Angiographic Profile Of Patients Research Articles

Clinical and Angiographic Profile of Non-ST Elevation Myocardial Infarction Patients with Multivessel Disease: A Study in a Tertiary Care Hospital in Bangladesh

Background: Non-ST elevation myocardial infarction (NSTEMI) is a type of acute coronary syndrome without ST-segment elevation on electrocardiography. Many non-ST elevation myocardial infarction patients have multivessel disease, which leads to worse outcomes compared to single-vessel disease. Their clinical and angiographic profiles provide valuable insightf into the nature, severity, and treatment of this common cardiac condition. This study aimed to evaluate the clinical and angiographic profiles of non-ST elevation myocardial infarction patients with multivessel disease. Methods: This prospective study was conducted in the Department of Cardiology, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh from September 2022 to August 2023. The study enrolled 270 consecutive patients with NSTEMI. Coronary angiography and electrocardiogram were used in assessing the disease condition. The data were analyzed using SPSS version 23.0. Results: The mean age of total participants was 54.31 ±10.54 years and most of them were male (77.8%). Majority of the patients had hypertension (68.1%), diabetes mellitus (59.3%), and dyslipidemia (58.5%). In the clinical assessment, 89.6% of patients had femoral access, 31.1% had a bifurcation lesion, 8.1% showed calcification, and 22.6% had a left main lesion. Stents were used in 41.9% of cases, with a mean total stent length of 55.8 ±26.9 mm. The mean left ventricular ejection fraction was 49.10 ±7.3%. Among the major culprit vessel involvements identified, 6% involved the left main (LM) artery, 56% involved the left anterior descending (LAD) artery, 34% involved the left circumflex (LCX) artery, and 39% involved the right coronary artery (RCA). Regarding the final angiographic findings among the total participants, double vessel disease (DVD) was observed in 40% of cases, while triple vessel disease was observed in 60% of cases. Conclusion: The increased prevalence of triple vessel disease among non-ST elevation myocardial infarction patients underscores the importance of heightened vigilance among healthcare providers and policymakers. Understanding the clinical and angiographic profiles of these patients is essential for effective management strategies.

Clinical and Angiographic profile of patients with Coronary Artery Dissection

Clinical and Angiographic profile of patients with Coronary Artery Dissection

Clinical Echocardiographic And Angiographic Profile Of Patients With Significant Left Main Coronary Artery Stenosis

Clinical Echocardiographic And Angiographic Profile Of Patients With Significant Left Main Coronary Artery Stenosis

Clinical and Angiographic Profile of Patients with Coronary Artery disease among Nigerians and Indians

Background: Coronary Artery Disease (CAD) in young and old individuals represents a special subsets that clinical profile and angiographic findings are different from older population. Better understanding of CAD in these groups of population would lead to further improvement in prevention and management. However, there are no data regarding coronary artery disease in Nigerian and Indian population. So this study was aimed to analyze the clinical profile and angiographic pattern of coronary artery disease among Nigerian and Indian patients.

CLINICAL AND ANGIOGRAPHIC SPECTRUM AMONG CASES WITH LEFT MAIN CORONARY ARTERY DISEASE

Objective: Left main coronary artery disease (LMCA) is a significant threat factor for amplified morbidity and mortality in the analysis and treatment plan of coronary artery disease. Multivessel disease of other coronary arteries is seen in 80% of patients with left main disease. With drug-eluting stents and advances in percutaneous coronary intervention, the management of this disease is not purely surgical. Hence, angiographic profile of patients with left main coronary artery stenosis was evaluated. Methods: A total of 700 cases of significant coronary arterial disease clinical and those underwent coronary angiography were studied and their coronary angiogram was analyzed with respect to pattern of involvement. Results: Of these cases, 72 patients have LMCA disease of those 24 cases have obstructive and 48 cases have non-obstructive disease and among them, 63.9% were diabetic; 55.5% were hypertensive, 44.4% have dyslipidemia, and 48.6% were smokers. Mean age was 56.5 years and mode of presentation was non-ST-elevation myocardial infarction (STEMI) in 59.7%; CSA in 30.5%, and STEMI in 9.7% cases. Distal left main was most common involvement in 79.2% cases of which 61.1% have bifurcation and 18.1% have non-bifurcation lesions. Isolated ostial involvement is seen only in 6 patients. 93% had involvement of other coronary arteries, 9.7% had SVS; 22% had DVD; and 61% had TVD. Conclusion: Overall, the incidence of LMCA disease was 10.2% and 3.4% had only significant obstructive lesion. Distal bifurcation was the most common form of involvement and TVD was reported to be the most common association.

