scholarly journals Angiographic Studies of Coronary Artery Disease in Dhulikhel Hospital

2013 ◽  
Vol 9 (1) ◽  
pp. 43-46
Author(s):  
R Koju ◽  
S Humagain
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stable Angina ◽  
Coronary Stenosis ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Coronary Syndrome ◽  
Diagnostic Angiography ◽  
Artery Disease

Background Coronary Artery Diseases (CAD), one of the the leading causes of death, is increasing globally. The number of CAD is also increasing in Nepal. Dhulikhel Hospital is also providing cardiovascular services to populations from semiurban and rural population of mid region of country. It started coronary angiography services from April 2012. This paper aims to analyze pattern of coronary artery occlusion in patients undergoing coronary angiography during April to September months of 2012. Methods There were a total of 36 cases of diagnostic angiography and coronary interventions done in Dhulikhel Hospital from April to September 2012. Among them 32 cases of coronary angiography done for Acute Coronary Syndrome and Stable Angina, were analyzed using SPSS 17. Results Males were higher in number than females and majority of the patients were above 55 years. Out of 32 cases, 13 (40.6%) had Acute Coronary Syndrome (ACS) and 19(59.4%) had Stable Angina. Six out of 32 were found to have normal coronaries. One patient with ACS had normal coronary. Out of all the patients with coronary stenosis, four had left main disease, 14 had LAD stenosis, 7 had LCX stenosis and 12 patients had RCA stenosis. Thirteen had severe coronary stenosis. Nine out of 12 ACS patients had more than one coronary artery involved, which is significantly higher than the stable angina group (P<0.01). Severe stenosis was found to be more common in ACS group (p<0.001) when compared to the stable angina group. Conclusion Coronary angiography is a useful diagnostic and therapeutic tool for CAD. Coronary status is significantly different in ACS and stable angina. ACS has more chance of having multivessel stenosis whereas stable angina has single vessel, less severe or normal coronaries. Severity of stenosis is also high in ACS than in stable angina. DOI: http://dx.doi.org/10.3126/njh.v9i1.8348 Nepalese Heart Journal Vol.9(1) 2012 pp.43-46

P2245Sex differences in the in-vivo markers of platelet activation among patients with ischemic heart disease: insights from the EVA study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Raparelli ◽  
G F Romiti ◽  
N Sperduti ◽  
G F Santangelo ◽  
M Vano ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Sex Differences ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
Clinical Presentation ◽  
Coronary Syndrome ◽  
Chronic Angina ◽  
Artery Disease

Abstract Background/Introduction Ischemic heart diseases (IHD) are not synonymous with obstructive flow-limiting coronary artery disease (CAD), especially in women. Platelet dysfunction is suggested as a potential mechanism favouring ischemia in non-obstructive CAD. However, it is unknown whether sex differences in platelet function of patients with non-obstructive CAD exist. Purpose We assessed for sex differences in in-vivo markers of platelet activation among patients with the acute coronary syndrome and chronic stable angina, with or without obstructive CAD Methods From the “Endocrine Vascular disease Approach” (EVA) study, we selected IHD patients undergoing urgent or elective coronary angiography with complete baseline clinical characteristics and angiographic data. Non-obstructive CAD was defined as the presence of coronary stenosis <50%. Thromboxane B2 (TxB2) and soluble P-selectin (sP-s) were measured at baseline. A sex-stratified analysis of platelet biomarkers was performed. Results Among two-hundred-seventy-seven patients (mean age 67±11, 37% women), non-obstructive CAD was documented in 25% of patients. Acute coronary syndrome (ACS) was the reason for angiography in 61% of cases. Women had more frequently ACS, as compared with men (54.8% vs 41.3%, p=0.001), with predominantly non-obstructive CAD. Median serum TxB2 (121.5 [92.7–174.0] vs 103.5 [83.0–140.2] pg/ml, p=0.005) and plasma sP-s (27.0 [18.7–35.0] vs 22.0 [16.0–30.0] ng/ml, p=0.006) levels were higher in patients with ACS as compared with the ones with stable chronic angina. The median concentration of TxB2 was significantly increased in women as compared with men, regardless of the clinical presentation and the coronary stenosis degree (all comparison, p<0.001). However, women with non-obstructive CAD were the group with the highest serum levels of TxB2 (140.0 [111.0–152.0] pg/ml). Sex differences in the plasma sP-s level were also observed among patients with stable chronic angina (women, 26 [20.0–34.0] vs men, 21 [16.6–27.7] ng/ml, p=0.002) and with non-obstructive CAD (women, 26 [20.5–34.5] vs men, 18.5 [16.6–26.0] ng/ml, p=0.003). Conclusion(s) Women with IHD and non-obstructive CAD had increased level of TxB2 and sP-s as compared with men, independently by the clinical presentation. Further investigations are warranted to verify the role of platelet hyperactivation in the pathogenesis of myocardial ischemia with non-obstructive coronary artery disease among women. Acknowledgement/Funding Scientific Independence of Young Researchers Program (RBSI14HNVT) - Ministry of Education, University and Research (MIUR)

