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Background: The myocardial performance index (MPI) can assist in the non-invasive diagnosis of coronary artery disease (CAD) in patients selected for further management. However, there is limited data on MPI in patients with Acute Coronary Syndrome (ACS), and its relationship with the severity of coronary atherosclerosis in this group remains unclear. This study aims to determine whether MPI can predict the angiographic severity of CAD and to evaluate its association with both systolic and diastolic dysfunction in patients with ACS. Methods: This Hospital Based Analytical Prospective cross-sectional study included a total 155 patients with acute coronary syndrome from December 2022 to May 2024 who underwent coronary angiography. Echocardiography evaluation of Myocardial Performance Index was done by using Pulse wave Doppler evaluation. Angiographic severity was done through Gensini scoring system. The ROC curves were constructed. It was deemed statistically significant when p< 0.001) between the Myocardial Performance Index (MPI) and the Gensini scoring system in the patients with Acute Coronary Syndrome. Results: In this study, patients were categorized based on low, mid, and high Syntax and Gensini scores. The MPI (Tei Index) exhibited statistically significant positive correlation with the Gensini scor e. Conclusion: Echocardiographic assessment of the Myocardial Performance Index (MPI) in patients with acute coronary syndrome can serve as a valuable surrogate marker for the detection of severity of coronary artery disease. It also has the potential to predict the complexity of coronary artery disease and guide the necessary interventions. [ABSTRACT FROM AUTHOR]

Background: Clinical scoring systems such as the GRACE, TIMI and HEART score can predict major adverse cardiovascular events, but they cannot be used to demonstrate the degree and severity of coronary artery disease. We investigated the potential of these clinical Score in detecting the existence and severity of coronary artery disease based on SYNTAX score. Methods-cross-sectional study was conducted for a period of 1 years from August 2022 to August 2023. Association between the scores was established by the Pearson's linear correlation test while the accuracy of the clinical scores versus SYNTAX score was determined with the ROC curve. Results: A total of 150 patients were enrolled. Median GRACE, TIMI and HEART scores were 95, 4 and 6, respectively, whereas the median SYNTAX was 14. When evaluating the ROC curve, we observed that raised levels of all clinical scores could accurately predict a high SYNTAX score (>32). The association of SYNTAX score with HEART, TIMI, and GRACE scores resulted in an area under the receiver operating characteristic ROC curve (AUC) of 0.811 (95% CI 0.72-0.912, p < 0.01), 0.792 (95% CI 0.641-0.972), and 0.761 (95% CI 0.531-0.791), respectively. Conclusion: The clinical scores presented a positive association with the SYNTAX score. The combined use of HEART and GRACE and TIMI, offers good accuracy for detecting angiographic complexity. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome (ACS) patients can be successfully treated with percutaneous coronary intervention (PCI). The anti-anginal drug Nicorandil works to improve microvascular circulation and boost coronary blood flow. During percutaneous coronary intervention (PCI), an intracoronary injection of nicorandil can be utilized to treat the severe no-reflow phenomena. By enhancing microvascular circulation in those with acute myocardial infarction, it also lessens the occurrence of the slow-flow phenomena. We describe case series pertaining to complete heart block following intracoronary administration of nikorandil during percutaneous coronary intervention. Electrocardiography monitor of cath-lab unit showed complete heart block during hemodynamic monitoring while PCI.Coronary angioplasty was done in all three patients. In all three the patients after placing a stent in proximal RCA, coronary angiography showed TIMI grade 2 flow in RCA, 2 mg nicorandil was intracoronary administrated. Immediately, there was complete heart block following Nicorandil administration, the rhythm reverted to sinus after immediate administration of 0.6 mg atropine. All patients had a good outcome during follow-up after 1 month. Addition to the literature: Up to now, there has been no report of complete heart block caused by intracoronary administration of nicorandil. Although intracoronary nicorandil is one of the most often employed techniques to increase coronary flow, much more focus should be placed on nicorandil's side effects. [ABSTRACT FROM AUTHOR]

Background: Serum uric acid (SUA) level is one of the cardiovascular risk factors, according to numerous researches. The purpose of the research is to determine how SUA levels relate to the severity of coronary artery disease (CAD) in patients with acute coronary syndrome(ACS) as determined by angiography and the Syntax score. Method : This investigation was done in patients who came to our institution with acute coronary syndrome between August 2022 and September 2023. Following admission, SUA and other blood parameters were ascertained. Initially, the patients were categorized into three groups based on their Syntax scores: low, moderate, and high. The low group included scores ≤22, intermediate (22-33), and high scores (>33). Results: The study included 150 patients. The mean age of the study population was 60.5 ± 8.0 years. 52 were female (34.6%) and 98 were male (65.3%). Of the patients, 60.0% had hypertension, 55.6% had diabetes mellitus, 60.0% had smoking, 75.3% had dyslipidemia. The mean SYNTAX score was 16.6 ± 11.9. According to the SYNTAX score (31.1 %) had mild CAD (SYNTAX score: 1–22), (38.9%) had moderate CAD (SYNTAX score: 23–32), and had 33% severe CAD (SYNTAX score: ≥ 33). The mean SUA values were 5.23 ± 1.4 mg/dL in the mild CAD group, 6.0 ± 1.4 mg/dL in the moderate CAD group, and 6.7 ± 1.6 mg/dL in the severe CAD group. According to Spearman’s rho analysis, a positive correlation between the SUA levels and the SYNTAX score was determined to be statistically significant (p < 0.001, r = 0.240; p = 0.002, r = 0.150 in men; p = 0.001, r = 0.203 in women). Conclusions: SUA levels are associated with the severity of CAD in patients with ACS. An elevated SUA may be useful as a biomarker of the severity of CAD. [ABSTRACT FROM AUTHOR]