Acute Coronary Syndrome in Young (≤45 Years) Patients: An Observational Study

Background: Acute coronary syndrome (ACS) is witnessing a demographic transition with increasing prevalence among younger individuals (≤45 years). Hence, this study was designed to evaluate the clinical features, risk factors, and angiographic profile of young (aged ≤ 45 years) patients with ACS and to compare it with the older (aged >45 years) patients with ACS. Materials and Methods: An observational study was conducted at a tertiary care center in India from July 2020 to December 2021. A total of 157 patients were enrolled, among which 90 patients were included in cases (group-I). The inclusion criteria were patients presenting with ACS aged between 18 and 45 years. There were two control groups, including 34 patients with ACS (aged >45 years) in Group II and 33 healthy volunteers in Group III (aged 18–45 years). Baseline demographic details, risk factors, and angiographic profile of patients with ACS in each group were recorded and compared. Results: Mean age of Group I was 39.79 ± 5.15 years and of Group II was 59.74 ± 8.21 years. Smoking (P = 0.027) and family history of coronary artery disease (P = 0.022) were the significant risk factors of ACS in Group I. Compared to non-ST elevation myocardial infarction (16.7%), ST-elevation myocardial infarction (83.3%) was predominant among younger patients with ACS. Single-vessel disease was prevalent among younger patients (62.2%) as compared to older patients with ACS (41.20%). Conclusion: Younger patients with ACS exhibited a distinct clinical and angiographic profile compared to older patients with ACS.

Prevalence of Metabolic Syndrome and its Clinical and Angiographic Profile in Patients with Naive Acute Coronary Syndrome

Prevalence of Metabolic Syndrome and its Clinical and Angiographic Profile in Patients with Naive Acute Coronary Syndrome

A Study of Coronary Angiographic Profile in Patients Undergoing Permanent Pacemaker Implantation with High Risk of Coronary Artery Disease in A Tertiary Care Centre, In North-East India

A Study of Coronary Angiographic Profile in Patients Undergoing Permanent Pacemaker Implantation with High Risk of Coronary Artery Disease in A Tertiary Care Centre, In North-East India

Comparison of Clinical and Angiographic Profiles of Patients with or without Left Main Coronary Artery Disease in Patients Undergoing Angiography for Acute Coronary Syndrome

Background: High death rates are seen in cases with heart disease affecting the left major coronary artery. The left main coronary artery has different flow dynamics and pathophysiology than other coronary arteries. It is important to identify the best management options for patients with left main coronary artery disease based on their anatomic pattern. Objective: To compare the clinical and angiographic profiles of patients with or without left main coronary artery disease in patients undergoing angiography for ACS. Methods: An observational cross-sectional study was conducted. Invasive coronary angiography was performed on 985 adult patients diagnosed with coronary artery disease throughout a 6-month study period. The research participants were split into two groups: left main (Group 1) and non-left main (Group 2) following coronary angiography. It was determined whether there were any statistically significant variances between the two groups by comparing their demographics, risk factors, and angiograms. Results: In group 1, the mean age and SD are 54.3±8.4 and in group 2, they are 54.4±11.9. There were 748 men (75.9% of the total) and 236 females (23.9%). Out of the male participants, 630 were assigned to Group 2 (non-LMCA) and 118 were placed in Group 1 (LMCA). All of the females were present in group 2. Left main illness tends to be greater in males, as indicated by the results of the comparison research between the two groups (p=0.046). BMI comparisons across the groups indicated no statistically significant difference (p>0.05). The most common presentation was non-ST elevated ACS, which was significantly related to the LM group (p<0.05). The coronary angiogram of 867 patients showed no left main artery involvement in 88.0% of patients, while the left main in 118 cases was 12.0%. For this research, 985 participants had coronary angiography performed by cardiac catheterization. From the total of 985 patients, 89 (9.0%) were classified as having "normal" or "non-critical" coronary arteries, 227 (23.1%) as having "single vessel disease," 296 (30.0%) as having "double vessel disease," and 374 (38.0%) as having "triple vessel disease." There are 867 individuals (88.0%) with no involvement of the left main artery, and 118 patients (12.0%) having left main disease among the population investigated. Conclusion: Patients with NSTE-ACS, diabetes and LMCA disease were considerably more likely to be men. They were also more likely to have a favorable family history (ACS). Triple vessel disease and distal left main disease were more prevalent among patients. Keywords: Left main coronary artery, Coronary angiography, Coronary artery disease, acute coronary syndrome.

