scholarly journals Predictive Roles of Right Coronary Artery Disease Severity and Systemic Immune Inflammation Index in Predicting Atrial Fibrillation After Coronary Bypass Operations in Patients with Right Coronary Artery Disease

2021 ◽  
Vol 24 (6) ◽  
pp. E977-E982
Author(s):  
YUSUF ATA ◽  
Mustafa Abanoz
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Bypass Graft ◽  
Postoperative Atrial Fibrillation ◽  
Cerebrovascular Event ◽  
Gensini Score ◽  
Immune Inflammation ◽  
Artery Disease

Background: Postoperative atrial fibrillation (PoAF) is observed at a rate of 25-40% in the postoperative period after coronary artery bypass graft (CABG) surgery and can increase mortality, morbidity, and treatment costs. Inflammation and coronary artery disease (CAD) severity are important parameters to predict PoAF. Methods: Patients with right coronary artery (RCA) disease who underwent isolated CABG operation between January 1, 2017 and April 15, 2020, were included in the study retrospectively. Demographic features, preoperative total Gensini score (TGS), right coronary Gensini score (RCGS), systemic immune inflammation index (SII), and postoperative characteristics were recorded. Results: A total of 283 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 211, median age=60 (33-82) years), and those who did were included in Group 2 (N = 72, median age=68 (42-85) years). There were no statistically significant differences between the two groups, in terms of gender, hypercholesterolemia, cerebrovascular event/trans-ischemic attack history, body mass index, diabetes mellitus, smoking, beta blocker/angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, ejection fraction and left atrium diameters. As a result of multivariate analysis, advanced age (OR: 2.816 CI 95%: 1.687-3.498 P < .001), hypertension (OR:0.896, CI 95%: 0.578-0.965, P = .022), SII (OR: 1.548 CI 95%: 1.265-2.896, P = .003), TGS (OR: 1.235, CI 95%: 1.096-2.424, P = .012), and RCGS (OR: 2.112, CI 95%: 1.665-4.156, P < .001) values were determined as independent predictors for predicting postoperative atrial fibrillation. Conclusion: In this study, we showed that RCGS and SII values were independent predictors of PoAF after CABG operations in patients with right coronary artery disease.

scholarly journals Prevalence and association of thyroid disorders with selected risk factors and severity of disease in patients confirmed of Coronary Artery Disease

2020 ◽  
Vol 19 (4) ◽  
pp. 678-684
Author(s):  
EM Samantha Bardara ◽  
Sagarika Ekanayake ◽  
Chandanie Wanigatunge ◽  
Aruna Kapuruge ◽  
GA Sarath Kumara
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Subclinical Hypothyroidism ◽  
Bypass Graft ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Gensini Score ◽  
Anthropometric Data ◽  
Artery Disease ◽  
Lipid Parameters

Objective: Subclinical hypothyroidism (SCH) has been identified as a risk for atherosclerosis and Coronary Artery Disease (CAD). The aim of this study was to determine the prevalence and association between hypothyroidism or subclinical hypothyroidism (SCH) and lipid parameters, anthropometric data and the severity of coronary artery disease (CAD) in patients awaiting Coronary Artery Bypass Graft Surgery (CABG) from a selected center. Method: A cross sectional analytical study was carried out amony patients awaiting CABG in a selected center. Thyroid profile (enzyme immunoassay method), lipoprotein (a) [Lp(a)], C- reactive protein (CRP) (immunoturbidimetric method) were determined and the Gensini score calculated. Lipid parameters and details of current medication were obtained from the medical records and anthropometric data were measured. Results: From a total of 102 patients 3% were on treatment for hypothyroidism and 15% had subclinical hypothyroidism. A significantly high (p= 0.04) percentage of SCH patients (75%) were dyslipidemic. There were no significant differences observed in lipid profiles and Lp(a) among SCH and euthyroid patients when the total sample or dyslipidemic sample was considered. However, a significantly high percentage (58%, p<0.05) of SCH patients on statins had a higher level of low density lipoprotein cholesterol (LDLc) compared to euthyroid dyslipidemic patients. A significant negative (p< 0.05) correlation was observed between thyroid stimulating hormone concentration and high density lipoprotein cholesterol (r= -0.67) in SCH group. No significant differences were observed in anthropometric data, CRP or Gensini score of SCH and euthyroid patients with CAD. Conclusion: The prevalence of dyslipidemia among SCH patients with CAD was significantly high. The patients suffering from SCH exhibited higher levels of LDLc compared to euthyroid patients from both the total and dyslipidemic groups. SCH patients under statin treatment displayed a higher LDLc suggesting a strong association between coronary artery disease and thyroid disease. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.678-684

