Background: Clinical guidelines recommend that optimal management of acute coronary syndrome should include patient risk stratification. Predicting the anatomical extension of coronary artery disease is also potentially useful for clinical decision. The objective of our study is to determine whether the GRACE risk score correlates with the angiographic extent and severity of coronary artery disease in patients with ST elevation myocardial infarction.Methodology: 50 patients diagnosed with Acute Myocardial Infarction were included as sample by purposive sampling method. GRACE risk score for each patient was calculated and the patients were divided into groups according to the GRACE risk score: low risk (<108); intermediate risk (109-140). The severity of the coronary artery disease was assessed by vessel score and Gensini score. Relation between Grace score and Gensini score was evaluated.Results: Mean GRACE score of study population was 128.3±22.7. Mean Gensini score was 23.88±17. Mean Gensini score were 15.47±10.4, 27.75±9.26 and 31.52±16.91 in low GRACE risk group, intermediate group and high risk group respectively and the difference of mean Gensini score was statistically significant (p=0.006). In our study correlation co-efficient between GRACE risk score and Gensini score was r=0.17 (p=0.04). Multiple regression analysis showed that age more than 50 years (p=0.02), ST segment deviation (p=0.01), smoking (p=0.02), hypertension (p=0.01) were able to independently predict patients with severe CAD.Conclusion: Our study demonstrates that the GRACE risk score carries a significant positive correlation with the coronary artery disease severity in patients with STEMI.Cardiovasc. j. 2015; 8(1): 30-34
Pharmacological therapy is mostly employed in the management of supraventricular tachyarrhythmias in different part of the world including Bangladesh. However, Radiofrequency catheter ablation has been found to be highly effective and safe in the treatment of such tachyarrhythmias. Objective: The current study is aimed at sharing our experiences of 842 patients who presented with Supraventricular tachycardias and were diagnosed by EPS and treated with Radiofrequency catheter ablation. Methods: This descriptive study has been carried out in the cardiac electro physiology Department of NICVD, Dhaka, Bangladesh from 2nd January 2015 to 31st December, 2020. Electrophysiology study(EPS) was carried out to identity and diagnose the mechanism of different SVTs in 842 consecutive patients. RF catheter ablation was used to interrupt the tachycardia circuit. Results: Out of a total 842 patients who underwent Electrophysiology study, 435 were found to have atrioventricular nodal re-entry tachycardia (AVNRT) as underlying mechanism and 391 were having accessory pathway responsible for the reentry mechanism; of these accessory mediated tachycardia, 250 patients were manifested accessory pathway (WPWS); 141 were concealed accessory pathway (out of them 365 were presented with orthodromic and 26 as antidromic reciprocating tachycardia); moreover among the accessory pathway 231 patients were found having left sided accessory pathway whereas 155 having right sided pathway; 12 patients were having focal atrial tachycardia and 4 were found atrial flutter as the underlying cause for SVT. Radiofrequency catheter ablation was used with an overall success rate of 95%, recurrence rate of 2% without any significant complication. Complication: One patient developed pulmonary thrombo-embolism, 6 patients developed DVT of right lower limb, 4 patients developed complete heart block. Conclusion: RF catheter ablation is safe and highly effective mode of treatment of different types of supraventricular tachyarrhythmias which is emerging and becoming popular in our country. Bangladesh Heart Journal 2021; 36(2): 68-73
Coronary artery disease (CAD) is the most common cause of mortality and morbidity all over the world. It is also becoming a significant burden on healthcare service in Bangladesh. Atherosclerosis is the main pathology behind coronary artery disease. Endothelial dysfunction plays a crucial role in the process of atherosclerosis. Microalbuminuria (MA) is a reliable marker of endothelial dysfunction. This is why microalbuminuria is recognized as a simple marker of atherogenic milieu It was a cross sectional analytical study carried out in the department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of May, 2013 to April, 2014. After ethical consideration a total of 120 patients with IHD admitted in the department of Cardiology who fulfilled the inclusion and exclusion criteria and underwent coronary angiogram were taken as sampling population by purposive sampling. 1st morning spot urine sample was taken for measurement of ACR.Microalbumnuria was measured by rate nephelometry using Behring protein analyzer. All the study subjects were placed into two groups according to ACR value (group I- positive urinary ACR >30 mg/g & group II-Normal urinary ACR <30 mg/g). Angiographic severity of coronary artery disease was assessed by vessel score and stenosis score. Age and sex distribution of the subjects in two groups with MA and without MA were similar. No significant difference was observed between two groups with regard to smoking, dyslipidaemia, hypertension and family history of IHD. Prevalence of diabetes mellitus was significantly more in subjects with MA than without MA (60% vs 33.9%, p=0.006). All 40 patients of group I had significant CAD. 57(71.2%) patients of group II had significant CAD and 23(28.8%) patients had no significant CAD. The difference was highly significant (p<0.001). Single vessel involvement was significantly more frequent in subjects of group II than group I (35.0% vs15.0%, p=0.022) Double vessel involvement was more in group I than group II, but the difference was not statistically significant (36.8% vs 32.40%,p=0.641).Triple vessel involvement was significantly more frequent in subjects of group I than group II (50.0% vs10.7%, p<0.001). The mean stenosis score of group I was significantly higher than group II (95% CI 4.966 to 2.809, p<0.001). The mean ±SD total coronary vessel score of group I was 16.60±4.75 with a range of 7.0-21.0 and mean ±SD total coronary vessel score of group II was 8.26±6.24 with a range of 0.0-21.0. The mean total score of group I wassignificantly higher than group II (95% CI 10.558 to 6.117, p<0.001). Patient with microalbuminuria has more extensive and complex angiographic coronary artery disease compared to those without microalbuminuria.University Heart Journal Vol. 10, No. 1, January 2014; 18-22
Brugada syndrome is a potentially lethal and eminently treatable entity that may present with palpitations or syncope. This article presents the case of a young patient with Brugada syndrome and reviews key features in the epidemiology, pathophysiology, diagnosis, treatment and prognosis of this condition.Cardiovasc. j. 2015; 8(1): 69-72
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