European Journal of Cardiovascular Medicine

Results for " TVD"

Found 4 results

Research Article Open Access

Incidence, Clinical Presentation and Predictors of Left Main Coronary Artery Disease in High-Risk Patients with a First Episode of Non-St Elevation Acute Coronary Syndrome

Pages 1067 - 1074

Abstract

Background: NSTE-ACS with significant left main coronary artery (LMCA) disease or its equivalent needs early revascularization in where a significant number of cases CABG may be the treatment of choice. Anticipating LMCA disease or its equivalent may help in proper planning of revascularization. This study was carried out to find out clinical, electrocardiographic and echocardiographic predictors of LMCA disease in high-risk patients with a first episode of NSTE-ACS and also to find out the incidence of LMCA disease among those patients. Results: In this hospital based observational study 300 patients admitted with 1st episode of NSTE-ACS and classified as very high and high-risk category according to 2015 ESC guideline, were evaluated in respect to clinical, biochemical, ECG and echocardiographic parameters. Later coronary angiography was done. Overall LMCA disease patients were more symptomatic and severely ill but not statistically different from TVD patients. ST elevation in aVR ≥1mm had more specificity but less sensitivity in predicting LMCA disease. ST elevation in both aVR and V1 (ST elevation in aVR ≥ V1) and ST elevation in aVR + ST depression in I, II, V4-6 were other significant ECG predictors of LMCA disease. Incidence of NSVT/VT and high grade of diastolic dysfunction were significantly high among LMCA disease patients. None of the clinical or biochemical parameters could be established as predictor of LMCA disease. Incidence of overweight, central obesity, persistent chest pain, severe shortness of breath, severe heart failure, high total cholesterol, high LDL, low left ventricular ejection fraction and very low left ventricular global longitudinal strain were high among LMCA disease. But there was no statistically significant difference between LMCA disease and TVD with respect to any of these parameters. All of these parameters are significantly better in non LMCA/TVD group and could differentiate LMCA/TVD cases from non LMCA/TVD patients with statistical significance. Conclusion: Though any of these parameters couldn’t predict LMCA disease but these parameters could suggest severe form of coronary artery disease; i.e., either LMCA disease or triple vessel disease which might need urgent CABG.

Research Article Open Access

Assessment of Gender Differences in Clinical and Angiographic Profile of Patients with Stemi in a Tertiary Care Hospital

Pages 862 - 872

Abstract

Background: Acute myocardial Infarction (AMI) is one of the leading causes of mortality in both developed and developing countries.The prevalence of obstructive coronary artery disease is lower in women despite the greater magnitude of myocardial ischemia and associated mortality in comparison with men. These gender-based differences can be attributed to genetic, hormonal differences and the differences acknowledged to exist at cellular levels. Methodology: This is a retrospective observational study of 625 patients presented with STEMI and who underwent coronary angiography over 1 year period from July 2022 to June 2023 at King Geroge Hospital, Visakhapatnam with the objective of assessing the differences in clinical profile, risk factors and coronary angiographic profile of STEMI patients among men and women. The Data regarding demographic characteristics, coronary risk factors (smoking, hypertension, and diabetes mellitus), and other comorbidities (body mass index (BMI)] was collected in patients with STEMI. Data was analyzed using the MS Excel, SPSS version 21. The Chi‑square test, unpaired t test and Fisher’s exact test were used to assess the significance of variables. Results: Among 625 STEMI patients, 407 patients were males and 218 were females with male preponderance which is statistically significant. The mean age of presentation of males and females was 54.3 yearsand 58.8 years respectively. Women are on average older than men. More of the younger women were presented with STEMI than men. Among risk factors, hypertension and smoking were the most common risk factors for men. Hypertension was most common risk factor in women with statistical significance compared to men, whereas smoking was statistical significance in men compared to women. There was no much difference in BMI of men and women. Anterior wall MI was the most common clinical presentation in both men and women. Conclusion: On angiography, TVD and LMCA+DVD involvementwas more in women than men with statistical significance. Mild CAD was more common in men compared to women with statistical significance. LAD was the most common vessel involved in both men and women.

