scholarly journals Left main and/or three-vessel disease in patients with non-ST-segment elevation myocardial infarction and low-risk GRACE score: Prevalence, clinical outcomes and predictors

2018 ◽  
Vol 37 (11) ◽  
pp. 911-919
Author(s):  
João Filipe Carvalho ◽  
Adriana Belo ◽  
Kisa Congo ◽  
David Neves ◽  
Ana Rita Santos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Low Risk ◽  
Left Main ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Grace Score

scholarly journals TCT-97 Clinical Outcomes of Unprotected Left Main ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 78 (19) ◽  
pp. B40-B41
Author(s):  
Aaqib Malik ◽  
Tomo Ando ◽  
Alexandros Briasoulis ◽  
Jayakumar Sreenivasan ◽  
Hisato Takagi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Left Main ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Clinical and Angiographic Characteristics of Female Patients Undergoing Coronary Angiography in a Tertiary Hospital in Bangladesh

2019 ◽  
Vol 7 (1-2) ◽  
pp. 9-14
Author(s):  
Sahela Nasrin ◽  
F Aaysha Cader ◽  
M Maksumul Haq
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Left Ventricular ◽  
Left Main ◽  
St Segment Elevation ◽  
Female Patients ◽  
Vessel Disease ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Artery Disease

Background & objective: Coronary artery disease (CAD) is increasingly prevalent among female population, particularly in South Asia, and a large number of female patients currently undergo coronary angiography for a variety of indications. The objective of this study was to investigate the clinical and angiographic characteristics of female patients undergoing coronary angiogram, in a tertiary cardiac center in Bangladesh. Methods: This retrospective observational study was conducted at Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh during the period from 1st September 2005 to 31st August 2016. A total of 7,627 female patients who underwent coronary angiography were included. Obstructive coronary artery disease (CAD) was defined as a stenosis ≥70% in at least one of the three major coronary arteries or a stenosis ≥50% in left main stem. Result: Nearly two-thirds (64.4%) of patients comprised of age group of 41-60 years with mean age of the patients being 55.4 ± 10.2 years. Unstable angina (38.2%) was the commonest indication for coronary angiography followed by stable ischemic heart disease (25.1%), non-ST segment elevation myocardial infarction (12.8%), ST segment elevation myocardial infarction (9.3%), left ventricular failure (7.5%), post-myocardial infarction angina (6%) and atypical chest pain (1.3%). Over three quarters were hypertensive 68.3% were diabetic and 29% and dyslipidemiac. Over 40% of the patients were overweight and 20% were obese. On trans-thoracic echocardiography, 65.2% had normal left ventricular (LV) systolic function; 17.6% and 9.9% had mild and moderate LV systolic dysfunction respectively. Nearly 30% had normal epicardial coronary arteries on angiography, while 17.4%, 16.5% and 37.2% had triple vessel disease (TVD), double vessel disease (DVD) and single vessel disease (SVD) respectively. Following angiography, 33.4% were advised PCI, 30.2% optimal medical management and 15.3% CABG. A few (3.2%) were advised for revascularization either by CABG or PCI. Conclusion: Unstable angina is the most common indication for coronary angiography among Bangladeshi females. A clustering of risk factors for CAD such as hypertension, diabetes and overweight or obesity are observed in them. Of the obstructive CADs, SVD is the most frequent finding, indicating that females undergoing CAG are likely to have diffuse CAD, although left main disease is not uncommon in this population. Further comparative studies with matched male population are recommended to find the differences in clinical and angiographic findings with respect to sex. Ibrahim Card Med J 2017; 7 (1&2): 9-14

Patient survival after acute myocardial infarction treated with primary percutaneous coronary intervention within the left main coronary artery according to time of admission

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Januszek ◽  
K Bujak ◽  
M Gasior ◽  
D Dudek ◽  
S Bartus
Keyword(s):  
Myocardial Infarction ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Night Time ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes ◽  
Overall Mortality

Abstract Background Previously published studies assessing the time effect of primary percutaneous intervention (PCI) on long-term clinical outcomes in an overall group of patients with acute coronary syndromes has been widely investigated. It has been suggested that night-time admission may negatively influence long-term overall mortality. Patients treated within the left main coronary artery (LMCA) belong a narrow group of high-risk procedures that require an operator and a team with high skills. Purpose The aim of the presented study was to assess the relationship between the time of pPCI (day- vs. night-time) and overall mortality among patients treated due to AMI within the LMCA. Methods This observational study was performed on 443,805 patients hospitalised due to non-ST segment elevation myocardial infarction (NSTEMI) or ST-segment elevation myocardial infarction (STEMI). Patients were prospectively enrolled between January 2006 and December 2018 in the ongoing Polish Registry of Acute Coronary Syndromes (PL-ACS). From the overall group of patients, the authors selected 5,404 patients treated within the LMCA. After taking exclusion criteria into consideration, the patients were divided according to time of PCI treatment: daytime hours (7:00 a.m.-10:59 p.m.) – 2,809 patients and night-time hours (11:00 p.m. - 6.59 a.m.) – 473 patients. Results Patients treated during night-time and daytime did not differ significantly in age (70.79 [61.52–79.73] vs. 69.73 [60.8–78.82] years, p=0.13) or gender – males (67.6% vs. 67.0%, p=0.79). Patients treated during daytime presented with significantly higher rate of STEMIs (67.2% vs. 49.9%) and lower rate of NSTEMIs (32.8% vs. 50.1%) in comparison to those treated during night-time (p<0.001). The 30-day and 12-month overall mortality rates were significantly greater among patients treated during night-time hours (20.3% vs. 14.9%, p=0.003) and (31.7% vs. 26.2%, p=0.001). Kaplan-Maier survival curves confirmed this relationship (p=0.001). Multiple regression analysis did not confirm that the time of pPCI (day- vs. night-time) is significantly related to survival (hazard ratio [HR]: 1.22; 95% confidence interval [CI]: 0.96–1.55, p=0.099). However, significance was achieved for the left ventricle ejection fraction (HR: 0.95; 95% CI: 0.94–0.95, p<0.001), systolic blood pressure on admission (HR: 0.995; 95% CI: 0.991–0.998, p=0.005), age (HR: 1.04; 95% CI: 1.03–1.05, p<0.001), the use of intra-aortic balloon counterpulsation (HR: 1.04; 95% CI: 1.03–1.05, p<0.001) and diagnosed peripheral artery disease (HR: 1.55; 95% CI: 1.2–2.01, p<0.001). Conclusions The time of pPCI (day- vs. night-time) in patients with AMI and treated within the LMCA is related to the overall 30-day and 12-month survival which is poorer in those treated during the night-time. However, this relationship was not confirmed by multiple regression analysis and was not found to be significant among other stronger predictors. Funding Acknowledgement Type of funding source: None

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