Coexistence and outcome of coronary artery disease in Takotsubo syndrome

2020 ◽  
Vol 41 (34) ◽  
pp. 3255-3268 ◽  
Author(s):  
L Christian Napp ◽  
Victoria L Cammann ◽  
Milosz Jaguszewski ◽  
Konrad A Szawan ◽  
Manfred Wischnewsky ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Artery Occlusion ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Takotsubo Syndrome ◽  
Normal Coronary Arteries ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Aims Takotsubo syndrome (TTS) is an acute heart failure syndrome, which shares many features with acute coronary syndrome (ACS). Although TTS was initially described with angiographically normal coronary arteries, smaller studies recently indicated a potential coexistence of coronary artery disease (CAD) in TTS patients. This study aimed to determine the coexistence, features, and prognostic role of CAD in a large cohort of patients with TTS. Methods and results Coronary anatomy and CAD were studied in patients diagnosed with TTS. Inclusion criteria were compliance with the International Takotsubo Diagnostic Criteria for TTS, and availability of original coronary angiographies with ventriculography performed during the acute phase. Exclusion criteria were missing views, poor quality of angiography loops, and angiography without ventriculography. A total of 1016 TTS patients were studied. Of those, 23.0% had obstructive CAD, 41.2% had non-obstructive CAD, and 35.7% had angiographically normal coronary arteries. A total of 47 patients (4.6%) underwent percutaneous coronary intervention, and 3 patients had acute and 8 had chronic coronary artery occlusion concomitant with TTS, respectively. The presence of CAD was associated with increased incidence of shock, ventilation, and death from any cause. After adjusting for confounders, the presence of obstructive CAD was associated with mortality at 30 days. Takotsubo syndrome patients with obstructive CAD were at comparable risk for shock and death and nearly at twice the risk for ventilation compared to an age- and sex-matched ACS cohort. Conclusions Coronary artery disease frequently coexists in TTS patients, presents with the whole spectrum of coronary pathology including acute coronary occlusion, and is associated with adverse outcome. Trial registration ClinicalTrials.gov number: NCT01947621.

scholarly journals Levels of pregnancy-associated plasma protein A in patients with coronary artery disease

2008 ◽  
Vol 31 (2) ◽  
pp. 85 ◽  
Author(s):  
Zhi-Yuan Liu ◽  
Jin-Ying Zhang ◽  
Tong-Wen Sun ◽  
Yan-Jun Zhang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Plasma Protein ◽  
Stable Angina ◽  
Protein A ◽  
Serum Levels ◽  
Control Group ◽  
Coronary Syndrome ◽  
Artery Disease

Purpose: To investigate the levels of pregnancy-associated plasma protein A (PAPP-A) or insulin-like growth factor -1 (IGF-1) in patients with acute coronary syndrome. Methods: Serum PAPP-A and IGF-1 was measured with biotin–tyramide-amplified enzyme immunoassay and Enzyme Linked Immuoserbent Assay, respectively, in patients with ST elevation acute myocardial infarction (STEMI, n=12), unstable angina (UAP, n=15), and stable angina (n=15). PAPP-A and IGF-1 was also measured in 16 healthy subjects (control group). Results: The serum levels of PAPP-A in the STEMI (16.9±10.3 mIU/L) and UAP group (15.2±10.5 mIU/L) were higher than in the stable angina (8.5±3.1 mIU/L) or control group (8.4±2.0 mIU/L, P < 0.01). The serum levels of IGF-1 in the STEMI (132.3±40.9 µg/L) and UAP group (127.3±36.0 µg/L) were also higher than in the stable angina (44.9±18.5 µg/L) or control group (67.7±24.5µg/L, P < 0.01). There were no differences in serum levels of PAPP-A or IGF-1 among the single, double and three vessel lesion groups. The serum levels of PAPP-A (19.9±10.1 mIU/L) and IGF-1 (153.2±52.4 µg/L) after PCI were higher than those before PCI (15.1±10.0 mIU/L and 91.4±51.0 µg/L, respectively, P < 0.01). A positive correlation was found between PAPP-A and IGF-1 levels in the STEMI and UAP group before PCI (r=0.48?P < 0.01). Conclusion: PAPP-A and IGF-1 are elevated in patients with acute coronary syndrome. They may be used as biomarkers for vulnerable plaques in patients with coronary artery disease. Whether post-PCI elevation of IGF-1 can be used to predict restenosis of coronary arteries remains to be seen.

