scholarly journals Clinical and Angiographic Characteristics of Female Patients Undergoing Coronary Angiography in a Tertiary Hospital in Bangladesh

2019 ◽  
Vol 7 (1-2) ◽  
pp. 9-14
Author(s):  
Sahela Nasrin ◽  
F Aaysha Cader ◽  
M Maksumul Haq
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Left Ventricular ◽  
Left Main ◽  
St Segment Elevation ◽  
Female Patients ◽  
Vessel Disease ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Artery Disease

Background & objective: Coronary artery disease (CAD) is increasingly prevalent among female population, particularly in South Asia, and a large number of female patients currently undergo coronary angiography for a variety of indications. The objective of this study was to investigate the clinical and angiographic characteristics of female patients undergoing coronary angiogram, in a tertiary cardiac center in Bangladesh. Methods: This retrospective observational study was conducted at Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh during the period from 1st September 2005 to 31st August 2016. A total of 7,627 female patients who underwent coronary angiography were included. Obstructive coronary artery disease (CAD) was defined as a stenosis ≥70% in at least one of the three major coronary arteries or a stenosis ≥50% in left main stem. Result: Nearly two-thirds (64.4%) of patients comprised of age group of 41-60 years with mean age of the patients being 55.4 ± 10.2 years. Unstable angina (38.2%) was the commonest indication for coronary angiography followed by stable ischemic heart disease (25.1%), non-ST segment elevation myocardial infarction (12.8%), ST segment elevation myocardial infarction (9.3%), left ventricular failure (7.5%), post-myocardial infarction angina (6%) and atypical chest pain (1.3%). Over three quarters were hypertensive 68.3% were diabetic and 29% and dyslipidemiac. Over 40% of the patients were overweight and 20% were obese. On trans-thoracic echocardiography, 65.2% had normal left ventricular (LV) systolic function; 17.6% and 9.9% had mild and moderate LV systolic dysfunction respectively. Nearly 30% had normal epicardial coronary arteries on angiography, while 17.4%, 16.5% and 37.2% had triple vessel disease (TVD), double vessel disease (DVD) and single vessel disease (SVD) respectively. Following angiography, 33.4% were advised PCI, 30.2% optimal medical management and 15.3% CABG. A few (3.2%) were advised for revascularization either by CABG or PCI. Conclusion: Unstable angina is the most common indication for coronary angiography among Bangladeshi females. A clustering of risk factors for CAD such as hypertension, diabetes and overweight or obesity are observed in them. Of the obstructive CADs, SVD is the most frequent finding, indicating that females undergoing CAG are likely to have diffuse CAD, although left main disease is not uncommon in this population. Further comparative studies with matched male population are recommended to find the differences in clinical and angiographic findings with respect to sex. Ibrahim Card Med J 2017; 7 (1&2): 9-14

scholarly journals Takotsubo Cardiomyopathy and Non-ST-Segment Elevation Myocardial Infarction: Predictors of Left Ventricular Dysfunction

2017 ◽  
Vol 11 ◽  
pp. 117954681771610
Author(s):  
Andrew Hinojos ◽  
Thomas E Vanhecke ◽  
Susan Enright ◽  
Nathan Elg ◽  
Kristina Gifft ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
Retrospective Case ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Lv Dysfunction ◽  
St Segment ◽  
Artery Disease ◽  
Control Study

Background: Acute coronary syndrome (ACS) from non-ST-segment elevation myocardial infarction (NSTEMI) and Takotsubo (TK) cardiomyopathy present with similar initial clinical features and can result in left ventricular (LV) dysfunction and acute heart failure. Methods: This study was a retrospective case-control study that identified patients aged 18 years and older who presented with ACS and underwent cardiac catheterization. Results: There were a total of 321 patients in the TK group and 1031 patients in the NSTEMI group. There was significantly worse LV dysfunction in the TK group with average ejection fraction (EF) of 44.35% (±15.11%) versus NSTEMI with an average EF of 47.36% (±13.5%) ( P < .001). The presence of TK yielded of an odds ratio (OR) of 2.373 (95% confidence interval [CI]: 1.165-3.618) and presence of peripheral artery disease (PAD) yielded an OR of 2.053 (95% CI: 1.165-3.618). Conclusions: The presence of TK cardiomyopathy and PAD were independent predictors of patients who had LVEF of <35% and elevated B-type natriuretic peptide levels.

