Coronary Artery Dominance in Western Maharashtra Population by Angiographic Method

Coronary artery disease (CAD) is going to become a significant cause of death in the world. The CAD is increasing day by day because of the changing lifestyle of people. The responsible factors for CAD are diabetes, hypertension, addiction and heredity also. So, the present work is undertaken to study the dominant pattern of coronary artery in the Maharashtra population. The present study was a hospital-based, prospective and observational study of 360 patients who have coronary artery disease undergoing coronary angiography. This study carried out from May 2018-November 2019 of both genders of 25 years of age and above [Male-215(59.72%) and female was 145(40.27 %)]. Out of that, the youngest patient below 40 years male was 30(73.17%), and the female was 11(26. 82%). While above 40 years males were 185(57.99%) and females was 134(42%). The patients with a history of by-pass surgery and angioplasty were excluded. Invasive angiography was performed by either femoral or radial artery using radio-opaque dye (OMNIPCK-50ml) that is visible by an x-ray machine (GE. INNOVA). The socio-demographic Proforma of patients, the pattern of coronary arterial dominance were recorded. Right coronary artery was dominant in 273(75.83%) patients observed in this study. While LCx was dominant in 49(13.6%) and co-dominant in 38 (10.55%) patients. Knowledge of study can be helpful to cardiologists for anatomical assessment of coronary arteries for diagnostic purposes and invasive studies.

Do Statins Have a Positive Impact on Patients with Coronary Microvascular Dysfunction on Long-Term Clinical Outcome? A Large Retrospective Cohort Study

Objectives. To investigate the influence of statins on major adverse cardiovascular events (MACE) in patients with coronary microvascular dysfunction (CMVD). Participants. 23,494 patients who received coronary angiography (CAG) were included. Thrombolysis in Myocardial Infarction, Myocardial Perfusion Grading (TMPG), a useful angiographic method, was used to evaluate CMVD. Results. Using multivariate analysis, NYHA III/IV (HR, 1.44; 95% CI, 1.03-2.01; P=0.031), PCI history (HR, 3.69; 95% CI, 2.57-5.31; P<0.001), TG (HR, 1.15; 95% CI, 1.06-1.26; P=0.001), creatinine (HR, 1.00; 95% CI, 1.00-1.01; P<0.001), cTnT (HR, 0.98; 95% CI, 0.96-0.99; P<0.001), heart rate (HR, 0.98; 95% CI, 0.97-0.99; P=0.001), β-blocker (HR, 0.68; 95% CI, 0.51-0.91; P=0.008), aspirin (HR, 0.38; 95% CI, 0.24-0.61; P<0.001), and statins (HR, 0.33; 95% CI, 0.19-0.60; P<0.001) significantly correlated with reduced MACE in CMVD patients. In subgroups analysis, statins decreased MACE overall (HR, 0.33; 95% CI, 0.19-0.59; P<0.001) and in CMVD patients with smoking history (HR, 0.64; 95% CI, 0.43-0.93; P=0.014), diabetes (HR,0.27; 95% CI,0.12-0.61; P=0.002), hypertension (HR, 0.10; 95% CI, 0.03-0.36; P=0.001), and hypertension and diabetes (HR, 0.09; 95% CI, 0.014-0.53; P=0.008). Conclusion. Statins could reduce MACE in patients with CMVD.

Angiographic assessment of coronary arteries atherosclerosis of the heart transplant

Aim.To estimate the frequency and expressiveness of atherosclerotic lesions of the transplant coronary arteries of the determined by an angiographic method.Materials and methods.Coronary angiography was executed to 518 recipients of heart aged from 10 till 72 years (average 56,92 ± 12,1) within the first week after transplantation of heart (a median 6; 3–42 days). Men – 466, women – 52. Initial status of recipients: UNOS 1A – 217 of people, UNOS 1B – 89 of people, UNOS 2 – 212 people. Included the following criteria of the donor in the analysis: sex, age, cause of brain death.Results.Angiographic signs of atherosclerotic lesions of coronary arteries are discovered in 166 cases, in 65 cases defined as significant stenosis which demanded performance of the percutaneous coronary intervention (PCI). In 352 cases symptoms of atherosclerosis are not revealed (group of comparison). At recipients in the status UNOS 1A and UNOS 1B discovered the transmission of atherosclerosis (TA) more often, than recipients in the status UNOS 2 (54% and 36%, respectively). Age of donors in group with transmission of atherosclerosis was 50,2 ± 0,7 years, and in group of comparison – 41 ± 0,6 years (r = 0,0005). Range of donors age in groups did not differ and made 18–66 years for group of comparison and 20–67 years for group with transmission of atherosclerosis, but in subgroup of PCI made 31–67 years. Gender influence on the frequency of transmission of coronary atherosclerosis it is not revealed. Acute violation of brain blood circulation as the cause of brain death was observed in 76% of cases at TA group and 61% in group of comparison.Conclusion.The age of the donor and acute violation of brain blood circulation are the factors associations with probability of transmission of coronary atherosclerosis, however it is important to consider the status of the recipient.