scholarly journals CHA2DS2-VASc-HSF Score may Better Predict the Development of Total Coronary Artery Occlusion in Acute Coronary Syndrome

Angiology ◽  
2021 ◽  
pp. 000331972110403
Author(s):  
Sara C. Sanlialp ◽  
Musa Sanlialp ◽  
Serdar Guler
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Coronary Syndrome

scholarly journals Angiographic Studies of Coronary Artery Disease in Dhulikhel Hospital

2013 ◽  
Vol 9 (1) ◽  
pp. 43-46
Author(s):  
R Koju ◽  
S Humagain
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stable Angina ◽  
Coronary Stenosis ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Coronary Syndrome ◽  
Diagnostic Angiography ◽  
Artery Disease

Background Coronary Artery Diseases (CAD), one of the the leading causes of death, is increasing globally. The number of CAD is also increasing in Nepal. Dhulikhel Hospital is also providing cardiovascular services to populations from semiurban and rural population of mid region of country. It started coronary angiography services from April 2012. This paper aims to analyze pattern of coronary artery occlusion in patients undergoing coronary angiography during April to September months of 2012. Methods There were a total of 36 cases of diagnostic angiography and coronary interventions done in Dhulikhel Hospital from April to September 2012. Among them 32 cases of coronary angiography done for Acute Coronary Syndrome and Stable Angina, were analyzed using SPSS 17. Results Males were higher in number than females and majority of the patients were above 55 years. Out of 32 cases, 13 (40.6%) had Acute Coronary Syndrome (ACS) and 19(59.4%) had Stable Angina. Six out of 32 were found to have normal coronaries. One patient with ACS had normal coronary. Out of all the patients with coronary stenosis, four had left main disease, 14 had LAD stenosis, 7 had LCX stenosis and 12 patients had RCA stenosis. Thirteen had severe coronary stenosis. Nine out of 12 ACS patients had more than one coronary artery involved, which is significantly higher than the stable angina group (P<0.01). Severe stenosis was found to be more common in ACS group (p<0.001) when compared to the stable angina group. Conclusion Coronary angiography is a useful diagnostic and therapeutic tool for CAD. Coronary status is significantly different in ACS and stable angina. ACS has more chance of having multivessel stenosis whereas stable angina has single vessel, less severe or normal coronaries. Severity of stenosis is also high in ACS than in stable angina. DOI: http://dx.doi.org/10.3126/njh.v9i1.8348 Nepalese Heart Journal Vol.9(1) 2012 pp.43-46

Coexistence and outcome of coronary artery disease in Takotsubo syndrome

2020 ◽  
Vol 41 (34) ◽  
pp. 3255-3268 ◽  
Author(s):  
L Christian Napp ◽  
Victoria L Cammann ◽  
Milosz Jaguszewski ◽  
Konrad A Szawan ◽  
Manfred Wischnewsky ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Occlusion ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Takotsubo Syndrome ◽  
Normal Coronary Arteries ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Aims Takotsubo syndrome (TTS) is an acute heart failure syndrome, which shares many features with acute coronary syndrome (ACS). Although TTS was initially described with angiographically normal coronary arteries, smaller studies recently indicated a potential coexistence of coronary artery disease (CAD) in TTS patients. This study aimed to determine the coexistence, features, and prognostic role of CAD in a large cohort of patients with TTS. Methods and results Coronary anatomy and CAD were studied in patients diagnosed with TTS. Inclusion criteria were compliance with the International Takotsubo Diagnostic Criteria for TTS, and availability of original coronary angiographies with ventriculography performed during the acute phase. Exclusion criteria were missing views, poor quality of angiography loops, and angiography without ventriculography. A total of 1016 TTS patients were studied. Of those, 23.0% had obstructive CAD, 41.2% had non-obstructive CAD, and 35.7% had angiographically normal coronary arteries. A total of 47 patients (4.6%) underwent percutaneous coronary intervention, and 3 patients had acute and 8 had chronic coronary artery occlusion concomitant with TTS, respectively. The presence of CAD was associated with increased incidence of shock, ventilation, and death from any cause. After adjusting for confounders, the presence of obstructive CAD was associated with mortality at 30 days. Takotsubo syndrome patients with obstructive CAD were at comparable risk for shock and death and nearly at twice the risk for ventilation compared to an age- and sex-matched ACS cohort. Conclusions Coronary artery disease frequently coexists in TTS patients, presents with the whole spectrum of coronary pathology including acute coronary occlusion, and is associated with adverse outcome. Trial registration ClinicalTrials.gov number: NCT01947621.

