scholarly journals Relationship between Hemoglobin A1c Level and Severity of Coronary Artery Disease Among The Hospitalized Patients with Acute Coronary Syndrome

2018 ◽  
Vol 33 (2) ◽  
pp. 80-84
Author(s):  
Syed Dawood Md Taimur ◽  
Sahela Nasrin ◽  
M Maksumul Haq ◽  
MA Rashid ◽  
Hemanta I Gomes ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hemoglobin A1c ◽  
Diabetic Patients ◽  
Age Group ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Group A ◽  
Artery Disease ◽  
Group B

Background : Diabetes mellitus is one of the important risk factors for coronary artery disease. The hemoglobin A1c is used for evaluating glycemic control in diabetic patients. Here, we conducted the study to evaluate the relationship between HbA1c level and severity of coronary artery disease among the hospitalized patients with ACS. Materials & Methods : This cross sectional study was conducted in the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from September 2015 to December 2015. Total of one hundred patients were studied and they were grouped on the basis of their glycaemic status. One hundred patients with acute coronary syndrome were enrolled in this study. Out of them fifty were diabetic (HbA1c>6.5%) and rest of were nondiabetics (HbA1c<6.5%) ( group-A and B). Results: Out of one hundred patients fifty eight were male and fourty two were female. Mean age of patients in group-A was 58.54±10.22 years and mean age of patients in group-B was 54.52±13.69 years. Mean age of male and female was 57.72±11.48 years and 54.0±13.08 years respectively. Mean HbA1c of patients in group-A was 11.43±1.43% and group-B was 6.34±0.915%. 38% of group-A and 22% of group-B had triple vessel disease, 26% of group-A and 20% of group- B had double vessel disease and 28% of group-A and 18% of group-B had single vessel disease, and 8% of group-A and 40% of group-B had normal coronary arteries. 48% patients of age group 46-50 in group-A had more incidence in coronary artery disease than other age group which was statistically significant ( p=0.035). 61-75 years age group in group-B patients had coronary artery disease than other age groups which was statistically not significant(p=0.084). Patients of group-A was significantly relation with coronary artery disease (p>.001) and six times greater coronary artery disease than patients of group-B (OR= 6.15, 95% CI for OR =2.074 -18.289). Conclusions: In this way the importance of appropriate glycaemic control has been emphasized in diabetic patients. This study showed the relation between HbA1c levels and the severity of CAD in patient with type-II diabetes mellitus .Our findings demonstrate that elevated HbA1c level was risk factor for severity of coronary artery disease in ACS patients. Bangladesh Heart Journal 2018; 33(2) : 80-84

scholarly journals Angiographic Severity of Coronary Artery Disease in Diabetic and Non-Diabetic Patients in a Tertiary Care Centre

2015 ◽  
Vol 10 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Tanjima Parvin ◽  
KMHS Sirajul Haque ◽  
Md Abu Siddique ◽  
SM Ahsan Habib ◽  
Mukhlesur Rahman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Main Stem ◽  
Diabetic Patients ◽  
Left Main ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Left Main Stem ◽  
Severe Coronary Artery ◽  
Artery Disease

Objective: Diabetes mellitus, a common metabolic disorder, is often associated with severe coronary artery disease. In this study, we compared the angiographic severity of coronary artery disease in diabetic patients compared with that of non diabetic patients.Methods: This observational study comprised of 102 subjects who had coronary artery disease on coronary angiography in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2009 to December 2009. The patients were divided into two groups: one group with 24 (23.5%) diabetic patients and another group with 78 (76.5%) non diabetic patients. Demographic, clinical, laboratory and angiographic data were analyzed and compared between two groups.Results: Mean age±SD of the study subjects was 52.8±9.5 years and 94 (92%) of them were male. Diabetic patients were older (mean age±SD; 57.6±9.5 versus 51.3±9.9 years; p 004), and had higher frequency of hypertension (75% versus 50%, p 0.036), chronic stable angina (71% versus 41%, p 0.018), and lower frequency of smoking (42% versus 67%, p 0.034) and acute coronary syndrome (29% versus 59%; p 0.018) in comparison to non diabetic patients. Left main stem disease (21% versus 5%, p 0.031) and three-vessel disease (50% versus 31%, p 0.094) were more prevalent in diabetic patients. Severe coronary artery stenosis was significantly more present in diabetics than non diabetics (Gensini score, 50.9±29.9 versus 32.6±21.9, p 0.001).Conclusion: Diabetic patients are more likely to have severe and extensive coronary artery disease. Left main stem and triple vessel disease are more commonly seen in diabetic patients compared to non diabetic patients.University Heart Journal Vol. 10, No. 1, January 2014; 13-17

scholarly journals Profile of acute coronary syndrome in young diabetics: a review

