scholarly journals Association of Ankle-Brachial Index with the Angiographic Severity of Patient with Coronary Artery Disease

2018 ◽  
Vol 10 (2) ◽  
pp. 201-205
Author(s):  
Abul Hasnat Md Jafar ◽  
Md Abdul Kader Akanda ◽  
Md Khalequzzaman ◽  
Sanjib Chowdhury ◽  
Muhammad Azmol Hossain ◽  
...  

Background: The Ankle-Brachial Index has been shown to be a good marker of systemic atherosclerosis and a powerful indicator of cardiovascular morbidity and mortality This study evaluated the relation of ABI with the angiographic severity of patient with coronary artery disease.Methods: This is a hospital based cross-sectional analytical study. 100 adult Bangladeshi patients who were admitted and underwent coronary angiography according to inclusion and exclusion criteria were the study population. All patient’s ABI were measured and coronary angiography were done. Patients were divided into two groups according to ABI. Group I with ABI >0.90 and group II with ABI <0.90.Results: In group I 65(82.2%) were men and 16(19.8%) were women. In group II 18(94.7%) patients were men and 1(5.3%) was women. Significant co-relation was found between low ABI and severity of CAD. Low ABI group showed more severe form of CAD with higher prevalence of triple vessel diseases, significant stenosis and more involvement of left main (LM) and left anterior descending(LAD)artery. Single vessel disease was found more with normal ABI. Hypertension, diabetes mellitus and Low ABI showed predictors of significant severe stenosis of coronary arteries.Conclusion: Low ankle brachial index is a predictor of the severity of coronary artery disease. So it could be incorporated in our day to day clinical cardiology practice as non-invasive, bedside test to assess and predict the severity of coronary artery disease.Cardiovasc. j. 2018; 10(2): 201-205

2013 ◽  
Vol 6 (1) ◽  
pp. 3-9
Author(s):  
Md. Sk. Mamun ◽  
AAS Majumder ◽  
M Ullah ◽  
S Alam

Background: Cardiovascular diseases are the leading cause of death and morbidity in diabetic patients and this group is two to four times as likely to develop cardiovascular disease than the nondiabetic group, women being specially involved in this situation. In women , diabetes appear to be a stronger risk factor for the development of coronary heart disease than in men regardless of age ,menopausal status and whether or not the patient is insulin or non-insulin dependent. Objective of this study was to compare the angiographic extent of coronary artery disease between diabetic men and diabetic women. Method: This observational study was undertaken on 100 diabetic patients ( 50 women and 50 men) admitted inNational Institute of Cardiovascular disease (NICVD) during the period of July, 2006 to April ,2007.Diabetic women with coronary artery disease constitute the study group-I and diabetic men with coronary artery disease matched for age (±5 years) and risk factors , the study group-II . Coronary angiography was done in all patients & findings were analyzed. Segmental distribution method for coronary artery lesions was used to describe the distribution of atherosclerotis in coronary artery. Results: The mean age of group I was 51.02 ±8.93 years and that of the group II was 50.99± 9.83 years. In this study it was found that Diabetic women with coronary artery disease (CAD) had a higher coronary artery score, CAS (11.02±5.034) as compared to the diabetic men with CAD ( 8.04±4.866) (p<0.001). Diabetic women had also higher number of diseased vessels ( 78.67% vs 67.34%; p<0.01) and higher number of vessel score 3 ( 58% vs 34%; p<0.001). As compared to the diabetic men, diabetic women had a higher total number of coronary artery lesions (183 vs 136; p<0.001), a higher number of lesions per patient (3.66/ patients vs 2.72/patients; p<0.001) and a higher number of diffuse vessels (13.56% vs 8.91%;p<0.05). Conclusion: Diabetic women with coronary artery disease have more severe disease on coronary angiography as compared to diabetic men with coronary artery disease. The diffuse coronary artery involvement was also significantly higher in diabetic women than men. Cardiovascular Journal Volume 6, No. 1, 2013, Page 3-9 DOI: http://dx.doi.org/10.3329/cardio.v6i1.16108


1970 ◽  
Vol 6 (1) ◽  
pp. 23-25
Author(s):  
SM Ahsan Habib ◽  
M Nazrul Islam ◽  
Kamal Pasha ◽  
Saleh Ahmed Nurul Alam ◽  
Khaled Mohsin ◽  
...  

