Coronary Angiographic Findings In Patients Research Articles

Correlation of Duke Treadmill Score with Coronary angiographic Findings in Patients with Stable Ischemic Heart Disease

Aim: To determine the correlation of Duke treadmill score with angiographically determined obstructive coronary artery disease (CAD) Study design: observational cross sectional study, comparative type Place and duration: The study was done at Cardiac Center Bahawalpur from August 2020 to July 2021. Methods: The patients who had stable angina and underwent exercise tolerance testing as well as coronary angiography were included in the study. The data was collected on a predesigned proforma. The difference in the prevalence of obstructive CAD with regards to Duke treadmill score (DTS), gender, diabetes mellitus, hypertension, smoking and family history was determined with Chi square test using SPSS 20; ap value of < 0.05 was taken as significant. Results: Total 71 patients were enrolled for study. Mean ageof the participants was 48.25 ± 8.7 years. It was a male dominant population. A significant difference in the prevalence of obstructive CADwas noted in low, intermediate and high risk groups according to DTS. The prevalence of obstructive coronary artery disease was not significantly different with regards to gender, diabetes mellitus, hypertension, smoking and family history. However obstructive CAD was more prevalent in those who presented with typical angina as compared to those who had atypical symptoms. Conclusion: Obstructive CAD significantly differs in low, intermediate and high risk groups according to DTS. Keywords: Duke treadmill score, coronary artery disease

Association of Hs-CRP Levels in Patients with Acute Coronary Syndromes and it’s Correlation with Angiographic Severity of Coronary Artery Stenosis

Objectives: Significant advances have been made toward the development of biomarkers for prognostication of patients with atherosclerotic cardiovascular disease. One such marker is high-sensitivity C-reactive protein (hsCRP). It is a marker of inflammation mainly used to predict the risk of adverse cardiovascular (CV) events. Recent research also supports its role in atherogenesis. It is involved throughout the process of atheromatous plaque development. However, limited information is available about the relationship between levels of hs-CRP levels in patients presenting with acute coronary syndromes (ACS) and its association with outcomes. We conducted this study to assess the correlation between the levels of hs-CRP and the coronary angiographic findings in patients presenting with ACS and its correlation with outcomes. Materials and Methods: we carried an observational prospective study in patients presenting with ACS admitted to cardiology intensive coronary care unit in a tertiary care hospital. Patients underwent invasive coronary angiogram and serum Hs-CRP levels testing apart from other routine investigations. Correlation between severity of coronary stenosis, Hs-CRP levels and left ventricular ejection fraction (LVEF) at discharge was then assessed using statistical analysis. Results: Positive correlation was found between Hs-CRP levels and severity of coronary stenosis. Negative correlation was found between Hs-CRP levels and LVEF at discharge. Conclusion: We found that hs-CRP levels correlate well with angiographic severity. It was also observed that higher the hs-CRP levels more the number of vessels involved with patients with the left main + triple vessel disease (TVD) and TVD having maximum scores.

Prevalence of new Onset Right Bundle Branch Block in Acute Myocardial Infarction and its Coronary Angiographic Findings in Patients Attending NICVD

Background and Aim: Acute myocardial infarction patients with left and right bundle branch block significantly contributes to higher risk of mortality. Right bundle branch block (RBBB) has clinical implications in acute myocardial infarction setting. The present study aimed to determine the prevalence of new onset RBBB in acute myocardial infarction and its association with coronary angiographic findings. Methodology: This cross-sectional study was conducted on 82 acute myocardial infarction (AMI) patients in National Institute of Cardiovascular Diseases (NICVD), Karachi from January 2022 June 2022. Study protocol was approved from the institution research and ethical committee. All the patients of either gender with an age range 25 years to 85 years having acute myocardial infarction were included. Written informed consent was taken. Patients with previous RBBB, had implanted pacemaker, and presentation of symptoms >24 hours were excluded. Detailed history and clinical examination of each individual was done. Patients’ angiographic findings after eligibility based on coronary angiography was done and recorded. All the data were entered into pre-designed profroma. SPSS version 26 was used for data analysis. Results: Of the total 82 AMI patients, there were 48 (58.5%) male and 34 (41.5%) females. Age-wise distribution of AMI patients were as follows; 17 (20.7%) 25-45 years, 28 (34.2%) 46-65 years, and 37 (45.1%) 66-85 years. The overall mean age was 54.62±6.82 years. The prevalence of new onset RBBB and without RBBB was 17 (20.7%) and 65 (79.3%) respectively. Of the 17 AMI with RBBB patients, the incidence of single vessel disease, double vessel disease, triple vessel disease, and left main stem disease was 3 (17.6%), 5 (29.4%), 6 (35.3%) and 3 (17.6%) respectively. Majority of patients aged 46 years to 65 years had RBBB in 9 (32.1%), followed by 6 (16.2%) in patients 66-85 years and 2 (11.8%) in patients aged 25-45 years. Conclusion: The present study concluded that the prevalence of new onset RBBB was 20.7% among acute myocardial infarction patients. The incidence of triple vessel disease was prominent in acute myocardial infarction patients with RBBB followed by double vessel disease. Also, elderly patients of acute myocardial infarction patients were more susceptible to RBBB than younger one. Keywords: Right bundle branch blockage, Acute myocardial infarction, Coronary angiography

