scholarly journals Impaired Renal Function is Associated with Severe Coronary Artery Disease in Chronic Stable Angina Patients

2014 ◽  
Vol 7 (1) ◽  
pp. 17-23
Author(s):  
JN Saha ◽  
AAS Majumder ◽  
NA Chowdhury ◽  
M Ullah ◽  
MG Azam ◽  
...  

Background: Cardiovascular disease is the leading cause of morbidity and mortality in renal impaired patients. Many of the patients of chronic kidney disease die of cardiovascular disease before requiring dialysis. Cardiovascular disease in renal impaired patient is potentially preventable and treatable. The aim of this study was to evaluate the association between renal impairment and coronary artery disease severity in chronic stable angina patients. Methods: 110 patients with chronic stable angina who got admitted for coronary angiography were included in the study. They were divided into impaired renal function group (with estimated glomerular filtration rate [eGFR] <90 ml/min/1.73m2) and normal renal function group (eGFR e” 90 ml/min/1.73m2) on the basis of eGFR. The severity of the CAD was assessed by angiographic Vessel score and Gensini score. Results: Mean Gensini score was significantly high in impaired renal function group (42.30±24.9 vs 25.65±17.9, p <0.05). There was significant negative correlation between eGFR and vessel score (r=-0.30, p <0.05) and between eGFR and Gensini score (r =-0.65, P <0.05). In multivariate logistic regression analysis, after adjustment of factors eGFR remain independent predictors of severe CAD (P=0.002, OR -5.73). Conclusion: Impaired renal function, assessed by eGFR is associated with angiographic severe coronary artery disease in chronic stable angina patients and this association is independent of conventional cardiovascular risk factors. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20796 Cardiovasc. j. 2014; 7(1): 17-23

2018 ◽  
Vol 10 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Ratan Kumar Datta ◽  
Md Mamunur Rashid ◽  
MG Azam ◽  
Md Salahuddin Ulubbi ◽  
Mohammad Khalilur Rahman Siddiqui ◽  
...  

Background: Neutrophil to lymphocyte ratio (NLR) has been proposed as a new prognostic marker in patients with chronic stable angina (CSA). NLR is a cheap, easily available, non-invasive and routinely done procedure to predict the severity of coronary artery disease.Methods: 110 patients with stable coronary artery disease were evaluated to calculate the NLR from January, 2016 to September, 2016. The patients were divided into two groups: Group I NLR>2.38 and group II NLRd”2.38. Coronary angiogram was done during index hospitalization. The severity of the coronary artery disease was assessed by vessel score and Gensini score and was compared between the groups.Results: NLR was significantly higher in the group of high vessel score and high Gensini score. We found significant weak association between NLR and vessel score (r=0.30, p=0.004) and a moderate positive correlation between NLR and Gensini score (r =0.65, P=0.001). With the increase of NLR, vessel score and Gensini score increases demonstrating more severe coronary artery disease. Univariate logistic regression analysis of variables of interest revealed that age, hypertension, dyslipidemia, serum creatinine, total WBC count and NLR were independent predictor of severe coronary artery disease with odds ratio (OR) being 1.88, 3.93, 5.01, 5.54, 4.05 and 5.70 respectively. In multivariate logistic regression analysis, after adjustment of factors NLR remain independent predictors of severe CSA (OR = 5.73; p = 0.002).Conclusion: Increased neutrophil to lymphocyte ratio is associated with angiographically severe coronary artery disease in chronic stable angina and this association is independent of conventional cardiovascular risk factors.Cardiovasc. j. 2018; 10(2): 164-170


2021 ◽  
Vol 35 (2) ◽  
pp. 106-113
Author(s):  
Md Sadaqul Islam Sikdar ◽  
Md Mamunur Rashid ◽  
Md Khalekuzzaman ◽  
Iftekhar Alam ◽  
Mst Nazmun Nahar ◽  
...  

Background: Prevalence of coronary artery disease (CAD) among Bangladeshi population is higher in urban than rural population. Among the conventional risk factors diabetes mellitus is a major concern for Bangladeshi population. Fibrinogen (Fg) in plasma is associated with severity of CAD in some populations with acute coronary syndrome. Objective: The aim of the study was to find out the correlation between circulating fibrinogen level and severity of coronary artery disease in patients with type 2 diabetes mellitus with chronic stable angina (CSA). Methods: The study was carried out in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka from October 2015 to March 2016.Total 132 patients with chronic stable angina (CSA) and type 2 diabetes mellitus who got admitted for coronary angiogram were included in the study and they were divided into 2 groups according to the on admission level of fibrinogen. Coronary angiogram (CAG) was performed in all patients. The severity of the CAD was assessed by angiographic vessel score and Gensini score. Results: Mean Gensini score was 27.0±22.3 vs 22.2±16.4 and mean vessel score 1.6±0.9 vs 1.2±1.0 in group I and group II respectively (p=0.03 and 0.04, respectively). There was positive correlation between Fg and CAD severity in term of vessel score (r=0.19) and Gensini score (r=0.15). Univariate and multivariate analysis revealed that dyslipidemia, smoking and elevated fibrinogen were the independently significant predictors of severe CAD in type 2 diabetic patients with CSA. Conclusion: Elevated plasma fibrinogen positively correlates with the severity of CAD in patients with diabetes mellitus having chronic stable angina. Bangladesh Heart Journal 2020; 35(2) : 106-113


2017 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.


2010 ◽  
pp. 29-44
Author(s):  
Juan Carlos Kaski

Overview of stable angina 32 Treatment of stable angina 34 Pharmacological therapy for stable angina 36 Myocardial reperfusion therapies for stable angina 40 Prinzmetal’s variant angina 40 Cardiac syndrome X 41 Further reading 41 Clinical trials 42 Ischaemic heart disease is the leading cause of morbidity and mortality in the developed world. The prevalence of stable angina increases with age, affecting 10–15% of women and 10–20% of men aged 65–74 years. Below the age of 50–55 years, a more distinct discrepancy between the sexes is seen, with a higher incidence seen among middle-aged men. In fact, approximately 70% of all patients with chronic stable angina are male....


2013 ◽  
Vol 14 (1) ◽  
Author(s):  
Sabrina H Rossi ◽  
Emily P McQuarrie ◽  
William H Miller ◽  
Ruth M Mackenzie ◽  
Jane A Dymott ◽  
...  

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