2017

DOI: 10.7860/jcdr/2017/29104.10460

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An Evaluation of the Numbers and Locations of Coronary Artery Disease with Some of the Major Atherosclerotic Risk Factors in Patients with Coronary Artery Disease

Behshad Naghshtabrizi

¹

,

²

,

Jalaleddin Amiri

³

et al.

Abstract: Introduction: Despite definite recognition of major atherosclerotic risk factors, the relationship between the pattern of coronary artery disease and these risk factors is unknown.

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Cad Definition and Syntax Score Calculation1

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Cited by 8 publications

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“…This is a usual scenario in various other countries including other centers of Nepal. 11-13, [22][23][24] Radial route (right radial artery) was the most preferred route to perform PCI (both primary and elective) in our study followed by right femoral artery. With the advancement of the techniques and experience, this is now becoming popular all over the world.…”

Section: Discussionmentioning

confidence: 97%

“…This was similar in a study done in western countries. 24 Primary PCI was done for STEMI of any types (most commonly for anterior wall) in almost 85% of cases. This is a usual scenario in various other countries including other centers of Nepal.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Profile and Outcomes of Patients Undergoing Percutaneous Coronary Intervention: A 5 Year Experience

¹

2021

J Coll Med Sci-Nepal

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Introduction: Ischemic Heart Disease is the leading cause of mortality and morbidity in the world. Among the ACS, the mortality rate is highest for ST Elevation Myocardial Infarction. Primary Percutaneous Coronary Intervention has emerged as the therapy of choice with better outcomes. In this study we have studied the profile and outcomes of patients with coronary artery diseases in our part of world. Methods: A retrospective, cross-sectional study was done in the department of medicine (cardiology unit) of Manipal Teaching Hospital, Pokhara. All the cases undergone PCI were taken and analyzed accordingly for the clinical profile and outcomes within the hospital stay from April 2015 to March 2020 (5 years). The data was collected in a preformed proforma and was entered in excel sheet and analyzed using SPSS software version 21. Various statistical tools were used accordingly and p values were considered significant at a predetermined alpha level of 5%. Results: The total number of procedures done for coronary arteries in Cath lab for 5 years were 2602 of which 2014 were angiographies and 588 were percutaneous coronary interventions/ angioplasties. The male-female ratio was 2.01. Out of 588 angioplasties, 326 were primary. Fifty-five percent of patients undergone angioplasties were age more than 65. Twelve percent of patients with acute coronary syndromes were young (less than 40 years of age). Smoking was the commonest risk factor (71%) followed by hypertension (52%), Dyslipidemia (50%) and Diabetes (18%). Anterior wall myocardial infarction involving left anterior descending artery was the commonest presentation. Right radial artery was the preferred route for procedure (69%) followed by right femoral artery (22%). Fourteen patients (2.3% of total, 5.0% in Primary) died. Most of the deaths were patients having anterior wall STEMI involving LAD with high TIMI scores (>6) (P: 0.0003). Conclusions: Ischemic heart disease is the commonest cause of mortality worldwide. In our study population, there was male preponderance. ST Elevated MI was the most common presentation of acute coronary syndrome and almost 85% cases posted for primary angioplasty. LAD was the most common artery causing IHD and also was significantly associated with high TIMI score and mortality. ACS in young is alarmingly increasing in this part of world probably associated with increased rates of smoking in younger population.

“…This is a usual scenario in various other countries including other centers of Nepal. 11-13, [22][23][24] Radial route (right radial artery) was the most preferred route to perform PCI (both primary and elective) in our study followed by right femoral artery. With the advancement of the techniques and experience, this is now becoming popular all over the world.…”

Section: Discussionmentioning

confidence: 97%

“…This was similar in a study done in western countries. 24 Primary PCI was done for STEMI of any types (most commonly for anterior wall) in almost 85% of cases. This is a usual scenario in various other countries including other centers of Nepal.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Outcomes of Patients Undergoing Percutaneous Coronary Intervention: A 5 Year Experience

