Proximal left anterior descending coronary stenosis: The functional equivalent of triple vessel disease?

1982 ◽  
Vol 49 (4) ◽  
pp. 957 ◽  
Author(s):  
Paul Phillips ◽  
Jeffrey S. Borer ◽  
Jonathan Goldstein ◽  
Jerome Jacobstein ◽  
Jeffrey Moses ◽  
...  
Keyword(s):  
Coronary Stenosis ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Functional Equivalent

P873Plasma PCSK9 levels and atherosclerosis burden in the coronary arteries of patients undergoing coronary angiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Panahi ◽  
M S Ghahrodi ◽  
M S Jamshir ◽  
M A Safarpour ◽  
M Pirro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Stenosis ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Vessel Disease ◽  
Coronary Calcifications ◽  
Triple Vessel Disease

Abstract Background Plasma PCSK9 levels, a novel and effective therapeutic target for CVD prevention, have been associated with CVD events irrespective of traditional risk factors. Whether PCSK9 levels predict coronary artery disease (CAD) burden and severity is a matter of dispute. Purpose To investigate the association between plasma PCSK9 levels and CAD characteristics, including number of major diseased vessels, severity of coronary stenosis, and the burden of coronary calcifications. Methods One hundred and one patients undergoing coronary angiography were recruited for this cross-sectional study. The number of major coronary diseased vessels was defined as the presence of ≥1 stenoses ≥50% in diameter of at least one major coronary artery. CAD severity was defined as either the absence of coronary stenosis (no-CAD), CAD<50% or CAD≥50% in one or more coronary arteries. The burden of coronary calcifications was estimated by angiography visual inspection and classified as absent, mild, moderate or severe. Results Coronary angiography showed single, double and triple vessel disease in 26 (25.7%), 23 (22.8%) and 21 (20.8%) patients, respectively; 20 (19.8%) and 11 (10.9%) pts had either minimal CAD (<50%) or normal angiographic findings. Also, calcifications were absent in 65 patients (64.4%), and mild, moderate and severe in 23 (22.8%), 11 (10.9%) and 2 (2%) patients, respectively. Plasma PCSK9 levels were significantly associated with age (rho=0.22, p=0.025) and SBP (rho=0.21, p=0.034), and were almost doubled in patients with chronic kidney disease (CKD) as compared to those without CKD [164.6 ng/mL (104.6–187.0) vs 94.8 ng/mL (86.8–114.9), p=0.006]. Among patients without CKD, those with CAD≥50% had higher plasma PCSK9 levels than those without [97.1 ng/mL (87.8–143.0) vs 83.2 ng/mL (73.4–102.6), p=0.04]. In the overall population, higher plasma PCSK9 levels were found in pts with triple vessel disease [165.7 ng/mL (121.3–180.5)] than in those with double/single vessel involvement [97.9 ng/mL (87.6–99.8) and 88.4 ng/mL (87.3–97.4), p<0.001 for both comparisons] or without CAD [87.5 ng/mL (74.3–114.9), p<0.001]. Also, a trend toward an increase of plasma PCSK9 levels was found with higher CAD severity [no-CAD: 87.5 ng/mL (74.3–114.9), CAD<50%: 89.1 ng/mL (78.9–105.3), CAD≥50%: 97.6 ng/mL (87.9–155.3), p=0.051], which turned significant after exclusion of CKD patients (p=0.042). Adjustment for age, sex, plasma LDL-cholesterol levels, statin use and CKD abolished the association between PCSK9 and CAD severity but not with the number of significantly diseased vessels and the burden of coronary calcifications. Conclusions Circulating PCSK9, whose plasma levels are significantly influenced by the presence of CKD, discriminates patients with significant coronary artery stenosis from those without CAD. In addition, both the number of diseased coronary vessels and total coronary calcifications are independently predicted by an elevated plasma PCSK9 level. Acknowledgement/Funding None

scholarly journals Association of Glycosylated Haemoglobin Level with the Severity of Coronary Artery Disease in NSTEMI Diabetic Patients

2015 ◽  
Vol 8 (1) ◽  
pp. 43-48
Author(s):  
Mahmod Mohammad Salim ◽  
Malik Fazila Tun Nesa ◽  
Rahman Mohammad Arif ◽  
Hossain Mohammad Delwar ◽  
Mandal Md Raihan Masum
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Gensini Score ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Group I ◽  
Group Ii ◽  
Artery Disease ◽  
Vessel Score

