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Background: CAD is the most common heart disease. It can describe asymptomatic atherosclerosis, stable angina, and acute coronary syndrome (unstable angina, NSTEMI, STEMI). Multifactorial CAD. Modifiable and non-modifiable etiologic factors exist. Gender, age, family history, and genetics are unchangeable. Smoking, obesity, cholesterol levels, and psychosocial factors are modifiable. Methods: Institutional Ethics Committee approved the prospective observational case-control study (Regd. No. ECR/84/Inst/OR/2013/RR-20). The Department of Cardiology at S.C.B Medical College and Hospital, Cuttack, comprised 80 CAD outpatients or inpatients between 2020 and 2022. Controls were age- and sex-matched. Patients with acute or chronic kidney illness, traumatic heart disease, head injury, morbidity, or refusal were eliminated. Results: FBS, cholesterol, HDL, LDL, total and direct bilirubin, SGOT, SGPT, and alkaline phosphatase differed between groups (P<0.05). 56.25 percent had severe CAD and 30 percent mild. Cases have greater copeptin than controls (P<0.0001). ROC curve analysis found a cut-off value of 0.98 and sensitivity and specificity of 83.8% and 76.2%. Conclusion: In contrast to healthy controls, CAD patients had greater copeptin levels, according to our study. In these cases, copeptin levels can be employed as a biomarker. [ABSTRACT FROM AUTHOR]

Background: Cardiac involvement in diabetes commonly manifests as coronary artery disease. The current study's objective is to evaluate, via coronary angiography, the association between diabetes mellitus and coronary artery disease. Methods: The coronary angiography of 100 patients with significant coronary obstruction, between the age group from 30 years to 75 years of age, who were admitted with acute coronary syndrome from July 2023 to December 2023 at our centre were analysed. The coronary vessels involvement among patients with diabetes mellitus and without diabetes were compared. Results: Total 100 patients data was analysed, 50 with diabetes and 50 without diabetes with significant coronary vessel disease. In our study we found that the incidence of Triple vessel disease in diabetic patients was much higher (50%) compared to non-diabetics (18%). The incidence of double vessel disease in diabetic patients was also higher (26%) compared to non-diabetics (22%). And single vessel disease was much higher in non-diabetics (60%) than in nondiabetic patients. Conclusion: In comparison to non-diabetics with acute coronary syndrome, our study demonstrated that the incidence of multivessel disease, severity and diffuse involvement of the coronary vessels, and earlier onset of coronary vessel involvement were all significantly greater in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Soluble CD40 ligand (sCD40L) has been shown to have a significant role in pathogenesis of atherosclerosis development and plaque destabilization. The present study was done to investigate the association of sCD40L with angiographic severity of coronary artery disease in patients suffering from acute coronary syndrome (ACS). Methods: The study group comprised of 75 patients suffering from acute coronary syndrome. Blood sample was collected witnin 24 hours of admission prior to any intervention or angioplasty. Patients were divided into three groups of angiographic vessel score (AVS) according to coronary artery blockage - AVS1, AVS2, AVS3. Serum levels of sCD40L and CRP were measured using an ELISA and Troponin T was estimated by electro chemiluminiscence. Severity of coronary artery disease was evaluated using angiograpic vessel score (AVS). Results: Out of 75 study patients, 65 (87.5%) were males with mean age of 51.7 years. There was significant association between sCD40L levels and Angiographic vessel score (p=0.001) with sCD40L levels increasing with its severity [AVS-1, AVS-2 and AVS-3; 0.65 ng/dl (2.5), 0.20 ng/dl(2.66), 3.7 ng/dl(5.99)]. On the other hand, the median hs-CRP levels had no significant relationship with Angiographic vessel score (AVS-1, AVS-2 and AVS-3; 7.42 (5.3), 5.92 (5.9) and 7.19 (6.25) respectively) Conclusion: Serum sCD40L levels were found to be significantly associated with angiographic severity in patients suffering from acute coronary syndrome compared to hs-CRP levels. [ABSTRACT FROM AUTHOR]

