Clinical Characteristics and Angiographic Profile of Acute Coronary Syndrome Patients in a Tertiary Hospital of Bangladesh

Ahmed, Mohsin; Rubaiyat, Khandaker Abu; Saleh, Mohammed; Chowdhury, Abdul Wadud; Khuda, CM Khudrate E; Ferdous, Kazi Abul Fazal; Hasan, Nahid; Hoque, Abu Taher Mohammad Mahfuzul; Islam, Kazi Nazrul; Amin, Gaffar

doi:10.3329/bhj.v33i1.37018

Cited by 7 publications

(10 citation statements)

References 11 publications

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“…Similar studies in Bangladesh found mean age of IHD patients to be 50.15 ± 8.8 years which is also similar to this study. 3,34 In this study, male patients were more in both high-risk group and low risk group respectively and the difference between the two groups was not significant. The study conducted by other authors in Bangladesh found that male are predominant.…”

Section: Discussioncontrasting

confidence: 49%

Evaluation of the Glycosylated Haemoglobin as a Predictor of Severity of Coronary Artery Disease in Non-diabetic NSTEMI Patients

et al. 2022

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Background: Glycated hemoglobin (HbA1c) values reflect two to three months average endogenous exposure haemoglobin to glucose including postprandial spikes and have low intra-individual variability particularly in non-diabetic patients. Elevated HbA1c is regarded as an independent risk factor for coronary artery disease (CAD) in patients with or without diabetes mellitus (DM). The purpose of this study is to determine the correlation between the level of HbA1c and the severity of coronary artery disease in non-diabetic non ST elevation myocardial infarction (NSTEMI) patients. Methods: This observational study was carried out with total of 64 non-diabetic patients with a history of NSTEMI. Patients were divided into 2 groups based on HbA1c - one group having HbA1c ³5.7 – 6.4% (High risk group) and another group with HbA1c < 5.7% (Low risk group). Severity of CAD was assessed using Gensini score derived from coronary angiographic data. Gensini score < 36 points was regarded as mild coronary artery disease and Gensini score 36 points as moderate to severe coronary artery disease. Then patients with high and low risk HbA1C groups were correlated with severity of CAD. Results: Over 55.5% patients with HbA1c in high-risk group (5.7 – 6.4%) had severe CAD as opposed to 28.6% patients with HbA1c in low-Risk group (<5.7%). The individuals with high-risk group of HbA1c was 3.1 (95% of CI = 1.1 – 8.9) times more likely to have severe CAD than those with HbA1c < 5.7% (p = 0.031). Spearman correlation between HbA1c and Gensini score depicted that the two variables exhibit a linear relationship indicating that Gensini score rises parallel with the rise of HbA1c (r = 0.289, p = 0.021). Conclusion: The study concluded that over half of the non-diabetic, NSTEMI patients with high-risk range HbA1c are likely to have severe CAD than those with HBA1c within normal range. Cardiovasc j 2022; 15(1): 26-35

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Section: Discussioncontrasting

confidence: 49%

Evaluation of the Glycosylated Haemoglobin as a Predictor of Severity of Coronary Artery Disease in Non-diabetic NSTEMI Patients

et al. 2022

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“…17 This retrospective study was carried out at the department of Cardiology, MCVTC November 1, 2017 to October 31, 2018. The mean age of the study population was 59.3+12.8 years as compared to 60+12 years in a study by Mohanan et al 20 , 58+11 years by Sahed et al in Pakistan 21 , 51+8.80 years by Ahmed et al 22 in Bangladesh and 62+5 years in COURAGE trial 23 conducted in the USA. fifty six percent of patients were above 60 years and 14 % of patients were below 45 years and 21% were below 50 years compared to 27% in a study by Agrawal et al 24 Overall, women were older with female age of 61.75+10.85 years vs male age of 58.5+13.35 years compared to 66.41+13.1 years vs 52.49+11.7 years in a study by Singh et al 25 and 70.7+12.7 years vs 63.8+12.9 years in a study by Isorni et al 26 Among 419 patients, majority of the patients were male (75.7%) and only 24.7% were female.…”

Section: Discussionmentioning

confidence: 78%

“…Similarly, Kumar et al 29 and Tewari et 37 al also similar finding Angiographically, absolutely normal vessels were present in 6.4% and minor coronary artery disease was seen in 3.8 % patients which was more prevalent in UA followed by NSTEMI. Angiographically normal coronary was seen in 14 % cases of ACS in a study by Ahmed et al 22 . In UA, many patients may have been over diagnosed and so were false positive.…”

Section: Angiographic Profilementioning

confidence: 89%

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Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.

Shakya¹,

Jha²,

Gajurel³

et al. 2019

Nepalese Heart J.

