الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Acute coronary syndrome (ACS) refers to a spectrum of clinical presentations ranging from those for ST-segment elevation myocardial infarction (STEMI) to presentations found in non–ST-segment elevation myocardial infarction (NSTEMI) or in unstable angina. In terms of pathology, ACS is almost always associated with rupture of an atherosclerotic plaque and partial or complete thrombosis of the infarctrelated artery. COVID-19 Reporting and Data System (CO-RADS) is another initiative for standardization, published in mid-March of 2020, which differs from the RSNA’s approach as it is based in previous efforts such as Lung-RADS, PI-RADS, and BI-RADS, which grades the findings on how likely the diagnosis of COVID-19 is. This system was evaluated using 105 randomly selected chest CT scans of patients admitted to the emergency department with clinical suspicion of COVID-19. It also promotes clear, descriptive terms that reduce report ambiguity, offer good performance in predicting moderate-to-severe disease and have a good interobserver agreement. The multifactorial coagulopathy caused by COVID-19 justifies the common incidence of life-threatening thrombotic complications, such as venous thromboembolism (VTE), pulmonary embolism (PE), and ACS. More specifically, patients with ACS and concurrent COVID-19 represent a distinctive clinical setting characterized by hallmarks of heightened thrombogenicity. The aim of the study was to determine the risk of cardiac insults in patients with high CORADS detected in C.T chest. This study was conducted on 100 patients diagnosed with acute coronary syndrome referred to Tanta University Hospitals, Cardiovascular Department within 6 months starting from November 2021. The main results of the study revealed that: • A total of 100 patients with acute coronary syndrome (72 males and 28 females) were recruited in our study with ages ranged between 32 and 71 years and a median age of 58.5 years. In terms of risk factors distribution, out of 100 acute coronary syndrome patients, 39% were diabetic, 59% were hypertensive, 51% were smokers and 63% had dyslipidemia. On the other hand, no patient had history of previous acute coronary syndrome. • laboratory and clinical investigations as the studied patients had a median RBS of 182 mg/dL and a median MAP of 97 mmHg. The majority of our patients (73%) suffered from respiratory symptoms. • 14% of the studied patients had CO-RADS 1, 8% had CO-RADS 2, CO-RADS 3 was the most prevalent grade in approximately half patients (46%), 21% had CO-RADS 4 and 11% had CO-RADS 5. In terms of ACS type, 74 of the 100 studied patients had STEMI, 12 patients had non-STEMI and 14 had unstable angina. Out of the 74 STEMI patients, 56.76% had anterior STEMI, 35.14% had inferior, 12.16% had posterior and 10.81% had lateral STEMI. • We found no statistically significant relation between the type of ACS and age, sex distribution or risk factors (DM, HTN, smoking and dyslipidemia). On the other hand, there was a statistically significant relation between type of ACS and the prevalence of respiratory symptoms as patients with STEMI had significantly higher prevalence rate of respiratory symptoms compared to those with unstable angina. • The simple logistic regression analysis revealed that positive respiratory symptoms and CO-RADS were significantly associated with the incidence of STEMI. Patients with respiratory symptoms had higher odds of experiencing STEMI compared to those with no. As compared to patients diagnosed with CO-RADS 1, those with CO-RADS 3, CO-RADS 4 and CO-RADS 5 had significantly higher odds of having STEMI. • The simple logistic regression analysis revealed that CO-RADS were significantly associated with the incidence of NSTEMI as patients diagnosed with CO-RADS 3 and had significantly lower odds of experiencing NSTEMI when compared to those with CORADS 1. • The simple logistic regression analysis showed that positive respiratory symptoms were significantly associated with the incidence of unstable angina as patients with respiratory symptoms had lower odds of experiencing unstable angina when compared to those with no symptoms. Based on our results, positive respiratory symptoms and CO-RADS were significantly associated with the incidence of STEMI and NSTEMI. So, the risk of cardiac insults increases in patients with high CORADS detected in C.T chest.