scholarly journals Evaluation of Platelet Parameters in Patients With Coronary Artery Disease

2020 ◽  
Author(s):  
Mahdieh Mehrpouri1 ◽  
Afshin Ahmad Pour ◽  
Esmail Shahabi Satlsar
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Healthy Volunteers ◽  
Ecg Changes ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Artery Disease

Coronary artery disease (CAD) is one of the leading causes of death worldwide; therefore, identifying new risk factors to predict the severity of the disease is thought to be associated with mortality reduction. In an effort to investigate whether platelet parameters are related to the extent of CAD and can be considered as risk factors, we designed experiments to evaluate platelet parameters in these patients. In a cross‐sectional study, sixty-nine patients with CAD (including fifty-two patients with acute coronary syndrome and seventeen patients with stable angina) and sixty-four healthy volunteers were evaluated for platelet count, mean platelet volume (MPV), and platelet distribution width (PDW). Echocardiography, electrocardiogram (ECG), and coronary angiography were conducted as well. Results showed significantly higher values for MPV and PDW in patients with acute coronary syndrome as compared to patients with stable angina and healthy volunteers (P<0.001 and P=0.009, respectively). There was no significant difference in platelet count between patients and healthy volunteers (P=0.379). Our results also revealed a significant difference in the ejection fraction (EF) percentage between the three groups (P=0.008). Investigating the correlation between platelet parameters and EF percentage, ECG changes, and the results of coronary angiography did not show any significant association. The present study showed that the elevated levels of MPV and PDW in patients with CAD are not related to the extent of coronary artery disease, which was estimated by echocardiography, ECG changes, and coronary angiography. Thus, these parameters cannot be considered as risk factors for coronary artery disease.

scholarly journals ASSOCIATION OF THROMBOLYSIS IN MYOCARDIAL INFARCTION (TIMI) RISK SCORE WITH EXTENT OF CORONARY ARTERY DISEASE IN PATIENTS WITH UNSTABLE ANGINA AND NSTEMI

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S787-91
Author(s):  
Saleha Abbas ◽  
Abdul Hameed Siddiqui ◽  
Ammar Cheema ◽  
Ayesha Abbas ◽  
Syed Khawar Abbas Jaffri ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Unstable Angina ◽  
Risk Score ◽  
Coronary Syndrome ◽  
Co Morbidity ◽  
Artery Disease

Objective: To evaluate the correlation between thrombolytic in Myocardial Infarction risk score with the severity of coronary lesions found by coronary angiography during hospitalization in patients with non-ST elevation Acute coronary syndrome. Study Design: Cross sectional study. Place and Duration of Study: Adult Cardiology department, Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi from Jul to Dec 2018.Methodology: Patients who had chest pain suggestive of angina or anginal equivalent symptoms and diagnosis of Acute Coronary Syndrome (ACS) were included in the study. Patients with Acute Coronary Syndrome were risk stratified with Thrombolysis In Myocardial Infarction risk scores and were further evaluated with coronary angiograms to assess the extent of coronary artery disease. Results: Total 115 patients were recruited in the study with mean age 57.08 ± 10.2 years. There were 87 (75.7%) male patients while 28 (24.3%) female patients. The most common co-morbidity was hypertension 66 (57.4%) followed by diabetes mellitus 39 (33.9%) and smoking 25 (21.7%). 71 (61.7%) patients had one angina episode in the last 2 hours while 34 patients had two angina episodes in the last 2 hours. Cardiac biomarkers were raised in 36 (31.3%) patients. 60 (52.2%) used aspirin in the last 7 days. Chi-square test was applied between Thrombolysis In Myocardial Infarction Score and Coronaries lesions, which showed statistically significant results (p<0.001). Conclusion: Our study demonstrates that among patients presenting with Non-STE Acute coronary syndrome i.e. unstable angina /NSTEMI who are referred for coronary angiography, clinical risk stratification according......

scholarly journals Left Main Coronary Artery Spasm: Case Report

2021 ◽  
Author(s):  
Vijay Kumar Bodicherla ◽  
Srikrishna Srikakulapu ◽  
Lalitha Nemani
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stable Angina ◽  
Left Main Coronary Artery ◽  
Coronary Artery Spasm ◽  
Chronic Stable Angina ◽  
Left Main ◽  
Coronary Syndrome

AbstractVasospasm of coronary artery is a well-known cause for acute coronary syndrome (ACS) but left main coronary artery (LMCA) spasm is very rare. It may be iatrogenic or spontaneous. Here we report a case of a 44-year-old female who presented with chronic stable angina and experienced LMCA vasospasm while undergoing coronary angiography.

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