Myocardial infarction with nonobstructive coronary arteries: clinical characteristics and features of the acute period

The aim – to define the clinical and anamnestic features of myocardial infarction, which determine the prognosis of patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) in the acute period.Materials and methods. The study included 33 patients with MINOCA (group I), and 73 patients with myocardial infarction (MI) with obstructive coronary artery disease (CAD) (group II) who were hospitalized in Clinical hospital # 8. Angiography, echocardiography, ECG, clinical laboratory tests were performed for all patients.Results and discussion. As a result of a comparative analysis, it was found that the number of women in the group of patients with MINOCA (group I) was significantly higher than in group II (p=0.00001). The prevalence of risk factors such as hyperlipoproteinemia and smoking (p=0.0497; p=0.0096) in group I was lower than in group II. The average level of diastolic blood preasure in group I was significantly higher than in group II (p=0.002911). It was found that in the group I level of hemoglobin (p=0.003834), leukocytes (p=0.000376) and lymphocytes (p=0.003423) was significantly lower than in the group II, in group II diastolic dysfunction type I was prevailed (p=0.0084).Conclusions. Study showed that women were more likely to have MINOCA than men. Proportion of patients with hyperlipidemia and smoking in the group I was lower than in the group II. Patients in the group I more likely had diastolic dysfunction, lower hemoglobin and leukocytes level than in patient with MI with obstructive CAD. Independent factors associated with the development of complications in the acute period of MINOCA were a decrease in diastolic blood preasure, an increase in systolic blood preasure and age (multivariate regression logistic analysis).

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MOTERŲ MIOKARDO INFARKTO KLINIKINĖS SIMPTOMATIKOS IR BAIGČIŲ YPATUMAI

Sveikatos mokslai ◽

10.5200/sm-hs.2015.007 ◽

2015 ◽

Vol 25 (1) ◽

pp. 44-49 ◽

Cited By ~ 1

Author(s):

Žaneta Petrulionienė ◽

Pranas Šerpytis ◽

Dovilė Jančauskaitė ◽

Urtė Gargalskaitė ◽

Brigita Brazauskaitė ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Heart Rhythm ◽

Type I ◽

Type Ii ◽

Group I ◽

Primary Arterial Hypertension ◽

St Elevation ◽

Atrial Fibrilation ◽

Group Ii

Objective. The aim of the present study was to compare differences of symptoms, comorbidities, risk factors and outcomes in younger (up to 55 years-old) and older (over 55 years-old) women with acute myocardial infarction. Materials and methods. In this retrospective study we analised 473 cases of women with acute myocardial infarction treated in 2012. Patients were divided into two groups according to their age: group I (up to 55 years) and group II (older than 55 years). The first group included 37 patients while the second group - 436 patients. Results. The average age of patients was 72,3 ± 11,07 m. Myocardial infarction with ST elevation were diagnosed to 54,3%, of wich Q+ 70,4%, Q- 29,6% (p 0,001), non-ST elevation 45,7%, of wich Q+ 6,5%, Q- 93,5% (p 0,001), no statistically significant difference was observed between the groups. 73% women in group I had primary arterial hypertension (I grade 2,7%, II 59,5%, III 10,8%), in the second group - 92,7% (I grade 0,7%, II 86%, III 6%), (p 0,001). Moreover, 13,5% patients in group I had diabetes (5,4% of type I, 8,1% of type II), in the group II 23,9% (0,3% of type I, 23,6% of type II), (p 0,001). Heart rhythm disorders were more often in women over 55 years-old (32,8%), (p=0,006). Among these patients, persistent atrial fibrilation were identified in 27,2%, permanent atrial fibrilation in 18,4%, ventricular fibrilation in 4,1% patients (all p 0,001). 5,4% women in younger group had previously experienced myocardial infarction while in older group - 20% (p=0,03). The spread of the pain to left hand was more common in the group of younger patients (27%) (p=0,047). Futhermore, in group I 18,9% felt weakness, while in group II - 38,5% (p=0,018). Fatal outcomes were observed in 6,8% patients, all of them were older than 55 years. Among patients with fatal outcomes Killip IV were found to 78,1% patients (p 0,001). Conclusions. Older women (≥ 55 years-old) treated for acute myocardial infarction more often had the grade II of primary arterial hypertension, heart rhythm disorder, previously experienced mycardial infarction and felt weakness. Younger patients (below 55 years old) had type I diabetes more often and were characterized by pain spreading to the left arm. Determined Killip IV leaded to increased lethality.

