scholarly journals Ischemic Heart Disease

2021 ◽  
Author(s):  
Saraí López De Lucio ◽  
Marco Antonio López Hernández

All over the world ischemic heart disease remains as the leading cause of death, followed by stroke. Ischemic heart disease, also called coronary artery disease has a broad spectrum of clinical manifestations from the acute coronary syndromes which include, unstable angina pectoris and acute myocardial infarction with and without elevation of the ST segment and chronic coronary disease. In patients with diabetes mellitus the cardiovascular complications mainly ischemic heart disease, are the main cause of morbidity and mortality. However, in population-based studies, the risk of heart failure in patients with diabetes mellitus is significantly increased following adjustment for well-established heart failure risk factors such as hypertension or ischemic heart disease. Ischemic heart failure angiographically diagnosed is associated with a shorter survival than non-ischemic heart failure. Coronary artery disease is independently associated with higher mortality.

PPAR Research ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Izabela Wojtkowska ◽  
Tomasz A. Bonda ◽  
Andrzej Tysarowski ◽  
Katarzyna Seliga ◽  
Janusz A. Siedlecki ◽  
...  

TNFα and PPARγ are important modulators of metabolism, inflammation, and atherosclerosis. Coronary artery disease is the leading cause of heart failure (HF). The aim of the study was to assess whether polymorphisms of the TNFα (-308G>A) and PPARG2 (Pro12Ala) genes are associated with the risk of developing HF by patients with ischemic heart disease. Methods. 122 patients without HF (aged 63 ± 8.8 years, 85% males) with confirmed coronary artery disease qualified for coronary bypass grafting were enrolled in the study. After the procedure, they were screened for cardiac parameters. Those with elevated NT-proBNP or diminished left ventricular ejection fraction during follow-up were assigned to the HF group (n=78), and the remaining ones to the non-HF group (n=44). The TNFα -308G>A and PPARG2 Pro12Ala polymorphisms were detected using the TaqMan method. Results. The distributions of TNFα -308G>A and PPARG2 Pro12Ala did not differ between the HF and non-HF groups (-308G>A: 16% vs. 11.4% of alleles; Pro12Ala: 23.9% vs. 20.5% of alleles, respectively). IL-6 concentration in the plasma of TNFα A-allele carriers at months 1 and 12 after CABG was higher in the HF group compared to the non-HF group (1 month after CABG: 5.3 ± 3.4 vs. 3.1 ± 2.9, p<0.05; 12 months after CABG: 4.2 ± 3,9 vs. 1.4 ± 1.2, p<0.01, respectively). Both polymorphisms were not related to changes in the plasma TNFα concentration or other parameters related to HF. Conclusions. Our study did not reveal any correlation between the PPARG2 Pro12Ala and TNFα -308G>A polymorphisms and development of HF in patients with ischemic heart disease after coronary bypass grafting.


2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
P Yooprasert ◽  
P Vathesatogkit ◽  
V Thirawuth ◽  
W Prasertkulchai ◽  
T Tangcharoen

Abstract Funding Acknowledgements None Background Fragmented QRS complex (fQRS) on 12-lead EKG is not uncommon in general population. Previous studies found an association between fQRS and myocardial scar, heart failure, and increased cardiac mortality. However, data in adults without history of coronary artery disease is limited. We aimed to evaluate whether there is an association between fQRS and ischemic heart disease (IHD) diagnosed by stress cardiac MRI. Method We retrospectively reviewed data from 604 patients who underwent stress cardiac MRI, in which 50 patients were excluded due to known history of coronary artery disease or incomplete stress test. A positive result was defined as stress-induced perfusion defect in at least 2 contiguous myocardial segments corresponding to epicardial coronary territory, or a presence of ischemic scar. The 12-lead EKG done on the same day with MRI, prior to stress testing, were analyzed. Fragmented QRS was defined as the presence of additional R wave (R’), notching in the nadir of R or S wave, or the presence of more than one R’ in any EKG leads. Both cardiac MRI and EKG were analyzed by two independent observers. Result   Final analysis included 554 patients, 39% were male, with a mean age of 67.8 ± 11.1 years. There was positive stress cardiac MRI in 219 patients (39.5%). Older age, diabetes mellitus, and hypertension were more frequent in the positive group (p &lt;0.05). fQRS was identified in 300 patients (54.2%). Baseline characteristic did not differ significantly between patients with and without fQRS. There is an association between fQRS and IHD, OR 1.605 (95% CI 1.136-2.269), p = 0.007. Using linear regression, the number of leads with presence of fQRS showed an association with IHD (OR 1.204, p = 0.005). After adjustment for age, diabetes, hypertension, renal function, and left ventricular ejection fraction, the strong association between fQRS and IHD persisted, OR 1.709 (95% CI 1.182-2.470), p = 0.004. Conclusion In patients without known history of coronary artery disease, fragmented QRS is independently associated with ischemic heart disease diagnosed by stress cardiac MRI. Multiple regression analysis OR 95% CI p-value Age (years) 1.013 0.992 - 1.035 0.234 Diabetes mellitus 1.532 1.032 - 2.274 0.034 Hypertension 1.194 0.737 - 1.935 0.471 GFR (ml/min/1.73m&sup2;) 0.999 0.987 - 1.011 0.904 LV ejection fraction (%) 0.972 0.950 - 0.994 0.014 fragmented QRS 1.709 1.182 - 2.470 0.004