Background: Relation between diabetes mellitus and ischemic heart disease is well established. But the effect of HbA1C on severity of coronary artery disease remains uncertain in non-ST elevation myocardial infarction and diabetic patient. Objective of our study was to know the relationship of HbA1C with the severity of coronary artery disease.Methods: In this cross sectional analytical study a total of 104 NSTEMI diabetic patients were enrolled by purposive sampling. They were divided into two groups according to the level of HbA1C, Group-I patients having HbA1C<7% and Group-II patients having HbA1C >7%. Vessel score and Gensini score was calculated from coronary angiogram and compared between groups.Results: Single vessel disease were significantly higher in group-I compared to Group-II( 38.5% vs 7.7% in Group-I vs Group-II,p<0.05). Double vessel disease were higher in group-II compared to Group-I but the difference was statistically not significant (42.3% vs 48.1% in Group-I vs Group-II respectively (p>0.05). Triple vessel disease were significantly higher in group-II compared to Group- I (19.2% vs 44.4% in Group-I vs Group-II,p<0.05). Mean Vessel score was higher in Group-II compared to Group-I(1.73 ± 0.86 vs 2.50 ±0.70 in Group-I vs Group-II, p<0.05). Mean Gensini score was higher in Group-II compared to Group-I (44.6 ± 38.4 vs 76.9 ± 44.6 in Group-I vs Group-II, p<0.05). There were significant positive linear correlation between HbA1C and Vessels score and Gensini score (p<0.05).Conclusion: This study may be concluded that the presence of HbA1C >7% are associated with of severe coronary artery disease in NSTEMI with diabetes mellitus.Cardiovasc. j. 2015; 8(1): 43-48

scholarly journals Angiographic profile of young patients (≤ 40 years) in a tertiary care center of Nepal

2020 ◽  
Vol 11 (6) ◽  
pp. 68-71
Author(s):  
Binay Kumar Rauniyar ◽  
Arun Kadel ◽  
Kiran Prasad Acharya ◽  
Kartikesh Kumar Thakur ◽  
Rakesh Bahadur Adhikari ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Tertiary Care ◽  
Significant Coronary Artery Disease ◽  
Young Patients ◽  
Vessel Disease ◽  
Single Vessel ◽  
Triple Vessel Disease ◽  
Artery Disease ◽  
Single Vessel Disease

Background: With rise in prevalence of conventional risk factors like diabetes, hypertension, smoking, dyslipidemia and obesity the incidence of coronary artery disease in young patients have increased in the recent decades even in developing world. There have been multiple studies done in Nepal studying the angiographic profile of coronary disease in general population. However, only few studies has been done till date on the angiographic profile in the young population in our country. Aims and Objectives: In this study, we aim to determine the angiographic profile of young patient ≤ 40 years in a tertiary care centre of Nepal. Materials and Methods: A retrospective analytic study was done in Shahid Gangalal National Heart Centre from January 2019 to December 2019. Individuals of both genders with age ≤ 40 years who underwent coronary angiography were included. Results: Total 109 patients were included. Out of 109, 89 were male and 20 were female. The mean age for male was 35.55 ± 4.31 and for female was 38.55 ± 1.90 (P = 0.003). Among 61 (55.96%) patients who had significant coronary artery disease, 33 patients (30.27%) with single vessel disease, 15 patients (13.76%) had double vessel disease, and 13 patients (11.92%) had triple vessel disease. Left anterior descending (LAD) artery was found to be most frequently involved in all patterns of Coronary artery disease (CAD). Smoking was the most common coronary risk factor present in 29.3% of patients followed by hypertension, family history of premature CAD and diabetes in 14.6%, 7.5% and 5.5% of patients respectively. Overall, the prevalence of smoking was more in males (31.4%) than in females (20%). Conclusion: Single vessel disease (SVD) was most prevalent in young patients with significant CAD. LAD is the most commonly involved coronary artery followed by Right coronary artery (RCA) and Left Circumflex (LCX).

scholarly journals Angiographic profile of NSTEMI patients with or without metabolic syndrome

2016 ◽  
Vol 15 (4) ◽  
pp. 511-516
Author(s):  
Md Aminul Haque ◽  
Nazir Ahmed ◽  
Fazila Tun Nesa Malik ◽  
Tawfiq Shahriar Huq ◽  
Md Kalimuddin ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Medical Science ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Increased Risk ◽  
Significant Difference ◽  
Artery Disease ◽  
Considerable Morbidity ◽  
Vessel Score

