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.
Background: The demographic characteristics of Iraqi patients with the metabolic syndrome (MS) and presenting with acute coronary syndrome (ACS) has been scarcely studied before.
Aim of the study To study the socio-demographic characteristics of a group of Iraqi patients with MS presenting with ACS.
Patients and Methods: A convenience sample of 150 cases presenting with ACS and admitted to the coronary care unit (CCU) of Al-Yarmouk Teaching Hospital in Baghdad from mid-January through July 2011 were included in the current cross-sectional study. The data needed for the study was collected through a direct interview to fill a questionnaire by all cases carried out by a consu
... Show MoreIn this work an enzyme linked immunosorbent assay (ELISA) technique has been used for detection of some inflammatory markers in serum of acute coronary syndrome (ACS)-Patients Admitted to the cardiac care unit (CCU) of Iraqi Centre For Heart Diseases and Ibn AlNafees Teaching Hospital. The present method includes quantitative measurement of interleukine-6 (IL-6) and C-reactive protein (CRP), as their increase during symptoms may be responsible for identifying the mechanism of myocardial damag, in addition to their best performance than other quantitative tests perhaps due to their association with atherosclerotic process that belongs to the endothelial dysfunction. Aim of this study is to estimate the prevalence and correlation of IL-6 w
... Show MoreBackground: Diabetes mellitus is a well known risk factor for acute coronary syndrome but the hypothesis that patients with acute phase hyperglycemia, regardless the previous diagnosis of diabetes, have worse prognosis than those with normal glucose values is controversial. This paper aims to estimate the prevalence of admission hyperglycemia, its effect on in-hospital prognosis of diabetic and non-diabetic patients with acute coronary syndrome, and to compare it with 2nd day fasting plasma glucose as a prognostic marker.
Methods: One hundred patients, (59) diabetic and (41) non-diabetic, with documented acute coronary syndrome enrolled in this study over the period of June/ 2009-Jan./2010 from coronary c
The expression of the Proprotein Convertase Subtilisin/Kexin Type 9 gene (PCSK9) is inextricably related to lipid levels and a risk of atherosclerotic coronary artery disease (ASCAD). The present study aims to measure the quantity of PCSK9 gene expression and the effect of methylation on its expression level taking part in the pathogenesis of acute coronary artery disorder.
A current study included 150 subjects from the Iraqi population, 100 ASCAD patients and 50 healthy controls. The concentration of PCSK9 in each serum sample was determined by the ELISA technique, the expression levels of the PCSK9 gene in whole blood were estimated by RT-qPCR – Quantitative Reverse Transcription PCR method, and DNA
... Show MoreBackground:The most principal mechanisms of cardiomyopathies are;high preload and afterload and low myocardial contractility, imbalance of trace elements may cause myocardial metabolic dysfunction and may have a role in aetiology of cardiomyopathy, particulary in IDC. Trace elements are being increasingly recognized as essential mediators of the development and progression of heart diseases.
Methods: Study design Multi case-control study and single center estimation of trace elements concentrations in a number of volunteer settings this study was conducted in the Department of Cardiology, Ibn Albitar Hospital, and in the Physiological Chemistry Department of the College of Medicine, Baghdad University, fr
Background: Diabetes mellitus (DM) is a metabolic and vascular illness associated with two to four times coronary artery disease (CAD) events and mortality which correlate well with fasting, postprandial plasma glucose and HbA1c level. Other factors such as aging, gender, smoking, dyslipidaemia and hypertension also play an important role in diabetic micro- and macro-vascular complications. Type 2 DM is reported now to be CAD equivalent.
Patients and Methods: A cross sectional study of 118 patients including 90 males and 28 females being 63 diabetics and 55 non-diabetics over the period from March-November 2007 in Iraqi center for cardiac diseases who were underwent coronary angiographic study.
Results
BACKGROUND : Bifurcational coronary lesions are
frequent and amounts to almost one fifth of routine
practice concerning up to 15 – 20 % of cases .
Revascularization by percutaneous coronary
intervention ( PCI ), of bifurcational lesion has
become easier by stenting yet it remains a frequent
challenge.
OBJECTIVE : To evaluate the success and hospital
complications of two most frequent technique of stent
deployment in bifurcational PCI.
METHODS : We prospectively analysed the data of
140 consecutive patients with bifurcational PCI at
Ibn_Al-Bitar Hospital for cardiac surgery for the
period from July 2008 to July 2009 .
Depending on whether the side branch was stented or
not, the patient has fa
Background: Coronary artery bypass graft is routinely performed on an arrested heart using cardiopulmonary bypass with aortic cross clamping and Cardioplegia. Off-pump coronary artery bypass graft (OPCABG) is being increasingly used in selected cases as an attempt to decrease morbidity and mortality.
Objective: The main objective of this study is to clarify those patients who are indicated for OPCABG despite it is surgically demanding technique and to evaluate the mortality and morbidity associated with such procedures.
Patients and methods: It is a retrospective study of 28 patients with coronary artery disease, in need for coronary artery bypass graft admitted and surgically treated at the Iraqi Centre fo
Evaluation of Anti-Helicobacter pylori Antibodies in A group of Iraqi Patients with Atherosclerosis and Coronary Artery Disease
Evaluation of Anti-Helicobacter pylori Antibodies in A group of Iraqi Patients with Atherosclerosis and Coronary Artery Disease