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The interplay between myocardial bridging and coronary spasm in patients with myocardial infarction and non-obstructive coronary arteries: pathogenic and prognostic implications

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.139 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

RA Montone ◽

F Gurgoglione ◽

MG Del Buono ◽

MC Meucci ◽

G Iannaccone ◽

...

Keyword(s):

Myocardial Infarction ◽

Unstable Angina ◽

Coronary Arteries ◽

Obstructive Coronary Artery Disease ◽

Coronary Spasm ◽

Interquartile Range ◽

Myocardial Bridging ◽

Adverse Cardiovascular Event ◽

Provocative Test

Abstract Funding Acknowledgements Type of funding sources: None. Background Myocardial bridging (MB) is associated with endothelial dysfunction and may represent a cause of angina in patients with non-obstructive coronary artery disease (NOCAD). Purpose Herein, we assessed the interplay between MB and coronary vasomotor disorders, evaluating also their prognostic relevance in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA) or stable NOCAD. Methods We prospectively enrolled consecutive NOCAD patients undergoing intracoronary acetylcholine provocative test to assess the presence of epicardial or microvascular spasm in patients with suspected angina or MINOCA. Myocardial bridging was diagnosed by coronary angiography. The incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, non-fatal MI and rehospitalisation for unstable angina, was assessed at follow-up. We also assessed angina status using Seattle Angina Questionnaires (SAQ). Results We enrolled 310 patients (mean age 60.6 ± 11.9; 136 [43.9%] men; 169 [54.5%] stable NOCAD and 141 [45.5%] MINOCA). MB was found in 53 (17.1%) patients. MB was an independent predictor of spasm and MINOCA (p < 0.05). At follow-up (median 22 months, interquartile range [13-32]), patients with MB had a higher rate of MACE and a lower SAQ score (all p < 0.001) compared with patients without MB. The rate of MACE was considerably higher in patients with both spasm and MB than in the remaining patients (12/42 [28.6%] vs. 13/268 [4.8%], p < 0.001). Conclusion Among patients with NOCAD coronary spasm associated with MB predicts a worse clinical presentation with MINOCA and a worse clinical outcome at medium-long term follow-up, thus identifying a high-risk subset of patients with MB with relevant therapeutic implications. MB and clinical outcomesCharacteristicsOverall population(n= 310)Presence of Myocardial bridging(n= 53)Absence of Myocardial bridging(n = 257)p valueMACE [n, (%)]25 (8.1)12 (22.6)13 (5.1)<0.001CV Death [n, (%)]1 (0.3)0 (0.0)1 (0.4)0.649MI occurrence [n, (%)]6 (1.9)2 (3.8)4 (1.6)0.286Hospitalization for unstable angina [n, (%)]18 (5.8)10 (18.9)8 (3.1)< 0.001Recurrent angina [n, (%)]70 (22.6)20 (37.7)50 (19.4)0.004SAQ [median (IQR)]82 [78; 88]78 [68; 84]84 [78; 88]< 0.001Follow-up time [months, median (IQR)]22 [15;32]20 [15; 28]23 [15; 34]0.10CV Cardiovascular; MI: Myocardial Infarction; IQR: InterQuartile Range; MACE: Major Adverse Cardiovascular Event; SAQ: Seattle Angina Questionnaire.Abstract Figure Outcomes

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THE CLINICAL COURSE OF MYOCARDIAL INFARCTION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH RECURRENT EPISODES OF ISCHEMIA

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-5-136-143 ◽

2021 ◽

pp. 136-143

Author(s):

Gordienko A.V. ◽

Epifanov S.Yu. ◽

Sotnikov A.V.

