NON-INVASIVE PREDICTORS AND PREVALENCE OF LEFT MAIN OR TRIPLE VESSEL DISEASE IN PATIENT WITH CORONARY ARTERY DISEASES
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 5
Abstract
BACKGROUND Aim- Coronary artery disease is one of the common cause of death all over the world. There have been only few studies done regarding non-invasive predictors and prevalence of left main (LMD) or triple vessel disease (TVD) in patients with CAD. Uncertainties still exist about their prevalence and predictors in patients with CAD. Our aim was to detect non-invasive predictors, prevalence and clinical profiles of LMD/TVD patients. MATERIALS AND METHODS We collected data of 200 consecutive patients with CAD at our hospital (a tertiary care center). Selective coronary angiography in multiple views was performed by standard technique to define both the extent and severity of disease. Patients with LMD/TVD were included in the study and evaluated for their non-invasive predictors. Patients were divided into two groups-acute coronary syndrome (ACS) group and patients with stable coronary disease group (EA-Effort angina). Stable coronary disease group means TMT positive patients. A predefined proforma was completed in every patient with a detailed clinical history, physical examination, and investigation studies. The clinical history revealed information about age, gender, risk factors, modes of presentation, and duration of symptoms. The details of physical examination including anthropometric data, vital signs and complete systemic evaluation were recorded. The subjects were evaluated for conventional risk factors i.e. smoking, diabetes mellitus, systemic hypertension and family history of premature CAD. RESULTS Diabetes and dyslipidaemia was more common in ACS group compared to EA group and it was statistically significant. AWMI was most common in ACS group. Low ejection fraction and high TIMI score was seen in ACS group and it was statistically significant. Incidence of TVD+LMD was 17%, only TVD 24% and only LMD was 9%, it is comparable with other study. ECGaVR elevation was seen in 24% patients and it was statistically significant and it is comparable with other study. The most common predictors of TVD/LMD disease were heart failure at clinical presentation (reported in 44% of studies), degree of ST elevation in lead aVR (reported in 24% of cases) and high TIMI score (reported in 88% of cases) were the most powerful predictors, all of them were statistically significant. CONCLUSION We concluded that an ST↑aVR of 0.5 mm or greater predicted LMD/TVD and an independent predictor of prognosis during hospitalization period. Low ejection fraction and high TIMI score are also good noninvasive predictors of LMD /TVD. Prevalence of LMD and TVD in our study was 9% and 24% respectively.
Authors and Affiliations
Basavaraj Devendrappa Baligar, Narendra Shankargouda Hiregoudar, Prakash S. S, Manjunath Nanjappa Cholenahalli, Uday Subhas Bande
SERUM CREATINE PHOSPHOKINASE LEVEL- AS A SEVERITY MARKER IN ACUTE ORGANOPHOSPHATE POISONING
BACKGROUND Organophosphorus (OP) pesticides are arguably one of the most common cause of morbidity and mortality due to poisoning worldwide especially in developing countries like India, where agriculture is the backbone...
ROLE OF MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF INTERNAL DERANGEMENT OF KNEE JOINT
BACKGROUND Knee injuries are very common due to sports and repetitive activities. Accurate evaluation of the knee injuries is very essential for the proper management and outcome. The objective of this study is to correl...
DEPRESSIVE FEATURES AND SUICIDAL IDEATION IN ADULTS WITH OBSESSIVE COMPULSIVE DISORDER- A HOSPITAL BASED CROSS SECTIONAL STUDY
BACKGROUND Obsessive Compulsive Disorder (OCD) is a chronic distressing anxiety disorder associated with significant functional impairment. Because of the demoralization and hopelessness caused by obsessive compulsive sy...
STUDY OF UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS AND PRESENCE OF HELICOBACTER PYLORI INFECTION AMONG ADULT PATIENTS OF UPPER ABDOMINAL PAIN AND DYSPEPSIA
BACKGROUND Dyspepsia is a common presenting complaint of various upper gastrointestinal disorders. The symptoms of causes of dyspepsia often overlap and this makes aetiological diagnosis difficult. Endoscopy is the ideal...
DOPPLER STUDY IN HIGH-RISK PREGNANCIES IN THIRD TRIMESTER OF PREGNANCIES FOR PREDICTION OF ADVERSE PERINATAL OUTCOME
BACKGROUND Our study aimed to evaluate the Doppler value in third trimester of pregnancy where the features at risk is suspected. The patient with abnormal findings are identified and intervened for timely confinement. A...