Search

Background: Multivessel disease(MVD) is linked to a poorer prognosis, increased complications, longer hospital stays, and higher in-hospital mortality when compared to single-vessel disease(SVD).The purpose of this study is to explore the clinically relevant predictors of acute cornary syndrome (ACS) combined with MVD., Methods: This multicenter retrospective study included 68,378 ACS patients from 240 hospitals.The clinical data were retrospectively analyzed with univariate and multivariate analyses to identify the predictive factors for MVD., Results: When compared to SVD group, the MVD group showed a higher incidence of Major Adverse Cardiovascular Events(MACCEs), including all-cause death, myocardial infarction, stent thrombosis, and ischemic stroke during hospitalization, These differences were found to be statistically significant (P < 0.05) .The multivariate analysis revealed that age over 75 years (OR: 1.246, 95% CI: 1.176, 1.319), LDL/HDL ratio > 1.98 (OR: 1.245, 95% CI: 1.192, 1.302), history of heart failure (OR: 1.446, 95% CI: 1.143, 1.829), hypertension (OR: 1.274, 95% CI: 1.225, 1.325), diabetes (OR: 1.341, 95% CI: 1.278, 1.406), eGFRs < 60 ml/min·1.73m2 (OR: 1.179, 95% CI: 1.112, 1.249), family history of CAD (OR: 1.236, 95% CI: 1.108, 1.379), and high homocysteine levels (OR: 1.209, 95% CI: 1.029, 1.420) are independent predictors of MVD. The incidence of multivessel disease increased from 37.7 to 58.6% with an increase in the number of predictive factors, while the incidence of single vessel disease decreased from 62.3 to 41.4%. This trend was statistically significant (P trend < 0.001)., Conclusions: MVD is strongly correlated with a range of risk factors including diabetes, hypertension, LDL/HDL ratio greater than 1.98, hyperhomocysteinemia, family history of CAD, reduced glomerular filtration rate (< 60 ml/(min·1.73m 2 ), age over 75 years, and a history of heart failure. Furthermore, as the number of predictive factors increases, the odds ratio (OR) for patients with MVD also increases, reaching 2.344 times the OR for patients without any predictive factors., (© 2024. The Author(s).)

Objectives: Patients with unstable angina and non-ST-elevated myocardial infarction (NSTEMI) present with a spectrum of cardiac events and death. Hence, early accurate management should be initiated. This can be achieved by risk stratifying the patients as early as possible on hospital admission. Thrombolysis in myocardial infarction (TIMI) risk score assessment is used widely for this purpose. It helps to standardize the approach of management and compare the extent and number of vessels involved in the coronary angiogram. This research aims to assess coronary artery disease (CAD) in individuals with NSTEMI by examining the extent of vessel involvement and the complexity of coronary artery blockages, using the SYNTAX score about the TIMI risk score. Materials and Methods: This cross-sectional observational study involved 60 participants who were selected based on specific inclusion and exclusion criteria. The TIMI risk score was computed for each individual, categorized as either <4 or =4, and the results of their coronary angiogram were analyzed to assess the degree of vessel involvement, categorizing it as either single-vessel disease (SVD) or multi-vessel disease (MVD). The Syntax score was computed for all angiograms and divided into two groups based on whether it was =22 or >22. Results: The average age of the participants in our study was 56 ± 10.64, with an age range of 34. Gender distribution revealed a higher proportion of males, constituting 68.3% (41 individuals), while females accounted for 31.7% (19 individuals). The angiogram results demonstrated that among the patients with TIMI score <4, 70% (14 individuals) had SVD, 30% (6 individuals) had MVD, and among those with score =4, 15% (6 individuals) had SVD while 75% (34 individuals) had MVD. In the subgroup analysis of TIMI <4, a Syntax score <22 was observed in 15 cases of SVD and a score >22 was observed in cases of MVD. Likewise, in the TIMI >4 group, a Syntax score <22 was observed in 12 cases of SVD and a score >22 was observed in 28 cases of MVD. Conclusion: This study noted that patients with non-ST-segment elevation acute coronary syndrome who underwent coronary angiogram and had a TIMI score of =4 were observed to have a 13-fold increased likelihood of having multi-vessel Coronary artery disease (CAD) compared to those with a TIMI score of <4. TIMI score of =4 had a 7 times higher chance of getting a SYNTAX score >22. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. It occurs due to blockage of blood vessels supplying the area of the heart. Increased age, diabetes, hypertension, dyslipidemia, and significant alcohol history are some of the major risk factors for acute coronary syndrome (ACS). After coronary angiography, (CAG) angioplasty is the mainstay of treatment. Objectives: The objectives were: (1) To assess the clinical profile of patients with ACS. (2) To study the angiographic profile of patients with ACS. Materials and Methods: A cross-sectional study of 110 patients who underwent CAG at a tertiary care teaching hospital, Amritsar, from April 2021 to July 2022 was studied. Detailed history and echocardiographic findings were obtained. Angiographic findings were studied with management. Data were analyzed using SPSS (version 22) and Chi-square test. Results: Double-vessel disease was the most common angiographic abnormality in unstable angina and ST-elevation myocardial infarction (STEMI); whereas in non-STEMI, triple-vessel disease was the most common. The left anterior descending artery was the most common artery involved. Patients with the age of 51-60 years were the most commonly involved patients, and males had a more severe form of CAD. Smoking did not affect the severity of the disease. Conclusions: Increased age, male sex, and patients with diabetes mellitus, hypertension, and dyslipidemia were predisposed to develop ACS. Smoking did not affect the severity or pattern of artery involvement. [ABSTRACT FROM AUTHOR]