Correlation study of Myocardial strain imaging with angiographic findings in patients with chronic stable angina

Background: Global Longitudinal Strain (GLS) measured by 2D speckle-tracking strain echocardiography (2D-STE) can detect impaired longitudinal left ventricle (LV) function at rest which is associated with significant coronary artery stenosis. Objective: Global longitudinal strain (GLS) may be used to predict the presence, extent and severity of CAD according to coronary angiographic findings in patients with chronic stable angina. Methods: 2D-STE and coronary angiography were performed on 100 individuals with suspected stable angina pectoris who had normal resting conventional echocardiography. Global longitudinal strain were assessed and were correlated with coronary angiography for each patient. Results: Statistically significant difference was found when comparing the mean GLS among patients with normal coronaries and different degrees of coronary artery disease (CAD).Mean GLS was – 20.76±1.39, -17.66±0.65, - 16.05±0.58 and -14.22±0.65 for normal/minor, single vessel, two vessels and three vessels respectively(p<0.001). Patients with significant left main (LM) stenosis had GLS of 14.41±1.27 compared with GLS of 17.1±1.91in patients without LM stenosis (p=<0.001). In our study cutoff value for detection of single vessel disease was -18.300 with good sensitivity and specificity (100% and 96.6%, respectively) with AUC (Area Under the Curve) 0.996 and p value< 0.001.

Frequency of new onset right bundle branch block in acute myocardial infarction and its coronary angiographic findings in patients presenting at Tertiary Care Hospital, Peshawar

Background: Right bundle branch block has prognostic significance in the setting of acute myocardial infarction; this research is intended to determine the incidence of new-onset right bundle branch block in acute myocardial infarction and its angiographic findings.
 Methodology: This descriptive cross-sectional study was conducted in a tertiary care hospital, i.e., the Cardiology Department, Lady Reading Hospital, Peshawar, from 13/5/2016 to 13/11/2016. A total of 91 patients were included in the study. Baseline investigation, including ECG (Nihan Koden), Coronary angiography (Siemens Healthineers), on patients who qualify for early invasive therapy and angiographic findings. All the information, like age and gender, was recorded. 91 patients with acute myocardial infarction who presented within 24 hours were observed, in which male to female ratio was 1.17:1. The study enrolled the age group from 30 up to 75 years.
 Results: Average age was52.6±7.71 years. New onset right bundle branch block (RBBB) was found in 13(14.29%) patients in acute myocardial infarction.
 Conclusion: In conclusion, RBBB was observed in 13% of patients where angiographic findings showed triple vessel disease 38.5%, double vessel coronary artery disease 30.8%, single vessel disease 15.4%, and left main stem disease15.4% respectively, there is a high rate of severe CAD in patients presenting with RBBB in the setting of the acute coronary syndrome, so early reperfusion is recommended.

Sex differences in coronary angiographic findings in patients with stable chest pain: analysis of data from the KoRean wOmen\u2019S chest pain rEgistry (KoROSE)

BackgroundFocused evaluations on potential sex differences in the angiographic findings of the coronary arteries are scarce. This study was performed to compare the angiographic extent and localization of coronary stenosis between men and women.MethodsA total of 2348 patients (mean age 62.5 years and 60% women) with stable chest pain undergoing invasive coronary angiography (CAG) were recruited from the database of the nation-wide chest pain registry. Obstructive coronary artery disease (CAD) was defined as ≥ 50% stenosis of the left main coronary artery and/or ≥ 70% stenosis of any other epicardial coronary arteries.ResultsAlthough women were older than men (64.4 ± 10.3 vs. 59.5 ± 11.4 years, P < 0.001), men had worse risk profiles including high blood pressure, more frequent smoking and elevated triglyceride and C-reactive protein. The prevalence of obstructive CAD was significantly higher in men than in women (37.0% vs. 28.4%, P < 0.001). Men had a higher prevalence of LM disease (10.3% vs. 3.5%, P < 0.001) and three-vessel disease (16.1% vs. 9.5%, P = 0.007) compared to women. In multiple binary logistic regression analysis, the risk of men having LM disease or three-vessel disease was 7.4 (95% confidence interval 3.48–15.97; P < 0.001) and 2.7 (95% confidence interval 1.57–4.64; P < 0.001) times that of women, respectively, even after controlling for potential confounders.ConclusionsIn patients with chest pain undergoing invasive CAG, men had higher obstructive CAD prevalence and more high-risk angiographic findings such as LM disease or three-vessel disease.

