scholarly journals A Study of Prevalence and Predictors of Acute Ischemic CVA Patients Admitted to Manipal Teaching Hospital, Pokhara, Nepal

2020 ◽  
Vol 2 (1) ◽  
pp. 42-46
Author(s):  
Bishnu Jwarchan ◽  
Nikunja Yogi ◽  
Suman Adhikari ◽  
Prabin Bhandari ◽  
Subita Lalchan
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Statistical Significance ◽  
World Health ◽  
Systemic Hypertension ◽  
Female Ratio ◽  
History Of ◽  
Artery Disease ◽  
Health Organization

 Background: According to the World Health Organization (WHO), 15 million people suffer stroke worldwide each year. Of these, 5 million die, and another 5 million are left permanently disabled. Materials and methods: A retrospective hospital based observational study was carried out in patients with ischemic CVA. Modified Ranking Scale (MRS) on the follow up on 30 days after discharge was obtained. MRS 0-2 was categorized and good outcome and MRS 3-6 was categorized as poor outcome. Results: Out of 56 patients studied 33.9 % were less than 60 years of age and 63.1% were greater than 60 years of age. Male to female ratio was 1.55. MCA territory infarct was the most common with the frequency of 76.8%. There was significant association of HTN, DM, coronary artery disease and other factors as well with the outcome of the patients. Conclusion: On regards to clinic-social demographic parameters there was statistical significance between the gender of the patient, history of systemic hypertension, history of diabetes mellitus and coronary artery disease and outcome of the patient in 30 days follow up.

scholarly journals High-performance Cardiovascular Medicine: Artificial Intelligence for Coronary Artery Disease

2021 ◽  
Author(s):  
H.M.K.K.M.B. Herath ◽  
G.M.K.B. Karunasena ◽  
H.D.N.S. Priyankara ◽  
B.G.D.A. Madhusanka
Keyword(s):  
Artificial Intelligence ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Performance ◽  
Alcohol Intake ◽  
World Health ◽  
Essential Factor ◽  
Artery Disease ◽  
Health Organization

Abstract Cardiovascular disease (CVD) is identified as the leading cause of death globally, according to the World Health Organization (WHO). Approximately 17.9 million people are dying due to cardiovascular disease, which is an estimation of 31% of all deaths worldwide. CVDs are generally affecting the heart and blood vessels in the human body. Since healthcare is an essential factor for a country and its economy, researchers are looking for solutions to predict disease before getting into serious problems. This research introduces a method to development of an algorithm to predict coronary artery disease based on artificial intelligence. The algorithm was tested with 72 random subjects, which covered 11 attributes such as age, gender, height, weight, systolic and diastolic blood pressure, cholesterol, glucose, smoking, alcohol intake, and physical activities. According to the results, the prediction accuracy of the system was 81.62% at 0.879 precision.

scholarly journals Efficacy of amiodarone in the treatment of ventricular arrhythmias in patients with coronary artery disease in Bangladesh

2021 ◽  
Vol 29 (2) ◽  
pp. 158-164
Author(s):  
Dipal Krishna Adhikary ◽  
Sujoy Kumar Saha ◽  
Manzoor Mahmood ◽  
Md Ariful Islam Joarder ◽  
Chayan Kumar Singha ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ventricular Arrhythmias ◽  
Symptomatic Improvement ◽  
Amiodarone Therapy ◽  
Female Ratio ◽  
The Difference ◽  
Artery Disease ◽  
Female Male Female

