scholarly journals Angiographic Comparison of Coronary Artery Disease between Diabetic Men and Women

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

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


1970 ◽  
Vol 1 (2) ◽  
pp. 161-164
Author(s):  
AAS Majumder ◽  
S Nasrin ◽  
AQM Reza ◽  
MAU Chowdhury

Background : Postmenopausal women are at greater risk for coronary artery disease (CAD) than premenopausal women. This may be due to deprivation of estrogen, which acts directly and indirectly on the vasculature. In light of this finding the aim of the study was to find the relation of serum estrogen level with severity of atherosclerotic lesion and number of risk factors in CAD among postmenopausal women. Methods: One hundred postmenopausal women undergoing coronary angiography (CAG) were studied. Among them 50 patients with estrogen level <25 pg/ml constituted study Group I and another 50 postmenopausal women with >25 pg/ml constituted study Group II. Serum estrogen level was measured by radioimmunoassay. Other important risk factors like dyslipidaemia, diabetes mellitus, hypertension, family history of CAD, smoking and waist circumference were evaluated between the 2 groups of patients. CAG findings were analyzed by eye estimation and by Gensini score. Results: All the risk factors were significantly higher in Group I patients than that of Group II. Among the risk factors hypertension was most prevalent (64%) in Group I and dyslipidaemia (40%) in Group II. Multivariate regression analysis showed that serum estrogen was a strong and an independent predictor of CAD (p=0.001) when considered with other standard risk factors. Association between the angiographic severity of CAD and serum estrogen level were evaluated and negative correlation was observed, i.e. lower the serum estrogen level higher the vessel score. Conclusion: In postmenopausal women serum estrogen level is a strong & an independent predictor of CAD. It is also found that low estrogen group of postmenopausal women with CAD have more severe atherosclerotic lesions in comparison to the group with normal estrogen level. Keywords: Risk factor, Coronary artery disease, Postmenopausal women, Angiographic profile. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8235 Cardiovasc. j. 2009; 1(2): 161-164


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


2021 ◽  
Vol 35 (2) ◽  
pp. 134-139
Author(s):  
Md Mamunuzzaman ◽  
Mahboob Ali ◽  
Mir Jamal Uddin ◽  
Shaila Nabi ◽  
Kajal Kumar Karmoker ◽  
...  

Background: In nondiabetic patients with non-STsegment– elevation myocardial infarction, hyperglycemia may be associated with adverse outcome. Objective: To find out the association between HbA1c levels and the severity of coronary artery disease in non-diabetic patients with non-ST-segment elevation myocardial infarction Methods: This cross sectional analytical study was carried out at the National Institute of Cardiovascular Diseases (NICVD), Dhaka, during the period from July, 2012 to May, 2013. This study was done with an aim to find out the association between the HbA1c level and the angiographic severity of coronary artery disease in patients with non-ST- elevation myocardial infarction without diabetes mellitus. A total of 170 patients with NSTEMI without diabetes mellitus who agreed to undergo coronary angiography were included in the study. Eighty five patients were selected having HbA1c <5.7% (Group I) and 85 patients were selected having HbA1c ranging from 5.7% to 6.4% (Group II). Severity of the Coronary Artery Disease (CAD) was assessed by angiographic vessel score, and Gensini score. Results: The mean age of the studied patients was 51.0±9.0 years ranging from 30 to 80 years and male to female ratio was 4.5:1. The incidence of hypertension and level of RBS were significantly higher in group II than group I. The HbA1c level increased in accordance with the vessel score increment. There was a significant difference of the mean value of HbA1c among the vessel involvement groups. In this study mild CAD (scored”36) was significantly higher in group I and moderate to severe CAD (score>36) was significantly higher in group II according to Gensini score. This study showed a positive correlation between HbA1c and vessel score (r=0.47, p=0.01) and also between HbA1c and Gensini score (r=0.41, p=0.01). Conclusion: Elevated HbA1c levels in non-diabetic non- ST- elevation myocardial infarction patients are associated with the severity of coronary artery disease. Bangladesh Heart Journal 2020; 35(2) : 134-139


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


Author(s):  
Elifcan Gezer ◽  
Mehtap Cevik ◽  
Cansu Selcan Akdeniz ◽  
Ismail Polat Canbolat ◽  
Selen Yurdakul ◽  
...  

