Analysis of anomalous origin of coronary arteries by coronary angiography in Chinese patients with coronary artery disease

Myocardial Infarction with Non-obstructive Coronary Arteries-MINOCA is a clinical syndrome that encompasses a subgroup of heterogeneous patients who present with myocardial infarction yet do not have any significant coronary artery obstruction on angiogram. From several studies it is understood that MINOCA has a 8.8% prevalence of all Myocardial Infarction (MI) presentations, with no characteristic distinguishing clinical features when compared with MI-CAD( Coronary artery disease), except for patients being younger with a female preponderance & less likely to have hyperlipidemia. The prognosis is extremely variable, depending on the causes of MINOCA. Clinical history, echocardiography, coronary angiography, and left ventriculography represent the first-level diagnostic investigations. Ibrahim Card Med J 2015; 5 (1&2): 61-66

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Can Patients with Chest Pain and Normal Coronary Arteries Be Discriminated from Those with Coronary Artery Disease Prior to Coronary Angiography?

Angiology ◽

10.1177/0003319789040004065 ◽

1989 ◽

Vol 40 (4) ◽

pp. 276-282

Author(s):

Vaskar Mukerji ◽

Martin A. Alpert ◽

John E. Hewett ◽

Brent M. Parker

Keyword(s):

Coronary Artery Disease ◽

Chest Pain ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Normal Coronary Arteries ◽

Artery Disease

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Among Ectasia Patients with Coexisting Coronary Artery Disease, TIMI Frame Count Correlates with Ectasia Size and Markis Type IV Is the Commonest

Cardiology Research and Practice ◽

10.1155/2015/282170 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hasahya Tony ◽

Kai Meng ◽

Bangwei Wu ◽

Qiutang Zeng

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Flow Velocity ◽

Coronary Arteries ◽

Coronary Flow ◽

Coronary Artery Ectasia ◽

Timi Frame Count ◽

Type Iv ◽

Artery Disease

Background. Coronary artery ectasia (CAE) occurs in 0.3 to 5.3% of patients undergoing coronary angiography. TIMI frame count (TFC) is an index of coronary flow that correlates with flow velocity. In ectasia patients, there is delayed coronary flow with increased TFC.Methods.We evaluated angiograms of 789 patients for presence of CAE, coronary artery disease (CAD), and Markis type of CAE. We measured ectasia size and length and their correlation with TFC in ectatic right coronary arteries (RCA) of patients with CAE and CAD.Results.30 patients had CAE (3.8%). Of these 16.7% had isolated CAE, while 83.87% had CAE and CAD. Among CAE and CAD patients, the RCA was most involved (70.4%), and Markis type IV CAE was the commonest (64%). In isolated CAE, the RCA, LAD, and LCx were equally involved (33.3%). Patients with CAE and CAD had significantly higher TFC compared to controls,P=0.035. There was a positive correlation of moderate strength, between ectasia size and TFC,r(17) = 0.598,P=0.007. Ectasia length was not significantly correlated with TFC, rho (17) = 0.334,P=0.163.Conclusion.Among patients undergoing angiography, CAE has a prevalence of 3.8% and Markis type IV is the commonest. Larger ectasias are associated with slower coronary flow.

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Does Myocardial Bridge Appear More Frequently and Diffusely on Radial Access Coronary Angiography?

10.21203/rs.3.rs-537384/v1 ◽

2021 ◽

Author(s):

oktay senoz ◽

zeynep yapan emren

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Clinical Laboratory ◽

Conventional Coronary Angiography ◽

Myocardial Bridge ◽

Radial Access ◽

Left Anterior Descending Artery ◽

Artery Disease

Abstract Background: Although the incidence of myocardial bridge (MB) has been defined in different conventional coronary angiography (CCA) studies,the frequency of MB in radial access coronary angiography (RACA) is unknown.The aim of this study was to determine the incidence of MB in patients undergoing RACA.Method: A total of 2600 consecutive patients who underwent RACA were retrospectively investigated to detect the presence of MB.The clinical,laboratory, and angiographic features of the patients with MB were analyzed. Results: MB was detected at an incidence of 10.2%, in 255/2600 patients who underwent RACA.The most involved coronary artery was the left anterior descending artery (LAD) (86.9%) and the mid segment (84.9%) was the most affected section.Co-involvement of multiple coronary arteries by MB was 7.8%. Coronary artery disease (CAD) was determined in 102 (36.2%) of the coronary arteries with MB, 82.4% which were proximal to the MB.Conclusion: These data demonstrated that the incidence of MB able to be detected on RACA was much higher than reported in previous CCA studies.