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Background and Aims: Acute coronary syndrome (ACS) refers to a group of clinical symptoms consistent with new onset or worsening ischemic symptoms. ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) are the three types of ACS. The objectives were to study the risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in ACS among patients admitted in Cardiology Department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC). Methods: This is a restrospective study of 419 ACS patients admitted and treated in MCVTC from November 2017 to October 2018. Patients were divided into STEMI, NSTEMI and UA then analyzed for various risk factors, angiographic patterns and severity of coronary artery disease. Results: Mean age of presentation was 59.3Å}12.8 years. Majority were male 317(75.7%). Most patients had STEMI 252 (60.1%) followed by NSTEMI 98 (23.4%) and UA 69 (16.5 %). Risk factors: smoking was present in 241 (57.5%), hypertension in 212 (50.6%), diabetes in 144 (34.4%), dyslipidemia in 58 (13.8%). Single-vessel disease was present in 34.6 % patients, double- vessel disease was present in 27.44 % patients and triple vessel disease was present in 26.3 % patients, left main disease in 1.4 % patients. Normal coronaries were present in 6.4% patients and minor coronary artery disease in 3.8 % patients. Conclusions: STEMI was the most common presentation. Three quarters of ACS were male patients. Smoking was most prevalent risk factor. Single vessel involvement was the most common CAG finding in all spectrum of ACS. Diabetic patients had more multivessel disease.

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“…CVDs account for 50% of all non-communicable disease (NCD) deaths in the world each year and represent a significant threat to human welfare and sustainable development. 1 Coronary artery disease (CAD) is an increasingly important medical and public health problem and is the leading cause of mortality in Bangladesh. Like other, South Asians Bangladeshis are unduly prone to develop CAD which is often premature in onset, follows a rapidly progressive course and angiographically more sever.…”

Section: Introductionmentioning

confidence: 99%

Association of Diabetic Retinopathy with Angiographic Severity of Coronary Artery Disease in Patients with Non- ST Elevation Myocardial Infarction

et al. 2022

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Background: Bed side ophthalmoscopic examination is a simple measure of diagnosis of diabetic retinopathy and has been shown to be a predictor of poor outcome in various cardiovascular conditions including coronary artery disease (CAD). Retinopathy lesions are fairly common findings in clinic settings and may predict risk of coronary heart disease (CHD). The present study was intended to find the relationship between diabetic retinopathy with the severity of coronary artery disease in patients with NSTEMI. Methods: This cross-sectional observational study was conducted in the Department of cardiology, National Institute of Cardiovascular Diseases and Hospital (NICVD), Dhaka, Bangladesh, from March 2019 to August 2020. A total of 120 DM with NSTEMI patients undergoing coronary angiogram and also fundoscopic examination with fundal photography during the index hospitalization were included in this study. Study subjects were divided into two groups on the basis of diabetic retinopathy (Group-I: NSTEMI with diabetic retinopathy ; Group- II: NSTEMI without diabetic retinopathy). Severity of coronary artery disease was determined by Gensini score and correlation between diabetic retinopathy and Gensini score was assessed. Results: Gensini score was significantly higher in patients with diabetic retinopathy than that in patients without diabetic retinopathy (62.2±27.7 vs. 43.3±25.3,p<0.001).Gensini score increased with increasing severity of diabetic retinopathy(P <0.001).The risk of having severe CAD in patient with diabetic retinopathy was 13.03 (95% CI =2.410-70.419) (P<0.003).A significant correlation between diabetic retinopathy and Gensini score was noted (p value <0.001) Conclusion: It may be concluded that presence and severity of diabetic retinopathy is associated with angiographically severe coronary artery disease in patient with non-ST elevation myocardial infarction (NSTEMI) and it may be considered as an independent predictor of severity of CAD. As is a bed side assessment, so before performing coronary angiography ,it appears to be additive for risk stratification. University Heart Journal 2022; 18(1): 50-53

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Clinical Characteristics and Angiographic Profile of Acute Coronary Syndrome Patients in a Tertiary Hospital of Bangladesh

Cited by 7 publications

References 11 publications

Evaluation of the Glycosylated Haemoglobin as a Predictor of Severity of Coronary Artery Disease in Non-diabetic NSTEMI Patients

Evaluation of the Glycosylated Haemoglobin as a Predictor of Severity of Coronary Artery Disease in Non-diabetic NSTEMI Patients

Clinical characteristics, risk factors and angiographic profile of acute coronary syndrome patients in a tertiary care center of Nepal.

Association of Diabetic Retinopathy with Angiographic Severity of Coronary Artery Disease in Patients with Non- ST Elevation Myocardial Infarction

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