Most common cause of Peripheral Arterial Disease (PAD) is atherosclerosis. Atherosclerosis is a generalized disease, also involving coronary and carotid arteries. Often atherosclerotic coronary artery disease (CAD) is associated with PAD. This prospective observational study was conducted in the National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, during July 2004 to June 2005. Total 58 patients with PAD were included in the study. Patients were classified as group I having normal coronary artery, group II insignificant CAD (Left main <50% stenosis, others <70% stenosis) and group III, significant CAD (Left main ≥50% stenosis, others ≥70% stenosis). Ankle-brachial index was significantly low (0.75±0.25 Vs 0.37±0.40) in the patients with coronary artery disease (Group II and III) compare to non-CAD (P =0.001).This study suggests that ankle-brachial index (ABI) have significant relation with the presence of CAD. Key words: Ankle-Brachial Index; peripheral arterial disease DOI: 10.3329/uhj.v6i1.7186University Heart Journal Vol.6(1) 2010 pp.23-25


2014 ◽  
Vol 7 (1) ◽  
pp. 4-10 ◽  
Author(s):  
M Ahmed ◽  
NA Chowdhury ◽  
G Sofdar ◽  
SK Chakrovortty ◽  
M Rahman ◽  
...  

Background: Fibrinogen has been identified as an independent risk factor for cardiovascular disease and associated with traditional cardiovascular risk factors. Few reports have so far investigated the relationship between fibrinogen levels and the extent of coronary artery disease (CAD) as evaluated by coronary angiography. Therefore the current study was carried out to evaluate the relationship between fibrinogen levels and the extent of CAD as evidenced by coronary angiography. Method: A total of 210 patients having ischemic heart disease including chronic stable angina, unstable angina, non-ST elevated myocardial infarction & ST elevated myocardial infarction were evaluated in National Institute of Cardiovascular Disease (NICVD), Dhaka with a view to find out the relationship between fibrinogen levels and the extent of CAD undergoing coronary angiography. Patients were divided in 3 groups according to fibrinogen levels: Group I = fibrinogen levels <400 mg/dl, Group II = fibrinogen levels (400-600) mg/dl, Group III = fibrinogen levels > 600 mg/dl. In this study, angiographic severity was assessed by vessel score, stenosis score and lesion morphology and tries to find out their relationship with angiographic severity and fibrinogen level. Result: Using a prospective analytic design we studied 210 patients who were divided into 3 groups : Vessel score in Group I, Group II & Group III were 1.14 ± 0.56, 2.24 ± 0.58, & 3.00 ± 0.65 respectively which was statistically significant (p < 0.01) and Stenosis score in group- I, group- II & group- III were 6.00 ± 4.19, 18.72 ± 4.94, & 32.41 ± 15.75 respectively which was statistically significant (p < 0.01). Regarding morphology of the lesions, complex lesions in group I, group II & group III were 21%, 32% & 39% respectively (statistically significant; p < 0.01). Conclusion: High fibrinogen level is independently and significantly associated with more severe coronary artery disease. Serum fibrinogen can be used as a new and even simpler tool for risk stratification in acute coronary syndrome. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20784 Cardiovasc. j. 2014; 7(1): 4-10


2013 ◽  
Vol 5 (2) ◽  
pp. 173-181 ◽  
Author(s):  
NI Sharafat ◽  
M Khalequzzaman ◽  
M Akhtaruzzaman ◽  
AK Choudhury ◽  
S Hasem ◽  
...  

Background: It has been found that there is strong association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Qualitative importance of QTc dispersion on the base line ECG in patients with MI is recognized clinically but quantification of this phenomenon is less commonly used in clinical practice, which might be a better independent risk predictor of this group of patients. Methods: A total of 100 patients were selected, Study populations sub-divided into two groups on the basis of QTc dispersion. In group I (comparison group): QTc dispersion is <60 milliseconds (msec) in group II (study group) : QTc dispersion e”60milliseconds(msec). 50 patients in each group. QT dispersion was calculated on standard resting 12 lead ECGs. QT interval was measured from the beginning of the inscription of the QRS complex to the point at which the T wave returned to the isoelectric line. Angiographic severity of coronary artery disease was assessed by- Vessel score, Friesinger score and Leaman score. Interpretation of coronary angiogram was reviewed by at least two cardiologists. . Results: The mean vessel score for group I patients was 1.16±0.68 and that of group II patients was 2.30±0.64 and the mean difference was statistically significant (p<0.05). Patients those had single vessel involvement had mean QTc dispersion 57.05, patients those had double vessel disease mean QTc dispersion was 102.00 and patients those had triple vessel involvement had mean QTc dispersion 177.60. There was a strong positive correlation with the QTc dispersion and increasing number of vessel involvement (Pearson’s correlation coefficient). The mean Friesinger score for group I patients was 4.84±2.56 and that of group II patients was 9.80±2.60. The mean difference was significantly (p<0.05) higher in group II patients. There was a strong positive correlation between the QTc dispersion and Leaman score (Pearson’s correlation coefficient). In group I patients 56% had insignificant coronary artery disease and 44% had significant coronary artery disease defined by Friesinger index (n=100). In group II patients 6% had Insignificant coronary artery disease & had 94% significant coronary artery disease. Conclusion: QTc dispersion>60 ms had independent predictive value for the severity of coronary artery disease. The greater the QTc dispersion the higher the number of coronary artery involvement. We observed that there is a positive correlation between prolonged QT dispersion and coronary artery disease severity in terms of Vessel score, Friesinger score, Leaman score. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14322 Cardiovasc. j. 2013; 5(2): 173-181


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

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


2014 ◽  
Vol 71 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Predrag Djuric ◽  
Zorica Mladenovic ◽  
Aleksandra Grdinic ◽  
Dragan Tavciovski ◽  
Zoran Jovic ◽  
...  