2020 ◽  
Vol 7 (5) ◽  
pp. 869
Author(s):  
Lakshmi Narayanan ◽  
Mohamed Hanifah
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Clinical Presentation ◽  
Exclusion Criterion ◽  
Diabetic Patients ◽  
Angiographic Finding ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Artery Disease

The clinical presentation and angiographic findings of coronary artery disease (CAD) varies from diabetic and non-diabetic patients and varies with the age of presentation. Coronary artery disease in patients below the age of 45 is a special subset. The objective of this study is to compare the clinical and angiographic profile in patients with the acute coronary syndrome (ACS) with diabetes mellitus (DM) and without DM below the age of 45 years. Clinical Presentation of coronary artery disease in young patients with various risk factors differs, which plays an important role in management strategies. This was conducted through internet search on PubMed and ProQuest database from 2000 to until 2019. Key words used for searching are acute coronary syndrome, young diabetics, and clinical, angiographic profile. An important exclusion criterion is studies which included type one diabetic patients. Totally 35 papers were reviewed. Pattern of involvement of coronary arteries as assessed by the coronary angiographic study is found to be different in younger CAD patients. Atypical clinical presentation and distinct angiographic finding are common in diabetics below the age of 45. In most of the studies single vessel disease (SVD) is the most common angiographic finding in young CAD and non-diabetics. While the diabetics showed the more diffuse pattern of double vessel disease (DVD).

scholarly journals Relationship between HDL-Cholesterol and Angiographic Severity of Coronary Artery Disease

2018 ◽  
Vol 33 (1) ◽  
pp. 32-38
Author(s):  
Mohammed Iqbal Ahmed ◽  
Khandker Mohammad Akhtaruzzaman ◽  
Mohammad Arifur Rahman ◽  
Mohammad Selim Mahmod ◽  
Shamsun Nahar
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Lipoprotein Cholesterol ◽  
Coronary Artery Diseases ◽  
Vessel Disease ◽  
Significant Difference ◽  
Low Hdl ◽  
Group A ◽  
Artery Disease ◽  
Group B

Background: Dyslipidaemias is one of the major risk factor for Coronary artery diseases (CAD).There is an inverse correlation between high density lipoprotein cholesterol (HDL-C) and the risk of coronary artery disease. Understanding the angiographic characteristics of coronary artery diseases (CAD) in low and normal HDLC patients and its association with severity of CAD is very important for future intervention. Although highdensity lipoprotein cholesterol (HDL-C) is well established predictor of future cardiovascular event, little information is available regarding its correlation with the prevalence and severity of angiographically evaluated coronary artery diseases (CAD).Materials and Methods: This cross-sectional comparative study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from January 2012 to December 2013. We included 100 patients with coronary artery diseases and divided into two groups. 50 patients with low HDL-C (<40 mg/dl) were taken in study group (Group-A) and 50 patients with normal HDLC (>40 mg/dl) were taken in control group (Group-B) according to inclusion and exclusion criteria. Coronary angiography was performed via the trans-femoral approach using standard techniques. Severity of CAD was determined by vessels score and Friesinger score.Results: The age [51.1 (SD 8.7) years vs 51.4 (SD 8.2) years; p>0.05] and sex [45 (90.0%) male and 5 (10.0%) female vs 41 (82.0%) male and 9 (18.0%) female; p=0.249] were similar in group-A and group-B. The conventional risk did not show any significant difference between low and normal HDL level group such as age, sex, smoking, diabetes mellitus, hypertension, BMI, hypercholesterolaemia, high serum LDL, hypertriglyceridaemia and family history of CAD (p>0.05 each). No significant vessel disease [3 (6.0%) vs 14 (28.0%); p=0.008] and single vessel disease [11 (22.0%) vs 25 (50.0%); p=0.020] were significantly fewer in group A than that of group-B; while double vessel disease [14 (28.0%) vs 5 (10.0%); p=0.039] and triple vessels disease [22 (44.0%) vs 6 (12.0%); p=0.002] were significantly higher in group-A than that of group-B. Friesinger score 0 [3 (6.0%) vs 11 (22.0%); p=0.033] and Friesinger score 1 to 4 [6 (12.0%) vs 24 (48.0%); p=0.01] were significantly fewer in group A than that of group-B; while Friesinger score 5 to 9 [20(40.0%) vs 9 (18.0%); p=0.041] and Friesinger score 10 to 15 [21 (42.0%) vs 6 (12.0%); p<0.004] were significantly higher in group-A than that of group-B. Among all respondents conventional risk factors were not statically significant between the groups. A significant negative correlation was found between serum HDL-C (mg/dl) and number of diseased vessel (r=0.370; p<0.001) and also Friesinger score (r=0.388; p<0.001).Conclusion: It may be concluded that low HDL-C level is associated with angiographically more severe coronary artery diseases reflected by vessels score and Friesinger score as compared to normal or high HDL-C level.Bangladesh Heart Journal 2018; 33(1) : 32-38

scholarly journals Association of Glycosylated Haemoglobin Level with the Severity of Coronary Artery Disease in NSTEMI Diabetic Patients