¹

2021

J Coll Med Sci-Nepal

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Introduction: Ischemic Heart Disease is the leading cause of mortality and morbidity in the world. Among the ACS, the mortality rate is highest for ST Elevation Myocardial Infarction. Primary Percutaneous Coronary Intervention has emerged as the therapy of choice with better outcomes. In this study we have studied the profile and outcomes of patients with coronary artery diseases in our part of world. Methods: A retrospective, cross-sectional study was done in the department of medicine (cardiology unit) of Manipal Teaching Hospital, Pokhara. All the cases undergone PCI were taken and analyzed accordingly for the clinical profile and outcomes within the hospital stay from April 2015 to March 2020 (5 years). The data was collected in a preformed proforma and was entered in excel sheet and analyzed using SPSS software version 21. Various statistical tools were used accordingly and p values were considered significant at a predetermined alpha level of 5%. Results: The total number of procedures done for coronary arteries in Cath lab for 5 years were 2602 of which 2014 were angiographies and 588 were percutaneous coronary interventions/ angioplasties. The male-female ratio was 2.01. Out of 588 angioplasties, 326 were primary. Fifty-five percent of patients undergone angioplasties were age more than 65. Twelve percent of patients with acute coronary syndromes were young (less than 40 years of age). Smoking was the commonest risk factor (71%) followed by hypertension (52%), Dyslipidemia (50%) and Diabetes (18%). Anterior wall myocardial infarction involving left anterior descending artery was the commonest presentation. Right radial artery was the preferred route for procedure (69%) followed by right femoral artery (22%). Fourteen patients (2.3% of total, 5.0% in Primary) died. Most of the deaths were patients having anterior wall STEMI involving LAD with high TIMI scores (>6) (P: 0.0003). Conclusions: Ischemic heart disease is the commonest cause of mortality worldwide. In our study population, there was male preponderance. ST Elevated MI was the most common presentation of acute coronary syndrome and almost 85% cases posted for primary angioplasty. LAD was the most common artery causing IHD and also was significantly associated with high TIMI score and mortality. ACS in young is alarmingly increasing in this part of world probably associated with increased rates of smoking in younger population.

“…Severity of CAD base on the number of diseased vessel was divided to 5 groups: normal coronary artery or mild CAD (angiographically coronary artery lesions <40% lumen diameter stenosis), 10 two vessel diseases, three vessel diseases and left main.…”

Section: Cad Definition and Syntax Score Calculationmentioning

confidence: 99%

Association of epicardial fat thickness assessed by echocardiography with the severity of coronary artery disease

¹

,

²

,

³

et al. 2020

J Cardiovasc Thorac Res

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Introduction : Epicardial fat thickness (EFT) can reflect risk of cardiovascular disease particularly coronary artery disease (CAD). The aim of this study was to investigate the association of EFT assessed by echocardiography and presence as well as severity of CAD. Methods: Two hundred and twenty consecutive patients who candidate for coronary angiography because of possible CAD were studied. EFT was evaluated in standard parasternal long axis (PlAX) and parasternal short axis (PSAX) view from 3 cardiac cycles at the end of systole and diastole. The severity of CAD was defined in two ways: (1) SYNTAX score, (2) number of vessels with significant lesion. Results: PLAX (EFTS ) (EFT in systole) and PLAX (EFTd ) (EFT in diastole) were significantly higher in patients with CAD in comparison with patients without CAD (P = 0.046, P = 0.041 respectively). There was a significant correlation between PLAX (EFTS ) (P = 0.05), PLAX (EFTd ) (P = 0.04) and SYNTAX score. There was no statistically significant relationship between EFT and number of diseased vessel (P > 0.05). Multivariate analysis was done for adjusting the effects of confounding factors and it showed that EFT (OR: 10.53, P = 0.004) was significantly correlated severe CAD as assessed by the SYNTAX score. Conclusion: EFT assessed by transthoracic echocardiography was higher significantly in patients with CAD than in normal patients. EFT as an easily available and cost-effective echocardiographic feature might be useful to predict complexity of CAD.

“…[ 18 19 20 ] In Iran, 82.2% of NCD deaths are due to cardiovascular diseases (CVD), cancers, chronic pulmonary diseases, and diabetes; and diabetes mellitus and hypertension have a stronger relationship with sever coronary artery disease. [ 21 22 ]…”

Section: Introductionmentioning

confidence: 99%

Designing and investigating the validity and reliability of the health literacy questionnaire in Iran: Recognizing the risk factors for cardiovascular diseases, diabetes, and cancer

¹

,

²

,

³

et al. 2020

Int J Prev Med

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Background: Health literacy (HL) has been recognized as an important concept in patient education and disease prevention. The rising burden of noncommunicable diseases (NCDs) in Iran is significant. Hence, we designed and validated an HL questionnaire on the most important domains of NCDs, including cardiovascular diseases, diabetes, and cancer. Methods: Literature review was conducted to examine the definition and dimensions of HL. After reaching consensus about the HL dimensions and conceptual models in focus group discussions with experts, they designed questions in each domain. Then, face, content, and construct validity as well as reliability were determined by a pilot study on 72 participants. At the end, a cross-sectional study was implemented on 206 Hamedan university employees, to finalize the questionnaire. Results: After doing the pilot study and analyzing the collected data and according to the Bartlett's test of sphericity and Kaiser–Meyer–Olkin = 0.421 with P < 0.001, factor analysis was used. Considering the eigenvalue >1.4, a 27-item questionnaire in seven domains was obtained which included attitude toward health, understanding information, social support, socioeconomic conditions, access to health services, and application of health information. Cronbach's alpha was more than 0.70 in all domains except the last one (0.47). The second phase showed that overall 75.2% of the individuals had inadequate HL with lowest scores in the application of health information. Conclusions: The designed tool seems appropriate for measuring the HL level among the Iranian population in the field of prevention of cardiovascular disease, cancer, and diabetes. The results can help policy makers to improve health promotion interventions.

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