scholarly journals Precipitation of de novo atrial fibrillation during Shockwave Intravascular Lithotripsy® after pacing capture during the treatment of proximal right coronary artery disease: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-4
Author(s):  
Elizabeth Curtis ◽  
Ali Khan ◽  
Seif El-Jack ◽  
Tim Glenie
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
De Novo ◽  
Renal Stones ◽  
Ecg Gating ◽  
Artery Disease ◽  
History Of Use ◽  
Proximal Right Coronary Artery

Abstract Background Shockwave Intravascular Lithotripsy® has been recently translated to the treatment of coronary artery disease with a long history of use for ureteric stones where it has been observed to have caused cardiac arrhythmias. The risk of arrhythmia with the use of this method in coronary artery disease is currently unknown. Case summary A 72-year-old man undergoing planned percutaneous intervention to a heavily calcified proximal right coronary artery (RCA) lesion using S-IVL developed pacing capture from the device and subsequently new atrial fibrillation (AF) during the procedure. The technique resulted in successful treatment of the coronary lesion and he spontaneously reverted within an hour of the procedure before discharge. Discussion We postulate the pulsed energy delivered to break apart the calcium has the capacity to cause depolarization, and therefore, affect cardiac rhythm as seen in treatment of renal stones in the past before the introduction of routine electrocardiogram (ECG) gating. In this case, the proximity of the RCA to the right atrium caused short circuiting and development of AF in a susceptible patient. Both the pacing implications and the risk of arrhythmia needs to be investigated further and the potential for ECG gating of the pulsed energy to mitigate this effect needs to be explored to enhance the safety of this technique.

Coronary Angiographyic Findings in Patients of Acute Coronary Syndrome with Atrial Fibrillation

2021 ◽  
Vol 15 (12) ◽  
pp. 3418-3420
Author(s):  
Abdul Majid ◽  
Muhahmmad Khaleel Iqbal ◽  
Zeeshan Faisal ◽  
Amir Javed ◽  
Khalid Razzaq Malik ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Circulation ◽  
Culprit Lesion ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Artery Disease

Background: Acute coronary syndrome (ACS) is a fatal entity and can be even more deadly if they develops concomitant complications in the form of arrhythmias like atrial fibrillation. Coronary artery disease is thought to be more severe in cases with ACS and atrial fibrillation. Objective: To determine the angiographic findings in patients presenting with acute coronary syndrome and atrial fibrillation and To find the involvement of more common circulation (right or left coronary circulation) leading to atrial fibrillation in acute coronary syndrome. Materials and Methods: This 6 month case series study conducted at department of Cardiology, Sheikh Zayed Hospital, Rahim Yar Khan from14-01-20 to 14-09-20. A total of 198 cases aged 30-60 years of both gender were included in the study through non-probability consecutive sampling. Patients suffering with ACS and has atrial fibrillation on presentation or develops within 24 hours of admission were included. They underwent coronary angiography to look for number of vessels involved, severity of coronary artery disease and culprit vessel involved. Results: In this study there were total 198 cases. Mean age of the participants was 50.09±5.88 years and mean duration of atrial fibrillation was 14.91± 4.51 hours. There were 70 (35.35%) cases with DM, 78 (39.39%) with HTN and 61 (30.81%) smokers. STEMI was found in 35 (17.68%) and NSTEMI in 152 (76.77%) of cases as in figure 05. One vessel disease was observed in 26 (13.13%), two vessel disease in 147 (74.24%) and three vessel disease in 25 (12.63%) of cases. Mild disease on angiography was seen in 45 (22.73%), moderate in 132 (66.67%) and severe in 21 (10.61%) of the cases.it was found that out of 198 patients , 146 ( 74 %) had right coronary artery culprit lesion and 51 ( 26 %) has left sided coronary circulation culprit lesion and from left coronary circulation, left circumflex was most commonly involved : 41 ( 21 % ) of patients as compared to only 10 ( 5 %) patients had culprit in left anterior descending artery. Conclusion: AF in patients with ACS is most commonly associated with right coronary artery lesionsand right type of coronary circulation. In terms of number and severity of disease the most common pattern observed was two vessel disease comprising almost 3/4th of all cases and moderate disease was in most of the vesselsrespectively. Key words: ACS, Atrial fibrillation

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