scholarly journals Sex specificities of medical and social parameters in patients with coronary artery disease with different severity of depression

2021 ◽  
Vol 20 (1) ◽  
pp. 2425
Author(s):  
Yu. V. Nagibina ◽  
M. I. Kubareva ◽  
D. S. Knyazeva

Aim. To determine the sex specificities of medical and social parameters in patients hospitalized due to coronary artery disease (CAD), class II, III, IV angina, aged 35-60 years and assess the significance of their relationship with different levels of depression.Material and methods. The study involved 312 patients aged 35-60 with documented CAD, class II, III, IV angina. Two comparison groups were identified: group I — 138 patients (men, 81; women, 57) with CAD and without depression (mean age, 47,8±4,6 years); group II — 174 patients (men, 60; women, 105) with CAD and depression (mean age, 48,3±5,3 years). Medical and social data, the severity of depression and distress tolerance, psychological status and quality of life was assessed. Statistical analysis was carried out, which are presented as the mean and standard error of the mean (M±m). The odds ratio (OR) and 95% confidence interval (CI) were calculated. Differences were considered significant at p<0,05.Results. The prevalence of depression among patients with CAD was 55,77%, while women were 1,5 times more likely to suffer it than men. Depression was significantly associated with hyperglycemia, hypercholesterolemia, and class III-IV angina, regardless of sex. Class III and IV angina prevailed in women, while class II angina — in men (OR, 2,16; 95% CI, 1,37-3,41, p<0,001)). Women were more prone to degree II-III disability (group II, 26,67%; group I 8,77%; p=0,008), compared with men (group II, 27,54%; group I, 11,11%; p=0,012). Sedentary lifestyle was also associated to a greater extent with the female sex than with the male (OR, 2,89, 95% CI, 1,46-5,70, p=0,003; OR, 2,31, 95% CI, 1,19-4,48; p=0,014, respectively). Both men and women showed a significant association of depression with atherosclerosis (p<0,001), however, sex differences did not reach significance. Indicators such as lack of job and higher education, as well as smoking and arrhythmias were characteristic of both sexes, but had a greater impact on the mental condition of men (p=0,002, p<0,001, p=0,0014 and p=0,01, respectively). For men, the relationship of depression with diabetes (8,7 vs 0%; p=0,008), obesity (42,03 vs 19,75%; p=0,004), subordinate status (82,61 vs 64,2%; p=0,016) and unmarried status (60,87 vs 40,74%; p=0,02).Conclusion. There are significant differences in factors contributing to depression in different sex groups. The association of depression with CAD has an adverse effect on the physical and psychological health of both males and females. At the same time, women are more prone to mental disorders than men. It is necessary to further study the sex characteristics of medical and social parameters in order to personalize treatment methods.

2013 ◽  
Vol 5 (2) ◽  
pp. 173-181 ◽  
Author(s):  
NI Sharafat ◽  
M Khalequzzaman ◽  
M Akhtaruzzaman ◽  
AK Choudhury ◽  
S Hasem ◽  
...  

Background: It has been found that there is strong association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Qualitative importance of QTc dispersion on the base line ECG in patients with MI is recognized clinically but quantification of this phenomenon is less commonly used in clinical practice, which might be a better independent risk predictor of this group of patients. Methods: A total of 100 patients were selected, Study populations sub-divided into two groups on the basis of QTc dispersion. In group I (comparison group): QTc dispersion is <60 milliseconds (msec) in group II (study group) : QTc dispersion e”60milliseconds(msec). 50 patients in each group. QT dispersion was calculated on standard resting 12 lead ECGs. QT interval was measured from the beginning of the inscription of the QRS complex to the point at which the T wave returned to the isoelectric line. Angiographic severity of coronary artery disease was assessed by- Vessel score, Friesinger score and Leaman score. Interpretation of coronary angiogram was reviewed by at least two cardiologists. . Results: The mean vessel score for group I patients was 1.16±0.68 and that of group II patients was 2.30±0.64 and the mean difference was statistically significant (p<0.05). Patients those had single vessel involvement had mean QTc dispersion 57.05, patients those had double vessel disease mean QTc dispersion was 102.00 and patients those had triple vessel involvement had mean QTc dispersion 177.60. There was a strong positive correlation with the QTc dispersion and increasing number of vessel involvement (Pearson’s correlation coefficient). The mean Friesinger score for group I patients was 4.84±2.56 and that of group II patients was 9.80±2.60. The mean difference was significantly (p<0.05) higher in group II patients. There was a strong positive correlation between the QTc dispersion and Leaman score (Pearson’s correlation coefficient). In group I patients 56% had insignificant coronary artery disease and 44% had significant coronary artery disease defined by Friesinger index (n=100). In group II patients 6% had Insignificant coronary artery disease & had 94% significant coronary artery disease. Conclusion: QTc dispersion>60 ms had independent predictive value for the severity of coronary artery disease. The greater the QTc dispersion the higher the number of coronary artery involvement. We observed that there is a positive correlation between prolonged QT dispersion and coronary artery disease severity in terms of Vessel score, Friesinger score, Leaman score. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14322 Cardiovasc. j. 2013; 5(2): 173-181


