scholarly journals Triple vessel coronary artery disease in a rural Nigerian: A reflection of poor diagnostic infrastructure or rarity in prevalence? A call for action

2019 ◽  
Vol 5 (3) ◽  
pp. 109-111
Author(s):  
Akintunde Adeseye A ◽  
◽  
Olafiranye Oladipupo ◽  
◽  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Good Effect ◽  
Vessel Disease ◽  
Diagnostic Facility ◽  
Triple Vessel Disease ◽  
Artery Disease ◽  
Angioplasty And Stenting ◽  
Vessel Coronary Artery

The need for provision of more diagnostic facility for coronary angiography to diagnose coronary artery disease among Africans cannot be overemphasized as there is the possibility that coronary artery disease may not be as uncommon as it is presently estimated but may be manifesting with different phenotypic presentations compared to the Caucasians. We present an otherwise stable adult rural Nigerian with hypertension and diabetes who was diagnosed with a triple vessel disease and subsequently had coronary angioplasty and stenting with good effect.

scholarly journals COMPARATIVE STUDY OF CORONARY ANGIOGRAPHIC FINDINGS BETWEEN DIABETIC AND NON DIABETIC PATIENTS

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Pradeep Kurmi ◽  
Deepak Ameta ◽  
Chandra Bhanu Chandan
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Calcification ◽  
Diabetic Patients ◽  
Vessel Disease ◽  
Diffuse Disease ◽  
Triple Vessel Disease ◽  
Artery Disease

Background: Coronary artery disease (CAD) is one of the most important manifestation of diabetes mellitus. Objectives: To assess the extent of CAD in diabetic and non diabetic patients undergoing coronary angiography. Materials and Methods: 793 patients with suspected CAD, 202 diabetics and 591 non-diabetics were enrolled in the study. All patients underwent coronary angiography. Results: Normal coronaries were more common in non diabetic patients. Age at first presentation in diabetics was earlier as compared to non-diabetics. Diabetic female patients presented as early as third decade of life.  Single vessel involvement was significantly more in non diabetics [40.27%] as compared to diabetic patients[19.8%][P= <0.001], while there were statistically no significant differences in double vessel disease in both groups [P= 0.572]. Triple vessel disease were more common in diabetic than non diabetic patients [P= <0.001]. Left main disease, left circumflex coronary artery disease, coronary calcification, diffuse disease and CTOs were more common in diabetic patients. Conclusion: The severity and extent of CAD and incidence of triple vessel disease was significantly high in diabetics when compared to non diabetics. Key Words: Coronary angiography; Coronary artery disease; Diabetes mellitus.

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 Coronary angiography finding of exercise tread mill test positive patients in a tertiary care center

2017 ◽  
Vol 14 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Amit Shrestha ◽  
Sanjeev Thapa ◽  
Sheelendra Shakya ◽  
Ravi Shahi ◽  
Chandra Mani Paudel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stress Test ◽  
Tertiary Care ◽  
P Value ◽  
Vessel Disease ◽  
Mill Test ◽  
Artery Disease

Background and Aims: The use of coronary angiography in diagnosing coronary artery disease is limited by its invasive property. In the other hand correct interpretation of tread mill test data and its use as a key diagnostic modality also has been a problem. The study was thus aimed to see the diagnostic accuracy of treadmill test to rule out coronary artery disease.Methods: We included all the patients who had positive tread mill stress test and underwent coronary angiography and were subsequently analyzed for presence of coronary artery disease.Results: A total of 303 patients were included with 119 males and 184 females with mean age of 53.6±10.5 yrs and 51.7±8.6 yrs respectively. Normal coronaries was seen in 114(54.0%), borderline lesion in 29 (13.7%) and significant lesion in 68 (32.2%) with 48(22.7%) having single vessel disease, 29(13.7%) double vessel disease and 14(6.6%) triple vessel disease. Coronary artery diseases was highest among diabetics (57.7%, OR 1.72 (95 % CI: 0.92 to 3.20), p value-0.08).Similarly the risk of coronary artery disease was significantly highest among patient with ≥2 risk factor (OR: 8.10,95 % CI: 4.96 to 13.24, P < 0.0001). Gender distribution showed that coronary artery disease was significantly higher in males than females (53% vs 35% respectively, OR: 2.08, 95 % CI: 1.30 to 3.32, p value-0.002).Conclusion: The value of tread mill test to predict coronary artery disease is highest in patients with two or more risk factor especially in those with diabetes with significance increased among males.

scholarly journals Association between Endogenous Sex Hormones and Coronary Artery Disease in Postmenopausal Women