Case Report Open Access

Triple Vessel Disease: Surgical Strategies and Results of Coronary Artery Bypass Grafting- A case report

Sanika Gautam,

Anand Yadav

Pages 315 - 317

Abstract

Coronary artery disease (CAD) is a leading cause of mortality worldwide, particularly affecting younger adults with symptomatic atherosclerosis. This case report details a 44-year-old male patient presenting with chest pain and dyspnea, leading to a diagnosis of triple vessel disease (TVD). His medical history included hypertension and tobacco use, with a coronary angiogram revealing 100% occlusion in the left anterior descending artery (LAD) and right coronary artery (RCA), along with significant stenosis in other major vessels. Surgical intervention through coronary artery bypass grafting (CABG) was deemed necessary to restore blood flow. The surgery was conducted under general anesthesia with cardiopulmonary bypass, successfully utilizing both saphenous vein and internal thoracic artery grafts. Post-operative recovery was uneventful, and the patient was extubated within four hours. This case underscores the complexity of CABG in patients with TVD, highlighting the importance of tailored surgical strategies and meticulous technique to optimize outcomes and improve quality of life. The successful revascularization illustrates the potential benefits of CABG in high-risk patients with significant coronary blockages.

Research Article Open Access

Study Of Flow Mediated Dilatation of Brachial Artery in Patients with Coronary Artery Disease in Relation to Diabetes Mellitus.

Fareeha Afreen,

Rama Mishra R,

Tejashree P,

. Javeria Afshan,

. Seetha V S R Prashanthi

Pages 293 - 300

Abstract

Background and Objectives: Coronary artery disease (CAD) results from interaction of many risk factors, environmental influence and genetic predisposition. Endothelial and vascular smooth muscle dysfunctions are early abnormalities in atherosclerosis development in cardiometabolic disease. Diabetes is a significant risk factor for cardiovascular disease due to elevated oxidant levels contributing to vascular dysfunction and impaired vasodilatory effect mediated through release of nitric oxide (NO). Endothelial function assessed by brachial artery Flow mediated dilatation (FMD), a non-invasive test has been shown to be impaired in patients of CAD. As diabetes has been CAD risk equivalent, this study is being done to evaluate the mean FMD value in patients with and without diabetes mellitus and to correlate endothelial dysfunction in these patients through FMD. Methods: A cross-sectional study was done from January 2020 to June 2021, in which 84 patients of CAD were enrolled after informed consent. The patients were divided into 2 groups of diabetics and non-diabetics. Statistical analysis was done to compare mean FMD value between the 2 groups of diabetes and non-diabetes patients by using independent sample t test and correlation of endothelial dysfunction in diabetes through FMD was done by chi square analysis. Results: The mean age of patient was 53.81±9.52 years, males were predominant than females in the study with sex ratio of 1:4. The mean duration of diabetes was 4.91 with SD 1.22 years. The mean FMD in SVD (Single vessel disease) was 9.43± 4.48%, in DVD (Double vessel disease) mean was 8.55±2.83% and in TVD (Triple vessel disease) was 5.707±1.93%. Among the various biochemical parameters, increased creatinine, FBS, PPBS and TG was found to be statistically significant with respect to diabetes (p<0.01). The mean FMD (%) was found to be lower with values of 5.87 ±2.03% ( p<0.001) in diabetic group than in non-diabetic group, whose mean FMD was 11.51±3.27%. Conclusion: The mean FMD was found to be lower in diabetic group than in non-diabetic group, suggesting increased endothelial dysfunction in diabetic patients compared to non-diabetics in patients with known CAD. Also, FMD was found to be negative correlated with risk of cardiovascular disease in diabetic patients, where lower FMD was found to be associated with higher risk of endothelial dysfunction. Therefore, FMD is a non-invasive, simple, reliable technique which serves as an alternative to invasive procedures and can help to identify patients with endothelial dysfunction who are at a higher risk of CAD, and initiate early and appropriate management.

European Journal of Cardiovascular Medicine

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