2020 ◽  
Vol 3 (1) ◽  
pp. 70-73
Author(s):  
Reddi Basha Saheb Shaik ◽  
Rondla Madhumitha

Background: Cardiovascular disease (CVD) is the leading cause of death in the developed world. The present study was conducted to assess correlation of plasma 25-Hydroxy-Vitamin D level with angiographic severity in coronary artery disease. Subjects and Methods: The present study was conducted on 120 patients of CAD. Group I were cases and group II were control. Hypertension, type II diabetes mellitus status, smoking etc. was recorded. 2 ml of blood sample was taken from all patients and measurement of 25(OH) vit D levels was performed. Results: The mean BMI in group I was 24.6 kg/m2 and 24.8 kg/m2 in group II, smoking habit was seen in 78 in group I and 34 in group II, hypertension was seen in 65 in group I and 26 in group II, diabetes was seen in 52 in group I and 30 in group II, alcoholism in 36 in group I and 10 in group II, dyslipidemia was seen in 48 in group I and 15 in group II. The mean 25 (OH) vitamin D in group I was 15.1 ng/ml and 19.6 ng/ml in group. The difference was significant (P< 0.05). Maximum dyslipidemia (80.5%) patients had low vitamin D level followed by DM, smoking, BMI, alcoholism and alcoholism. There was no correlation between risk factors and vitamin D deficiency (P> 0.05). Conclusion: Authors found that in cases, vitamin D level was lowered as compared to control, however, there was no correlation between risk factors and CAD.


2015 ◽  
Vol 10 (1) ◽  
pp. 18-22
Author(s):  
Lohani Md Tajul Islam ◽  
Abu Sadique Abdullah ◽  
Sarker Md Alauddin Al Azad ◽  
Mohammad Jubayer ◽  
Md Gaffar Amin ◽  
...  

Coronary artery disease (CAD) is the most common cause of mortality and morbidity all over the world. It is also becoming a significant burden on healthcare service in Bangladesh. Atherosclerosis is the main pathology behind coronary artery disease. Endothelial dysfunction plays a crucial role in the process of atherosclerosis. Microalbuminuria (MA) is a reliable marker of endothelial dysfunction. This is why microalbuminuria is recognized as a simple marker of atherogenic milieu It was a cross sectional analytical study carried out in the department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of May, 2013 to April, 2014. After ethical consideration a total of 120 patients with IHD admitted in the department of Cardiology who fulfilled the inclusion and exclusion criteria and underwent coronary angiogram were taken as sampling population by purposive sampling. 1st morning spot urine sample was taken for measurement of ACR.Microalbumnuria was measured by rate nephelometry using Behring protein analyzer. All the study subjects were placed into two groups according to ACR value (group I- positive urinary ACR >30 mg/g & group II-Normal urinary ACR <30 mg/g). Angiographic severity of coronary artery disease was assessed by vessel score and stenosis score. Age and sex distribution of the subjects in two groups with MA and without MA were similar. No significant difference was observed between two groups with regard to smoking, dyslipidaemia, hypertension and family history of IHD. Prevalence of diabetes mellitus was significantly more in subjects with MA than without MA (60% vs 33.9%, p=0.006). All 40 patients of group I had significant CAD. 57(71.2%) patients of group II had significant CAD and 23(28.8%) patients had no significant CAD. The difference was highly significant (p<0.001). Single vessel involvement was significantly more frequent in subjects of group II than group I (35.0% vs15.0%, p=0.022) Double vessel involvement was more in group I than group II, but the difference was not statistically significant (36.8% vs 32.40%,p=0.641).Triple vessel involvement was significantly more frequent in subjects of group I than group II (50.0% vs10.7%, p<0.001). The mean stenosis score of group I was significantly higher than group II (95% CI 4.966 to 2.809, p<0.001). The mean ±SD total coronary vessel score of group I was 16.60±4.75 with a range of 7.0-21.0 and mean ±SD total coronary vessel score of group II was 8.26±6.24 with a range of 0.0-21.0. The mean total score of group I wassignificantly higher than group II (95% CI 10.558 to 6.117, p<0.001). Patient with microalbuminuria has more extensive and complex angiographic coronary artery disease compared to those without microalbuminuria.University Heart Journal Vol. 10, No. 1, January 2014; 18-22


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

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


2014 ◽  
Vol 71 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Predrag Djuric ◽  
Zorica Mladenovic ◽  
Aleksandra Grdinic ◽  
Dragan Tavciovski ◽  
Zoran Jovic ◽  
...  

