Prevalence and clinical presentation of myocardial bridge on the basis of the National Polish Percutaneous Interventions Registry and the Classification of Rare Cardiovascular Diseases

Abstract

BACKGROUND A myocardial bridge (MB) is defined as a congenital anomaly, in which a segment of an epicardial coronary artery takes an intramuscular course. AIMS The aim of the study was to evaluate the prevalence of MB in coronary arteries among patients who were diagnosed using coronary angiography. METHODS Data were obtained from the National Polish Percutaneous Interventions Registry for patients hospitalized between January 1, 2014, and December 31, 2016, in invasive cardiology departments in Poland and divided into groups with and without MB. RESULTS The study included 298 558 patients. The non-MB group comprised 296 133 patients (99.19%; women, 38.01%), while the MB group included 2425 patients (0.81%; women, 39.98%). The most frequent location of MB was the left anterior descending artery (n = 2355; 97.11% of patients). The MB group less often had diabetes (14.68% vs 21.63%), previous stroke (1.61% vs 2.96%), previous myocardial infarction (10.97% vs 21.97%), kidney disease (2.8% vs 5.04%), previous coronary artery bypass graft (1.03% vs 5.64%), previous percutaneous coronary intervention (13.20% vs 25.86%) than the non-MB group (P <0.0001). The incidence of acute coronary syndromes was lower in the MB group (P <0.0001), while smoking was more common (18.76% vs 16.87%, P <0.01). CONCLUSIONS Patients with MB were younger and had fewer comorbidities and risk factors for atherosclerosis than patients without MB. The condition was more common among patients with stable coronary artery disease. Smoking and female sex appeared to be associated with a more clinically symptomatic presentation of MB.

Out-of-hospital cardiac arrest: data from the National Registry of Invasive Cardiology Procedures (ORPKI) in a long-term survival analysis of patients with acute coronary syndromes in a Polish region

“…The same registry was also used for the evaluation of patients with rare cardiovascular diseases. 23 The present study assessed survival in patients with ACS and OHCA considering the effect of well -known risk predictors, such as age, diabetes mellitus, renal failure, multivessel coronary artery disease, and less commonly observed risk factors, such as the radiation dose absorbed by patients and the total amount of contrast media administered during invasive procedures. In our group of ORPKI patients, although it was relatively small, over the age of 66 years (FIGURE 1A).…”

Evaluation of Platelet Indices in Diabetic Patients with Myocardial Bridges

“…MB, which is the most common congenital coronary anomaly, has a prevalence of less than 5% following routine angiography 3 . MB was first identified in 1737 4 ; modern medicine has determined that MB accelerates atherosclerosis 5 . The condition is also more widespread in patients with coronary artery disease (CAD) 5 .…”

“…MB was first identified in 1737 4 ; modern medicine has determined that MB accelerates atherosclerosis 5 . The condition is also more widespread in patients with coronary artery disease (CAD) 5 . Feeding of the myocardium may be impaired by MB and may cause ischemia due to the shortening of the diastolic phase secondary to tachycardia in addition to the atherosclerosis induced by the bridge 5 .…”

“…The condition is also more widespread in patients with coronary artery disease (CAD) 5 . Feeding of the myocardium may be impaired by MB and may cause ischemia due to the shortening of the diastolic phase secondary to tachycardia in addition to the atherosclerosis induced by the bridge 5 . MB may cause chest pain upon exertion, arrhythmias, dyspnea, left heart failure, coronary spasm, acute coronary syndromes, and even sudden cardiac death 1 .…”

Myocardial bridge as a cause of myocardial ischemia and infarction: “Bridge over troubled waters” and turbulent coronary blood flow

“…[2][3][4] Although, MB is frequently asymptomatic, it may produce ischemic-related signs and symptoms, including acute myocardial infarction, heart failure, ventricular arrhythmias, and even sudden cardiac death. [5][6][7][8][9][10][11] MB was first observed by coronary angiography in 1960. 12 Since then it was reported with other imaging modalities such as coronary computed tomographic angiography, intravascular ultrasound, optical coherence tomography, intracoronary Doppler, and fractional coronary flow reserve.…”