Keyword(s):

Myocardial Infarction ◽

Cardiogenic Shock ◽

Clinical Features ◽

Control Group ◽

Study Group ◽

Type I ◽

Conduction Disorders ◽

Recurrent Myocardial Infarction ◽

Group I ◽

Mechanical Devices

Relevance. Recurrent myocardial infarction and early postinfarction angina negatively affects on the prognosis of myocardial infarction. Aim. To evaluate myocardial infarction clinical features in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 79 patients; II - control, without it - 432 patients. A comparative assessment of the myocardial infarction clinical features frequency in selected groups were performed. Results. The studied groups did not differ in the frequency of the main variants of the myocardial infarction course. In patients of the study group more often than in the control group, a complicated course of the disease was observed (88.2 and 50.2%, respectively; p < 0.0001), deaths (13.6 and 3.4%; p < 0.0001). Complications in the study group were dominated by arrhythmias (47.3 and 33.7%; p = 0.007), cardiogenic shock (13.6 and 6.1%; p = 0.006), myocardial ruptures (3.6 and 0.5% ; p = 0.004), thromboembolism (15.5 and 2.2%; p <0.0001), urinary dysfunction (7.3 and 2.5%; p = 0.01), Dressler's syndrome (4.5 and 1.1%; p = 0.009) and mental disorders (16.4 and 5.6%; p < 0.0001). Conclusions. Nonanginal forms of the disease in the study group were observed in 17% of cases. The complications of the disease for group I are characterized by cardiac arrhythmias and conduction disorders, thromboembolism, myocardial ruptures, cardiogenic shock, extracardiac complications of myocardial infarction. The study group has a worse prognosis, which requires early diagnosis, revascularization, the use of auxiliary mechanical devices, and careful implementation of standardized treatment algorithms.

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Abstract 13804: Clinical Profile and Outcomes of Myocardial Infarction With Non-obstructive Coronary Arteries in Older Adults

Circulation ◽

10.1161/circ.142.suppl_3.13804 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Ara H Rostomian ◽

Derek Q Phan ◽

Mingsum Lee ◽

Ray X Zadegan

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Los Angeles ◽

Coronary Arteries ◽

Medical Center ◽

Invasive Coronary Angiography ◽

Obstructive Coronary Artery Disease ◽

Kaiser Permanente ◽

Artery Disease

Introduction: Myocardial Infarction with non-obstructive coronary artery disease (MINOCA) is found in 5%-6% of patients with acute myocardial infarction (AMI). As such, the diagnosis and management of AMI patients with non-obstructive coronary artery disease (NOCAD) poses a challenge as compared to patients with MI with coronary artery disease (MICAD). Hypothesis: To evaluate the characteristics and outcomes of MINOCA in older patients as compared with MICAD patients, with and without revascularization. Methods: This was a retrospective observational study of patients ≥80 years old who underwent invasive coronary angiography (ICA) for AMI between 2009-2019 at Kaiser Permanente Los Angeles Medical Center. MINOCA was defied as <50% stenosis of coronary arteries on angiography with a troponin level ≥0.05 ng/ml. Patients with MINOCA vs MICAD were compared. Multivariate logistic regression was used to identify independent predictors of MINOCA and Kaplan-Meier survival analysis was used to analyze all-cause mortality between cohorts. Results: A total of 259 patients with MINOCA (mean ± SD age 83.8±2.7 years, 68% female) and 687 patients with MICAD (84.7±3.4 years, 40% female) were analyzed. Younger age (odds ratio [OR]=1.11; 95% confidence interval [CI]=1.05-1.18), female sex (OR=3.14; CI=2.20-4.48), black race (OR=2.53; CI=1.61-3.98), no history of prior stroke (OR=1.56; CI=1.06-2.33), atrial fibrillation or flutter (OR=2.04; CI:1.38-3.02), lower troponin levels (OR=1.08; CI:1.03-1.11), and lower triglyceride levels per 10 mg/dl increments (OR=1.06; CI:1.03-1.11) increased the odds of having MINCOA as compared to MICAD. At median follow-up of 2.4 years, MINOCA was associated with a lower rate of death (44.8% vs 55.2%, p<0.01) compared to un-revascularized MICAD, but no difference (31.3% vs 40.4%, p=0.68) when compared to re-vascularized MICAD. Conclusions: Patients age ≥80 years with MINOCA have fewer traditional risk factors compared to their counterparts with MICAD and fewer deaths compared to un-revascularized MICAD, but similar mortality compared to revascularized MICAD