Background/Aim. The FINish Diabetes RIsk SCore (FINDRISC) which includes age, body mass index (BMI), waist circumference, physical (in) activity, diet, arterial hypertension, history of high glucose levels, and family history of diabetes, is of a great significance in identifying patients with impaired glucose tolerance and a 10-year risk assessment of developing type 2 diabetes in adults. Due to the fact that the FINDRISC score includes parameters which are risk factors for coronary artery disease (CAD), our aim was to determine a correlation between this score, and some of its parameters respectively, with the severity of angiographically verified CAD in patients with stable angina in two ways: according to the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score and the number of diseased coronary arteries. Methods. The study included 70 patients with stable angina consecutively admitted to the Clinic of Cardiology, Military Medical Academy, Belgrade. The FINDRISC score was calculated in all the patients immediately prior to angiography. Venous blood samples were collected and inflammatory markers [erythrocyte sedimentation rate (ESR), leucocytes, C-reactive protein (CRP), total cholesterol, HDL cholesterol, triglycerides and fasting glucose] determined. Coronary angiography was performed in order to determine the severity of coronary artery disease according to the SYNTAX score and the number of affected coronary vessels: 1-vessel, 2-vessel or 3-vessel disease (hemodynamically significant stenoses: more than 70% of the blood vessel lumen). The patients were divided into three groups regarding the FINDRISC score: group I: 5-11 points; group II: 12-16 points; group III: 17-22 points. Results. Out of 70 patients (52 men and 18 women) enrolled in this study, 14 had normal coronary angiogram. There was a statistically significant positive correlation between the FINDRISC score and its parameters respectively (age, body mass index-BMI, waist circumference) and the severity of CAD according to the SYNTAX score (p < 0.001) and the number of diseased coronary arteries (p < 0.001). The patients with higher FINDRISC score (groups II and III) had more severe and extensive CAD according to the SYNTAX score than the group I. The odds ratio with 95% confidence intervals (CI) between the group III and the group I was 5.143 (95% CI 1.299-20.360, p = 0.002) and between the group II and the group I 5.867 (95% CI 1.590- 21.525, p = 0.007). There were no differences in odds ratio for multivessel disease according to FINDRISC score between the group II and the group III [1.141; (95% CI 0.348-3.734). In the group I mean SYNTAX score was 5.18, and more than 70% of patients had normal coronary angiogram. In the group II mean SYNTAX score was 17.06, and more than 70% of patients had 2-vessel disease and 3- vessel disease, and in the group III mean SYNTAX score was 18.89, and 2-vessel and 3-vessel disease had 36.36% and 31.82% patients, respectively. In multiple regression analysis, where SYNTAX score was dependent variable, and age, BMI, waist circumference, FINDRISC score were independent variables, we found that only FINDRISC score was independent predictor of SYNTAX score. Conclusion. The obtained results suggest a statistically significant correlation between the FINDRISC score and its parameters (age, BMI, waist circumference) and the severity of CAD according to the SYNTAX score and the number of diseased coronary arteries. The FINDRISC score may be useful in identifying patients at the high risk for coronary artery disease.


2015 ◽  
Vol 7 (2) ◽  
pp. 114-118
Author(s):  
Krishna Kanta Sen ◽  
Mahboob Ali ◽  
Amal Kumar Choudhury ◽  
Pradip Kumar Karmakar ◽  
Md Khalequzzaman ◽  
...  

Background: The association between extent and severity of coronary artery disease (CAD) and renal artery stenosis (RAS) has been well established in many studies. The aim of this study was to assess the incidence and severity of RAS in patients with CAD. Methods: Coronary angiogram (CAG) and renal angiogram was done in standard protocol. A total of 95 patients was included in the study and divided into two groups according to the presence of significant renal artery stenosis. In Group I 45 patients were having normal or insignificant renal artery stenosis. In Group II 50 patients were having significant renal artery stenosis. All data were recorded systematically in preformed data collection form. Results: In Group I, most common CAG findings were single vessel disease (SVD) (91.1%), triple vessel disease (TVD) (2.2%) and double vessel disease (DVD) (6.7%). No patients in Group I had Left Main (LM) disease. In Group II, most common CAG findings were DVD (42.0%) followed by SVD 32.0%, TVD 26.0% and LM 8.0%. There is statistically significant difference in Vessels Score, Friesinger Score and Leaman Score between the groups (p<0.05). Conclusion: The study revealed significant association between atherosclerotic renal artery stenosis (RAS) and severity of coronary artery disease (CAD). This indicates significant atherosclerotic renal artery stenosis (RAS) predict the severity of coronary artery disease. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22258 Cardiovasc. j. 2015; 7(2): 114-118