Background: Acute coronary syndrome (ACS) is a potentially life-threatening condition which is more common in elderly people, and young are relatively protected. Currently, the protective effect on young from coronary artery disease (CAD) is taken away by several risk factors. The aim of this study is to determine the conventional risk factors and angiographic correlation of CAD in young age (40 years). Materials and Methods: This study was a hospital-based retrospective cross-sectional analytical study involving 1151 patients of ACS admitted in the cardiac ICU from May 2016 to May 2018. Among these patients, coronary risk factors such as smoking, diabetes, hypertension, dyslipidemia, and family history were studied. Patients were divided into two groups, Group A: 40 years. Patients were evaluated angiographically. The significance of each risk factor between the groups was calculated by employing the Chi-square test and P < 0.05 was taken as statistically significant. Results: A total of 1151 cases were included in the study, of which 120 cases were

Background: Inflammation plays a key role in the pathogenesis of atherosclerosis and coronary artery disease (CAD). Aim and Objectives: The aim of this study was to assess the relation of serum high-sensitivity C-reactive protein (hs-CRP) with the presence and severity of CAD. Study Design: This was a cross-sectional, observational study done on patients with diagnosis of acute coronary syndrome (ACS) undergoing coronary angiogram (CAG). Materials and Methods: A total of 100 patients were included in this study satisfying the inclusion criteria. The inclusion criteria were patients with the diagnosis of ACS undergoing CAG. All enrolled patients underwent hs-CRP, hemoglobin, serum creatinine, fasting lipid profile, blood sugar level, resting 12-lead electrocardiogram, creatine kinase–myocardial band, troponin -I, and CAG. Statistical Analysis: Data were analyzed for mean, percentage, standard deviation and Chi-square test for quantitative data using SPSS software version 21 (trial version), and P < 0.05 was considered statistically significant. Results: A total of 63% of male and 37% of female patients underwent CAG. The mean level of hs-CRP was 2.73 (±0.73) mg/L. The level of hs-CRP, severity of coronary artery involvement, and CAD risk factors was significantly more with an hs-CRP level of 1–3 mg/L followed by >3 mg/L. The significant number of patients with double-vessel disease (DVD) and triple-vessel disease (TVD) had an hs-CRP level between 1 and 3 mg/L compared to single-vessel disease (SVD) with P < 0.03. About 67.57% of females and 44.44% of males had an hs-CRP level of 1–3 mg/L, respectively (P < 0.02). A total of 53% of population had an hs-CRP level between 1 and 3 mg/L, 23% had <1 mg/L, and 24% had >3 mg/L (P < 0.02). The hs-CRP was positively correlated with severity of CAD by angiogram (+0.21). Conclusions: A significant number of patients had an hs-CRP level of 1–3 mg/L. The severity of CAD was positively correlated with a level of hs-CRP in incremental fashion. Patients with DVD and TVD had a high hs-CRP level compared to SVD. The hs-CRP can be considered as novel CAD risk factors to be screened in the patients with CAD where it cannot be forecasted by traditional risk factors. [ABSTRACT FROM AUTHOR]