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Detection and Characterization of Prevotella Intermedia and Its In Vitro Susceptibility to Selected Antimicrobial Agents in Chronic Periodontitis and Acute Myocardial Infarction

10.26810/perioj.2019.a1 ◽

2019 ◽

Vol 3 (1) ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Deepa Anumala ◽

Mohan Kumar Pasupuleti ◽

Ravindra Reddy Nagireddy

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Chronic Periodontitis ◽

Antimicrobial Agents ◽

Prevotella Intermedia ◽

Causative Role ◽

In Vitro Susceptibility ◽

Group Iii ◽

Group I ◽

Group Ii

Background: Periodontal disease has been reported to play a causative role in acute myocardial infarction (AMI), which may add to the various risk factors associated with coronary heart disease. The objective of the present study was to investigate the presence of Prevotella intermedia – an established periodontal pathogen – in subgingival plaque samples of chronic periodontitis and AMI patients in order to identify a possible association, and to evaluate the susceptibility of Prevotella intermedia to nine antimicrobial agents. Methods: After undergoing screening for eligibility, a total of 50 subjects were included in the present study. Twenty patients were diagnosed with AMI and generalized chronic periodontitis (Group I), 20 patients were diagnosed with only AMI (Group II), and 10 subjects were healthy controls (Group III). The isolated Prevotella intermedia strains were tested for susceptibility to bacitracin, chloramphenicol, penicillin G, polymyxin, gentamycin, neomycin, tetracycline, cefotaxime, and cefoxitin using an antibiotic zonescale to determine minimum inhibitory concentrations (MICs). Results: Periodontal pathogens were identified by phenotypic and enzymatic methods. The mean bacterial load of Prevotella intermedia species was higher in Group I compared to Group II and Group III. It was also found that pencillin G, gentamycin, neomycin, tetracycline, cefotaxime, and cefoxitin inhibited 90% of Prevotella intermedia, whereas bacitracin, chloramphenicol, and polymyxin inhibited 80% of Prevotella intermedia. Thus, only 10% of Prevotella intermedia were resistant to these antibiotics. Conclusion: The present study confirms that Prevotella intermedia is associated with chronic periodontitis and AMI.

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Prediction of the Site of Coronary Artery Lesion in Acute Inferior Myocardial Infarction with Right Sided Precordial Lead (V4r)

Cardiovascular Journal ◽

10.3329/cardio.v4i1.9389 ◽

1970 ◽

Vol 4 (1) ◽

pp. 46-52

Author(s):

MS Alam ◽

M Ullah ◽

SU Ulabbi ◽

MM Haque ◽

R Uddin ◽

...

Keyword(s):

Myocardial Infarction ◽

Wave Group ◽

Precordial Lead ◽

Inferior Myocardial Infarction ◽

Group Iii ◽

T Wave ◽

Group I ◽

St Segment ◽

Group Ii ◽

Acute Inferior Myocardial Infarction

Background: The patient with inferior wall AMI, site of culprit lesions is an important determinant of outcome. Patient with RV infarction have a poor prognosis whereas those with occlusion of LCX have a good prognosis. Early diagnosis and treatment substantially reduce cardiac events particularly in high-risk patients. V4R can be used as to locate the site of obstruction. Materials and methods: 81 patients with acute inferior myocardial infarction admitted to the coronary care unit (CCU) within 12 hours after the onset of chest pain who underwent coronary angiogram were included in the study. Standard 12-lead ECG with right precordial lead V4R was recorded. Patients were categorized into within 3 groups according to early changes of V4R-Group- I - ST-segment elevation > 1 mm and positive T- wave, Group-II- ST-segment iso-electric and positive T-wave, Group-III- ST-segment depression >1 mm and negative T -wave. Results: In group I patients, highest percentage of the patients had lesion in proximal RCA (97.2%); whereas in group II patients, highest percentage in the distal RCA (89.7%) followed by LCX (41.4%) and in group III patients, highest percentage also in LCX (100.0%) followed by LAD (56.3%). Based on analysis of sensitivity and specificity, it was revealed that in group I patients of ECG finding suggested 100.0% sensitivity, 97.8% specificity and 98.8% accuracy. In group II patients, 92.9% sensitivity, 94.3% specificity and 93.8% had accuracy. In case of group III patients, 93.8% sensitivity, 98.5% specificity and 97.5% accuracy. Conclusion: The configuration of the ST-T segment in lead V4R is a sensitive and specific tool to recognize the occluded vessel in acute inferior MI whether it is proximal RCA, distal RCA or LCX. Since it is an inexpensive method, it can be readily used to locate the site of occlusion in AMI - Inferior. Keywords: Coronary artery disease; Myocardial infarction;, Lead V4r. DOI: http://dx.doi.org/10.3329/cardio.v4i1.9389 Cardiovasc. J. 2011; 4(1): 46-52