2021 ◽  
Vol 36 (2) ◽  
pp. 113-123
Author(s):  
Rashid Ahmed ◽  
Pinaki Ranjan Das ◽  
Asif Zaman Tushar ◽  
Tapash Saha ◽  
Mahboob Ali ◽  
...  

Background: The risk of coronary artery disease in women after menopause sharply rises in contrast to that of women before menopause because of hormonal protection against atherosclerosis. No research work has been done so far to see the angiographic pattern and severity of coronary artery disease in premenopausal women and their comparison with those of postmenopausal women. This study will help understand the pattern and severity of CAD both in premenopausal and postmenopausal women. Methods: This cross sectional analytical study was conducted over 100 ACS female patients who were purposively selected and agreed to do coronary angiogram during index hospital admission. Among them 50 patients were premenopausal status with CAD constituted study group I and another 50 postmenopausal women with CAD constituted study group II. The main objective of the study was to compare the angiographic severity of coronary artery disease between premenopausal and postmenopausal women with acute coronary syndrome. Angiographic severity of CAD was assessed by vessel score, Gensini score and Friesinger score. Results: LAD was the common artery involved (76% vs. 56%) followed by RCA (72% vs. 36%) and LCX (62% vs. 30%) in group-II compared to group-I and involvement of individual coronary artery was statistically significant (P values were 0.03, 0.003 and 0.001 respectively). Critical stenosis (70-99%) involving the all three major epicardial vessels (LAD, LCX and RCA) were found most frequently in group-II and the percentage of lesions were 56% vs. 30%; 56% vs. 22% and 54% vs. 22% respectively (p< 0.05). The vessel score of the study patients revealed that singe vessel involvement was significantly higher in group-I (52% vs. 24%) (p=0.003) and triple vessel involvement was found significantly higher in group-II (40% vs. 12%) (p=0.001). Severity assessment by Friesinger score showed normal (0) and low (1-4) Friesinger score significantly higher in group-I patients (P=0.04 and P=0.007 respectively) and high Friesinger score (11-15) was found significantly higher in patients in group II (p=0.001). Severity assessment by Gensini score of the study patients revealed significantly higher mild Gensini score in group-I patients (P=0.002) and severe Gensini score in group II patients (p=0.002). Conclusion: Coronary artery disease is one of the major important problems not only in postmenopausal women but in premenopausal women also. Postmenopausal women suffer from more triple vessels involvement, more diffuse and severe disease. This study results point out that premenopausal women suffer from less severe coronary artery disease and there is a trend to involve mid LAD more frequently in comparison to other two major coronary arteries and LM coronary artery in comparison to postmenopausal women. Bangladesh Heart Journal 2021; 36(2): 113-123


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Djuric ◽  
Z M Mladenovic Zorica ◽  
S O Obradovic Slobodan ◽  
M S Spasic Marijan ◽  
Z J Jovic Zoran ◽  
...  

