Left main and/or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score: Prevalence, clinical outcomes and predictors

Carvalho, J; Belo, Adriana; Congo, Kisa; Neves, David; Santos, Ana Rita; Picarra, B; Damásio, Ana Filipa; Aguiar, J

doi:10.1016/j.repc.2018.03.016

Cited by 11 publications

(14 citation statements)

References 27 publications

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“…The incidence of coronary artery occlusion among NSTEMI patients is frequent and has long been known. It is evident from the existing literature that older age, male gender, and higher resting heart rate are independent positive predictors of the presence of 3VD among NSTEMI patients [13]. In the current study involving 139 NSTEMI patients, 42 (30.2%) had significant 3VD.…”

Section: Discussionmentioning

confidence: 50%

“…Additionally, the occlusion was fairly distributed among the coronary arteries, i.e. 92.8% of the enrolled NSTEMI patients with 3VD had significant occlusion in the LAD artery followed by 57.1% in OM artery, 52.4% in both RCA and diagonal arteries and 50% in LCX artery, however, a study found that NSTEMI patients with 3VD were more likely to have an unidentified culprit artery (p < 0.001) [13].…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, NSTEMI patients with a comorbid condition like DM showed a high frequency of 3VD (p < 0.001). Similarly, a study assessing the prevalence, clinical outcomes, and predictors of left main (LM) and/or 3VD in NSTEMI patients, indicated that the majority of the NSTEMI patients with LM/3VD were diabetic or hypertensive (p < 0.001) [13]. Additionally, the occlusion was fairly distributed among the coronary arteries, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The angiographic and re-vascularization delay causes an irreversible negative impact on myocardial functioning [6]. However, the presence of 3VD among NSTEMI patients further adds prognostic complexities which can lead to poor long-term process [13], which can be improved by percutaneous or surgical revascularization [14]. As per the clinical guidelines, invasive strategies with cardiac catheterization, revascularization, and initiation of dual antiplatelet therapy is recommended for treatment among NSTEMI patients with 3VD [15].…”

Section: Introductionmentioning

confidence: 99%

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Frequency of Three-Vessel Disease Among Patients With Non-ST Segment Elevation Myocardial Infarction

Ahmed¹,

Khan²,

Shah³

et al. 2020

Cureus

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Background: Though the presence of three-vessel disease (3VD) among patients with non-ST Segment Elevation Myocardial Infarction (NSTEMI) is relatively common, very limited data is available regarding its clinical significance. The current study aimed to determine the frequency of 3VD among NSTEMI patients presenting at the tertiary care hospital of Karachi, Pakistan. Methodology: This cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi from August 15 2015 to February 15 2016 over a sample of 139 NSTEMI patients. Data regarding patients' baseline characteristics were recorded in a proforma. Coronary angiography was performed to determine the presence of 3VD. The frequency of occluded arteries and 3VD was also recorded and the collected data was then analyzed using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY, USA). Results: A total of 139 NSTEMI patients were enrolled in the study with a mean age of 50.47 ± 12.47 years. The majority of them were males (70.5%), mostly ≥ 40 years of age (67.6%). Among the comorbidities, 50.4% of patients had diabetes mellitus (DM), 61.9% were hypertensive and 30.9% had dyslipidemia. The overall frequency of 3VD among the enrolled NSTEMI patients was 30.2%. Three major arteries were found to be occluded; 68.3% NSTEMI patients had occlusion in the left anterior descending (LAD) artery, followed by right coronary artery (RCA) among 49.6%, 40.3% had left circumflex (LCX) artery occlusion, and 50.4% had diagonal and obtuse marginal (OM) artery occlusion respectively. Among the effect modifiers, no significant impact of age, gender, and smoking habits was observed on the frequency of 3VD among NSTEMI patients (p > 0.05). Among the reported comorbidities, DM was significant among NSTEMI patients with 3VD (p < 0.05). Conclusion: Our study results indicated that a significant proportion of NSTEMI patients had 3VD, independent of the effect of age and gender.

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Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Frequency of Three-Vessel Disease Among Patients With Non-ST Segment Elevation Myocardial Infarction

Ahmed¹,

Khan²,

Shah³

et al. 2020

Cureus

View full text Add to dashboard Cite

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“…Preliminary data from the literature suggest an association between high-d-dimer levels and NR. Moreover, in MI patients who cannot undergo cardiac catheterization, Ddimer concentrations may also be helpful to predict severity of coronary disease [37].…”

Section: Risk Strati Cation Using D-dimermentioning

confidence: 99%

Role of D-Dimer in the Risk Stratification of Acute Coronary Syndrome Patients: Implications for Antithrombotic Treatment. A Systematic Review and Exploratory Meta-analysis.

Biccirè

Farcomeni

Gaudio

et al. 2021

Preprint

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Background Data on the prognostic role of D-dimer in patients with acute coronary syndrome (ACS) are controversial. Our aim was to summarize current evidence on the association between D-dimer levels and short/long-term poor prognosis of ACS patients. We also investigated the association between D-Dimer and no-reflow (NR) phenomenon.Methods Systematic review and metanalysis of observational studies including ACS patients and reporting data on D-Dimer levels. PubMed and SCOPUS databases were searched. Data were combined with hazard ratio (HR) and metanalysed. The principal endpoint was a composite of cardiovascular events (CVEs) including myocardial infarction, all-cause and cardiovascular mortality. Results Overall, 32 studies included in the systematic review with 28,869 patients. Of them, 6 studies investigated in-hospital and 26 studies long-term outcomes. Overall, 23 studies showed positive association of high D-Dimer levels with CVEs. D-Dimer levels predicted poor prognosis in all studies reporting in-hospital outcomes. Five studies satisfied inclusion criteria and were included in the metanalysis, with a total of 8,616 patients. Median follow-up was 13.2 months with 626 CVEs. The pooled HR for D-dimer levels and CVEs was 1.264 (95% CI 1.134-1.409). Five out of 7 studies (4,195 STEMI patients) investigating the association between D-Dimer levels and NR showed a positive correlation of D-dimer levels with NR. Conclusions In patients with ACS D-Dimer was associated with higher in-hospital and short/long-term complications. D-Dimer was also higher in patients with NR phenomenon. The use of D-Dimer may help to identify patients with residual thrombotic risk after ACS.Trial registration: the review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews: CRD42021267233.

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Estratificação de risco nas síndromes coronárias agudas: quando o menos vale mais

Ferreira

2018

Revista Portuguesa de Cardiologia

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Left main and/or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score: Prevalence, clinical outcomes and predictors

Cited by 11 publications

References 27 publications

Frequency of Three-Vessel Disease Among Patients With Non-ST Segment Elevation Myocardial Infarction

Frequency of Three-Vessel Disease Among Patients With Non-ST Segment Elevation Myocardial Infarction

Role of D-Dimer in the Risk Stratification of Acute Coronary Syndrome Patients: Implications for Antithrombotic Treatment. A Systematic Review and Exploratory Meta-analysis.

Estratificação de risco nas síndromes coronárias agudas: quando o menos vale mais

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