Spectrum of coronary angiographic findings in patients with ST Elevation Myocardial Infarction (STEMI) undergoing primary PCI in a tertiary care center of Nepal

BackgroundEven in developing countries like Nepal, prevalence of ST-elevation myocardial infarction has been shown to be increased with rise in prevalence of conventional risk factors like diabetes, Hypertension, smoking, dyslipidemia and obesity. Our aim is to retrospectively analyze for various risk factors and angiographic patterns of coronary artery disease in patients with ST-elevation myocardial infarction undergoing Primary Percutaneous Intervention. ResultsDuring the period of 1 year (January 2019 to December 2019), 816 patients presented to our ER with acute STEMI, among them 437 (53.6%) patients underwent primary PCI strategy and among them 22 (5.3%) patients were died. Thirty-six (4.4%) patients received thrombolysis, among them 5 (13.9%) patients were died while remaining 343 (42.0%) patients were managed conservatively and among them 20 (5.8%) were died. The mean age of patient who underwent primary PCI was 58.5±12.7 years range from 25 years to 99 years. Among them 55–75 years old 217 (49.6%) were highest in number followed by<55 years old 180 (41.2%). Males 318 (72.8%) were predominant. Among those who underwent primary PCI, hypertension 214 (49%) was the most common risk factor, followed by smoking 198 (45.3%), diabetes mellitus 123 (28.1%), dyslipidemia 53 (12.1%) and family history of premature coronary artery disease 18 (4.1%). Among those patients, 292 patients (66.8%) had single vessel disease, 99 patients (22.7%) had double vessel disease, 41 patients (9.3%) had triple vessel disease and 5 patients (1.1%) had non-significant coronary artery stenosis. Left anterior descending (53.3%) was the most frequently found culprit artery, followed by right coronary artery, left circumflex, ramus intermedius and left main artery. ConclusionFifty percent of patients presented with acute ST-elevation myocardial infarction and underwent primary PCI were between 55–75 years of age. Hypertension and smoking were the most common risk factors present in those patients. Single vessel disease was most prevalent with left anterior descending found to be the most commonly involved coronary artery followed by right coronary artery and left circumflex.

The Significance of Platelet/Lymphocyte Ratio in Relation to Coronary Angiographic Findings in Patients with Coronary Artery Disease

The Significance of Platelet/Lymphocyte Ratio in Relation to Coronary Angiographic Findings in Patients with Coronary Artery Disease

English

English

Gender Specific Coronary Angiographic Findings in Patients with Coronary Artery Disease in the Age Year Group 40 to 60.

Gender Specific Coronary Angiographic Findings in Patients with Coronary Artery Disease in the Age Year Group 40 to 60.

Gender Specific Coronary Angiographic Findings in Patients with Coronary Artery Disease in the Age Year Group 40 to 60.

Gender Specific Coronary Angiographic Findings in Patients with Coronary Artery Disease in the Age Year Group 40 to 60.

Cardiac Events After Kidney Transplantation According to Pretransplantation Coronary Artery Disease and Coronary Revascularization Status

ObjectivesThe aims of this study were to compare the rates of cardiovascular events among renal transplant recipients according to pre-transplantation coronary artery disease (CAD) and revascularization status and to describe the coronary angiographic findings in patients with post-transplantation events. MethodsThis was a retrospective cohort study of patients who had coronary angiography within 2 years before kidney transplantation. The predictor variables were pre-transplantation CAD and coronary revascularization. The primary outcome was a composite of cardiovascular mortality, acute coronary syndrome, and post-transplantation revascularization. ResultsThe study included 403 patients. Pre-transplantation CAD was present in 73%, and 22% were revascularized. During a follow-up period of 5.6 years, the primary outcome occurred in 5% of the subjects without CAD, in 23% of those with CAD and no revascularization, and in 26% of those with CAD and revascularization (CAD hazard ratio [HR], 4.39 [P = .002]; revascularization HR, 1.27 [P = .36]). Thirty-five patients had a primary outcome and repeated coronary angiography, which demonstrated progression of previously nonsevere disease in the majority of cases. ConclusionsAdverse cardiovascular outcomes are common after renal transplantation and are associated with pre-transplantation CAD of any severity. Secondary prevention of CAD events should be a high priority in the management of this high-risk population.