Objective: Coronary artery disease (CAD) is the one of the leading cause of morbidity and mortality worldwide and statins are frequently prescribed in the treatment of CAD to help lower blood cholesterol levels. Since the main enzyme involved in the metabolism of statins is CYP3A4, we aimed to investigate the effect of CYP3A4 * 1B genotypes on plasma lipid profile in Turkish cardiovascular disease subject with and without obesity taking statin. Materials and Methods: The study group consisted of 85 cardiovascular disease patients who were prescribed statins and had routine biochemical analysis data. Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) assay were performed for genotyping of CYP3A4 *1B (rs2740574) polymorphism. Results: Genotype distribution of CYP3A4 *1B polymorphism was found for homozygous wild (AA) and homozygous polymorphic (GG) genotypes as 94.1% and 5.9% respectively. We did not detect patients with heterozygous genotype in our study group. We found that the mean LDL-c, TG and TC levels were higher in patients with CYP3A4 *1B GG compared to AA genotype. The frequency of CYP3A4 *1B GG genotype frequency (9.5%) was detected higher in the obese patients compared to the non-obese patients (7.7%) (χ2=0.037, p=0.85). Conclusions: Our results demonstrate that CYP3A4 *1B homozygous polymorphic genotype distribution tend to be higher in obese patients compared to non- obese patients with cardiovascular disease which may point *1B allele to have a slight effect on serum lipids during statin therapy. Additional studies with higher samples are needed for evaluating the role of CYP3A4 *1B on lipids in patients under statin therapy.


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


2017 ◽  
Vol 32 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Syed Dawood Md Taimur ◽  
M Maksumul Haq ◽  
MA Rashid ◽  
SM Keramat Ali ◽  
Md Shahjahan ◽  
...  

Background: Peripheral arterial disease (PAD) is a marker of increased risk for cardiovascular events and of poorer prognosis in patients with coronary artery disease (CAD). The prevalence of unknown PAD amongst patients with ACS varies between studies according to the mode of diagnosis.Aims: To evaluate the prevalence of peripheral arterial disease (PAD) in diabetic ACS patients with or without tobacco user by using ankle brachial index (ABI).We also assess the probable predictors of PAD among these patients.Methodology: This prospective observational study was conducted in the Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh starting from 1st January 2016 to 30th April 2016 over a period of four months. A total of 60 patients were studied. They were grouped on the basis of their smoking habit. Diabetic patients with ACS and tobacco user (smoke and smoke less) in group I and without tobacco user in group II.Results: The mean age of the studied patients was 56.63 ± 8.95 years, range from 25-90 years. 73.30% was male and 26.70% was female. Twenty three patients of tobacco user in group-I (n=30) had peripheral artery disease and ten patients of group-II (n=30) had peripheral artery disease. It was statistically significant (p=0.003).Conclusion: There is correlation between peripheral arterial disease and coronary artery disease. Diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.Bangladesh Heart Journal 2017; 32(1) : 3-9


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A S Elyamani ◽  
M A Elnozahi ◽  
A M Abdelmoteleb

Abstract Background Dyslipidemia is one of the most important factors for CAD. Atherogenic index of plasma (AIP) is a new indicator involved in dyslipidemia. However, its relation with CAD severity in diabetic patients is not well established yet. Aim of the Study To study the relationship between atherogenic index of plasma and severity of coronary artery disease (CAD) in the diabetic patients. Methods Our study was conducted on 150 diabetic patient with stable CAD undergoing elective coronary angiography in Al-Agoza Hospital from april 2016 to august 2018. Atherogenic index was calculated from the logarithmically transformed ratio of concentrations of TGs to HDL-C obtained from the patient’s lipid profile. correlation of the AIP and the severity of CAD according to Gensini scoring system was done. Results AIP had a statistically significant positive relation with IDDM (p = 0.033), NIDDM (p = 0.033), HTN (p = 0.024), dyslipedemia (p = 0.042). And a highly significant positive correlation with FBS (p &lt; 0.001, r = 0.479) and HbA1c (p &lt; 0.001, r = 0.538), proximal LAD lesions (p = 0.002), LCX (p &lt; 0.001), and the number of vessls affected (p = 0.005). AIP Also had a highly significant positive correlation with severity of CAD in terms of Gensini score (p &lt; 0.001, r = 0.692). Conclusion AIP is considered a good predictor of CAD severity and multivessel affection in diabetic patients.


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.


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