In-Hospital Outcome of Primary Percutaneous Coronary Intervention in Addict ST Elevation Myocardial Infarction Patients in Assuit University Hospital.

Myocardial infarction (MI), is a type of acute coronary syndrome, in which there is damage to the cardiac muscle as demonstrated by increased cardiac Troponin levels in the setting of acute ischemia (1). Myocardial infarction (MI) is a fatal disease that is caused by block in the oxygen supply of blood vessels of the heart muscle, leading to permanent heart muscle damage and death of its cells. According to world health organization (WHO) report published in 2014, 68% of global deaths annually related to non communicable diseases, Cardiovascular diseases constitute 31% of these deaths denoting that they are the leading cause of death (2). Risk factors of cardiovascular diseases include behavioral factors as eating un healthy food, smoking, alcohol intake, and other substance abuse.

Regarding management of MI, There have been several studies that have shown the superiority of percutaneous coronary intervention (PCI) as a treatment for ST-elevation myocardial infarction (STEMI) when compared with thrombolytic therapy in terms of reducing mortality rate and recurrence of myocardial infarction (MI) [3-5].

Regarding Drug abuse cardiovascular effects. It depends on the drug, dose, and route of administration, cardiovascular consequences can range from innocuous side effects, to life threatening ventricular arrhythmias and myocardial infarction.

Sympathomimetic drugs like amphetamines cause an increase in release of peripheral catecholamines stimulating increases in heart rate, systemic vascular resistance, and cardiac contractility, thus resulting in augmentation of cardiac output and blood pressure. In contrast, several drugs are directly cardiodepressant in the acute setting, and many drugs of both types are cardiotoxic causing cardiomyopathy and congestive heart failure with long-term use.

Changes in the balance of myocardial oxygen supply and demand with drug use can lead to myocardial ischemia. For example, cocaine increases oxygen demand in the myocardium while simultaneously decreasing supply by inducing epicardial coronary vasoconstriction. Modulation of lipid profiles, coagulation factors, platelet function, and inflammation further heighten the risk of cardiac ischemic events in patients using these drugs.