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Prognostic value of serum Uric Acid in-hospital Mortality and Morbidity in Patients with acute Myocardial Infarction

University Heart Journal ◽

10.3329/uhj.v12i1.34016 ◽

2017 ◽

Vol 12 (1) ◽

pp. 8-11

Author(s):

Md Deldar Hossain ◽

Sheuly Ferdousi ◽

Md Saiful Islam ◽

Debatosh Paul ◽

Ttuhin Sultana ◽

...

Keyword(s):

Myocardial Infarction ◽

Uric Acid ◽

Serum Uric Acid ◽

Odds Ratio ◽

Uric Acid Concentration ◽

Good Recovery ◽

Mortality And Morbidity ◽

Group I ◽

Serum Uric Acid Concentration ◽

Group Ii

Coronary artery disease (CAD) is one of the leading causes of death in the world and also in Bangladesh. This study was carried out to evaluate that Serum uric acid is a prognostic tool in acute myocardial infarction. In this study, 108 AMI cases were enrolled. All the patients were treated and managed identically by conventional standard management protocol. During hospital stay, patients were assessed for any kind of clinical outcomes e.g good recovery, mortality and morbidity (acute LVF, cardiogenic shock, arrhythmia and heart block). Patients with higher serum uric acid (SUA>6.5mg%, Group-II) were compared with Patients with lower serum uric acid (SUA<6.5mg%, Group-I). In Group I (n=66), good recovery, morbidity and mortality were found in 43 (65.2%), 21 (31.8%), 2(3.0%) patients and in Group II (n=42), good recovery, morbidity, mortality were 13 (31%), 23 (54.8%) and 6 (14.3%) patients respectively. In group II patients having high Serum uric acid concentration had low good recovery but high morbidity and mortality compared to group I patients. In group I (n=66), good outcome and bad outcome was found in 43(65.2%), and 23 (34.8%) patients and in group II (n=42), those were in 13 (31%) and 29 (69%) patents. Logistic regression analysis of serum uric acid concentration of study subjects were done considering uric acid as independent variable but outcome as dependent variable. It was shown that the odds ratio of mortality was 5.38(95% CI p<0.007), odds ratio of morbidity was 4.10(95% CI p<0.001) and odds ratio of bad outcome was 4.67(95% CI p<0.001). This findings indicates a patient having high uric acid had 5.38 times increased mortality, 4.10 times increased morbidity and 4.67 times increased bad outcome than patients having low serum uric acid concentration.University Heart Journal Vol. 12, No. 1, January 2016; 8-11

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Comparison of In-Hospital Outcomes of ST Elevation Myocardial Infarction in Patients Undergoing Transradial and Transfemoral Primary Percutaneous Coronary Intervention

Cardiovascular Journal ◽

10.3329/cardio.v11i2.40408 ◽

2019 ◽

Vol 11 (2) ◽

pp. 98-104

Author(s):

Fahdia Afroz ◽

Mir Jamal Uddin ◽

Md Khalquzzaman ◽

Mohammad Ullah ◽

Mohammad Khalilur Rahman Siddiqui ◽

...