Abstract Background Von Willebrand factor (VWF plays) central role in thrombogenesis, and circulates in a noncovalent complex with factor VIII (FVIII), acting as a transporter protein and stabilizer. VW factor protects FVIII from proteolytic inactivation and concentrate it at site of endothelial injury. Raised plasma VWF factor is detected in case of endothelial damage and it has been considered as a useful marker of endothelial dysfunction. Increased plasma FVIII has been found in venous thromboembolism and in some clinical conditions associated with chronic inflammation. The connection between FVIII and more incidence of arterial thrombosis is, partly, due to increased platelet adhesion/aggregation, induced by VWF at sites of arterial wall damage. The correlation between VWF factor, FVIII levels and acute coronary syndrome is well documented, but there are no available dates regarding relation between plasma levels of VW factor, FVIII and the severity of coronary artery disease according to SYNTAX I (SS) and Clinical SYNTAX score (CSS). Purpose The aim of this study was to determine the association between levels of VW factor and FVIII and the severity of coronary artery disease according to SS and CSS. Methods A total of 82 patients with symptoms of stable angina underwent coronary angiography and were divided into three groups according to SS and CSS: Group I (<22 points), Group II (23–32), Group III (>33). We calculated Clinical SYNTAX multiplying the value of SYNTAX score with the modified ACEF score, based on the patients' left ventricular ejection fraction, age and creatinine clearance derived using the Cockcroft–Gault equation. Results There were positive association between plasma levels of VW factor and severity of CAD according to SYNTAX I (Group I: 1.16±0.59, Group II: 1.52±0.62, Group III 1.49±0.80, Kruskal Wallis p=0.040) and Clinical SYNTAX score (Group I: 1.15±0.53, Group II: 1.38±0.72, Group III 1.57±0.75, Kruskal Wallis p=0.034). VW factor levels were significantly higher in Group II and Group III compared to Group I (SS: Mann- Whitney p=0.023 and 0.071, respectively), (CSS: p=0.251 and 0.009, respectively). We also found positive association between FVIII levels and severity of CAD according to SYNTAX I (Group I: 2.25±0.75, Group II: 2.21±0.53, Group III 2.97±0.95, Kruskal Wallis p=0.007) and Clinical SYNTAX score (Group I: 2.17±0.71, Group II: 2.26±0.68, Group III 2.89±0.87, Kruskal Wallis p=0.002). This study demonstrates that FVIII levels were significantly higher in Group III compared to Group I and Group II (SS: Mann- Whitney p=0.005 and 0.005, respectively), (CSS: p=0.001 and 0.014, respectively). The correlation between plasma levels of VW factor Conclusion Patients with stable angina pectoris and higher levels of VW and factor VIII had a higher Clinical SYNTAX and SYNTAX I score. Our study revealed that concomitant elevation in both VW and FVIII factors are a significant risk factor and predictor of more severe and extended CAD.


Angiology ◽  
2001 ◽  
Vol 52 (5) ◽  
pp. 311-316 ◽  
Author(s):  
Ertan Yetkin ◽  
Kubilay Senen ◽  
Mehmet Ileri ◽  
Ramazan Atak ◽  
Serkan Topaloglu ◽  
...  

QT dispersion defined as interlead QT variability in a 12-lead electrocardiogram was proposed by Day and associates as a simple method to evaluate the repolarization heterogenicity of the ventricular myocardium. The frequency of onset of myocardial infarction and sudden death has been reported to have a circadian variation, with a peak incidence in the early morning hours. The authors investigated whether there is diurnal variation of QT interval and QT interval dispersion in healthy subjects and in patients with coronary artery disease. The study popula tion consisted of two groups. Group I consisted of 62 subjects without coronary artery disease and group II consisted of 82 patients with coronary artery disease. Twelve-lead ECG was recorded for each patient in the morning (between 7 AM and 8 AM), afternoon (between 3 PM and 5 PM) and at night (between 11 PM and 1 AM), on the day after performance of coronary angiography. QTc dispersion was significantly higher in patients with coronary artery disease than in healthy subjects in the morning hours and afternoon (p< 0.001). Although the differ ences were much prominent in group I than group II, both QTc dispersion of morning and afternoon were significantly greater than those at night. There were no statistically significant differences between group I and group II at nighttime with respect to maximum QTc , minimum QTc intervals, and QTc dispersion (p>0.05). In conclusion, QT dispersion shows diurnal variation with an increase in the morning hours in both patients with coronary artery disease and subjects without coronary artery disease. The mechanism of diurnal variation of QT dispersion in patients with coronary artery disease is quite different from that of healthy subjects.


2007 ◽  
Vol 13 (4) ◽  
pp. 297-307
Author(s):  
M. M. Rudakov

Purpose: To compare vasomotor endothelial function in patients with coronary artery disease (CAD) with and without VA occurring during myocardial ischemia. Methods: We studied 48 patients with CAD who had electrocardiographic signs of ischemia during ergometer exercise testing. All patients were divided into 2 equal groups: group I with VA occurred at peak exercise or during recovery and group II without VA. Exercise test duration was similar in the groups I and II. None of the patients had severe arterial hypertension, diabetes mellitus or signs of heart failure. Assessment of endothelial-dependent flow-mediated vasodilation (FMD) and endothelial-independent nitroglycerin-mediated vasodilation of brachial artery (BA) was performed using high-resolution ultrasound. Plasma endothelin-1 levels were measured by immunoassay method. Results: FMD of BA was lower and duration of ischemic changes of ECG during recovery was greater in the group I compared with group II. There were no significant differences in plasma ET-1 levels among the groups I and II. Conclusions: The patients with CAD and VA occurring during ischemia have FMD impaired to a greater degree and duration of ischemic changes of ECG in recovery longer compared with ones without VA.


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