scholarly journals Prevalence and patterns of coronary artery disease in patients undergoing cardiac surgery for rheumatic and non- rheumatic valvular heart disease in a tertiary care center of Nepal

2018 ◽  
Vol 15 (2) ◽  
pp. 21-24
Author(s):  
Ravi Sahi ◽  
Arun Sayami ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Poudel ◽  
Hemant Shrestha ◽  
...  

Background and Aims: Coronary artery disease (CAD) constitute a major cause of cardiovascular morbidity and mortality worldwide with an enormous burden on healthcare resources. Prevalence and pattern of CAD in patients of rheumatic and non-rhemuatic valvular heart diseases varies widely with limited data on optimal strategies for diagnosis and treatment.Methods: This study includes 97 patients with rheumatic and non-rheumatic valvular heart disease who underwent coronary angiogram (CAG) before cardiac surgery. Patients were divided into two groups based on rheumatic heart disease (RHD) & non-rheumatic disease (Non-RHD) and correlate the patterns of CAD.Results: Out of 97 patients, 22 (22.6%) patients were found to have significant CAD. In patients with non-rheumatic origin CAD was common (15 patients, 68.1%) as compared to rheumatic origin (7 patients, 31. 8%). In rheumatic origin, the prevalence was 7(12.2%) out of 57 patients while in non-rheumatic origin, was 15(37.5%) out of 40 patients. In RHD group, all patients with CAD were found to have single vessel diease (SVD) while, in non-RHD group, 11 patients (73.3%) had SVD, 3 patients (16.7%) had double vessel disease (DVD) and one patient (5.6%) had triple vessel disease (TVD).Conclusions: Prevalence of CAD is higher in patients with non-RHD in comparison to those with RHD. We also found SVD to be the most common pattern of CAD in both rheumatic and non-rheumatic valvular heart disease.

2020 ◽  
Vol 11 (6) ◽  
pp. 68-71
Author(s):  
Binay Kumar Rauniyar ◽  
Arun Kadel ◽  
Kiran Prasad Acharya ◽  
Kartikesh Kumar Thakur ◽  
Rakesh Bahadur Adhikari ◽  
...  

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).


2021 ◽  
Vol 15 (9) ◽  
pp. 2757-2762
Author(s):  
Vinesh Kumar ◽  
Fawad Ali Siddiqui ◽  
Kiran Irfan ◽  
Muhammad Adeel Qamar ◽  
Ghulam Jaffar Shah ◽  
...  

Introduction: Higher levels of troponins >10 folds of upper normal limits (UNL) are considered as high-risk patients on coronary angiography sufferers having high levels of troponin-I (>10 folds upper limit normal level) had extra three-vessel coronary artery disease involvement. Objectives: To determine the frequency of degree of cardiovascular disease with Troponin-I level >10 folds ULN in NSTEMI patients at tertiary care hospital. Methodology: It is a cross-sectional study comprising of a total 800 patients recruited from the Department of Cardiology, National Institute of Coronary Disease, Karachi Pakistan based on Exclusion/Inclusion criteria. Results: There are 678 male as well as 122 female patients. The mean troponin-I level was 15.00±6.82 ng/ml. Single vessel disease found in 25.25% cases, two vessel diseases were observed in 37.75% cases, and three vessel diseases were observed in 20% cases. 83% were found with extent of CAD findings on angiography. There have been 678 male and also 122 female patients. The mean troponin-I level was 15.00±6.82 ng/ml. Single vessel disease found in 25.25% cases, two vessel diseases were observed in 37.75% cases, and three vessel diseases were observed in 20% cases. 83% were found with extent of CAD findings on angiography. Conclusion: The higher troponin level found significantly associated with extent of CAD and three vessel disease. To understand the cardiovascular troponin condition of the sufferer as soon as feasible is crucial. Keywords: Extent of Coronary Artery Disease, NSTEMI, Troponin-I Level >10 Folds ULN