2015 ◽  
Vol 8 (1) ◽  
pp. 43-48
Author(s):  
Mahmod Mohammad Salim ◽  
Malik Fazila Tun Nesa ◽  
Rahman Mohammad Arif ◽  
Hossain Mohammad Delwar ◽  
Mandal Md Raihan Masum
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Gensini Score ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Group I ◽  
Group Ii ◽  
Artery Disease ◽  
Vessel Score

Background: Relation between diabetes mellitus and ischemic heart disease is well established. But the effect of HbA1C on severity of coronary artery disease remains uncertain in non-ST elevation myocardial infarction and diabetic patient. Objective of our study was to know the relationship of HbA1C with the severity of coronary artery disease.Methods: In this cross sectional analytical study a total of 104 NSTEMI diabetic patients were enrolled by purposive sampling. They were divided into two groups according to the level of HbA1C, Group-I patients having HbA1C<7% and Group-II patients having HbA1C >7%. Vessel score and Gensini score was calculated from coronary angiogram and compared between groups.Results: Single vessel disease were significantly higher in group-I compared to Group-II( 38.5% vs 7.7% in Group-I vs Group-II,p<0.05). Double vessel disease were higher in group-II compared to Group-I but the difference was statistically not significant (42.3% vs 48.1% in Group-I vs Group-II respectively (p>0.05). Triple vessel disease were significantly higher in group-II compared to Group- I (19.2% vs 44.4% in Group-I vs Group-II,p<0.05). Mean Vessel score was higher in Group-II compared to Group-I(1.73 ± 0.86 vs 2.50 ±0.70 in Group-I vs Group-II, p<0.05). Mean Gensini score was higher in Group-II compared to Group-I (44.6 ± 38.4 vs 76.9 ± 44.6 in Group-I vs Group-II, p<0.05). There were significant positive linear correlation between HbA1C and Vessels score and Gensini score (p<0.05).Conclusion: This study may be concluded that the presence of HbA1C >7% are associated with of severe coronary artery disease in NSTEMI with diabetes mellitus.Cardiovasc. j. 2015; 8(1): 43-48

scholarly journals Clinical Characteristics and Angiographic Profile of Acute Coronary Syndrome Patients in a Tertiary Hospital of Bangladesh

2018 ◽  
Vol 33 (1) ◽  
pp. 10-15
Author(s):  
Mohsin Ahmed ◽  
Khandaker Abu Rubaiyat ◽  
Mohammed Abaye Deen Saleh ◽  
Abdul Wadud Chowdhury ◽  
CM Khudrate E Khuda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Healthy Person ◽  
Diabetic Patients ◽  
College Hospital ◽  
Coronary Syndrome ◽  
Triple Vessel Disease ◽  
Artery Disease

Aims: Coronary artery disease is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. The objectives were to study the clinical profile, risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients admitted in Cardiology Department of Dhaka Medical College Hospital, Dhaka.Materials and Methods: A total of 800 patients of ACS were analyzed for various risk factors, angiographic patterns and severity of coronary artery disease at DMCH, Dhaka, Bangladesh.Results: Mean age of presentation was 51.27±8.80 years. Majority were male 628 (78.5%) and rest were females (21.5%). Most patients had ST elevated myocardial infarction (STEMI) 509 (63.6%) followed by non-STEMI (NSTEMI) 207 (25.9%) and Unstable Angina (UA) 84 (10.5%). Risk factors: smoking was present in 388 (48.5%), hypertension in 289 (36.13%), diabetes in 235 (29.38%), dyslipidaemia in 169 (21.13%) and obesity in 356 (44.5%) patients. Singlevessel disease was present in 30.32% patients, Doublevessel disease was present in 23.23% patients and Triple vessel disease was present in 27.15% patients.Conclusion: STEMI was the most common presentation. ACS occurred earlier in comparison to Western population. Smoking was most prevalent risk factor. Diabetic patients had more multivessel disease.Bangladesh Heart Journal 2018; 33(1) : 10-15

scholarly journals Intra-Femoral Sheath Time: Does it Increase a Patient's Risk for Developing a Hematoma?