Background: Ventricular arrhythmias (VA) are among the most feared complications of coronary artery disease (CAD) and one of the major contributors of death in CAD patients. Antiarrhythmic drug (AAD) therapy is required for recurrent significant VA in the absence of need for further revascularization. But all AADs do not have the same efficacy against life threatening VA and supraventricular arrhythmias (SVAs). Methodology: All (50) patients admitted in the department of Cardiology, BSMMU with ventricular arrhythmias with CAD fulfilling the inclusion and exclusion criteria were included in the study. Informed written consent was taken from each patient before enrollment. Detailed history was taken and relevant physical examinations were done. Loading dose followed by maintenance dose of amiodarone was given and recorded. Relevant lab investigations were performed and recorded in predesigned semi-structured data collection sheet. Symptomatic improvement was assessed, relevant physical examination was done and lab investigations were performed at 1, 3 and 6 month follow up. After editing data analysis was carried out by using the Statistical Package for Social Science (SPSS) version 23.0 windows software. Results: The mean age was found 57.7±8.0 years with a range of 45 to 78 years. Almost two third (62.0%) patients were male and 19(38.0%) patients were female. Male female ratio was 1.6:1. Almost three fourth (74.0%) patients had chest pain, 15(30.0%) had palpitation and 11(22.0%) had shortness of breath. Two third (66.0%) patients had hypertension, 23(46.0%) had dyslipidemia, 17(34.0%) had smoking and 9(18.0%) had diabetes mellitus. Twenty nine (58.0%) patients had family history of IHD. The difference was statistically significant (p<0.05) when compared to baseline. Regarding arrhythmia, 45(90.0%) patients was found to have PVC in baseline and 3(6.4%) at 6th month. The reduction of PVC and VT at six month were statistically significant (p<0.05) when compared to baseline. Regarding outcome 2(4.1%) patients died, one patient dropped out due to thyroid dysfunction and 47 were alive. Conclusion: In conclusion it was found that different forms of ventricular arrhythmias like PVCs, VT were significantly reduced gradually with amiodarone therapy at 6th month follow up. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 158-164

scholarly journals Comparing the risk factors of coronary artery diseases in patients with stenotic and ectatic lesions

2017 ◽  
Vol 4 (12) ◽  
pp. 4411
Author(s):  
Bijan Zamani ◽  
Behzad Babapour ◽  
Firouz Amani ◽  
Mohsen Ghasemian
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Systemic Hypertension ◽  
City Hospital ◽  
History Of ◽  
The Mean ◽  
Artery Disease ◽  
Stenotic Lesions

Background: Coronary artery ectatic usually have relation with hyperlipidemia, systemic hypertension and male gender and its diagnosis done by angiography. Due to lack of proved risk factors for incidence of coronary artery ectatic lesions and also its important. The aim of this study was to compare the risk factors of coronary artery in patients with ectatic and stenotic lesions. Methods: This is a descriptive and analytical study that has been done on 300 patients hospitalized in Ardabil city hospital. Patients were enrolled according to the criteria and undergone to angiography. According to result of angiography, patients who have ectatic lesions as the first group and patients whose lesions were stenotic were named as the second group. Information obtained from patients entered in the checklist and analyzed by statistical methods in SPSS.16. Results: 22% of patients with ectatic lesions and 78% with stenotic lesions in patients with ectatic lesions. The mean age was 58.7 years and 74.2% were male and in patients with lesions stenotic the mean age was 60.7 years and 54.3% were male. Based on angiography results, in patients with ectatic lesions 42.4% have engaged in a carotid and 44.4% were two clashes coronary arteries in group stenotic. 34.7% of patients have history of previous mi, 32.9% history of coronary artery disease, 54.7% history of smoking, 56% had diabetes mellitus and 56% had hypertension. History of previous MI (p=0.028), smoking (p=0.04) and diabetes mellitus (p=0.001) and history of coronary artery disease are effective risk factors in two groups. Conclusions: The results showed that previous history of myocardial infarction, smoking and DM have significant relation with type of lesions. 

Abstract 12642: Left Atrial Diameter as a Predictor of World Health Organization Group Two Pulmonary Hypertension Severity

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Scott L Purga ◽  
Elizabeth A Penner ◽  
Elizabeth Mauer ◽  
Irina Sobol ◽  
Evelyn M Horn ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Pulmonary Hypertension ◽  
Coronary Artery ◽  
World Health Organization ◽  
Left Atrial ◽  
World Health ◽  
Lv Mass ◽  
Group 2 ◽  
Artery Disease ◽  
Health Organization