Comparison of Clinical and Angiographic Profiles of Patients with or without Left Main Coronary Artery Disease

Background: Left main coronary artery disease constitutes highest risk lesion subset of CAD population. Flow dynamics and pathophysiology in the left main coronary artery are different from that of the other coronary arteries. So traditional risk factors might interact differently with left main artery resulting in different clinical and angiographic characteristics compared to others. Anatomic pattern evaluation in left main coronary artery disease is important in deciding best management options. However, their pattern and profiles were variably shown in different studies with discrepant Results suggesting geographic variation and lead to evaluation of characteristics in our own population. Better understanding this specific problem might lead to further improvement in its management. Methods: It was an observational cross-sectional study. Ninety-one adult coronary artery disease patients over the period of one year who underwent invasive coronary angiogram were studied. Study subjects were divided into two groups after coronary angiogram: Left main (Group 1) and Non-left main (Group 2) CAD. Demographic data, risk factor profiles and angiographic patterns of both groups were compared to see if any statistically significant difference present or not. Results: The mean age and standard deviation in group 1 is 55.2±9.4 and in group 2 is 55.5±12.9; the comparative analysis showed no statistically significant difference. Most of the patients were male 69 (76%) and the comparative study showed statistically significant differences (p=0.046) which showed left main disease tended to be higher in male. Majority (64%) had BMI in normal range with no significant difference. Among the risk factors comparison, diabetes and family history of CAD showed significant association with the left main cohort (p<0.05). Non-ST elevated ACS was the most common presentation and significantly associated with the left main group (p<0.05). On coronary angiogram, there were 80 patients (87.92%) who had no left main artery involvement while 11 patients (12.08%) had left main disease. The comparative study of coronary artery involvement among the two groups reveals no statistically significant differences (p>0.05) but triple vessel disease was found more commonly than single and double vessel disease. Distal lesions (64%) were found more frequently than other types of left main stenosis followed by ostio-proximal lesion (36%). Conclusion: In the patients with left main coronary artery disease, male gender, diabetes mellitus, positive family history and presentation with non-ST elevation ACS were found to be significantly associated. Distal left main lesion and triple vessel disease were commonly found. University Heart Journal 2022; 18(1): 3-9

Prevalence of metabolic syndrome and its clinical and angiographic profile in patients with naive acute coronary syndrome

Objective: The objective of the study is to evaluate the prevalence of metabolic syndrome (MS) and its clinical and angiographic profile in patients with naive acute coronary syndrome (ACS). Furthermore, this study tried to evaluate the severity of coronary artery disease in patients with and without MS. Methods: This was a single-center, cross-sectional study which prospectively enrolled 500 patients with naive ACS during the period from January 2017 to December 2018 at a tertiary care center in India. They were divided into two groups according to the presence and absence of MS based on revised NCEP ATP III guidelines. The ACS was defined based on the Joint Committee of the American College of Cardiology. After clinical evaluation and investigations, the prevalence of MS in ACS patients was calculated. Results: Prevalence of MS in this study was 46.2% and was more frequent in males (81%) compared to females (19%). Maximum number of patients with MS were between the age group of 40–59 years (55%). Prevalence of diabetes (56.7%), hypertension (58.0%), and smoking (45.88%) were significantly higher in patients with MS (P < 0.001). Most prevalent components of MS were low high-density lipoprotein (HDL) levels, increased blood pressure, fasting blood sugar, and triglyceride levels (P < 0.001). Conclusion: Prevalence of MS was high in patients with ACS and was more often after the age of 40 years and most commonly seen in males. Low HDL levels, increased blood pressure, and blood sugar were most prevalent components in the criteria for MS. Patients with MS tend to have more complex coronary lesions.

