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The Impact Of Severity Of Ischaemia In Acute Coronary Syndrome On The Extent Of Coronary Artery Disease At Angiography The Role Of Past Ischaemia
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Background: Clinical classification of patients with acute coronary syndrome is essential step in identifying severe cases before referring them, fairly quickly, for the ultimate investigation of coronary angiography .Hence it is important to find out the extent at which the severity of the disease, based on clinical classification, agrees with its severity at angiography and to see whether traditional Risk factors or pas ischaemia played a role.
Patients and Methods : The angiographer data of 178 consecutive pts with Acute Coronary Syndrome (ACS) were retrospectively analyzed. The pts consisted of 114 with Unstable Angina (UA)  and 64 pts with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). Patients were classified depending upon the predominating clinical assessment during hospitalization into four groups of progressively worsening ischaemia. They were; group 1; New onset Angina; 27 pts, group 2; Deteriorating Chronic Angina, 33 pts, group 3; Rest Angina 54 pts, and, group 4; Non-ST-Elevation Myocardial Infarction (NSTEMI), 64 pts.
Results : Coronary Angiography revealed that the frequency of multi-vessel coronary Disease (MVD) in group 1, 2, 3, and 4 were 48%, 73%, 72%, and 56% respectively which meant that worsening of ischaemia was not accompanied by commiserate increase of the frequency of MVD in Rest angina and NSTEMI. To explain that we calculated the average number of Five traditional Risk Factors; Hyperlipidaemia (HL), Diabetes Mellitus (DM), Hypertension (HTN), Smoking (SM), and Positive Received March 2006 Family History (PFH) in the four groups ofACS (R.F. score) and they were 1.72, 1.87, 2.13, 2.51 in Accepted May 2006 groups 1,2,3, and 4 respectively. Then we studied the relation of having one, two, three, and four orfive Risk Factors and the frequencies of Multi-vessel disease and they were; 43%, 67%, 76%, and 84% respectively which meant that the frequency of MVD ought to increase from group 1 to group 4 supporting the clinical classification. This prompted us to look into the individual Risk factors. The clinical data showed that the incidence of HL had risen
significantly in Ch. D. angina and Rest Angina (P: 0.03) and that the incidence of SM had risen significantly in NSTEMI (P.• 0.001). Since the angiographic data had demonstrated a significant association of HL with MVD and SM with SVD we may understand why the rate of MVD was not higher  in NSTEMI than UA. To explain why the frequency of MVD in Rest Angina (g. 1) was not higher than Ch. D. Angina (g. 2) despite having worse ischaemia and higher R.F. Score we scrutinized the data and noticed that the main difference between group 1 and group 2 that chronic stable angina had preceded the onset of UA in Group 2 while it did not do in group 1. On the other hand Rest Angina and NSTEMI pis were a mixture of those with and without prior ischaemia. To follow this point further we divided both groups into two subgroups: one with history of prior ischaemia and one without it. The frequency
of MVD in Rest Angina and NSTEMI with prior ischaemia were 83%% and 81 %% compared to 54% and 39% respectively in pts without it.
Conclusion this study has shown that clinical classification in Acute Coronary Syndrome may predict severity of the underlying CAD to some extent however considering the no. Of risk factors and which Risk factor and whether there was antecedent ischaemia would improve the prediction a great deal.

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Chronic Kidny Disease and Risk of coronary Artery Disease,Aprospective study
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AbstractBackground:Reduced glomeular filtration rate isassociated with increasedmorbidity in patientswith coronary arterydisease.Objectives :To analyze the declining eGFR andmortality risks in a patients with Chronic KidneyDisease and have had Coronary Artery Diseaseincluding risk factors .Patientsand Methods:The study included (160)patientsbetween the ages of 16 and 87years.Glomerular filtration rate was estimated (eGFR)using the Modification of Diet in Renal Diseaseequationand was categorized in the ranges<60 mL· min−1 per 1.73 m2and≥ 60 ml/min/1.73 m2.Baseline risk factors were analyzed by category ofeGFR,.The studied patients in emergencydepartment, were investigatedusing Coxproportional hazard models adjusting for traditiona

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Publication Date
Fri Jan 02 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
In hospital outcome and complications of percutaneous coronary intervention in acute coronary syndrome, Gender Differences
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Background: women with acute coronary syndrome have increased in-hospital morbidity & mortality as compared with men following percutaneous coronary intervention (PCI). It remains unclear if this difference secondary to the sex or other confounding variables.

Patients and Methods: We sought to examine the characteristics and outcomes of 71 consecutive women (49.2%) and men (50.7) undergoing PCI at The Iraqi Center of Heart Diseases from October 2005 to March 2006.

Results: There were significant differences in the baseline characteristics between both sexes. Women more frequently had SVD(single vessel desiease) (25.7% vs. 16.6%) and 2VD (37.1% vs. 16.6%) while Men wer

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of Serum Apelin in Acute Coronary Syndrome Patients
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Background: Acute coronary syndrome refers to any group of clinical symptoms compatible with acute myocardial ischemia including unstable angina (UA), Non-ST-segment elevation myocardial infarction (NSTEMI) & ST-segment elevation myocardial infarction (STEMI).
Apelin is a novel endogenous peptide with inotropic and vasodilatory properties, it was recently reported that serum measurements of apelin were similar to its immunohistochemical data in vessels and heart tissues.
Objectives: This study aims to evaluate serum levels of apelin in patients with Acute Coronary Syndrome related to severity of presentation.
Patients and Methods: The present study was conducted during the period from September 2014 until March 2015. Fifty-n

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Publication Date
Sun May 12 2019
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Importance of two-dimensional strain imaging in diagnosis of coronary artery disease
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Background: Strain imaging assessing regional myocardial deformation and can be used to quantify regional myocardial function and differentiate between ischemic and non ischemic myocardium.