Objective: Left atrial (LA) enlargement and dysfunction have poor prognostic significance in heart failure and coronary artery disease. However, the correlation between LA diameter and World Health Organization (WHO) Group 2 pulmonary hypertension (PH) severity has not been well studied. Hypothesis: We hypothesized that LA enlargement as a marker of LA remodeling in response to pressure and volume overload may contribute to higher pulmonary arterial pressures (PAP) in this population, independent of comorbidities and left ventricular ejection fraction (LVEF). Methods: After exclusion for severe left-sided valvular disease, 100 patients with isolated or mixed WHO Group 2 PH defined by right heart catheterization were studied in a cross-sectional retrospective analysis at a single institution. Linear LA anteroposterior diameter was obtained from the parasternal long-axis view on two dimensional TTE. LVEF, LV E/A Ratio, and LV Mass Index were measured according to ASE guidelines. LV E/A and LV Mass Index was recorded in 80 subjects and 79 subjects, respectively. Mean PAP was assessed on RHC. TTE and RHC were performed within one year of each other. Results: LA diameter was significantly associated with mean PAP after adjustment for age, sex, body-mass index, presence of coronary artery disease, hypertension, atrial fibrillation, and LVEF in multivariable linear regression analysis. In this multivariable model, a one centimeter increase in LA diameter predicted an average increase in mean PAP of 2.78 mmHg (95% CI 0.10, 5.46, p = 0.0423). In a subset of this population, LVEF, LV E/A Ratio, and LV Mass Index were not significant predictors of mean PAP. Reduction in cardiac index was noted with increasing LA diameter but this trend did not reach statistical significance. Conclusion: LA enlargement is significantly associated with increased mean PAP in patients with WHO Group 2 PH. LA enlargement may be a proxy for LA dysfunction and our data suggests that increased LA diameter may be a predictor of WHO Group 2 PH severity. Further studies of LA dimension, volume, and function are warranted to further our understanding of the left atrium’s relationship to PH.

Abstract 77: Statin Adherence and Persistence Among Japanese Patients With High Risk Vascular Disease: A Japan Claims Database Analysis

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Zhenxiang Zhao ◽  
Patrick L McCollam ◽  
Keith L Davis ◽  
Juliana Meyers ◽  
Masahiro Murakami
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Baseline Period ◽  
Claims Database ◽  
History Of ◽  
Artery Disease ◽  
Statin Adherence ◽  
Statin Use

BACKGROUND: High risk vascular disease (HRVD defined as cerebrovascular disease [CVD], coronary artery disease with diabetes [CADD], history of acute coronary syndrome [ACS], or peripheral artery disease [PAD]) is among the biggest health problems affecting Japanese, with CVD and coronary artery disease (CAD) being the 2nd and 3rd most common causes of death. Despite proven efficacy of statins in reducing CV mortality, limited research is available to systematically study statin adherence and persistence for HRVD patients in Japan. OBJECTIVE: Examine statin adherence and persistence in HRVD patients. METHOD: A retrospective cohort study was conducted using the Japan Medical Data Center (JMDC) database, a large Japanese administrative claims database with 10 insurance societies (payers), and integrated inpatient, outpatient, and pharmacy claims of approximately 0.8 million covered lives from 2006-2011. Patients > 18 years with HRVD (CVD, PAD, CADD or history of ACS [≥30days through 365 days after discharge for ACS]) between 01/01/2008 to 12/31/2009, were identified for this study with minimum 12-month pre- and 24-month post-index insurance eligibility. Statin use was measured during the 12-month baseline period and the 24-month follow-up period. The date of the first HRVD claim(s) satisfying the above inclusion criteria was defined as the index date. Statin use was examined for the overall HRVD group as well as subgroups of patients with CVD only, PAD only, CADD only, history of ACS only, and patients with multiple HRVDs. Statin adherence, calculated using the medication possession ratio [MPR], and statin persistence, assessed with survival analysis techniques using a ≥30-day gap to define discontinuation, were measured in the 24-month follow-up period for the overall HRVD patient group. RESULTS: There were 10,400 HRVD patients identified in the JMDC database. Mean age was 52.8 and 57.1% were male. Statin use during the baseline period showed 12.1% of HRVD patients taking statins (CVD only: 10.2%; PAD only: 9.6%; CADD only: 14.6%; history of ACS only: 46.7%; CADD and a history of ACS: 48.3%; 2 affected artery beds: 17.8%; 3 affected artery beds: 19.5%). Statin use increased to 32.9% during the 24-month follow-up period (CVD only: 27.6%; PAD only: 26.6%; CADD only: 45.1%; history of ACS only: 54.4%; CADD and a history of ACS: 58.3%; 2 affected artery beds: 49.3%; 3 affected artery beds: 45.5%). For Japanese HRVD patients who used a statin, mean/median MPR was 0.89/0.94 and 82.1% of statin users were adherent (MPR ≥80%) to their statin therapy during the 24-month follow up period. The median time to statin discontinuation was 679 days during the 24-month follow up period. CONCLUSION: Statin use after HRVD diagnosis was modest and highest in ACS patients and patients with multiple affected vascular beds. Statin adherence was high among patients with HRVD in Japan.