2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.


Author(s):  
Harindra C Wijeysundera ◽  
Feng Qiu ◽  
Maria C Bennell ◽  
Madhu K Natarajan ◽  
Warren J Cantor ◽  
...  

Background: Wide variation exists in the diagnostic yield of coronary angiography in stable ischemic heart disease (IHD). Previous work has primarily focused on patient factors for this variation. We sought to understand if system and physician factors, specifically hospital and physician type, as well as physician self-referral, have incremental impacts on the yield of coronary angiography, above and beyond that of patient factors alone. Methods: All patients who underwent a diagnostic coronary angiogram for possible stable IHD, at the 18 cardiac centers in Ontario, Canada were identified from October 1st, 2008 to September 30th, 2011. Obstructive coronary artery disease was defined as stenosis greater than 70% in the main coronary arteries or greater than 50% in the left main artery. Physicians were classified as either invasive or interventional. Hospitals were categorized into cath only, stand-alone PCI and full service centers. Multi-variable hierarchical logistic models were developed to identify system and physician level predictors of obstructive coronary artery disease, having adjusted for patient factors. Results: Our cohort consisted of 60,986 patients who underwent a diagnostic angiogram for possible stable IHD, of which 33,483 had obstructive coronary artery disease (54.9%), ranging from 41.0% to 70.2% across centers. Self-referral rates varied from 4.8% to 74.6%. Fewer self-referral patients (52.5%) had obstructive coronary artery disease compared to non-self-referral patients (56.5%), with an odds ratio (OR) of 0.89 (95% CI 0.85-0.93;p <0.001), after accounting for patient factors. Angiograms performed by interventional physicians had a higher likelihood of showing obstructive coronary artery disease (60.1% vs. 50.8%; OR 1.22; 95% CI 1.17-1.28; p<0.001). Fewer angiograms at cath only centers showed obstructive disease (45.0%) compared to full service centers (58.1%); this was of borderline significance (OR 0.59; 95% CI 0.34-1.00; p=0.05). Conclusion: Physician and system factors are important predictors of the diagnostic yield of coronary angiography in stable IHD, even after accounting for patient characteristics. Further study into the drivers of how these physician and system factors impact diagnostic yield is an important focus for quality improvement.


1982 ◽  
Vol 63 (3) ◽  
pp. 15-17
Author(s):  
E. V. Tsybulina ◽  
L. A. Emelyanova

A comparative analysis of the effectiveness of antianginal drugs (papaverine, persantine, intensain, nitrong, anaprilin) in combination with climacteric myocardial dystrophy in women was carried out. The data obtained make it possible to recommend beta-blockers (anaprilin, obzidan) for the treatment of coronary artery disease in women against the background of pathological menopause for wider use.


Author(s):  
Anders B. Mathiasen ◽  
Marina J. Harutyunyan ◽  
Erik Jørgensen ◽  
Steffen Helqvist ◽  
Rasmus Ripa ◽  
...  

1972 ◽  
Vol 29 (2) ◽  
pp. 171-179 ◽  
Author(s):  
William A. Neill ◽  
Melvin P. Judkins ◽  
Dharam S. Dhindsa ◽  
James Metcalfe ◽  
Donald G. Kassebaum ◽  
...  

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