Objectives: The role of SYNTAX (SX) score in assessing the complexity of coronary artery disease (CAD) is well established. In this study we investigate the relationship between conventional risk factors of CAD with its complexity using SX score. Methods: The study consisted of 52 patients with CAD who were admitted to Cardiology Department-Menoufia University Hospitals for elective coronary angiography. The overall SX score was calculated prospectively using the SX score algorithm. Then comparison was done between populations with and without each risk factor. Results: There was a statistically significant correlation between age, hypertension, diabetes mellitus, dyslipidemia and smoking with SX score results (p < 0.05) and an insignificant correlation regarding body mass index and gender (p > 0.05). In a multivariate regression analysis, including conventional risk factors of CAD as independent covariates, it revealed that aging, having diabetes mellitus and smoking were identified as significant independent risk factors for CAD complexity. Conclusion: Advanced age, having diabetes mellitus and cigarette smoking are considered to be independent risk factors for the complexity of CAD. Therefore, when these factors present, we expect that the SX score of the patient to be high indicating a complex CAD.
Objective This study was designed to reinforce the duke treadmill score of anginas during the treadmill stress test through a comparative study between the result of SPECT MPI study and the duke treadmill score of the suspected CAD since many centers and cardiology units have no capability of MPI study and eventually, that improve the early detection and the management of the high-risk cases in the limited units. Background Coronary artery disease is the leading cause of death worldwide and in our country Egypt. The diagnosis of CAD can be difficult to make. Frequently, the disease is diagnosed only after the patient has had a heart attack as symptoms of CAD range from unstable angina to no symptoms at all. Duke treadmill score (DTS) is well recognized as a simple prognostic score in patients with suspected coronary artery disease (CAD). Patients and Methods A retrospective review of the studies patients underwent stress treadmill test MPI between January to October 2020 were consecutively included in our study. The study was conducted in ALFA Scan Radiology Center, Cairo, Egypt. Results There was a highly statistically significant difference between the high risk and the other 2 groups (low & moderate) regarding the inability to continue the test. Where High-risk group showed an increased incidence of early inability to continue and there was a significant relation between the duke treadmill score and Aston summed stress score among the studied patients (P= 0.018). Conclusion Duke's score is valid in predicting coronary arterial disease. High-risk Duke's score patients need to be referred directly to coronary angiography for they usually have significant coronary disease. DTS can provide pre-processing guidance about revascularization for physicians before the procedure. Additional Content An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.
Background Aortic root motion was used only as a surrogate parameter of global left ventricular systolic function depending on its direct proportion to cardiac output. We hypothesize that aortic root motion angle and aortic root motion amplitude may overcome many limitations of EF calculation by M mode and two dimensional methods and are easier and reproducible.Objective The aim of this study is to asses systolic aortic root motion measured by M mode and aortic root motion angle as novel indices of global left ventricular systolic function.Patients and methods one hundred patients were enrolled in this study and divided into four groups: according to their age (above and below 60 years) and EF (above and below50%). They were subjected to full history taking, careful clinical examination, and conventional echo-Doppler study .Systolic aortic root motion obtained from long axis parasternal view by M-mode echo guided by 2D echo, and aortic root motion angle was traced off line and mathematically measured. Also global logitudinal strain (GLS) and global longitudinal strain rate (GLSR) from apical 4,3 and 2 chamber views were measured offline.Results Statistical analysis of collected data show that there are significant differences between control groups and patient groups in aortic root motion angle (t= 16.9 and p value <0.001, and in aortic root motion amplitude (t= 20.1 and p value <0.001). Aortic root motion (cm) and aortic root motion angle have significant positive correlation with EF(Mm), EF(2D), Fs, global longitudinal strain(GLS) and global Strain rate . The best cutoff value of aortic root motion angle was 19.5 degree, with sensitivity of 93.9%, specificity of 96.1.Aortic root motion angle >19.5 predicts systolic function >50% and that<19.5 predicts systolic function <50% The best cutoff value of aortic root SAM was 8.5 mm. An aortic root SAM of ˂ 8.5 mm predicts an LVEF of ˂ 50% with sensitivity of 95.9%, specificity of 96.1%.Conclusion The amplitude of systolic aortic root motion (SARM) by (M-mode) and aortic root motion angle are well- correlated with the EF and GLS and could be considered as novel indices of global left ventricular systolic function with high accuracy and reproducibility .
Background: Microvascular angiopathies in DM patients are associated with elevated levels of glycated hemoglobin (HbA1c). However, the connection between HbA1.c and the severity of CAD and coronary perfusion in DM patients remains obscure. Objectives: Evaluation if there is a correlation between HbA1c levels and the complexity of coronary artery lesions, as measured by the Syntax score among middle-aged DM patients who have been referred for elective coronary angiography. Patients and Methods: 50 patients with type 2 diabetes participated in this prospective, randomized clinical investigation. Patients who voluntarily had coronary angiography at 6th October Insurance Hospital, Giza, Egypt between April 2021 and January 2022 were evaluated for coronary artery blockage. Results: Syntax score was highly statistically significant relation between Syntax score and HbA1c where Syntax score significantly increased among patients in group III (29.70±5.14) than patients in group II (14.53±4.42) and patients in group I (6.00±2.66), (P<0.001). Moreover, there were significant positive correlations between smoking and total cholesterol with Syntax score (P<0.05). However, no significant correlations were found between Syntax score with age, sex, HTN, serum creatinine, LDL, HDL, and triglyceride of the studied patients, (P>0.05). ROC curve analysis shows that, the best cutoff value of HbA1c in detection of severity disease using syntax score was ≥6.95, with AUC=0.705, sensitivity 86%, specificity 73%, with significant level p=0.016 Conclusion: The severity of coronary artery lesions in diabetic patients was significantly linked with their HbA1c levels. Further, after accounting for other potential dangers, the HbA1c value was discovered to be a significant predictor of coronary artery lesion complexity.
Coronary artery disease (CAD) is the most common cause of morbidity and mortality in the world, This study aimed to compare cobalt-chromium BMS with DES in small artery stenosis in non-diabetic patients with ACS according to patients' clinical characteristics, acute and late results. the examination was led on 100 non-diabetic patients conceded with intense coronary condition and alluded to Cath. As per kind of stent utilized in mediation, the patients were arranged into: DES gathering: included 50 patients with sedate eluting stents to treat all over again coronary sores. BMS gathering: included 50 patients with cobalt chromium stents to treat anew coronary injuries. Every patient was exposed to full history taking, total clinical assessment, ECG, echocardiography, and serum creatinine. 5% of patients had composite end point, ISR and MI following a half year of development while 4% of patients had TVR and 1% of patients had CABG. Just a single patient passed on in our examination. There was no noteworthy contrast among DES and BMS bunch with respect to coronary angiographic, procedural information and clinical results during development. the utilization of medication eluting stent versus cobalt chromium stent was related with a decrease in target vessel revascularization in little supply route stenosis through half year catch up with no distinction in death and nonfatal myocardial dead tissue.
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