Objectives: to assess sensitivity and specificity of strain imaging in detection of coronary artery disease in comparison with coronary angiography.
Patients and Methods:
ninety six patients were referred to Ibn albitar center for cardiac surgery, Baghdad, Iraq with symptoms of coronary artery disease for a period between June 2014 and April 2015, all of whom were evaluated by two dimensional echocardiography and all were found to have good left ventricular systolic function with no regiona

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Evaluation of Serum RANKL Level in Acute Coronary Syndrome
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Background: Acute coronary syndrome (ACS) is a common disease, and a major determinant of morbidity and mortality in all races. The pleiotropic effects of the receptor activator of nuclear factor-kappa B ligand (RANKL) such as modulation of cell survival, mineralization and inflammation, make it an interesting candidate mediator in the progression and destabilization of atherosclerotic lesions.Objectives: This study was performed to investigate the role of RANKL in the pathogenesis of ACS.Methods: The levels of RANKL were measured by ELISA method in sera of 60 ACS patients, 31 patients with unstable angina (UA) and 29 patients with myocardial infarction (MI) in comparison with 20 apparently healthy controls.Results: Current data indicate

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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Clinical And Angiographic Characteristics Of Left Main Coronary Artery Disease, A Retrospective Study
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Background : Left main coronary artery (LMCA) disease represents important and serious portion of coronary artery disease(CAD).
Aim: The aim of this study is to estimate the incidence of LMCA disease among patients with CAD undergoing coronary artery angiography and to evaluate clinical characteristics of patients with LMCA disease.
Methods: The study involved review of clinical notes and coronary angiography of 1020 patients with CAD in Ibin Al Bitar hospital for cardiac surgery between April and September 2004.This review included evaluation of electrocardiogram (ECG), echocardiogram(ECHO), ECG exercise test (EET) and coronary angiography.
Results: Among 56 patients proved to have left main corona

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of the Risk Factors of Coronary Artery Diseases in Al-Nasiriyah City
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Objective: to assess the risk factors of coronary artery disease patients.
Methodology: A non-probability (purposive) sample of (100) patients. The study population consisted of
a sample of adults from both genders whose ages were 30 years and more, and was newly diagnosed as
having CAD by coronary angiography in the cardiac catheterization unit of An Nasiriyah heart center.
Results: The result of the study showed that the most common modifiable risk factors were low HDL-C
levels (58%), smoking (53%), hypertension (46%), diabetes mellitus (34%), obesity (30%), high
triglycerides (19%), hypercholesterolemia (17%), and high LDLC (14%). All these factors were positively
and significantly associated with the development

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Hs-CRP and Haptoglobin Levels in Iraqi Patients with Coronary Artery Disease
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Background: Acute phase proteins which include C-reactive protein (CRP) and haptoglobin (Hp) are associated with inflammatory diseases such as injury, infection or malignancy, cardiovascular disease and obesity. Atherogenic index of plasma (AIP) evaluated as the atherogenicity index is correlated with different diseases.
Objective : The study was to investigate hs-CRP and Hp concentration in Iraqi patients with coronary artery disease (CAD) and calculate AIP which predicts this disease.
Subject and Method: The study included 64 subjects (39 patients with CAD and 25 healthy subjects as a control group). The markers of inflammatory hs-CRP and Hp levels were measured. Lipid profile (Total cholesterol TC,

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Publication Date
Sun Apr 05 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Relation of the Ankle Brachial Index (ABI) to left ventricular systolic function in patients with coronary artery disease
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Background: Atherosclerosis is a diffuse disease process, being present in one vascular bed predicts its presence in the others. Ankle –Brachial Pressure Index (ABI) is a simple index related to the extent of atherosclerosis in coronary and noncoronary arterial beds, reflecting generalized atherosclerosis.
Objectives: the aim of this study is to evaluate the relation of ABI to left ventricular systolic function using echocardiography in patients with coronary artery disease (CAD).
Patients and Methods: Sixty seven patients (67) with CAD of either sex (70% males) with mean age 58± 6 years enrolled in this study, from December 2013 till May 2014; all were referred to the Iraqi Centre for Heart Disease (I.C.H.D.) for further evalua

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Publication Date
Tue Jul 13 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence of peripheral arterial disease among patients with acute coronary syndrome, a sample of Iraqi patients in Al-Yarmook Teaching Hospital 2016
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Abstract

Background: A significant proportion of patients with ischemic heart disease have been associated with peripheral arterial disease, yet it is still underestimated by our health system as many of patients are asymptomatic and this condition remains under diagnosed and therefore undertreated.

Objective: To study prevalence of peripheral arterial disease of the lower limbs in patient with acute coronary syndrome and its association with certain risk factors.

Method: A cross sectional descriptive study was conducted in the coronary care unit at Al-Yarmouk Teaching Hospital from the 1st of January 2016 to the 1st of Novem

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