Background and Objectives There is little data regarding the characteristics of young Vietnamese patients (<40 years old) who get acute coronary syndrome (ACS). This study aimed to compare the risk factors, clinical-subclinical characteristics, coronary lesions, and mortality prediction (based on the GRACE and TIMI scores) of young ACS patients with their older counterparts. Methods A cross-sectional descriptive study was conducted amongst 69 patients with ACS at the Cardiovascular Center of Hue Central Hospital from May 2017 to December 2018. These patients were divided into two groups: 33 patients were < 40 years old (group 1), and 36 patients were ≥ 40 years old (group 2). Demographic data, risk factors profile, clinical-subclinical characteristics, coronary lesions, and mortality prediction were compared between the two groups. Results Compared with group 2, group 1 had a higher proportion of severe angina (the prevalence of angina graded III-IV by CCS classification was 69.7% in group 1 versus 36.1% in group 2, P = 0.0108) and lower systolic pressure (median was 120 mmHg in group 1 versus 135 mmHg in group 2, P = 0.006). The prevalence of unstable angina and STEMI was higher in group 1 (51.5% and 36.4% in group 1 versus 30.6% and 11.1% in group 2, respectively), while NSTEMI was higher in group 2 (58.3% in group 2 versus 12.1% in group 1, P = 0.0002). The prevalence of single-vessel CAD, normal coronary angiography (CAG), nonobstructive CAD in group 1 was also higher and multi-vessel CAD was lower than group 2 (45.5%, 33.3%, 12.1% and 9.1% in group 1 versus 33.3%, 2.8%, 2.8% and 61.2% in group 2, respectively). The Gensini, GRACE, and TIMI scores were lower in group 1 (median was 5; medium was 78.55 and median was 2 in group 1 versus 37.5, 130.22 and 3 in group 2, respectively). Smoking was a risk factor for obstructive CAD in group 1 (OR = 7.12, 95% CI: 1.25–40.63, P < 0.05). Conclusion Young patients with ACS tended to be males, smokers, and with positive familial history; the grade of angina was more severe, and systolic pressure was lower; the prevalence of unstable angina and STEMI was higher. Smoking was a risk factor for obstructive CAD in young patients.
Arteriovenous malformations (AVMs) embolization is considered as a promising option either its single treatment or in combination with surgery, and the use of low-density N-butyl cyanoacrylate (NBCA)/Lipiodol is acceptable mixture agents but its application should be performed by experienced endovascular teams. We describe a successful case preoperative embolization of high-flow AVMs with low-density NBCA/Lipiodol. A 26-year-old male patient was hospitalized with a big pulsatile mass at the right thigh. Doppler ultrasound showed a mass with high systolic, and diastolic velocities coming from the right superficial femoral artery. Angiogram showed a large and high-flow AVM type IV, according to Yakes classification. Low-density NBCA/Lipiodol 12.5% were performed to obstruct all the nidus and feeding arteries. Extirpation surgery was implemented 4 days after the complete embolization procedure.
Overview: Coronary angiography is the gold standard for definitive diagnosis of obstructive ischemic coronary disease. However, this is an invasive, expensive test, and may have a number of complications. Models of pre-test probability (PTP) in the guideline of the European Society of Cardiology 2013 and 2019 are easy to use and apply even to doctors who are not cardiologists, and can be implemented at the medical facilities. We aim to assess the sensitivity and specificity of different PTP stratification models follow ESC2013 and 2019; and their use in the relation to SYNTAX score and cardiovascular risk factors. Materials and Methods: Patients (n=108) with chest pain had been treated at Ninh Thuan Provincial Hospital from January 2019 to May 2020. The PTP stratification models were calculated according to the recommendations of the European Society of Cardiology (ESC) 2013 and 2019. Coronary angiography was enrolled for the diagnosis, Quantitative coronary analyzed (QCA) - based stenosis assessment was used with a cut-off of ≥ 50% diameter reduction for significant lesions of coronary artery and SYNTAX score were calculated.Diagnostic accuracy was calculated by usingsensitivity, specificitywhich were analyzed by using statistical software SPSS version 20.0. Results: In the 2013 pre-test probability model,group withmedium PTP andhigh PTPhad the sensitivity of 57.14%, 100% respectively; the overall sensitivity for both groups (the medium and high pre-test) was 59.36%; and the specificity was 58.33%. In the 2019PTP model, group withmedium PTP and high PTP had the sensitivity of 41.67%, of 67.57% respectively;the overall sensitivity for both groups (the medium and high scores PTP) was 61.22%; and the specificity was 80%. The group of low SYNTAXscore (<23) had at most 93 cases, accounting for 86.1%; the lowest was the group of high SYNTAX score (≥ 33 points) accounting for 2.8%. There were statistically significant differences in patients with and without smoking, history of hypertension for both PTP model 2013 and 2019. Conclusion: Sensitivity and specificity of the 2013 and 2019 PTP were quite high in the relation to the severity of coronary artery which were evaluated by SYNTAX score.
