scholarly journals The Correlations between Admission Heart Rate and Corrected QT Interval Prolongations with Coronary Artery Disease in Patients with Acute Coronary Syndrome

Author(s):  
Shaimaa Mohamed Amer Abo Elnoaas ◽  
Raghda Ghonimy El Sheikh ◽  
Mohamed Ahmed Abd Elaal ◽  
Ayman Ahmed El Sheikh

Background: Coronary heart disease is a major cause of mortality and this health problem is reaching pandemic in both developed, and developing countries. ACS carries significant morbidity and mortality and the prompt diagnosis, and appropriate treatment is essential. HR was identified as a risk predictor of ACS. Both continuous increase in high baseline heart rate and decrease in low baseline heart rate are associated with higher risk of CVD. Decreased heart rate could also cause dispersion of atrial repolarization which, in turn, initiate cardiovascular events. Aim: The aim of this study was to assess the correlation between heart rate and severity of coronary artery disease in patient with acute coronary syndrome. Patients and Methods: The retrospective study was conducted on 120 patients that fulfilled the inclusion criteria were recruited from Cardiology department in Tanta university hospitals presented with acute coronary syndrome. Results: There was highly significant difference between both groups regarding admission heart rate & QTc interval. Both groups of low AHR< 60 bpm & high AHR >90bpm were significantly associated with severe CAD &.Mainly those patients with higher admission heart rate were more likely to have higher Syntax scores (severe coronary lesion). Also, patients with prolonged QTc had severe coronary artery diseases, higher SS & high probability to suffer adverse cardiac events more than patients without prolonged QTc interval. Conclusion: The current study showed that QTc interval prolongation and admission HR are independent predictors of the severity of coronary artery disease in patients with acute coronary syndrome.

2020 ◽  
Author(s):  
Mahdieh Mehrpouri1 ◽  
Afshin Ahmad Pour ◽  
Esmail Shahabi Satlsar

Coronary artery disease (CAD) is one of the leading causes of death worldwide; therefore, identifying new risk factors to predict the severity of the disease is thought to be associated with mortality reduction. In an effort to investigate whether platelet parameters are related to the extent of CAD and can be considered as risk factors, we designed experiments to evaluate platelet parameters in these patients. In a cross‐sectional study, sixty-nine patients with CAD (including fifty-two patients with acute coronary syndrome and seventeen patients with stable angina) and sixty-four healthy volunteers were evaluated for platelet count, mean platelet volume (MPV), and platelet distribution width (PDW). Echocardiography, electrocardiogram (ECG), and coronary angiography were conducted as well. Results showed significantly higher values for MPV and PDW in patients with acute coronary syndrome as compared to patients with stable angina and healthy volunteers (P<0.001 and P=0.009, respectively). There was no significant difference in platelet count between patients and healthy volunteers (P=0.379). Our results also revealed a significant difference in the ejection fraction (EF) percentage between the three groups (P=0.008). Investigating the correlation between platelet parameters and EF percentage, ECG changes, and the results of coronary angiography did not show any significant association. The present study showed that the elevated levels of MPV and PDW in patients with CAD are not related to the extent of coronary artery disease, which was estimated by echocardiography, ECG changes, and coronary angiography. Thus, these parameters cannot be considered as risk factors for coronary artery disease.


Angiology ◽  
2019 ◽  
Vol 70 (8) ◽  
pp. 774-781 ◽  
Author(s):  
Xiaoteng Ma ◽  
Zhijian Wang ◽  
Jianlong Wang ◽  
Fang Liu ◽  
Dai Zhang ◽  
...  

We evaluated the relationship between admission heart rate (HR) and coronary artery disease severity and complexity in patients with acute coronary syndrome (ACS). A total of 884 patients (mean age 59 [11] years, 24.7% female) who underwent coronary angiography for ACS and were treated with primary or selective percutaneous coronary intervention were included in this cross-sectional study. The measurement of admission HR was based on the first available resting electrocardiogram after admission. The SYNTAX score (SS) was calculated. Patients with an SS ≤ 22 (n = 538) were classified as the low SS group and those with an SS > 22 (n = 346) were classified as the intermediate-to-high SS group. Admission HR was greater in the intermediate-to-high SS group compared with the low SS group (75 [10] bpm vs 67 [8] bpm, P < .001). Admission HR was positively and significantly correlated with the SS ( r = 0.475, P < .001). After multivariate analysis, admission HR (per 1 standard deviation, ie, 10 bpm) remained an independent predictor of intermediate-to-high SS (odds ratio: 3.135, 95% confidence interval: 2.538-3.873, P < .001). Admission HR is independently and positively associated with the SS. Thus, elevated admission HR may be useful to identify patients with ACS with a high coronary atherosclerotic plaque burden.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Reda ◽  
M Ashraf ◽  
A Bendary ◽  
A Elbahry ◽  
E Farag ◽  
...  