Clinical and angiographic profile of patients presenting with first acute myocardial infarction in a tertiary care centre, Government General Hospital, Guntur

Clinical and angiographic profile of patients presenting with first acute myocardial infarction in a tertiary care centre, Government General Hospital, Guntur

Prevalence, risk factors, and coronary angiographic profile in patients with tortuous coronary artery

Kontext: Vinutost (tortuozita) koronárních tepen je častý nález při katetrizaci koronárních tepen. I když se lze s vinutostí koronárních tepen často setkat na koronarogramech pacientů s bolestí na hrudi, uvádí se vzácně, protože není známo, zda má nebo nemá tento nález význam pro funkci srdce. Někteří autoři definují vinutost koronárních tepen jako &#8805; 3 po sobě následujících zakřivení v úhlu 45° (nebo více) alespoň v jednom koronárním řečišti. Cíle: Cílem naší studie bylo stanovit prevalenci vinutosti koronárních tepen u pacientů s koronarografickým vyšetřením provedeným v káhirské fakultní nemocnici, se zvláštním důrazem na klinický obraz, tradiční rizikové faktory ischemické choroby srdeční (ICHS), stanovení závažnosti onemocnění podle koronarogramu pomocí Gensiniho a cévního skóre. Pacienti a metody: Tato retrospektivní longitudinální studie se prováděla v období od listopadu 2018 do dubna 2019. Ze 788 pacientů, u nichž byla koronarografie provedena pro vyloučení ICHS, jich bylo do studie zařazeno 200 (100 s vinutostí koronárních tepen a 100 bez vinutosti koronárních tepen). Po zkontrolování popisů koronarogramů všech pacientů jsme vybrali 100 případů s vinutostí koronárních tepen. Jako kontroly sloužilo 100 pacientů bez vinutosti koronárních tepen. U všech pacientů byla odebrána důkladná anamnéza a provedeno fyzikální vyšetření. Následně bylo provedeno diagnostické koronarografické vyšetření femorálním nebo radiálním přístupem. Koronarogramy posoudil off-line kardiolog, který nebyl seznámen s anamnézou pacientů. Vinutost koronárních tepen byla definována jako &#8805; 3 zakřivení (a &#8805; 45° změna průběhu tepny) podél hlavního kmene alespoň jedné tepny, která byla přítomna v systole i diastole. Byla vypočítána Gensiniho a cévní skóre. Shromážděné údaje byly analyzovány statistickým softwarovým balíčkem IBM pro společenské vědy (Statistical Package for Social Science, SPSS), verze 23. Výsledky: Prevalence vinutosti koronárních tepen byla 12,7 %. S vinutostí koronárních tepen pozitivně korelovaly věk nad 65 let a ženské pohlaví. Hypertenze byla častější u pacientů s vinutostí koronárních tepen než u pacientů bez vinutosti (74 % vs. 48 %; p &lt; 0,001). Vinutost se vyskytla častěji u r. circumflexus (left circumflex artery, LCX) (52 %) než u r. interventricularis anterior (20 %). Aterosklerotická stenóza byla přítomna častěji při vinutém než nevinutém segmentu. Hodnoty Gensiniho a cévního skóre byly vyšší ve skupině bez vinutých koronárních tepen. Prevalence ICHS u pacientů s vinutostí koronárních tepen dosáhla hodnoty 48 % versus 52 % u pacientů bez vinutých koronárních tepen. Závěr: Pacienti s vinutostí koronárních tepen bez stenózy koronárních tepen aterosklerotické etiologie mohou vykazovat symptomy jako typická bolest na hrudi. Byla nalezena pozitivní korelace vinutosti koronárních tepen s hypertenzí a ženským pohlavím, ale negativní korelace s ICHS. Pacienti s vinutostí koronárních tepen mohou vykazovat symptomy jako typická bolest na hrudi, nebyla však u nich nalezena stenóza koronárních tepen. Vinutost se vyskytuje u LCX častěji než u jiných koronárních tepen. Gensiniho a cévní skóre byla vyšší než ve skupině bez vinutých koronárních tepen. &#169; 2021, ČKS.

