regarding the relationship between coronary vessel dominance and outcome after ST-segment elevation myocardial infarction (STEMI). Objectives: The study was designed to evaluate the prognostic value of coronary arterial domi»nance post primary PCI during hospital stay and at 3-month follow-up, which included; cardiac mortality, heart failure, non fatal myocardial infarction, re-vascularization, Stroke/TIA and re-admission for ACSPatients &Methods:Three hundredconsecutive patients(mean age 57.35 ±13.41 years and 91.33% men) wereadmitted toDallah hospital, from January 2015 to December 2016, with ST-elevation myocardial infarction (STEMI) who underwent successful primary percutaneous coronary interventionwith TIMI III flow and without complications. The patients had been divided into 3 groups according to angiographic coronary dominance, 227(75.7%)right coronary dominant group,40(13.3%)left coronary dominant group and 33(11%)balanced coronary dominant group.Patients were evaluated with 2-D and 3-D echocardiography within 48 hours of admission (baseline) and at 3-month follow-up after STEMI.Results:Right dominance was present in 75.6%, left dominance in 13.3%, and balanced dominance was present in 11%. The main finding of this study was that a left dominant system was associated with increased risk of cardiac mortality, heart failure, non-fatal myocardial infarction, re-vascularization, stroke/TIA shortly after primary PCI,during hospital stay and at 3-months follow up post-STEMI. Moreover, slightly lower left ventricular ejection fraction at discharge was observed by both 2-D and 3-D echocardiography in patients with a left dominant system, and it was comparable to a right dominant and balanced system at 3-months follow up post-STEMI suggesting that left coronary vessel dominance remained independent predictor of worse prognosis after correcting for abnormal left ventricular systolic function