scholarly journals Recent Advances in the Treatment of ST-Segment Elevation Myocardial Infarction

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Mun K. Hong
Keyword(s):  
Myocardial Infarction ◽  
Primary Angioplasty ◽  
Left Ventricular ◽  
Pharmacologic Therapy ◽  
Future Research ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Recent Advances ◽  
St Segment ◽  
Artery Disease

ST-segment elevation myocardial infarction (STEMI) represents the most urgent condition for patients with coronary artery disease. Prompt diagnosis and therapy, mainly with primary angioplasty using stents, are important in improving not only acute survival but also long-term prognosis. Recent advances in angioplasty devices, including manual aspiration catheters and drug-eluting stents, and pharmacologic therapy, such as potent antiplatelet and anticoagulant agents, have significantly enhanced the acute outcome for these patients. Continuing efforts to educate the public and to decrease the door-to-balloon time are essential to further improve the outcome for these high-risk patients. Future research to normalize the left ventricular function by autologous stem cell therapy may also contribute to the quality of life and longevity of the patients surviving STEMI.

scholarly journals Clinical and Angiographic Prole of Patients with Left Bundle Branch Block

2018 ◽  
Vol 6 (1-2) ◽  
pp. 14-19
Author(s):  
Sahela Nasrin ◽  
F Aaysha Cader ◽  
M Maksumul Haq
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Systolic Dysfunction ◽  
Bundle Branch Block ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Artery Disease

Background & objective: Left bundle branch block (LBBB), resulting in an alteration of the normal sequence of activation in the left ventricle, commonly occurs in patients with underlying heart disease particularly coronary artery disease (CAD), but it may also be associated with progressive conducting system disease in an otherwise structurally normal heart. The aim of this study was to evaluate the clinical and angiographic profile of patients presenting with LBBB. Materials & Methods: This study was a cross-sectional observational study. A total of 542 patients of LBBB (as evident by ECG) who underwent coronary angiography from 1st September 2005 to 31st August 2016 were identified from the records of Cath Lab database of Ibrahim Cardiac Hospital & Research Institute and were selected for the study. LBBB was defined as a QRS complex duration ≥120 ms with a broad notched or slurred R wave in leads I, aVL, V5 and V6. Results: Majority (95.8%) of the patients was over 40 years of age with mean age being 59.7 ± 10.7 years (range: 25-95 years). Nearly 60% of the patients were male, 62.2% diabetic and 69.7% hypertensive. Over one-third (37.1%) of patients had moderate left ventricular (LV) systolic dysfunction (ejection fraction 30-44%) and 7% had severe LV systolic dysfunction. Over half (51.9%) had normal body mass index. Unstable angina (45.8%) was the most common indication for angiography. Other indications included non-ST segment elevation myocardial infarction (17.2%), ST segment elevation myocardial infarction (11.3%), stable coronary artery disease (SCAD) (9.8%), prior myocardial infarction (13.3%) and atypical chest pain (2.6%). Nearly 60% of the patients had obstructive coronary artery disease and the rest (40.6%) had normal epicardial coronaries on angiography. Among those with obstructive CAD, 4.1% had left main disease, 20.5% had triple vessel disease (TVD), 14.4% double vessel disease (DVD) and 9.5% single vessel disease (SVD). Conclusion: There is an optimum prevalence of CAD among LBBB patients, with TVD being predominant. LBBB cases with normal coronaries are no less. The latter cases suggest an alternative cause for LBBB. Thus, the usual diagnosis of CAD in patients with presumably new onset LBBB may be over-estimated in clinical practice. Ibrahim Card Med J 2016; 6 (1&2): 14-19

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