Clinical and Angiographic Profile of Patients with Severe Left Ventricular Systolic Dysfunction without Established Coronary Artery Disease

Objective: Coronary artery disease (CAD) is the most common etiology of heart failure with reduced ejection fraction (EF). Coronary angiography is usually not done in patients with severe left ventricular systolic dysfunction (LVSD) without a history of acute coronary syndrome or angina, due to fear of increased risk. Hence, the prevalence of CAD in such cases remains unknown. This study aimed at analyzing the clinical and angiographic profile of the patients with severe LVSD (EF ≤35%) without established CAD. Methods: This was a prospective, observational study conducted from January 2018 to July 2019. One hundred consecutive patients (≥18 years) with severe LVSD (EF ≤35%) without established CAD were assessed for underlying CAD by coronary angiography. Patients were divided into those with no CAD and CAD. Patients having CAD were further classified into those with significant CAD and severe CAD based on angiographic lesion severity. The risk factors contributing to significant CAD were analyzed. Results: Sixty-four patients had no CAD and 36 patients had CAD, of which 34 and 26 patients had significant CAD and severe CAD, respectively. 41.7% patients had double-vessel disease followed by 33.3% and 25% patients having triple-vessel disease and single-vessel disease, respectively. The risk factors for significant CAD were male &gt;55 years/female &gt;65 years, male gender, diabetes mellitus, smoking, and dyslipidemia. Multivariate logistic regression analysis showed diabetes and dyslipidemia to be the independent risk predictors for significant CAD. Conclusion: Occult CAD is present in high proportions in patients with severe LVSD without established CAD specially in presence of risk factors such as diabetes, male &gt;55 years/female &gt;65 years and dyslipidemia. Hence, coronary angiography should be considered strongly in such patients having one or more of these risk factors.

A study of clinical &amp; angiographic profile of patients with young stroke in tertiary care center of Southern Rajasthan

: Understanding the exact etiology of stroke in the young has great relevance to its prevention and management. Recent development in the surgical and interventional therapy of extra cranial and intracranial vascular diseases have made it necessary to correctly identify the causative as well as contributory factors of stroke.This cross sectional observational study was done on patients admitted in the stroke unit of Geetanjali Medical College, Udaipur of aged 15 to 50 years with stroke and who have underwent at least one standard vessel imaging procedure within 2 weeks of stroke onset. Out of 310 patients, majority of the strokes occurred in the setting of a rheumatic valvular heart disease (63.6%), with mitral valve disease being the most frequent association. Almost 80% of patients had normal ECG whereas 20% of the patients had an ECG abnormality.70% of patients had normal ECHO and the most frequent etiologic abnormality detected was valvular heart disease. Scan and MRI was done in 180 patients. The most commonly performed angiographic procedure was CT angiogram. TOF MRA was the next most commonly performed angiographic procedure. The highest yield for picking up abnormalities was noted in the CT Angiography. The yield of CT angiography was 35.4% and 37.7% for extracranial and intracranial vasculature respectively.Arterial dissections are fairly common in young population and should be considered in appropriate clinical setting and all patients should have a good and timely angiographic assessment to rule out dissections. Thus, this study highlights the importance of risk factor evaluation, and control, complete etiological evaluation including angiographic assessment in the diagnosis, management and planning of secondary prevention strategies in young patients with stroke.

English

BACKGROUND Acute Myocardial Infarction (AMI) can lead to death, and thrombolytic therapy (TLT) is a common treatment protocol. However, thrombolysis is not always successful, and there are numerous contributing factors. We wanted to compare and contrast the coronary angiographic profile of patients with successful and failed thrombolysis with tenecteplase. METHODS Cases of AMI receiving tenecteplase were categorized as successful and failed thrombolysis groups. Fifty patients in each group were compared for various characteristics such as age, sex, risk factors, time to thrombolysis, LV function, number of coronary vessels involved, angiographic lesion characteristics, thrombolysis in myocardial infarction (TIMI) flow, and to look for features that may predispose to thrombolysis failure. To determine the association between variables, chi-square test and logistic regression were used. RESULTS The mean age in the successful &amp; failed thrombolysis group was 50.72 years and 53.48 years. Gender, diabetes, hypertension, smoking, alcohol, type of MI were not statistically significant for failed thrombolysis. All patients with window period &lt; 3 hrs had successful thrombolysis and most patients with window period &gt; 6 hrs had failed thrombolysis (87.2 %). (P &lt; 0.001). Most patients (75.9 %) with Type A lesions had successful thrombolysis and patients with Type B &amp; C lesions (88.1 %) had failed thrombolysis. (P &lt; 0.001). CONCLUSIONS In patients with longer window periods, failed thrombolysis was more common and was associated with complex coronary lesion morphology. This study reemphasizes the value of early thrombolysis for effective reperfusion and clinical outcome improvement. KEYWORDS Failed Thrombolysis, Tenecteplase, Angiographic Profile