Is creatinine clearance an independent variable altering electrocardiographic, echocardiographic and coronary angiographic findings in patients with acute coronary syndrome

Is creatinine clearance an independent variable altering electrocardiographic, echocardiographic and coronary angiographic findings in patients with acute coronary syndrome

Impact of waist circumference on hospital outcome and coronary angiographic findings of patients with acute ST-segment elevation myocardial infarction

Background Several studies showed that ST-segment elevation myocardial infarction (STEMI) patients with high body mass index (BMI) have better in-hospital outcomes.

Coronary angiographic findings in patients with complete left bundle branch block in Erbil city /Iraq

Background and objective: The goal of this study was to determine the association of complete left bundle branch block (LBBB), site , severity & risk factors of coronary artery disease (CAD). Complete Left bundle branch block increases the risk of cardiac mortality, and prognosis is primarily determined by the underlying CAD. Because the presence of complete LBBB makes the noninvasive identification of CAD less informative, patients with complete LBBB often are referred for coronary angiography to assess the presence and severity of CAD. Methods: A total of 150 consecutive patients with complete LBBB admitted to the coronary care unit were enrolled from the age of 27 to 81 years with the mean age of 59.32 ± 10.5. Male 84 (56%), Female (44%). History, basal investigations echocardiography and virology screen were performed. Coronary angiography has been done for all patients for different reasons of presentation. Results: Critical CAD 70 (46.7%), Left ventricular systolic dysfunction (LVSD) 50 (33.3%). Hypertension found in 83 (55.3%), diabetes mellitus (DM) in 44 (30%), DM& left ventricular systolic dysfunction(LVSD) were more associated with critical CAD. Conclusion: In our study complete LBBB was more common among hypertensive patients. In DM patients was associated with severe CAD. With Left anterior descending artery being the most common artery involved.

Relation of Cardiovascular Risk Factors with Coronary Angiographic Findings in Iraqi Patients with Ischemic Heart Disease

Background: Atherosclerotic coronary artery disease is a major cause of death all over the world. Among patients with coronary artery disease, there are different cardiovascular risk factors which may exhibit their effects on coronary angiographic findings. This work aimed to study the relation of different cardiovascular risk factors with coronary angiographic findings in patients with ischemic heart disease (IHD). Methods: This case-series prospective study involved 220 patients with IHD who underwent coronary angiography in Mosul Cardiac Catheterization Unit in Ibn-Sina Teaching Hospital over a period of five months from April 1st through August 31st 2006. Patients with different coronary risk factors including smoking, positive family history of IHD, type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia, obesity and physical inactivity who presented with IHD were categorized and compared according to presentations into; ST-elevation myocardial infarction (STEMI) ( n = 72), Non-ST-elevation myocardial infarction (NSTEMI) and/or unstable angina (n = 98) and chronic stable angina (n = 50) and then the patients were re-grouped according to the number of cardiovascular risk factors into patients with 3 risk factors (n = 95). Results: There were significant associations between the risk factors and the angiographic characteristics in patients with IHD. There were more significantly stenosed lesions among patients with > 3 risk factors compared to patients with < 3 risk factors (p < 0.05). Lesions were more diffused (p < 0.01), with higher incidence of left ventricular dysfunction (p < 0.001) among former patients compared to later ones. Conclusions: Significant findings were observed in the angiographic profile of patients with multiple risk factors. There were more multi-vessels and diffused angiographic findings among patients with chronic stable angina.

Does Motor Dysfunction After Cerebral Infarction Impede the Development of Angina Symptoms?

Previous studies based on coronary angiography or computed tomography coronary angiography have demonstrated a high prevalence of coronary stenosis in patients with cerebral infarction and no prior history of coronary artery disease (CAD). The purpose of the present study was to compare the coronary angiographic findings of patients with prior cerebral infarction with those of patients with no prior cerebral infarction. Consecutive patients (n = 126) who underwent a first coronary angiography for suspected CAD but had no prior history of CAD were classified into 2 groups, those with a clinical history of cerebral infarction (cerebral infarction group) and those without a clinical history of cerebral infarction (noncerebral infarction group). The incidences of diabetes mellitus, peripheral artery disease, coronary stenosis, and multivessel disease were significantly higher in the cerebral infarction group than in the noncerebral infarction group. Multiple logistic regression analysis relating to coronary stenosis identifi ed prior cerebral infarction (P = 0.0027, odds ratio = 4.414) and diabetes mellitus (P = 0.0446, odds ratio = 2.619) as explanatory factors. Thirty-four of 78 patients (44%) with coronary stenosis did not have angina symptoms. Multiple logistic regression analysis regarding the lack of angina symptoms identified motor dysfunction (modified Rankin scale ≥ 2) (P = 0.0028, odds ratio = 8.323) as an explanatory factor. The results of the present study suggest that compared with patients without cerebral infarction those with the disorder have a high prevalence of coronary stenosis, and indicate that the development of angina symptoms is influenced by the severity of motor dysfunction.