Abstract Background Egypt is the most populous country in Middle East and North Africa and has one of the highest rates of the cardiovascular (CV) deaths in the region. Despite governmental primary preventive efforts, very little is known about the prevalence and characteristics of premature coronary artery disease (CAD) among Egyptian patients with Acute Coronary syndrome (ACS). Methods From November 2015 to August 2018, data were collected from 3224 patients with ACS in 30 coronary care centers covering 11 governorates across Egypt, spanning the Mediterranean coast, Nile Delta, and Upper Egypt, with focus on premature CAD (defined as ACS before age 55 years in males and 65 years in females). Results The prevalence of premature CAD was 51%. They were significantly more females (35% versus 16%, P<0.001) with significantly higher level of education. Risk factors' (RFs) distribution showed a significantly higher prevalence of Type-1 Diabetes Mellitus (6% versus 4%, P=0.005), obesity (42% versus 33%, P<0.001) and smoking (50% versus 47%, P<0.001) in patients with premature CAD when compared to others. Interestingly, rates of documented dyslipidemia were similar between groups (49% versus 47%, P=0.45) with no significant difference in low density lipoprotein-cholesterol levels (131.7±48.5 versus 130.2±45.2 mg/dl, P=0.4). Patients with premature CAD tended to present more frequently with ST-elevation myocardial infarction (STEMI) (50% versus 46%, P=0.035), with higher rates of treatment using primary percutaneous coronary intervention compared to others (48% versus 44%, P=0.04). They were also significantly less likely to receive Coronary Artery Bypass Graft (4% versus 6.5%, P=0.003). Conclusion Prevalence of premature CAD is high among Egyptian patients with ACS, due to noticeably larger burden of traditional CV RFs especially smoking and possibly familial hypercholesterolemia. Much effort is still needed in screening for early detection of RFs of atherosclerosis together with more widespread adoption of diagnostic scores for FH such as Dutch Lipid Network criteria. Acknowledgement/Funding AstraZeneca


2020 ◽  
Vol 11 (5) ◽  
pp. 49-53
Author(s):  
Archana Bhat ◽  
Arunachalam Ramachandran ◽  
Pradeep Periera ◽  
Akshatha Rao Aroor

Background: Vitamin D, a fat-soluble vitamin has its receptor present in myriad of tissues and it modulates multiple cellular processes. Vitamin D deficiency is reported to be associated with coronary artery disease. Cardiovascular disease is the leading cause of mortality worldwide. Aims and Objective: The primary outcome was to investigate if there is a correlation of 25-OH levels with the percentage of luminal stenosis, as measured with coronary angiogram. The secondary outcome was to determine the differences in angiographically proven luminal stenosis across categories of 25-OH vitamin D levels. Materials and Methods: Thirty patients with acute coronary syndrome with diabetes mellitus were included in this cross-sectional descriptive study. All patients were tested for fasting vitamin D levels, fasting blood sugar, HbA1C and serum creatinine. Detailed history of the patients was recorded. Data was analyzed by the statistical software SPSS version 19 and p value <0.05 was considered significant. Statistical tests like Chi- square, independent t test and log regression was used. Results: In this study 30 patients undergoing coronary angiography for acute coronary syndrome, Vitamin D levels showed severe deficiency in 6.7% (2) cases while mild deficiency was seen in 50% of the cases. Patients with single vessel disease on the coronary angiogram had lower mean HbA1C (9.18) levels in our study. Patients with triple vessel disease had poorly controlled mean HbA1C levels (10.42). Conclusion: In this study we did not find any significant difference between the serum Vitamin D deficiency levels with patients with angiographic severity of the coronary artery disease. Patients with poorly controlled diabetes mellitus had more severe angiographic proven coronary artery disease.


Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 595
Author(s):  
Mircea Bajdechi ◽  
Cosmin Mihai ◽  
Alexandru Scafa-Udriste ◽  
Ali Cherry ◽  
Diana Zamfir ◽  
...  

The pathophysiology of accelerated atherosclerosis in people living with Human Immunofediciency virus (HIV) is complex. Coronary artery disease (CAD) has become an important cause of mortality in these patients. They often have atypical symptoms, leading to frequently missed diagnoses. We report a case of a 51-year-old male undergoing antiretroviral therapy who was admitted for acute coronary syndrome. He had severe coronary artery disease that involved difficult management.


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