scholarly journals Cardiac magnetic resonance assessment of diastolic dysfunction in acute coronary syndrome

2017 ◽  
Vol 45 (6) ◽  
pp. 1680-1692 ◽  
Author(s):  
Shah M. Azarisman ◽  
Karen S Teo ◽  
Matthew I Worthley ◽  
Stephen G Worthley
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Diastolic Dysfunction ◽  
Imaging Techniques ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Acute Setting ◽  
Coronary Syndrome

Chest pain is an important presenting symptom. However, few cases of chest pain are diagnosed as acute coronary syndrome (ACS) in the acute setting. This results in frequent inappropriate discharge and major delay in treatment for patients with underlying ACS. The conventional methods of assessing ACS, which include electrocardiography and serological markers of infarct, can take time to manifest. Recent studies have investigated more sensitive and specific imaging modalities that can be used. Diastolic dysfunction occurs early following coronary artery occlusion and its detection is useful in confirming the diagnosis, risk stratification, and prognosis post-ACS. Cardiac magnetic resonance provides a single imaging modality for comprehensive evaluation of chest pain in the acute setting. In particular, cardiac magnetic resonance has many imaging techniques that assess diastolic dysfunction post-coronary artery occlusion. Techniques such as measurement of left atrial size, mitral inflow, and mitral annular and pulmonary vein flow velocities with phase-contrast imaging enable general assessment of ventricular diastolic function. More novel imaging techniques, such as T2-weighted imaging for oedema, T1 mapping, and myocardial tagging, allow early determination of regional diastolic dysfunction and oedema. These findings may correspond to specific infarcted arteries that may be used to tailor eventual percutaneous coronary artery intervention.

scholarly journals Targeting myocardial ischaemic injury in the absence of reperfusion

2020 ◽  
Vol 115 (6) ◽  
Author(s):  
M. V. Basalay ◽  
D. M. Yellon ◽  
S. M. Davidson
Keyword(s):  
Coronary Artery ◽  
Infarct Size ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Ischaemic Injury ◽  
Coronary Syndrome ◽  
Acute Rupture ◽  
Subsequent Exposure ◽  
St Elevation ◽  
Collateral Vessels

Abstract Sudden myocardial ischaemia causes an acute coronary syndrome. In the case of ST-elevation myocardial infarction (STEMI), this is usually caused by the acute rupture of atherosclerotic plaque and obstruction of a coronary artery. Timely restoration of blood flow can reduce infarct size, but ischaemic regions of myocardium remain in up to two-thirds of patients due to microvascular obstruction (MVO). Experimentally, cardioprotective strategies can limit infarct size, but these are primarily intended to target reperfusion injury. Here, we address the question of whether it is possible to specifically prevent ischaemic injury, for example in models of chronic coronary artery occlusion. Two main types of intervention are identified: those that preserve ATP levels by reducing myocardial oxygen consumption, (e.g. hypothermia; cardiac unloading; a reduction in heart rate or contractility; or ischaemic preconditioning), and those that increase myocardial oxygen/blood supply (e.g. collateral vessel dilation). An important consideration in these studies is the method used to assess infarct size, which is not straightforward in the absence of reperfusion. After several hours, most of the ischaemic area is likely to become infarcted, unless it is supplied by pre-formed collateral vessels. Therefore, therapies that stimulate the formation of new collaterals can potentially limit injury during subsequent exposure to ischaemia. After a prolonged period of ischaemia, the heart undergoes a remodelling process. Interventions, such as those targeting inflammation, may prevent adverse remodelling. Finally, harnessing of the endogenous process of myocardial regeneration has the potential to restore cardiomyocytes lost during infarction.

scholarly journals Long-term Prognosis after Treatment of Total Occluded Coronary Artery is well Predicted by Neutrophil to High-Density Lipoprotein Ratio: a Comparison Study

Kardiologiia ◽  
2021 ◽  
Vol 61 (7) ◽  
pp. 60-67
Author(s):  
Mehmet Ozgeyik ◽  
Mufide Okay Ozgeyik
Keyword(s):  
Coronary Artery ◽  
Confidence Interval ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Mortality Prediction ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Increased Risk