Relationship of echocardiographic and coronary angiographic findings in patients with acute myocardial infarction secondary to penetrating cardiac trauma

Patients with cardiac wounds could experience a posttraumatic acute myocardial infarction (PAMI) as a complication. Usually, this complication is explained by occlusion of a coronary artery, but sometimes, it cannot be explained by this pathophysiologic finding. This study aimed to determine the incidence of PAMI, make an approximation of PAMI pathophysiology, and propose management strategies. A prospective observational study was conducted at San Vicente de Paul University Hospital in Medellin, Colombia. During 12 months, we studied 51 patients with a history of a cardiac stab injury. We evaluated variables, such as Revised Trauma Score (RTS), surgical and anesthetic data, and possible risk factors. Diagnosis of PAMI was based on electrocardiogram, echocardiography, and troponin I serum levels. All PAMI patients had an coronary angiography. Risk factors possibly related to the development of PAMI were explored. Fifty-one patients were evaluated; three died (5.9%). Of the patients, 35 (68.62%) did not develop PAMI, 6 (11.76%) developed PAMI with coronary injury, and 10 (19.6%) experienced PAMI without coronary injury (PAMIWCI). An RTS of 5.3 or lower and a Glasgow Coma Scale score of 9 or lower were risk factors associated with PAMIWCI (relative risk, 11.55; p = 0.03). We did not find a relationship between PAMI and the use of psychoactive substances or other comorbidities. Patients with penetrating cardiac trauma may develop PAMIWCI. Active search for PAMI must be done in all patients with cardiac stab wound trauma, even those without artery coronary injury or symptoms suggestive of coronary ischemia. It is likely that Glasgow Coma Scale score of 9 of lower and RTS of 5.3 of lower for patients with cardiac injury are associated with the development of PAMIWCI.

Abstract 186: Coronary Angiographic Findings in Patients with or Without ST-Segment Elevation Resuscitated After Out-of-Hospital Cardiac Arrest

Background: Long-term survival after out-of-hospital cardiac arrest (OHCA) has improved in the last decade with special focus on the post cardiac arrest syndrome. Therapeutic hypothermia and percutaneous coronary intervention (PCI) are the two most important in-hospital interventions. International guidelines recommend aggressive use of coronary angiography in patients with ST segment elevation myocardial infarction (STEMI), but it is not clear if also patients without ST elevation should undergo early coronary angiography (ECA). The aim of the study was to document outcome in all OHCA patients of cardiac etiology, with special focus on angiographic findings and survival among patients with or without ST segment elevation. Methods: All patients admitted to our hospital after primary resuscitated OHCA are registered in our Post-resuscitation care registry. Electrocardiogram (ECG), coronary angiographic findings and overall survival of patients admitted in 2008 with cardiac etiology were investigated retrospectively by reviewing medical charts. Patients were classified according to the presence of ST segment elevation on post-resuscitation ECG or not. Results: Altogether 62 patients were included. ST elevation was present in 33 (53%) patients in whom all underwent ECA, 24 (73%) had an acute coronary occlusion, 5 (15%) had old occlusions, 17 (51%) had multivessel disease, and 29 (88%) received PCI. Among the 29 (47%) patients without ST elevation, 24 (83%) underwent ECA, of whom 5 (17%) had an acute coronary occlusion, 12 (50%) had old occlusions, 18 (75%) had multivessel disease, and 12 (38%) received PCI. In total, 60% of the patients were treated with therapeutic hypothermia with no difference between the two groups. Overall survival was 64% and 59% in patients with and without ST elevation, respectively (ns). Conclusion: Overall survival after OHCA of cardiac etiology was good, with no difference between patients with or without ST segment elevation. The presence of ST elevation on ECG was highly associated with the presence of an acute coronary occlusion, but a substantial proportion of patients without ST elevation also had coronary occlusions treated by PCI and more studies are warranted to determine whether all patients should undergo ECA.

Coronary angiographic findings in patients with chest pain and right bundle branch block

Coronary angiographic findings in patients with chest pain and right bundle branch block