Aim: To study the clinical and angiographic profile of patients who are diagnosed with acute coronary syndrome having non obstructive coronary arteries. Materials and method: The study was designed to study seventy-three patients who had been diagnosed with ACS and found to have normal coronaries that is obstruction less than 50% after coronary angiography. All these subjects detailed clinical profile; angiographic profile was analysed. Results: This study on 73 MINOCA patients 41.10 % of them were young in the age group of 31- 40 years and most of them were males (56.2%) with dyslipidaemia (71.2%), comorbidities like diabetes mellitus is found in 78% of MINOCA patients. 78.1% had alcohol consumption history and smokers were 28.8% of study population. Positive family history of CAD was found among 42.5 % of study population. Majority of the subjects had NSTEMI (80.8%), elevated troponin (98.6%), RWMA in found among 49.3% and 35.6% had heart failure at presentation. Slow flow coronaries were found in 16.4% and culprit artery was LAD in 49.3% of MINOCA patients. Conclusion: This study complements the study of MINOCA and provides some new data in this field that could improve the future management of these patients. [ABSTRACT FROM AUTHOR]

Introduction-Coronary artery ectasia and aneurysm is an uncommon angiographic finding, which involves a part or complete length of the coronary artery. It leads to significant cardiovascular outcomes and is considered a risk factor for coronary artery thrombosis. This study aims to evaluate the prevalence of coronary artery ectasia and aneurysm, their segmental involvement, and clinical presentation in patients with and without coronary artery disease (CAD). Material and methods- We did a cross-sectional, retrospective analysis of 1764 coronary angiogramsperformed between July 2019 to June 2020. Segmental involvement of coronary artery ectasia and aneurysm is studied in patients with and without CAD. Results- Prevalence of isolated aneurysm was 1.1%, isolated ectasiawas 20.2%, and ectasia with the aneurysm was 2.9%. Prevalence of aneurysm was similar between CAD and non-CAD group (1.2 vs. 1.1%, p < 1.000). Prevalence of aneurysm with ectasia was also similar between CAD and non-CAD groups (2.9 vs. 3.2%, p = 0.785). The prevalence of isolated ectasia was more in the CAD vs. non-CAD group (22 vs. 13.7%, p < 0.001). Most commonly, coronary artery aneurysm and ectasia are presented as NSTEMI (non-ST elevation myocardial infarction) followed by STEMI (ST-elevation myocardial infarction). Conclusion- Coronary artery ectasia is more common than aneurysms. Isolated coronary ectasiawas prevalent in patients with coexisting coronary artery disease, unlike the aneurysm. Coronary artery ectasia and aneurysm most commonly presented as NSTEMI, followed by STEMI. [ABSTRACT FROM AUTHOR]

Introduction: It is usually considered that pain in acute coronary syndrome has no localising value to identify the coronary artery involved. A few studies have tried to correlate the location and radiation of pain to the occluded vessel with conflicting results. The present study was done to find out the relationship between the site and / or radiation of chest pain with culprit artery in acute ST elevation myocardial infarction (STEMI). Methods: Out of 469 patients admitted with STEMI for primary PCI, 274 patients were included. Exclusion criteria included patients with prior history of coronary syndrome, patients with multivessel disease (>50% lesion in non-culprit vessels), unable to localise the site and/or radiation of chest pain and unwillingness to give consent. Results: Majority of the patients (62.5%) with chest pain radiating to left arm were having LAD occlusion while the majority of the patients (57.1%) with chest pain radiating to right arm were having RCA occlusion. Patients with chest pain radiating to neck and or jaw were having statistically significant higher occlusion of RCA (96.4%) with a p value of <0.05. Surprisingly, LAD involvement was not present even in single case in acute coronary syndrome patients presented with chest pain radiating to neck/jaw. Conclusion: The present study showed a very high positive predictive value (96.42%) of radiation of anginal pain to neck/jaw radiation for predicting the RCA occlusion in patients presenting with acute ST elevation MI. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome is often precipitated by a sudden thrombosis induced by the rupture or erosion of an atherosclerotic plaque. In individuals with acute chest pain, culprit lesions' non-invasive detection has the ability to improve non-invasive risk classification. Coronary computed tomography angiography [CCTA] detects luminal stenosis and visualizes atheromatous mural changes [coronary plaques]. A higher risk of acute cardiovascular events is seen in individuals having a large plaque volume, positive remodeling, napkin-ring sign, spotty calcification, and low CT attenuation. Coronary CTA has shown to be a promising method for determining coronary lesions' functional significance via the use of rest/dynamic myocardial CT perfusion and/or CT-derived fractional flow reserve [FFR-CT]. Other invasive procedures as intravascular ultrasound and optical coherence topography gain important insights but are limited to high-risk patients. [ABSTRACT FROM AUTHOR]