Comparison Of Angiographic Findings Research Articles

Comparison of Angiographic Findings in Diabetic and Non-Diabetic Female patients presenting with Acute Coronary Syndrome at a Tertiary Cardiac Care Center in Karachi, Pakistan

Objective: -To evaluate the angiographic differences in female patients and to compare the frequency of different angiographic findings in diabetic and non-diabetic female cases with acute coronary syndrome. Place and Duration of Study: Department of Adult Cardiology, Tabba Heart Institute Karachi, Pakistan from 1st February 2018 to 31st August 2018 Study design: Cross-sectional study Methodology: Two hundred patients presenting with acute coronary syndrome undergoing angiography with diabetes mellitus and non-diabetes mellitus were enrolled. Demographic profile of the cases was recorded Angiography was performed by experienced cardiologist for all patients. Study outcome, number of vessels involved, type of vessels, was recorded for all patients. All the collected information was recorded using pre-designed structural questionnaire. Results: 67% were diabetic and 23% were non-diabetic. In diabetic group single vessel disease was observed in 29 (23%), 2 vessel disease in 37 (29.4%) and 3 vessel disease in 49 (38.9%) while in non-diabetic group single vessel disease, 2 vessel disease and 3 vessel disease was observed in 24 (32.4%), 19 (25.37%) and 19 (25.7%) respectively (P=0.092). Three vessel disease involving LAD+ Circumflex+ RCA is 49 [38.88%] and 19 [25.67%] in diabetic and non-diabetic group respectively. Three-vessel disease was more prevalent in diabetics but it was not statistically significant (p=0.092). Conclusion: Three vessel diseases is most frequently present as angiographic finding in female patients presenting with acute coronary syndrome. Keywords: Acute coronary syndrome (ACS), Diabetes mellitus (DM), Unstable angina, ST-elevated myocardial infarction

Comparison of angiographic findings among postmenopausal women using unopposed estrogen, estrogen/progestin combinations, and nonusers

Studies of the effects of menopausal hormone therapy on coronary artery disease (CAD) in postmenopausal women have provided contradictory results. Although recent experimental studies have revealed no beneficial effect of combination therapy with estrogen (E) and progesterone (P), the effect of monotherapy with E remains unknown. We retrospectively examined the medical records of 843 consecutive women aged ≥55 years who underwent their first cardiac catheterization between January 1996 and December 1998. We compared the presence and severity of CAD, defined as ≥1 diseased coronary vessel (with stenosis ≥50%), in women who only took E, E+P, or no menopausal hormone therapy. In all, 210 women (33%) took hormones, of whom 47 (22%) used E+P and 163 (78%) used E only. Women who used any hormones tended to be healthier than nonusers, but E+P users had a lower prevalence of risk factors and co-morbidities than E users. In unadjusted analyses, both the E and E+P groups were significantly less likely to have CAD than nonusers (relative risk [RR] 0.71, 95% confidence interval [CI] 0.58 to 0.84 for the E group; RR 0.76, 95% CI 0.54 to 0.99 for the E+P group). Demographic factors, CAD risk factors, co-morbidities, and primary prevention medication use explained the association between E+P and the presence of CAD (RR 1.14, 95% CI 0.74 to 1.39). In contrast, adjustment for these factors had a minimal effect on the association between E and CAD compared with nonusers (RR 0.79, 95% CI 0.59 to 0.98). Thus, the apparent protective effect of combination menopausal hormone therapy with E+P on CAD is due to differences in other patient characteristics. In contrast, unopposed E therapy may have a protective effect on CAD.

Recurrent Bleeding After Arterial Embolization in Patients with Hemoptysis: Comparison of Angiographic Findings and Relapsing Period

Purpose: To describe the angiographic findings of patients with recurrent hemoptysis after bronchial artery embolization (BAE) according to the point at which relapse occurred. Materials and Methods: From 125 patients who underwent BAE due to hemoptysis between 1996 and 2000, we selected 18 of 23 who underwent additional BAE due to recurrent bleeding after initial BAE . Depending on the point at which relapse occurred, they were divided into two groups (I and II, according to whether additional BAE was performed within two weeks of initial BAE or more than two weeks after this). We retrospectively compared the two groups in terms of angiographic findings, number of embolized arteries, and character of feeding arteries at initial and additional BAE. Results: Nine patients in group I (additional BAE: n=10) and nine in group II (additional BAE: n=13) were admitted for recurrent hemoptysis within two weeks of initial BAE and more than two weeks after this, respectively. In group I(n=29) and II(n=31), angiography demonstrated two direct and 27 indirect, and two direct and 29 indirect signs of hemorrhage, respectively. No statistically significant differences were observed (x=0.005, p=0.945). Among the embolized feeder ressels in group I (n=30) there were 20 bronchial artery and 10 non bronchial systemic collaterals, while for group II(n=35), the corresponding totals were 21 and 14. Again, no statistically significant differences were encountered(x=0.308; p=0.579). In group I, feeders were newly developed in one case(10%), previously embolized in five(50%), and missed in four(40%), while in group two the corresponding figures were none, twelve(92.3%), and one(7.7%). No significant differences were noted, though the incidence of previously embolized feeders in Group II was very high (x=5.383,p=0.068). Conclusion: Among patients in whom hemoptysis after BAE recurred at different times, the angiographic findings and number of embolized arteries were not significantly different, but differences in the nature of the feeder were noted. Patients in whom hemoptysis recurred more than two weeks after BAE showed more recanalization of previously embolized feeders than those in whom there was recurrence within two weeks.