Aim    Mortality prediction is very important for more effective treatment of patients with acute coronary syndrome. Hematological and lipid parameters have been used for this purpose, as this approach is non-invasive and cost effective. In this study, our aim was to evaluate which parameter predicts mortality most accurately.Material and Methods    Data of 554 patients with at least one total coronary artery occlusion were collected retrospectively. Receiver operating characteristic curves were used to determine the optimal cut-off points of Neu / HDL, Neu / Lym, Mono / HDL, Trig / HDL, HDL / LDL, Plt / Lym and Lym / HDL according to long-term cardiovascular survival. Median follow-up time was 520 days, and 30 patients died.Results    The mean age was 60.96±0.50 yrs. The area under the curve (AUC) for Neu / HDL was 0.830 (p<0.001, 95 % confidence interval [CI]: 0.753 to 0.908). The cut-off point was 0.269, with a sensitivity of 74.2 % and a specificity of 74.2 %. The AUC for Neu / Lym was 0.688 (p<0.001, 95 % CI: 0.586 to 0.790). The cut-off point was 5.322, with a sensitivity of 67.7 % and a specificity of 67.1 %. The Neu / HDL (hazard ratio, HR [confidence interval, CI]: 0.202 [0.075–0.545], p=0.002) and Neu / Lym (0.306 [0.120–0.777], p=0.013) were associated with increased risk of death according to multivariate Cox regression analysis.Conclusions    Neu / HDL offers a better long-term mortality prediction than Neu / Lym, Mono / HDL, Trig / HDL, HDL / LDL, Plt / Lym, or Lym / HDL after treatment of total coronary artery occlusion.

scholarly journals Myocardial infarction due to coronary embolism in a patient with dilated cardiomyopathy without atherosclerotic lesions on coronary angiography

2020 ◽  
Vol 16 (4) ◽  
pp. 404-408
Author(s):  
Radosław Walczewski ◽  
◽  
Robert Ryczek ◽  
Paweł Krzesiński ◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Dilated Cardiomyopathy ◽  
Thrombus Formation ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Coronary Syndrome ◽  
Atherosclerotic Lesions ◽  
Standard Management ◽  
Coronary Embolism

Coronary embolism is a potential cause of reduced myocardial perfusion and ischaemia, which may clinically manifest as myocardial infarction. Data on the incidence of coronary embolism as a mechanism underlying acute coronary syndrome are limited. Coronary embolism should be suspected as a cause of acute coronary syndrome in patients without coronary angiographic evidence of atherosclerosis, but with risk factors for intracardiac thrombus formation. The most important of these are atrial fibrillation and dilated cardiomyopathy. We present a case of a patient in whom the diagnosis of myocardial infarction was justified by the coexisting dilated cardiomyopathy, and where coronary artery occlusion most likely occurred through the embolic mechanism. Differential diagnosis of the aetiology of acute coronary syndrome should be performed in patients with myocardial infarction without coronary atherosclerosis. This allows to implement individualised causative treatment, which may differ from standard management in myocardial infarction.

scholarly journals Ritka etiológiájú fiatalkori szívinfarktus

2015 ◽  
Vol 156 (25) ◽  
pp. 1020-1025
Author(s):  
Gábor Zoltán Nagy ◽  
Gábor Gerges ◽  
Kálmán Csapó ◽  
Erika Csengő ◽  
Károly Minik
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Aortic Dissection ◽  
Young Patients ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Left Main ◽  
Diagnostic Challenge ◽  
Total Occlusion ◽  
Coronary Syndrome

Chest pain is not uncommon among young patients below the age of 35 years, however, it is rarely caused by acute coronary syndrome. The rarity of coronary artery occlusion in this population can easily lead to diagnostic mistakes. The authors present the case history of a 19-year-old young female, who was admitted to the emergency department of a local hospital due to the sudden onset of chest pain and malaise. ST-segment elevation was seen on the electrocardiogram raising the possibility of aortic dissection, therefore, emergency thoracic computed tomographic scan was performed. This proved to be negative and the patient was transferred to the coronary care unit. Urgent coronarography was carried out, which revealed the total occlusion of the left main coronary artery. The occluded artery was successfully opened with percutaneous coronary intervention, but despite revascularisation the patient died on the second postoperative day due to asystole. Autopsy revealed thrombotic embolization of the left main artery with consequent extensive haemorrhagic necrosis, involving almost the whole left ventricle. The source of embolization was not found. The authors note that left coronary artery occlusion in young patients can be a diagnostic challenge, because symptoms can be mistaken with aortic dissection or pulmonary embolism. Orv. Hetil., 2015, 156(25), 1020–1025.

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