Aortic knob calcification and coronary artery lesion complexity in non-ST-segment elevation acute coronary syndrome patients

2012 ◽  
Vol 40 (7) ◽  
pp. 606-611 ◽  
Author(s):  
Levent Korkmaz
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Lesion ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome

scholarly journals Timing of dual antiplatelet therapy in acute coronary syndrome: a problem of coronary artery bypass grafting accessibility for patients

2020 ◽  
Vol 25 (8) ◽  
pp. 3812
Author(s):  
T. S. Golovina ◽  
Yu. N. Neverova ◽  
R. S. Tarasov
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Antiplatelet Therapy ◽  
Coronary Artery Bypass ◽  
Dual Antiplatelet Therapy ◽  
Artery Bypass ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome

The feasibility of dual antiplatelet therapy as early as possible in patients with ST-segment elevation acute coronary syndrome, where percutaneous coronary intervention is recommended, has been proven: it improves treatment outcomes by reducing the risk of adverse ischemic events, including stent thrombosis and myocardial infarction.This article provides a detailed analysis of the evidence data and current recommendations on the validity and timing of dual antiplatelet therapy for acute coronary syndrome. The emphasis is made on the controversy regarding the early dual antiplatelet therapy in non-ST-segment elevation acute coronary syndrome. The rationale for using dual antiplatelet therapy only after coronary angiography and determining the revascularization strategy is described, which should increase the accessibility of coronary artery bypass graft surgery for patients.

Relation of vascular dilator function and cardiac autonomic function with coronary angiography findings in patients with non-ST segment elevation acute coronary syndrome

2020 ◽  
pp. 204887262091871
Author(s):  
Gaetano Antonio Lanza ◽  
Eleonora Ruscio ◽  
Gessica Ingrasciotta ◽  
Tamara Felici ◽  
Monica Filice ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Cardiac Autonomic Function ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease

Background A sizeable number of patients with a diagnosis of non-ST segment elevation acute coronary syndrome show non-obstructive coronary artery disease. In this study we assessed whether differences in vascular and cardiac autonomic function exist between non-ST segment elevation acute coronary syndrome patients with obstructive or non-obstructive coronary artery disease. Methods and results Systemic endothelium-dependent and independent vascular dilator function (assessed by flow-mediated dilation and nitrate-mediated dilation of the brachial artery, respectively) and cardiac autonomic function (assessed by time-domain and frequency-domain heart rate variability parameters) were assessed on admission in 120 patients with a diagnosis of non-ST segment elevation acute coronary syndrome. Patients were divided into two groups according to coronary angiography findings: (a) 59 (49.2%) with obstructive coronary artery disease (≥50% stenosis in any epicardial arteries); (b) 61 (50.8%) with non-obstructive coronary artery disease. No significant differences between the two groups were found in both flow-mediated dilation (5.03 ± 2.6 vs. 5.40 ± 2.5%, respectively; P = 0.37) and nitrate-mediated dilatation (6.79 ± 2.8 vs. 7.30 ± 3.4%, respectively; P = 0.37). No significant differences were also observed between the two groups both in time-domain and frequency-domain heart rate variability variables, although the triangular index tended to be lower in obstructive coronary artery disease patients (30.2 ± 9.5 vs. 33.9 ± 11.6, respectively; P = 0.058). Neither vascular nor heart rate variability variables predicted the recurrence of angina, requiring emergency room admission or re-hospitalisation, during 11.3 months of follow-up. Conclusions Among patients admitted with a diagnosis of non-ST segment elevation acute coronary syndrome we found no significant differences in systemic vascular dilator function and cardiac autonomic function between those with obstructive coronary artery disease and those with non-obstructive coronary artery disease.

Should the primary percutaneous coronary intervention pathway be redesigned?

2019 ◽  
Vol 14 (8) ◽  
pp. 1-15
Author(s):  
Sue Dean
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Elevation Acute Coronary Syndrome

Background/Aims The primary percutaneous coronary intervention pathway for patients experiencing an ST segment elevation acute coronary syndrome excludes patients with aVR ST elevation. These patients are treated on the non-ST segment elevation acute coronary syndrome pathway, which means that they have a coronary angiogram +/− intervention during their inpatient stay. Patients with non-ST segment elevation acute coronary syndrome have worse outcomes nationally. As such, research is required to demonstrate areas for improvement. This article examines the association between aVR ST segment elevation on the electrocardiogram and significant left main stem, proximal left anterior descending, or 3-vessel coronary artery stenosis in acute coronary syndrome to establish whether the primary percutaneous coronary intervention pathway should be redesigned. Methods Existing literature was searched, and relevant studies were considered and evaluated. Data were collected within local NHS Trusts on patients who had aVR ST segment elevation on the electrocardiogram. The data were analysed, and the findings were compared and synthesised with the literature. Results The study demonstrated a relationship between aVR ST segment elevation and significant disease. However, because of the numbers involved, analysis to demonstrate statistical significance was not possible, with the exception of aVR ST segment elevation and left main stem coronary artery, left anterior descending coronary artery and triple vessel disease, where p<0.05 in the population with left main stem coronary artery occlusion +/− other disease. The study demonstrated that aVR ST segment elevation should be treated as an ST segment elevation acute coronary syndrome equivalent, as it is a high-risk finding. These patients should go immediately to the cardiac catheter laboratory for a primary percutaneous coronary intervention. Conclusion The need for a change in the primary percutaneous coronary intervention pathway was established.

scholarly journals ST Segment Depression in 12 lead ECG and Severity of Coronary Artery Disease in Non-ST segment elevation Acute Coronary Syndrome

2017 ◽  
Vol 9 (2) ◽  
pp. 116-121
Author(s):  
Mohammad Emdadul Hoque Miah ◽  
Abul Hussain Khan Chowdhury ◽  
Khandaker Qamrul Islam ◽  
Mir Jamaluddin ◽  
Shakil Ghafur ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Positive Correlation ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease ◽  
Vessel Score

Background: Patients of non-ST segment elevation acute coronary syndrome (NSTE ACS) is a large group who gets admitted in coronary care units. 12-lead electrocardiogram (ECG) provides the simple available and earliest objective information for risk stratification of NSTEACS. We tried to find out the association between magnitude of ST segment depression and angiographic severity in NSTE ACS patients.Methods: This cross sectional study was carried out in patients with NSTE ACS patients admitted into and underwent coronary angiography. A total number of 105 consecutive patients were included in this study. ST segment depression was measured and categorized according to magnitude of ST segment depression into three groups as Group I: No (<1mm) ST segment depression, Group II: 1-2 mm ( e”1 to <2mm) ST segment depression and Group III: e” 2 mm ST segment depression. Cumulative sum of ST segment depression and number of leads in ST segment depression also measured in all ECG leads. Angiographic severity was assessed by vessel score and Friesinger index. Significant CAD was considered if Friesinger index was e” 5. Magnitude of ST segment depression was correlated with angiographic severity of coronary artery disease.Results: According to ‘Friesinger index’ 56(53.33%) patients had significant CAD and 49(46.66%) patients had insignificant CAD. Magnitude of ST segment depression found to have significant relationship with severity of coronary artery disease (p<0.001). Number of leads in ST segment depression also revealed positive correlation (r = 0.446; p<0.001). Positive correlation was also found between sum of the ST segment depression and Vessel score (r= 0.435; p<0.001).Conclusion: Magnitude of ST segment depression is positively correlated with the angiographic severity of coronary artery disease in non- ST segment elevation acute coronary syndrome.Cardiovasc. j. 2017; 9(2): 116-121

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