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Diagnostic Accuracy of 128-Slice Dual Source CT Coronary Angiography with Invasive Catheter Coronary Angiography in a Tertiary Care Teaching Hospital

10.53350/pjmhs211562057 ◽

2021 ◽

Vol 15 (6) ◽

pp. 2057-2062

Author(s):

Vishram Singh ◽

Suresh Babu Kottapalli ◽

Rakesh Gupta ◽

Nitin Agarwal ◽

Yogesh Yadav

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Diagnostic Accuracy ◽

Coronary Arteries ◽

Ct Coronary Angiography ◽

Dual Source Ct ◽

Ct Scanner ◽

Dual Source ◽

Artery Disease

Background: Coronary artery disease (CAD) morbidity and mortality increasing day by day in India as well as worldwide. Coronary arteries visualization by using invasive catheterization angiography is still using as a front-line diagnostic tool to evaluate the patients with CAD. 128 slice dual source CT improves the cardiac imaging such as high scanning speed, good temporal resolution and low radiation dose. Objective: To assess the diagnostic accuracy of 128-slice dual source CT cardiac angiography with conventional catheter angiography to find common arteries involved in CAD. Methods: This is a prospective, comparative, cross sectional study conducted at cardiology OPD. Patients with complaint of chest pain and suspected CAD were evaluated by CT and conventional coronary angiography and results were compared. Serum creatinine and ECG status were analyzed before the angiography. SIEMENS 128-slice Dual Source Flash Definition CT Scanner was used as a CT coronary angiography. Severity distribution of coronary artery disease, artery wise distribution of non-significant, significant lesions and coronary artery dominance pattern were analyzed and compared. Results: A total of 70 suspected CAD patients were selected and analyzed. American Heart Association (AHA) model of 17-segment was used to assess the coronary arteries. Normal angiograms reported in 15.71% patients and 58.57% had significant disease. A total of 356 lesions were identified from 690 out of 720 segments. Right coronary artery (RCA) is the most common location of significant lesions which contributes 33.5% (n=55/164). Coronary circulation of right-sided dominance was most commonly reported (70.0%). CT angiography showed 96.13% of an overall sensitivity, 96.28% specificity, 89.72% positive predictive value and 98.49% negative predictive value. Conclusion: 128-slice dual source CT scanner has showed high accuracy and act as non-invasive assessment of coronary arteries in patients with CAD Keywords: Cardiac angiography, Catheter coronary angiography, CT coronary angiography, 128-slice MDCT, Conventional angiography

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ASSOCIATION OF HYPERURICEMIA WITH THE PRESENCE AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY

Pakistan Heart Journal ◽

10.47144/phj.v54i2.2092 ◽

2021 ◽

Vol 54 (2) ◽

pp. 157-161

Author(s):

Ammar Akhtar ◽

Muhammad Zubair Zaffar ◽

Rashid Minhas ◽

Hadi Yousuf Saeed ◽

Gul Zaman Khan Niazi

Keyword(s):