Keyword(s):

Myocardial Infarction ◽

Vascular Complications ◽

Coronary Intervention ◽

Adverse Outcomes ◽

Transfemoral Approach ◽

Transradial Approach ◽

Group I ◽

Percutaneous Coronary ◽

St Elevation ◽

Group Ii

Background: Primary percutaneous coronary intervention (PPCI) has been performed traditionally by using femoral approach. Transradial approach has become increasingly popular as it is likely to be less complicating, more comfortable and relatively cost effective having mortality and morbidity benefits. The aim of the study was to compare the in-hospital outcomes of transradial PPCI with that of transfemoral route. Methods: A total of 80 patients with ST elevation myocardial infarction (STEMI) who underwent PPCI were enrolled in the study. Patients were divided in two groups. Group-I: transradial PPCI; and Group-II: transfemoral PPCI. All patients were followed up during the period of hospital stay and adverse outcomes were observed and compared between the groups. Results: The result showed that bleeding took place in 2.5% patient of Group-I and 15% patients of Group- II. Vascular complications occurred in 2.5% and 12.5% patients of Group-I and Group-II, respectively. In Group-II, 7.5% patients died with none in Group-I. In Group-II, 37.5% patients experienced some sort of adverse outcomes whereas only 15% of the patients of Group-I did have such experiences (p<0.05). Bleeding and vascular complications were significantly more in Group-II (p<0.05). The mean hospital stay time was significantly lower in Group-I (p<0.001). Conclusions: Transradial PPCI is safer than transfemoral approach in respect of procedural and post procedural complications including bleeding, vascular complications and mortality. So, transradial approach may be an attractive alternative to conventional transfemoral approach and can be practiced routinely for PPCI. Cardiovasc. j. 2019; 11(2): 98-104

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Correlation between extraintestinal manifestations and clinical parameters with the histologic activity index in patients with inflammatory bowel diseases

Vojnosanitetski pregled ◽

10.2298/vsp1310947s ◽

2013 ◽

Vol 70 (10) ◽

pp. 947-952

Author(s):

Milos Stulic ◽

Djordje Culafic ◽

Dragana Mijac ◽

Goran Jankovic ◽

Ivana Jovicic ◽

...

Keyword(s):

Disease Activity ◽

Clinical Laboratory ◽

Inflammatory Diseases ◽

Activity Index ◽

Clinical Parameters ◽

Extraintestinal Manifestations ◽

Cross Sectional ◽

Group I ◽

Significant Difference ◽

Group Ii

Bacground/Aim. Crohn's disease (CD) and ulcerative colitis (UC) are chronic, idiopathic, inflammatory diseases of the digestive tract. The aim of this study was to determine a possible correlation between the clinical parameters of the disease activity degree and the presence of extraintestinal manifestations with disease activity histopathological degree, in patients presented with CD and UC. Methods. This cross-sectional study included 134 patients (67 with CD and UC, respectively) treated at the Clinic of Gastroenterology, Clinical Center of Serbia, Belgrade. After clinical, laboratory, endoscopic, histopathologic and radiologic diagnostics, the patients were divided into two groups according to their histopathological activity. The group I comprised 79 patients whose values of five-grade histopathological activity were less than 5 (45 with CD and 34 with UC), while the group II consisted of 55 patients with the values higher than 5 (22 with CD and 33 with UC). The CD activity index (CDAI) and Truelove and Witts' scale of UC were used for clinical evaluation of the disease activity. Results. CD extraintestinal manifestations were present in 28.9% and 63.6% of the patients in the groups I and II, respectively (p < 0.05). Comparison of the mean CDAI values found a significant difference between these two patients groups (the group I: 190.0 ? 83.0, the group II: 263.4 ? 97.6; p < 0.05). No correlation of extraintestinal manifestations of the disease, Truelove and Witts' scale and histological activity was found in UC patients (p > 0.05). Conclusion. In the patients presented with CD, the extraintestinal manifestations with higher CDAI suggested a higher degree of histopathological activity. On the contrary, in the UC patients, Truelove and Witts' scale and extraintestinal manifestations were not valid predictors of the disease histopathological activity.

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Correlation between the FINish diabetes risk score and the severity of coronary artery disease

Vojnosanitetski pregled ◽

10.2298/vsp1405474d ◽

2014 ◽

Vol 71 (5) ◽

pp. 474-480 ◽

Cited By ~ 4

Author(s):

Predrag Djuric ◽

Zorica Mladenovic ◽

Aleksandra Grdinic ◽

Dragan Tavciovski ◽

Zoran Jovic ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Waist Circumference ◽

Coronary Arteries ◽

Syntax Score ◽

Group Iii ◽

Vessel Disease ◽

Group I ◽

Group Ii ◽

Artery Disease

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.

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