1970 ◽  
Vol 1 (2) ◽  
pp. 169-173 ◽  
Author(s):  
MS Kabir ◽  
AAs Majumder ◽  
MS Bari ◽  
AW Chowdhury ◽  
AM Islam

Background: Besides conventional classic risk factors of ischaemic heart disease other variables that have come under scrutiny for their potential contribution include estrogen deficiency, lipoprotein (a), plasma fibrinogen, plasminogen-activator inhibitor type I, endogenous tissue plasminogen activator (tPA), C-reactive protein and homocysteine. A number of studies have been undertaken worldwide shows strong correlation of raised fasting plasma homocysteine level with the development of atherosclerotic vascular diseases, myocardial infarction or increasing severity of coronary artery diseases. Objective: To find out the correlation of fasting plama homocysteine level with the severity of coronary artery disease in our population. Method: We undertook a study involving 100 patients of ischaemic heart disease (determined clinically & by non-invasive tests) in National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, over the period of one year from January 2003 to December 2003. Out of 100 patients, 50 patients having normal homocysteine level were considered as control and another 50 patients having raised plasma homocysteine level were taken as cases. Result: Out of 50 patients, 20% had single vessel disease, 48% had double vessel disease and 32% had 3 vessel diseases. On the other hand in control group 10% patients had normal coronary artery disease, 40% had single vessel disease, 32% had double vessel disease and 18% had triple vessel disease. Conclusion: The study showed significant increase in number of coronary artery involvement by atherosclerotic lesions with increasing levels of plasma homocysteine level. Key words: Homocysteine; Coronary artery disease; Coronary angiogram. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8124 Cardiovasc. j. 2009; 1(2) : 169-173


2017 ◽  
Vol 14 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Amit Shrestha ◽  
Sanjeev Thapa ◽  
Sheelendra Shakya ◽  
Ravi Shahi ◽  
Chandra Mani Paudel ◽  
...  

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.


2014 ◽  
Vol 66 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Cholenahally Nanjappa Manjunath ◽  
Ashish Agarwal ◽  
Prabhavathi Bhat ◽  
Khandenahally Shankarappa Ravindranath ◽  
Rajiv Ananthakrishna ◽  
...  

BMJ ◽  
1982 ◽  
Vol 284 (6311) ◽  
pp. 223-226 ◽  
Author(s):  
D R Ramsdale ◽  
E B Faragher ◽  
D H Bennett ◽  
C L Bray ◽  
C Ward ◽  
...  

Thrombosis ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Luiz Carlos Porcello Marrone ◽  
João Pedro Farina Brunelli ◽  
Ricardo Lutzky Saute ◽  
Gustavo Henrique Tomasi ◽  
Bianca Cecchele Madeira ◽  
...  

Background. Stroke is a leading cause of mortality and disability in Brazil and around the world. Cardioembolism is responsible for nearly 30% of the origins of ischemic stroke. Methods. We analyzed data of 256 patients with cardioembolic ischemic stroke (according to TOAST classification) who were admitted into the Hospital São Lucas-PUCRS from October 2011 to January 2014. The cardioembolic subtype was divided into six subgroups: arrhythmias, valvular heart disease, coronary artery disease, cardiomyopathy, septal abnormalities, and intracardiac injuries. The prevalence of the most important cardiovascular risk factors and medications in use for prevention of systemic embolism by the time of hospital admission was analyzed in each patient. Results. Among 256 patients aged 60.2 +/− 6.9 years, 132 males, arrhythmias were the most common cause of cardioembolism corresponding to 50.7%, followed by valvular heart disease (17.5%) and coronary artery disease (16%). Hypertension (61.7%) and dyslipidemia (43.7%) were the most common risk factors. Less than 50% of patients with arrhythmias were using oral anticoagulants. Conclusions. Identifying the prevalence of cardioembolic stroke sources subgroups has become an increasingly important role since the introduction of new oral anticoagulants. In this study, arrhythmias (especially atrial fibrillation) were the main cause of cardioembolism.


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