Coronary Artery Disease ◽

Uric Acid ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Control Group ◽

P Value ◽

Case Group ◽

Luminal Stenosis ◽

Artery Disease

Objectives: To determine the association of hyperuricemia with the presence and severity of coronary artery disease in patients undergoing coronary angiography. Methodology: This case control study was carried out in the Department of Cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan for six months. Total number of 292 patients (146 cases with coronary artery disease and 146 controls with normal coronary arteries) having age 40-60 years of both genders were included in this study. Coronary angiography was performed using standard angiographic techniques. After undergoing coronary angiography, patients with 50% luminal stenosis or more in any one of the coronary arteries were labeled case group. Patients with normal coronaries or less than 50% luminal stenosis in any one of the coronary vessels were taken as control group. Serum uric acid was advised and value was noted along with the basic demographic data and established risk factors of coronary artery disease. Results: Mean age was 50.79±6.08 years. Mean serum uric acid was 7.54±3.60 mg/dl. Hyperuricemia was diagnosed in 94 (64.40%) patients with significant CAD (case group) and in only 59 (40.40%) in control group. The odds ratio was 2.66 (95% CI 1.66 to 7.28) with p-value of <0.001. Triple vessel disease was diagnosed in 66.7% patients with hyperuricemia and in only 33.3% patients without hyperuricemia [OR 4.0 (2.09-7.64), p-value <0.001]. Conclusion: There is a significant association between the presence and severity of coronary artery disease with hyperuricemia.

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Incidence of coronary artery disease before valvular replacement in isolated severe aortic stenosis patients in Western Rajasthan

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20214415 ◽

2021 ◽

Vol 9 (11) ◽

pp. 3347

Author(s):

Ramesh Patel ◽

Sandeep Aggarwal

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Artery Disease

Background: The aim of the study was to evaluate the incidence of Coronary artery disease (CAD) and predictors of CAD in patients with severe AS in western Rajasthan population.Methods: Data from all consecutive patients with severe AS undergoing AVR at a major tertiary cardiac and vascular center in Udaipur were entered in a prospective registry beginning in 2015. Significant CAD was defined as one or more major coronary arteries having an estimated narrowing of ≥70% and left main coronary arteries having an estimated narrowing of ≥50% on coronary angiography. We excluded patients with multiple valve disease, significant aortic regurgitation, or prior CAD or valve surgery.Results: Mean age of 55 enrolled patients was 52.64±15.5 years. Diabetes mellitus and hypertension were present in 3.64% and 5.45% of patients, respectively. Moderate and severe Left ventricular ejection fraction (LVEF) was found in 16.36% and 10.91% patients, respectively. Only 5.45% patient had severe CAD and thus underwent AVR and coronary artery bypass grafting, and rest 94.55% patients underwent AVR. Mean age of patients who underwent AVR was 51.75±15.36 years and who underwent AVR and CABG was 68±11.14 years with no significant association (p=0.078). Proportion of patients requiring AVR and CABG was significantly higher in moderate (22.22%) and severe LVEF (16.67%) as compared to normal or mild (p=0.034).Conclusions: Coronary angiography before AVR will be considered in patients with multiple risk factors for cardiovascular disease or in patients above 68 years of age without risk factors for cardiovascular disease. However, larger studies on heterogeneous population are required to prove our findings.

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Management of ischaemia with non-obstructive coronary arteries (INOCA)

BMJ ◽

10.1136/bmj-2021-060602 ◽

2021 ◽

pp. e060602

Author(s):

John F Beltrame ◽

Rosanna Tavella ◽

Dione Jones ◽

Chris Zeitz

Keyword(s):

Coronary Artery Disease ◽

Chest Pain ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Obstructive Coronary Artery Disease ◽

Personalised Medicine ◽

Future Research ◽

Comprehensive Review ◽

Artery Disease

Abstract Up to half of patients undergoing elective coronary angiography for the investigation of chest pain do not present with evidence of obstructive coronary artery disease. These patients are often discharged with a diagnosis of non-cardiac chest pain, yet many could have an ischaemic basis for their symptoms. This type of ischaemic chest pain in the absence of obstructive coronary artery disease is referred to as INOCA (ischaemia with non-obstructive coronary arteries). This comprehensive review of INOCA management looks at why these patients require treatment, who requires treatment based on diagnostic evaluation, what clinical treatment targets should be considered, how to treat patients using a personalised medicine approach, when to initiate treatment, and where future research is progressing.

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