Context: The decision to perform an intervention on a narrowed coronary artery depends on the ischemia caused by the stenosis. The indication for intervention usually applies to cases with ≥70% stenosis of vascular diameter because of the risk of myocardial ischemia. Aims: To define the efficacy of fractional flow reserve (FFR) measurement in the evaluation of coronary artery stenosis. Methods: This prospective study was conducted on patients with intermediate coronary artery stenosis who underwent quantitative coronary angiography after coronary computed tomography angiography. Results: The study population consisted of 46 men and 26 women with a mean age of 66.0 ± 12.9 years. FFR was significantly correlated with the grade of angina pectoris (r = – 0.387; p<0.01) and showed a negative correlation with percentage diameter stenosis (r = – 0.241, p<0.05) and a positive correlation with the minimal lumen diameter (MLD; r = 0.377, p<0.05). The cut-off value to predict positive FFR was >55.62% diameter stenosis and MLD ≤ 1.08 mm. FFR ≤ 0.80 indicating intervention and FFR > 0.80 indicating medical therapy were observed in 56.9% and 43.1% of the cases, respectively. No major cardiac complications occurred during 12 months of follow-up in both groups. Conclusions: FFR measurements for intermediate stenosis of the coronary artery should be used to evaluate the possibility of myocardial ischaemia. If FFR is not available, a cut-off point of >55.62% diameter stenosis or MLD ≤ 1.08 mm can be used to predict the FFR results.
A 42-year-old male patient diagnosed with Wellens syndrome, the angiography showed the narrowing not only in left anterior descending artery but also in other arteries. Cardiac electrical storm can occur without complete revascularization and it can be managed successfully with the infusion of amiodarone and lidocaine in different veins.
Đặt vấn đề: Homocystein - acid amin chứa sulfur - là một sản phẩm của quá trình khử methionine và có liên quan quá trình hình thành mảng xơ vữa thông qua cơ chế tăng stress oxi hóa, tăng đông, thúc đẩy lớp cơ trơn mạch máu, đồng thời làm rối loạn nội mô mạch máu. Do đó, tăng Homocystein máu được xem là một yếu tố nguy cơ độc lập của bệnh mạch vành. Đối tượng và phương pháp nghiên cứu: Đối tượng nghiên cứu là những bệnh nhân ĐTĐ týp 2 có tổn thương động ĐMV ≥ 50% trên hình ảnh chụp ĐMV Thiết kế nghiên cứu: Mô tả, cắt ngang. Kết quả: - Nồng độ Homocystein máu trung bình ở BN ĐTĐ týp 2 có tổn thương ĐMV trong nghiên cứu. này là là 8,80 ± 5,31 μmol/L, tỷ lệ tăng Hcy máu > 15 μmol/L là 6,4%. - Nồng độ Homocystein máu trung bình ở nam giới cao hơn nữa giới có ý nghĩa thống kê với p < 0,05 (10,06 ± 6,61 so với 7,67 ± 3,52 μmol/L). - Nồng độ Homocystein máu trung bình ở nhóm BN suy thận (9,91 ± 3,03 μmol/L) cao hơn nhóm BN không suy thận (7,85 ± 6,57 μmol/L) có ý nghĩa thống kê với p < 0,01. - Nồng độ Homocystein máu trung bình ở các nhóm tuổi, nhóm thời gian mắc đái đường, nhóm mục tiêu điều trị ĐTĐ khác nhau không có ý nghĩa thống kê. Kết luận: Nồng độ Homocystein tăng ở BN ĐTĐ týp 2 có tổn thương ĐMV, nam tăng nhiều hơn nữ và nhóm BN có suy thận.
A 42-year-old male patient diagnosed with Wellens syndrome, the angiography showed the narrowing not only in left anterior descending artery but also in other arteries. Cardiac electrical storm can occur without complete revascularization and it can be managed successfully with the infusion of amiodarone and lidocaine in different veins.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.