2013 ◽  
Author(s):  
Colleen Planchon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Femoral Artery ◽  
Percutaneous Coronary Interventions ◽  
Medication Therapy ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
Group A ◽  
Artery Disease ◽  
Group B

Despite advancements in technology and medication therapy, coronary artery disease continues to remain the number one cause of death. Treatment for coronary artery disease requires life style modifications, medication therapy, percutaneous coronary interventions, and sometimes coronary artery bypass surgery. Though percutaneous coronary interventions are considered safe and are commonly occurring procedures, there are still risks for complications. One of the most frequently occurring complications is hematoma of the femoral artery site. The purpose of this study was to determine if there was an increased incidence of hematomas in individuals undergoing percutaneous coronary intervention with associated sheath times of less than five hours (Group A) as compared to sheath time of greater than five hours (Group B). The study used a retrospective, two group design and was conducted at a tertiary care center that performs over 1500 PCI’s annually. Inclusion criteria included adults over the age of 18 who were hemodynamically stable, had no known bleeding disorders, and were punctured once at the femoral artery to perform the percutaneous intervention. Two hundred fifty medical records were reviewed utilizing a data collection tool designed by the researcher. Total sample size was 55, 21 in Group A and 34 in Group B. Six hematomas were documented as occurring, but were not reportable based on the ACC definition. Hematomas were documented in the medical record using the terms “small”, “medium,” and “large” versus an objective measurement. No hematomas were identified using the ACC definition, which was the measurement standard for this research hospital. Sheath times in Group A averaged 4.02 hours, and group B 7.42 hours. There was a higher incidence of descriptive hematoma that did not meet the criteria of this study in Group B. Results call for recommendations of on-going documentation of post procedure hematomas using a standardized, reliable, and valid measuring tool. APRN’s can be instrumental in implementing change in patient care , hospital policy and on the national level by assuring that hematomas are accurately and consistently documented. Further research is indicated related to sheath times and potential associated negative outcomes.

scholarly journals Correlation of B-Type Natriuretic Peptide Level with Severity of Coronary Artery Disease in Non St Elevated Acute Coronary Syndrome with Normal Left Ventricular Function

2017 ◽  
Vol 12 (1) ◽  
pp. 17-22
Author(s):  
Sohel Mahmud ◽  
AKM Fazlur Rahman ◽  
SM Ahsan Habib ◽  
Chaudhury Meshkat Ahmed ◽  
SM Mustafa Zaman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Lv Function ◽  
Syntax Score ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Normal Left Ventricular ◽  
Artery Disease ◽  
The Relationship

Background: Coronary artery disease (CAD) is predicted to be the most common cause of death and disability globally by 2020. In Bangladesh, for better management of coronary artery disease and to reduce the burden of acute coronary events patients with non ST elevated acute coronary syndrome (NSTE–ACS) should be focused. B-type natriuretic peptide (BNP) can be suggested as a tool to predict severity of coronary atherosclerotic lesion even with normal left ventricular (LV) function and thus to categorize the patients for appropriate referral and invasive evaluation.Aims: This study is designed to assess the relationship between level of BNP and severity of coronary artery disease assessed with SYNTAX score in NSTE-ACS patients with normal LV function. Methods: This cross sectional observational study was conducted at UCC, BSMMU during the period of May 2014 to April 2015 among the patients with non ST elevated myocardial infarction (NSTEMI) and unstable angina. 116 patients were enrolled by non-random purposive sampling who was admitted for coronary angiogram. All the data were recorded in structured questionnaire including details of medical history, coronary risk factors and physical findings. In NSTE-ACS patients with normal LV function venous blood samples were collected for BNP and later SYNTAX scoring was assessed during coronary angiogram. The relationship between level of BNP and SYNTAX score in patients with both UA and NSTE-MI was assessed statistically to evaluate the validity of BNP as a tool to predict severity of coronary atherosclerotic lesions among the patients with NSTE-ACS.Results: The mean age was 57.84±8.82 years. Among the 116 patients, highest frequency of patients was in the age group 51-60 years 55(47.4%) .In which 88(75.9%) were male. Male:Female ratio is 3.1:1.The percentage of risk factors was higher in NSTEMI group and difference with UA was statistically significant (p <0.05). Serum BNP in UA 64.9±13.07 and in NSTEMI 107.2±11.53. The mean difference of serum BNP between two groups is statistically significant. In UA group the SYNTAX score was found 13.2±11.1 and in NSTEMI 19.9±13.5 which is statistically significant. In UA group maximum patients were found two vessel disease and in NSTEMI maximum patients in three vessel disease. 70.0% of patients of three vessel disease had e” 80pg/ml of BNP. The association is statistically significant (p< 0.05). Higher the level of BNP reflect higher the vessel involvement and SYNTAX score irrespective of UA and NSTEMI.Conclusion: Our study reveals BNP is a candidate for entry into the setting of principal risk scores. Our findings indicate that the level of BNP may reflect the severity of ischemic insult even when irreversible injury and systolic dysfunction have not occurred.University Heart Journal Vol. 12, No. 1, January 2016; 17-22

scholarly journals Subclinical Hypothyroidism with TSH>7 mIU/l and≤10 mIU/l and Coronary Artery Disease

