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
Keywords
Related Articles
- EP ID EP451990
- DOI 10.18410/jebmh/2018/89
- Views 63
- Downloads 0
PLEURAL EFFUSION: A REVIEW
A pleural effusion is an excessive accumulation of fluid in the pleural space. It can pose a diagnostic dilemma to the treating physician because it may be related to disorders of the lung or pleura, or to a systemic dis...
IMPACT OF GLYCEMIC CONTROL ON OXIDATIVE STRESS AND ANTIOXIDANT STATUS IN DIABETIC NEUROPATHY
INTRODUCTION: Oxidative stress due to enhanced free-radical generation and/or a decrease in antioxidant defense mechanisms has been implicated in the pathogenesis of diabetic neuropathy. This study was conducted to study...
FEASIBILITY OF LAPAROSCOPIC CHOLECYSTECTOMY IN GANGRENOUS CHOLECYSTITIS IN A TERTIARY CARE CENTER
BACKGROUND Gangrenous cholecystitis is considered the most severe form of acute cholecystitis. It is associated with high morbidity and sometimes mortality. In the past studies laparoscopic cholecystectomy was considered...
A STUDY OF FOREIGN BODIES IN THE CRICOPHARYNGEAL REGION AND OESOPHAGUS IN A TRIBAL REGION OF CHHATTISGARH
BACKGROUND Foreign body in the food passage is a common problem; but piercing foreign bodies in the food passage may cause fatal complications like retropharyngeal abscess, pneumothorax, ulcerative oesophagitis, pneumoni...
LOCALIZED NEUROFIBROMA OF LABIUM MAJUS: A CASE REPORT
Neurofibromatosis is an autosomal dominant progressive disorder with an incidence of approximately 1 in 3000 live births. Its recognized features include hyperpigmented skin lesions (Cafe-au-lait spots), neurofibromas, i...