Efficacy of ETV in Eleutheroside-E patients with LAM resistance, TDF is an alternative agent against HBV infection. Nonetheless, long-term efficacy and safety of TDF and ETV should be monitored in prolonged therapy in well-designed prospective studies with large sample sizes. The 6MWD is a good predictor for morbidity and mortality in patients with heart failure, pulmonary hypertension, and pulmonary disease. Normal values available for the 6MWD are based on different adult cohorts. However, there is no evidence regarding the ability of the 6MWT to predict outcomes in patients with ST-elevation myocardial infarction. Despite the improvement of different therapeutic modalities for patients with STEMI, major adverse cardiac eventsare still 8.7%. The prognostic models based on traditional cardiovascular disease risk factors do not fully explain the risk of future cardiovascular events in these patients. This 
clarifies why various risk scores have been introduced for STEMI patients with time. In the era of fibrinolysis, several different clinical scores have been used, including the GRACE, PAMIand TIMISTEMIscores. For the current era where primary percutanious coronary interventionis the gold standard, new risk scores have been introduced including Zwolle score, CADILLAC score, EuroSCORE and SYNTAX scores. However, not all patients had the facility to do PPCI. So for those undergoing fibrinolysis and cannot proceed for PPCI due to financial restraints, we still need to risk stratify these patients predischarge. In Upper Egypt, we need to provide our patients with the best available and affordable treatment modality. Exercise treadmill testing although provides information regarding prognosis in STEMI patients, but it is woefully underutilized. This can be explained partly by patients overly cautious or reluctant to participate in exercise after STEMI, and also testing is expensive, not widely available, and time consuming. In the present study, we evaluated the ability of the 6MWT to predict MACE in patients with STEMI Metyrapone treated with fibrinolysis. In a cohort of patients with STEMI treated with fibrinolysis, we found that shorter distance walked on 6MWT was associated with higher rates of heart failure, myocardial re-infarction, and death, independent of traditional cardiovascular disease risk factors and scoring systems. The 6MWT provided additional predictive information beyond traditional risk factors and scores. The ability of the 6MWT to predict cardiovascular events was similar to traditional GRACE risk score. These findings suggest that a simple 6MWT is a useful prognostic marker for identifying STEMI patients treated with fibrinolysis at low risk who may not need further interventions. There has been limited evidence regarding the prognostic ability of 6MWT in patients with STEMI treated with fibrinolysis. One study evaluated patients with chronic stable coronary heart disease and found 6MWT to be predictor of cardiovascular events. Another study evaluated patients with recent coronary artery bypass surgery undergoing cardiac rehabilitation and found 6MWT to be a predictor of mortality. Our findings extend the evidence that the 6MWT predicts cardiovascular events to patients with STEMI treated with fibrinolysis. The results of our study also expand beyond previous studies that have investigated 6MWT in patients with heart failure. Although 6MWT distance did not reliably correlate with cardiopulmonary exercise testing measures in previous studies.