2021 ◽  
Author(s):  
Roopali Khanna ◽  
Avinash Bansal ◽  
Sudeep Kumar ◽  
Naveen Garg ◽  
Satyendra Tewari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Postmenopausal Women ◽  
Sex Hormones ◽  
Sex Hormone ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Traditional Risk Factors ◽  
Artery Disease

Background Incidence of coronary artery disease (CAD) increases significantly in postmenopausal women, which is assumed to be an imbalance between serum androgen and estrogen levels. However, studies assessing serum sex hormones and CAD are few and have shown conflicting results. Objective To compare serum sex hormone levels and traditional risk factors among postmenopausal women with angiographically proven CAD and without CAD. Method The study included consecutive postmenopausal women undergoing coronary angiography in our institute from May 2016 to June 2017. The clinical and coronary angiographic data and traditional risk factors were assessed. Fasting serum levels of estradiol (E2), testosterone (T), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-S), and insulin were measured. Results A total of 121 postmenopausal women were included in the study; 69 were CAD and 52 without CAD. Single-vessel disease was most common (55.1%), followed by double-vessel disease (24.6%) and triple-vessel disease (20.3%). Women with CAD had significantly lower estradiol/testosterone (E2/T) ratio (3.7 ± 2.6 vs. 5.4 ± 4.2, p = 0.008) compared with non-CAD group. SHBG, DHEA-S, and insulin levels were similar in CAD and non-CAD groups. The serum level of estradiol predicted the E2/T ratio (r = 0.316, p < 0.001) and positively associated with DHEA (r = 0.181, p = 0.047). Testosterone was negatively associated with E2/T ratio (r = – 0.682, p < 0.001). There was no significant correlation of estrogen, testosterone, or E2/T ratio to lipid profile (total cholesterol, HDL, LDL) in women with CAD. Conclusion E2/T ratio was significantly lowered in postmenopausal women with CAD. E2/T ratio may be a used a predictor of CAD in postmenopausal women

201T1-Myocardial Scintigraphy: Current Status in Coronary Artery Disease, Results of Sensitivity/Specificity in 3092 Patients and Clinical Recommendations

1981 ◽  
Vol 20 (03) ◽  
pp. 136-147 ◽  
Author(s):  
N. Kanemoto ◽  
G. Hör
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Scintigraphy ◽  
Transluminal Angioplasty ◽  
Current Status ◽  
Clinical Recommendations ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Artery Disease ◽  
Sensitivity Specificity

This review is concerned with qualitative and quantitative sectorial 201Tl-redistribution analysis of exercise myocardial scintigraphy (EMS). In 3092 cases the sensitivity (specificity) was on average 83 (90) %, the average CAD prevalence being 71%. Sensitivity (Se) for EMS (ExECG) increased from 73 (43) % in single vessel disease through 83 (69) % in double vessel to 90 (77) % in triple vessel disease (n = 879); average Se was 77% for LAD-, 79% for RCA- and 65% for LCX-stenosis. Se for detection of the real extension of CAD conversely decreased from 59% in SVD through 41% in DVD down to 33% in TVD. Clinical recommendations for EMS and rest scans are outlined in CAD (atypical angina, follow-up after bypass-surgery, percutaneous transluminal angioplasty), in non-coronary artery disease (non-ischemic cardiomyopathies, right ventricular hypertrophy) and in pediatric cardiology.

Stable coronary artery disease: medical therapy versus percutaneous coronary intervention versus surgery

2010 ◽  
pp. 220-234
Author(s):  
Scot Garg ◽  
Joanna J. Wykrzykowska ◽  
Patrick W. Serruys
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Interventional Procedure ◽  
Coronary Intervention ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Stable Cad

Coronary artery disease (CAD) represents a wide spectrum of underlying anatomical disease ranging from near normal, minor single-vessel disease (SVD), to extensive triple-vessel disease. Its presentation is similarly variable, from a single episode of chest pain to acute coronary syndrome (ACS) or even death. The aim of treatment in CAD is to relieve symptoms and improve quality of life, reduce cardiovascular (CV) events, and prolong survival. There have been vast improvements in management over the years, following a greater understanding of the underlying pathophysiology, the identification and appropriate management of risk factors, development of new medication, and advances in revascularization techniques, both percutaneous and surgical. These developments have resulted in a move towards an anatomic treatment for CAD even though it is the minor lesion, so-called vulnerable plaque, which is suggested as the most likely culprit for mortality. Nevertheless, in those patients presenting with ACS or ST-elevation myocardial infarction the long-term benefits of percutaneous coronary intervention (PCI) have been confirmed in multiple randomized trials; however, debate surrounds the ideal management of the majority of patients who have angina, and who have not experienced any previous CV events or had an interventional procedure, so-called stable CAD.

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