P5331Aspirin use for prevention of cardiovascular events in patients with high lipoprotein(a): a population-based study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Karrthik ◽  
M Gad ◽  
N Bazarbashi ◽  
K Ahuja ◽  
Y Sammour ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Lipoprotein A ◽  
Preventive Cardiology ◽  
All Cause Mortality ◽  
History Of ◽  
Artery Disease

Abstract Background High lipoprotein(a) [Lp(a)] levels have been shown to increase Myocardial Infarction (MI) and all-cause mortality. However, studies evaluating the optimal preventive measures for that subset of cardiac patients are scarce. This study aims to study the outcomes of aspirin use versus no aspirin for the prevention of all-cause mortality and myocardial infarction in patients with high Lp(a) levels. Purpose We sought to determine the effect of Aspirin in reducing the rate of MI and all-cause mortality among patients with high lipoprotein(a) [Lp(a) ≥50mg/dL] Methods Patients who attended the preventive cardiology clinic from 2005 to 2016 and included in the Preventive Cardiology Database were included in the current single-center, retrospective, observational cohort study that was conducted according to the guidelines of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology Statement) checklist. The primary outcome was the incidence of myocardial infarction and the secondary outcome was all-cause mortality. Patients were excluded in cases of I) Lp(a)a <50mg/dL, II) history of malignancy, or III) being on anticoagulation/ dual antiplatelet therapy. The median duration of follow-up was 92 months from time of Lp(a) measurement to the last follow-up. Continuous variables were expressed as means ± standard deviation or median (IQR), and categorical variables were expressed as percentages (%). All statistical tests were two-sided. A propensity score-matched analysis was performed with 1:1 nearest match for Age, Gender, Race, Smoking status, BMI, Diabetes, Peripheral artery disease, Carotid artery disease, coronary artery disease, chronic kidney disease, Heart failure, Hypertension, Dyslipidemia, Stroke, family history of coronary artery disease, Lp (a), LDL, HDL, Triglycerides, glucose and total cholesterol. Results 1,805 patients fulfilled the inclusion and exclusion criteria out of 7,410 patients initially identified with recorded Lp(a) levels in the Preventive Cardiology Database. Of these, 376 patients were taking aspirin, and 1429 patients were not receiving aspirin. After propensity score matching for different baseline characteristics and comorbidities as mentioned above, 316 patients were matched in each group. Patients who were on Aspirin had a significantly lower rate of MI events compared to patients who were not on aspirin (6.96% vs 12.02%, P=0.03) and a lower rate, however statistically non-significant, of all-cause mortality (2.84% vs 4.11%, P=0.385). Conclusion The use of aspirin in patients with elevated Lp(a) levels significantly lowers the rate of myocardial infarction events. Larger randomized clinical trials are warranted to evaluate the use of aspirin for primary and secondary prevention of major adverse cardiovascular events in patients with high Lp(a) levels.

Abstract 19234: Exercise Echocardiography is Efficacious With Superior Cost Profile Compared to Exercise ECG as First Line Test in Patients With no History of Coronary Artery Disease and New Suspected Stable Angina; A Randomized Prospective Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Konstantinos Zacharias ◽  
Asrar Ahmed ◽  
Sothinathan Gurunathan ◽  
Benoy N Shah ◽  
Roxy Senior
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Exercise Stress ◽  
Cost Advantage ◽  
First Line ◽  
Exercise Ecg ◽  
History Of ◽  
Artery Disease