2020 ◽  
Vol 52 (02) ◽  
pp. 85-88
Author(s):  
Pedro Weslley Souza Rosário ◽  
Maria Regina Calsolari
Keyword(s):  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Subclinical Hypothyroidism ◽  
Calcium Score ◽  
Thyroid Stimulating Hormone ◽  
Group A ◽  
Artery Disease ◽  
Group B ◽  
Low Cardiovascular Risk

AbstractThe association of subclinical hypothyroidism (SCH) with increased cardiovascular risk is controversial when thyroid-stimulating hormone (TSH) concentration is<10 mIU/l, as well as its association with a higher coronary artery calcium score (CACS) in individuals with low cardiovascular risk. This study evaluated coronary artery disease (CAD) by CACS in asymptomatic, low-cardiovascular risk women with SCH and TSH>7 mIU/l and≤10 mIU/l untreated for 5 years after diagnosis. The CACS was obtained for two groups of women with low cardiovascular risk. Group A consisted of 32 women with mild SCH (TSH>7 mIU/l and≤10 mIU/l) who remained untreated for 5 years, and group B consisted of 32 euthyroid women matched for age and body mass index to group A. The CACS ranged from 0 to 350 (median 0, 25–75% interval: 0–10) in group A and from 0 to 280 (median 0, 25–75% interval: 0–0) in group B. Scores>0 and≥10 were significantly more frequent in group A (40.6 vs. 12.5% and 25 vs. 3.1%, respectively). A CACS≥100 was also more frequent in group A (18.75 vs. 3.1%), but the difference was not significant (p=0.1). The results of the study suggest that long-term SCH with TSH>7 mIU/l and ≤ 10 mIU/l is associated with a higher risk of CAD in individuals≤65 years, even in those with low cardiovascular risk.

scholarly journals Effect of Hemodialysis, Coronary Artery Disease and Diabetes on Cardiac Troponin T: A Prospective Survey Over One Year

2009 ◽  
Vol 3 (1) ◽  
pp. 69-77 ◽  
Author(s):  
François-Pierre Mongeon ◽  
Marc Dorais ◽  
Jacques Le Lorier ◽  
Daniel Froment ◽  
Élaine Letendre ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Diabetic Patients ◽  
Cardiac Troponin T ◽  
Coronary Syndrome ◽  
Before And After ◽  
Artery Disease ◽  
Esrd Patients

Background:Limited data is available about the effects of hemodialysis sessions, coronary artery disease (CAD), and diabetes on serum cardiac troponin T (cTnT) levels in patients with end-stage renal disease (ESRD).Objectives:To test whether hemodialysis could be associated with an increase in cTnT concentration. To evaluate if coronary artery disease (CAD) or diabetes are associated with higher cTnT levels in ESRD.Methods:Serum cTnT levels were measured immediately before and after dialysis 3 times over 1 year (0, 6, and 12 months).Results:A total of 100 ESRD patients without acute coronary syndrome (mean age of 58.5 years, 34% with diabetes, and 37% with CAD) gave 267 pre-dialysis and 260 post-dialysis blood samples. The mean (standard deviation) pre-dialysis cTnT levels were 0.06 (0.12), 0.05 (0.06), and 0.07 (0.07) mcg/L at 0, 6, and 12 months, respectively. The post-dialysis cTnT levels were similar on average. Among 259 samples with cTnT measured both before and after dialysis, 79 (30.5%) showed a decrease in serum cTnT, 97 (37.5%) showed an increase and 83 (32%) showed no change following dialysis. Mean cTnT was higher in CAD than in non-CAD patients. We observed no significant difference in mean cTnT levels between diabetic and non-diabetic patients.Conclusions:cTnT levels were not affected by individual hemodialysis sessions, and remained stable around 0.06 mcg/L over a 1-year period in ESRD patients. Random cTnT levels were higher in stable CAD patients undergoing hemodialysis.

Sign in / Sign up

Export Citation Format

Share Document