Background: Metabolic syndrome (MS) constitutes the clustering of clinical and biochemical risk factors, which are associated with increased risk of cardiovascular events. Non ST elevation myocardial infarction (NSTEMI) accounts for the important part of acute coronary syndrome (ACS) with considerable morbidity and mortality. The aim of this study was to investigate the association of MS with angiographic severity of coronary artery disease (CAD) in patients with NSTEMI.Methods: This study included 192 prospectively enrolled NSTEMI patients. The patients underwent coronary angiography (CAG). CAG were evaluated via Sullivan’s method.Results: Statistically significant difference in vessel score observed, such that higher triple vessel disease (TVD) in MS patients (42.7% vs. 15.6%, p<0.001) and single vessel disease (SVD) in patients without MS (45.8% vs. 21.9%, p<0.001). Patients with MS had higher mean total stenosis score (9.26±4.29 vs. 6.06±3.07, p<0.001) and mean extension score (53.70±18.11 vs. 39.11±17.59, p<0.001). Correlation analysis found direct correlation between angiographic scores and MS scores, total cholesterol, LDL-C, HDL-C, TG and waist circumference. Individual components of MS were independent predictors of high total stenosis score and extension score on multivariate linear regression analysis.Conclusion: Metabolic syndrome, as well as, individual components of MS was independently associated with angiographically severe CAD.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.511-516

scholarly journals Thallium-201 myocardial scintigraphy in patients with triple-vessel disease and ischemic exercise stress tests.

Circulation ◽  
1979 ◽  
Vol 59 (4) ◽  
pp. 714-721 ◽  
Author(s):  
J Leppo ◽  
T Yipintsoi ◽  
R Blankstein ◽  
R Bontemps ◽  
L M Freeman ◽  
...  
Keyword(s):  
Myocardial Scintigraphy ◽  
Thallium 201 ◽  
Exercise Stress ◽  
Stress Tests ◽  
Vessel Disease ◽  
Triple Vessel Disease

scholarly journals Caracterização do perfil e complicações intra-hospitalares dos pacientes submetidos ao cateterismo cardíaco em um hospital terciário

2017 ◽  
Vol 27 (1) ◽  
pp. 24806
Author(s):  
Débora Ferreira Braga ◽  
Gustavo Paes Silvano ◽  
Thainá Ferreira Furtado Pereira ◽  
Fabiana Schuelter-Trevisol ◽  
Daisson José Trevisol
Keyword(s):  
Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Hospital Stay ◽  
Cardiac Catheterization ◽  
Tertiary Care ◽  
Care Hospital ◽  
Puncture Site ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Triple Vessel Disease

DOI: 10.15448/1980-6108.2017.1.24806 Aims: To evaluate the profile of patients undergoing cardiac catheterization and in-hospital complications associated with the procedure.Methods: Cross-sectional analysis of baseline data of a retrospective cohort study conducted in a tertiary care hospital in southern Brazil between 2007 and 2013. The study included patients undergoing diagnostic or therapeutic cardiac catheterization. The data were extracted from electronic medical records using a standardized form and stored in a database for further analysis.Results: Out of 994 assessed patients, 584 (58.8%) were male. The mean age was 61.4 years. Hypertension was the most prevalent risk factor, followed by dyslipidemia and diabetes mellitus. Regarding clinical presentation, 550 (55.3%) patients had acute coronary syndrome, 402 (40.4%) had stable angina, and 42 (4.2%) were asymptomatic. Cineangiography was normal in 152 (15.3%) patients and abnormal in 842 (84.7%). Of these, 251 (29.8%)  had single vessel disease, 190 (22.6%) had double vessel disease, and 401 (47.6%) had triple vessel disease. The overall incidence of complications was 15.6%, and 1% of the patients suffered some kind of major event (death during the procedure and neurological complications during their hospital stay). Other complications included acute kidney injury (1.4%) and local vascular complications (13.2%), mainly hematoma at the puncture site. Fifty (5%) patients died during the hospital stay, 46 (92%) of them from cardiac causes. Conclusions: The patients undergoing cardiac catheterization were predominantly male, with mean age of 61.4 years. The most frequent risk factors for cardiovascular disease included hypertension, dyslipidemia, and diabetes mellitus. Most of the patients had triple vessel disease. The main indication for the procedure was acute coronary syndrome. The overall incidence of complications was 15.6% with predominance of hematoma at the puncture site.

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