Echocardiographic and Angiographic Profile of Patients with Lateral Wall Mi Ecg Presentation in Inferior Wall Mi (A Comparison Study)

Echocardiographic and Angiographic Profile of Patients with Lateral Wall Mi Ecg Presentation in Inferior Wall Mi (A Comparison Study)

A Study of angiographic profile of patients with acute myocardial infarction, thrombolysed vs non thrombolysed and correlation with lipoprotein (a)

A Study of angiographic profile of patients with acute myocardial infarction, thrombolysed vs non thrombolysed and correlation with lipoprotein (a)

Characteristics of ST-elevation myocardial infarction with failed thrombolysis.

Fibrinolytic therapy is an important reperfusion strategy, especially when primary percutaneous coronary interventions cannot be offered to ST-elevation myocardial infarction patients. Given that failed reperfusion after fibrinolytic therapy is common, it is pragmatic that the predictors, outcomes, and angiographic profiles of patients with failed thrombolysis are carefully scrutinized. We prospectively studied clinical variables and outcomes over 30 months in 243 ST-elevation myocardial infarction patients who received fibrinolytics as primary treatment. Logistic regression analysis was used to identify predictors of failed thrombolysis. Failed thrombolysis occurred in 38.68% of patients with a mean window period of 6.58 ± 1.42 h, and 55.32% of patients with failed thrombolysis had Killip class >I on presentation. Risk factors such as diabetes mellitus (55.32%), dyslipidemia (60.64%) and obesity (77.66%) were frequently associated with failed thrombolysis; 73.40% of patients with failed thrombolysis had Thrombolysis in Myocardial Infarction flow grade 0/1 in the infarct-related artery, and 58.51% of such patients needed a rescue percutaneous coronary intervention. The mean Thrombolysis in Myocardial Infarction risk score was 5.46 ± 2.77 in failed thrombolysis patients, with mortality of 4.25% at the 6-month follow-up. Non-resolution of presenting symptoms and ST changes on electrocardiography at 90 min served as the earliest indicators of failed thrombolysis, with a significant angiographic correlation. Clinical variables such as delayed presentation (>6 h), dyspnea, Killip class >I, cardiogenic shock, Thrombolysis in Myocardial Infarction score, and conventional risk factors including diabetes mellitus, dyslipidemia, and obesity represented cluster of predictors of failed thrombolysis.

Profile of acute coronary syndrome in young diabetics: a review

The clinical presentation and angiographic findings of coronary artery disease (CAD) varies from diabetic and non-diabetic patients and varies with the age of presentation. Coronary artery disease in patients below the age of 45 is a special subset. The objective of this study is to compare the clinical and angiographic profile in patients with the acute coronary syndrome (ACS) with diabetes mellitus (DM) and without DM below the age of 45 years. Clinical Presentation of coronary artery disease in young patients with various risk factors differs, which plays an important role in management strategies. This was conducted through internet search on PubMed and ProQuest database from 2000 to until 2019. Key words used for searching are acute coronary syndrome, young diabetics, and clinical, angiographic profile. An important exclusion criterion is studies which included type one diabetic patients. Totally 35 papers were reviewed. Pattern of involvement of coronary arteries as assessed by the coronary angiographic study is found to be different in younger CAD patients. Atypical clinical presentation and distinct angiographic finding are common in diabetics below the age of 45. In most of the studies single vessel disease (SVD) is the most common angiographic finding in young CAD and non-diabetics. While the diabetics showed the more diffuse pattern of double vessel disease (DVD).