CT-angiography as a non-invasive method for the evaluation of the patency of TIPSS (transjugular intrahepatic portasystemic shunt)

To evaluate the feasibility of determining patency of the transjugular intrahepatic portosystemic shunt (TIPSS) by non-invasive CT angiography (CTA). (1) Non-enhanced scanning of the shunt. (2) Bolus tracking by injecting 20 ml of non-ionic contrast material through a cubital vein access to determine the time to maximal shunt enhancement. (3) Contrast-enhanced spiral CT study applying a delay according to the time to peak of the shunt, 3 mm collimation, 5 mm table feed and 3 mm reconstruction interval. (4) 3D and multiplanar reconstructions. (5) Evaluation of the questions: intrahepatic shunt patent or not; evidence of intimal hyperplasia; evidence of stenosis and potential location. (6) Transjugular portography via the stent. (7) Comparison of angiographic findings and CT morphology. Eight patients had inconspicuous CTA. Four of them had a normal shunt at angiography, four had slight intimal hyperplasia. No intervention was necessary in these patients. CTA of three patients showed intimal hyperplasia (lumen reduction between 10% and 50%). The diagnosis was angiographically confirmed in all cases. Due to a high portosystemic gradient intervention was required in all. In five patients CTA and angiography showed a stenosis (reduction of shunt lumen > 50%). All required a revision including stent placement or PTA of the shunt tract. Four shunts were occluded; all occlusions were shown both in CTA and angiography. None of the shunts with normal findings at CTA required revision. All shunts conspicuous on CTA resulted in revision. In this study, CTA turned out to be an accurate, non-invasive method to evaluate the patency of TIPSS.

Comparison of angiographic findings, risk factors, and long term follow-up between young and old patients with a history of myocardial infarction

We compared the angiographic findings, coronary risk factors and five years prognosis in 200 patients ≤45, and 260 patients >45 years old who where admitted with an acute myocardial infarction. We found that family history and smoking were the most common risk factors in patients ≤45 years old P<0.04, P<0.0001, respectively, and hypertension and diabetes mellitus were more prevalent in patients >45 years, P<0.00001 for both. Young patients had a higher incidence of normal coronary arteries and a lesser one of triple vessel disease in comparison with old ones P<0.001 and P<0.04, respectively. There was also a tendency for young patients to have a higher frequency of single vessel disease. The long-term prognosis was favourable in the younger age group since the survival rate was much better, as well as the quality of life. Death in the young patients seems to be very often electrical owing to sudden ventricular fibrillation, whereas death in the elderly is more often associated with congestive heart failure.

Comparison of angiographic findings and demographic variables in patients with coronary artery disease presenting with acute pulmonary edema versus those presenting with chest pain

One hundred nineteen patients admitted to the coronary care unit with pulmonary edema were retrospectively reviewed to identify the demographic characteristics and underlying cardiac disorders of this population. The patients with pulmonary edema were compared with 119 patients admitted to the coronary care unit with chest pain. Cardiac catheterization in 71 patients with pulmonary edema and 93 with chest pain showed left main and 3-vessel coronary artery diseases to be equally common in both groups, although anginal pain was infrequent in patients with pulmonary edema (n = 28, 24%). Left ventricular function was reduced in the patients with pulmonary edema compared with those with chest pain (mean ejection fraction 42 vs 59%; p < 0.001). More patients with pulmonary edema were black, and had diabetes and preexisting hypertension than those with chest pain. The results of cardiac catheterization were the same for black and white patients with pulmonary edema. In conclusion, patients with pulmonary edema have a high incidence of cardiac disease, and pulmonary edema may be 1 manifestation of silent myocardial ischemia. Important demographic differences exist between patients admitted with pulmonary edema and those who present with chest pain.