Introduction: Exercise ECG (ExECG) is the initial investigation of choice according to AHA/ACC guidelines in patients with suspected stable angina, normal ECG and able to exercise.We hypothesized that Exercise Stress Echo (ESE), given its high feasibility (with contrast use) and superior diagnostic accuracy would confer a cost advantage over ExECG. Methods: Consecutive consenting patients with no previous history of coronary artery disease (CAD) and a calculated pre-test CAD risk of >10%, seen in our Rapid Access Clinic and able to exercise on the treadmill, were randomized into same day ExECG or ESE.Tests were classified as positive, negative or inconclusive for ischemia. Patients with negative tests were discharged from the clinic, with inconclusive tests were offered additional tests and with positive tests were offered Coronary Angiography (CA). Cost to diagnosis was calculated using the NHS tariff by adding the cost of all requested investigations up to an including CA on an intention to treat basis. Follow-up data on Death, Myocardial Infarction and Unplanned Revascularization were collected for a period of at least 1 year after the enrollment of the last study patient. Results: A total of 194 patients underwent ExECG (mean age 53, 66% male) and 191 patients ESE(mean age 55, 70% male).There were no significant differences in age, gender and in prevalence of diabetes mellitus, smoking and hyperlipidemia. Pre-test probability of CAD was also similar(39% vs. 40% p=0.6). Results of ExECG were:108(55.7% Negative), 14 (7.2%) Positive, 72(37.1%) Inconclusive and of ESE:191(94.8%) Negative, 9 (4.7%) Positive, 1(0.5%) Inconclusive. The positive predictive value for patients undergoing CA after a positive ESE was higher than that for positive ExECG (9/9 vs 9/14 p=0.04). Average cost to diagnosis was significantly lower for ESE vs Ex ECG ( £ 265 vs £ 331p=0.02). Over a mean follow-up period of 21±5 months there was no significant difference in cardiac event rates (1% vs. 0% p=0.1) in the ESE vs. ExECG groups. Conclusion: In this first randomized study, same day ESE was shown to be feasible, efficacious conferring superior cost advantage when compared to ExECG. This study suggests that ESE could be used as first line investigation in patients with suspected stable angina.

scholarly journals Coronary Angiographic Findings Among the Left Bundle Branch Block Patients

2018 ◽  
Vol 12 (2) ◽  
pp. 88-90
Author(s):  
Abu Tarek Iqbal ◽  
Md Ayub ◽  
Md Salehuddin ◽  
Khurshed Ahmed
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Bundle Branch Block ◽  
Care Hospital ◽  
Age Group ◽  
Bundle Branch Block ◽  
Female Ratio ◽  
Vessel Disease ◽  
History Of ◽  
Artery Disease

Introduction: Complete Left bundle branch block(LBBB) increases the risk of cardiac mortality, and prognosis is primarily determined by the underlying coronary artery diseases. The goal of this study was to determine the association of complete left bundle branch block (LBBB), with site, severity & risk factors of coronary artery disease (CAD) diagnosed by coronary angiogram(CAG).Methods: A total of 75 symptomatic patients with LBBB were evaluated in a one year period by coronary angiography in a tertiary care hospital of Chittagong, Bangladesh. Standard protocol and procedure were followed during doing both ECG and CAG. All data were compiled and were analyzed by SPSS-20.Results: Among 75 patients analyzed male were 40(53.3%) and female was 35(46.67%). Male to female ratio was 1:1.14.. Among all 22(29.33%) patients were at age group <60 years, 48(64%) were at age group 40-60 years and 5(6.6%) were <40 years of age. 34(45.3%) patients were from rural community. Regarding risk factor analysis 19(25.2%) patients had DM, 16(21.33%) patients had different kinds of dyslipidemia, 8(10.6%) patients were obese, 3(4%) patients had high cholesterol(>400mg/dl), 26(34.66%) patients were hypertensive, 21(28%) were smoker, 2(2.66%) were taking jarda, 8(10.6%) patients had family history of coronary artery disease and one patients had history of alcoholism. Angiographic study revealed 6(8%) had single vessel disease, 16(21.33%) had double vessel disease, 5(6.66%) had triple vessel disease and 48(64.00%) patients had normal vessels.Conclusion: LBBB may be assoictaed with normal to variable involvement of coronary arteryUniversity Heart Journal Vol. 12, No. 2, July 2016; 88-90

Sign in / Sign up

Export Citation Format

Share Document