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.


2015 ◽  
Vol 7 (2) ◽  
pp. 114-118
Author(s):  
Krishna Kanta Sen ◽  
Mahboob Ali ◽  
Amal Kumar Choudhury ◽  
Pradip Kumar Karmakar ◽  
Md Khalequzzaman ◽  
...  

Background: The association between extent and severity of coronary artery disease (CAD) and renal artery stenosis (RAS) has been well established in many studies. The aim of this study was to assess the incidence and severity of RAS in patients with CAD. Methods: Coronary angiogram (CAG) and renal angiogram was done in standard protocol. A total of 95 patients was included in the study and divided into two groups according to the presence of significant renal artery stenosis. In Group I 45 patients were having normal or insignificant renal artery stenosis. In Group II 50 patients were having significant renal artery stenosis. All data were recorded systematically in preformed data collection form. Results: In Group I, most common CAG findings were single vessel disease (SVD) (91.1%), triple vessel disease (TVD) (2.2%) and double vessel disease (DVD) (6.7%). No patients in Group I had Left Main (LM) disease. In Group II, most common CAG findings were DVD (42.0%) followed by SVD 32.0%, TVD 26.0% and LM 8.0%. There is statistically significant difference in Vessels Score, Friesinger Score and Leaman Score between the groups (p<0.05). Conclusion: The study revealed significant association between atherosclerotic renal artery stenosis (RAS) and severity of coronary artery disease (CAD). This indicates significant atherosclerotic renal artery stenosis (RAS) predict the severity of coronary artery disease. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22258 Cardiovasc. j. 2015; 7(2): 114-118


2021 ◽  
Vol 20 (1) ◽  
pp. 2425
Author(s):  
Yu. V. Nagibina ◽  
M. I. Kubareva ◽  
D. S. Knyazeva

Aim. To determine the sex specificities of medical and social parameters in patients hospitalized due to coronary artery disease (CAD), class II, III, IV angina, aged 35-60 years and assess the significance of their relationship with different levels of depression.Material and methods. The study involved 312 patients aged 35-60 with documented CAD, class II, III, IV angina. Two comparison groups were identified: group I — 138 patients (men, 81; women, 57) with CAD and without depression (mean age, 47,8±4,6 years); group II — 174 patients (men, 60; women, 105) with CAD and depression (mean age, 48,3±5,3 years). Medical and social data, the severity of depression and distress tolerance, psychological status and quality of life was assessed. Statistical analysis was carried out, which are presented as the mean and standard error of the mean (M±m). The odds ratio (OR) and 95% confidence interval (CI) were calculated. Differences were considered significant at p<0,05.Results. The prevalence of depression among patients with CAD was 55,77%, while women were 1,5 times more likely to suffer it than men. Depression was significantly associated with hyperglycemia, hypercholesterolemia, and class III-IV angina, regardless of sex. Class III and IV angina prevailed in women, while class II angina — in men (OR, 2,16; 95% CI, 1,37-3,41, p<0,001)). Women were more prone to degree II-III disability (group II, 26,67%; group I 8,77%; p=0,008), compared with men (group II, 27,54%; group I, 11,11%; p=0,012). Sedentary lifestyle was also associated to a greater extent with the female sex than with the male (OR, 2,89, 95% CI, 1,46-5,70, p=0,003; OR, 2,31, 95% CI, 1,19-4,48; p=0,014, respectively). Both men and women showed a significant association of depression with atherosclerosis (p<0,001), however, sex differences did not reach significance. Indicators such as lack of job and higher education, as well as smoking and arrhythmias were characteristic of both sexes, but had a greater impact on the mental condition of men (p=0,002, p<0,001, p=0,0014 and p=0,01, respectively). For men, the relationship of depression with diabetes (8,7 vs 0%; p=0,008), obesity (42,03 vs 19,75%; p=0,004), subordinate status (82,61 vs 64,2%; p=0,016) and unmarried status (60,87 vs 40,74%; p=0,02).Conclusion. There are significant differences in factors contributing to depression in different sex groups. The association of depression with CAD has an adverse effect on the physical and psychological health of both males and females. At the same time, women are more prone to mental disorders than men. It is necessary to further study the sex characteristics of medical and social parameters in order to personalize treatment methods.


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