Preferred Language
Articles
/
iqjmc-61
The Rate of Discordance between Syntax Score II and Cardiologist Decision as a Guide for Mode of Revascularization in Patients with Complex Coronary Artery Disease
...Show More Authors

treatment decisions for percutaneous coronary intervention (PCI) and/or coronary artery bypass graft (CABG) in patients with complex coronary artery disease (CAD) and/or unprotected left main stem disease (ULMSD).
Objectives: To assess the agreement between the clinical decisions of the cardiologist and the SS II recommendation regarding the revascularization strategies in patients with complex CAD and/or ULMSD.
Patients and Methods: Prospective data from patients who presented to Baghdad Medical City Catheterization Labs for coronary angiography and were followed up between January 2014 and November 2015 were analyzed. For these patients, SS II was assessed by the two anatomical variables (SS and presence of ULMSD) and six clinical variables (age, creatinine clearance, left ventricular ejection fraction, sex, chronic obstructive pulmonary disease, and peripheral vascular disease) to predict 4-year mortality after revascularization with PCI and/or CABG. These scores were then compared with the clinical decisions of cardiologists. After 1 year of data collection, we followed up the patients by phone to assess their mortality status. Patients were categorized into three groups according the interventional procedures: Group 1 (for PCI), Group 2 (for CABG), and Group 3 (for PCI vs. CABG).
Results: Two hundred patients were enrolled. Their mean age was 60.23 ± 9.836 years, and 157 (78.5%) were men. Depending on the clinical judgment of the cardiologist, 71 (35.5%) patients were referred for PCI (Group 1), 119 (59.5%) patients for CABG (Group 2), and the remaining 10 (5%) patients for PCI vs. CABG (Group 3). Based on an assessment of 4-year mortality by the SS II, CABG would have been the treatment of choice in 67 (33.5%) patients, PCI in 30 (15%) patients, and both the treatments in 103 (51.5%) patients. There was a concordance between the clinical decision of the cardiologist and SS II in 67 (33.5%) patients and discordance in 133 (66.5%) patients. Six patients died within 1 year, most of whom were from the discordant group.
Conclusion: There was a statistically significant discordance between the SS II recommendation and clinical judgment of the interventional cardiologist. SS II proved to be a useful objective tool to assist experienced clinical judgment in determining appropriate revascularization strategy for CAD patients.

المقدمة:درجة السنتاكس ٢ تعد طريقة ارشادية لاختيار طريقة العلاج في المرضى اللذين يعانون من امراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي.

الهدف: لتقييم نسبة عدم التوافق بين القرار السريري لاختصاصي القلبية وتوصيات درجة السنتاكس ٢ بالنسبة لخطة العلاج في المرضى المصابين بآمراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي.                       

طرائق البحث: يتم جمع معلومات المرضى اللذين يخضعون لاجراء القسطرة التشخيصية لشرايين القلب في صالات القسطرة في مدينة الطب وتتم متابعة المرضى ايضا وتكون مدة الدراسة للفترة من شهر كانون الثاني لسنة ٢٠١٤م الى شهر تشرين الثاني لسنة ٢٠١٥م وخلال هذه الفترة يتم تقييم المرضى عن طريق درجة السنتاكس ٢ وست متغيرات سريرية للتنبؤ بآحتمالية حدوث الوفاة خلال الاربع سنوات بعد عودة التوعي ومقارنتها مع القرار السريري لاختصاصي القلبية. ثم بعد مرور سنة على جمع الداتا، نقوم بمتابعة حالة المرضى عن طريق الاتصال الهاتفي لمعرفة إذا حدثت حالات الوفاة. يتم تقسيم المرضى الى ٣ مجاميع، المجموعة الاولى والتي تخضع للتداخل القسطاري، المجموعة الثانية والتي تخضع لعملية جراحية لزرع شرايين القلب، والمجموعة الثالثة والتي لديها احتمالية للخضوع للقسطرة او للعملية الجراحية.    

النتائج: تم اشراك مئتا مريض في الدراسة، معدل العمر ٦٠.٢٣ ± ٩.٨٣٦سنة، ١٥٧ (٧٨.٥٪) من المرضى ذكور. بالاعتماد على القرار السريري لاختصاصي القلبية تم تحديد ٧١ (٣٥.٥٪) من المرضى للخضوع للتداخل القسطاري (المجموعة الاولى)، ١١٩ (٥٩.٥٪) من المرضى تم ارسالهم لاجراء عملية جراحية (المجموعة الثانية) وبقية المرضى ١٠ (٥٪) تم ادراجهم تحت احتمالية خضوعهم للتداخل القسطاري او العملية الجراحية. بالنسبة لتققيم حالة الوفاة للاربع سنوات بالاعتماد على درجة السنتاكس ٢، كانت النتيجة ان العلاج المفضل هو العمليات الجراحية وبنسبة ٣٣.٥٪، في حين ان نسبة المرضى الخاضعين للتداخل القسطاري كانت ١٥٪، وكانت النسبة متوازية بالنسبة للمرضى الخاضعين للعمليات الجراحية او التداخل القسطاري ٥١.٥٪. كان هنالك توافق بين القرار السريري لاختصاصي القلبية ودرجة السنتاكس ٢ وبنسبة ٣٣.٥٪، في حين ان نسبة عدم التوافق للمرضى كانت ٦٦.٥٪. خلال سنة واحدة توفي ستة مرضى ومعضمهم كانوا من مجموعة عدم التوافق.                 

الاستنتاج: هذه الدراسة اظهرت عدم توافق هام بين توصيات درجة السنتاكس ٢ والقرار السريري لاختصاصي القلبية.

Crossref
View Publication Preview PDF
Quick Preview PDF
Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Practices regarding Patients Discharge Planning post Cardiac Surgery at Cardiac Centers in Baghdad city
...Show More Authors

Objective (s): to assess nurses' practices regarding discharge planning post-cardiac surgery and to find out the relationship between nurse practices and demographic characteristic (age, gander, level of education, years of experiences, and years of experiences in surgical ward).
Methodology: A descriptive study was carried out at cardiac centers and hospitals in Baghdad (Ibn Al- Bitar specialized center for cardiac surgery; Iraqi center for heart disease and Ibn al Nafees hospital). For the period of 6th February 2017 up to 1st of June 2018. A non-probability (purposive) sample of (58) nurses (male & female) who were working in surgical wards. The data was collected, by using of a questionnaire, which consists of two parts, part

... Show More
View Publication Preview PDF
Publication Date
Sun Jul 02 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
coronary artery lesions in patients with acute coronary syndrome . the role of the traditional risk factors
...Show More Authors

Background:

View Publication Preview PDF
Crossref
Publication Date
Fri Sep 04 2020
Journal Name
Al-kindy College Medical Journal
Association of Echocardiographic Epicardial Fat Thickness and Carotid Intima Media Thickness with the Severity of Coronary Artery Disease
...Show More Authors

Background: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coro

... Show More
View Publication Preview PDF
Crossref
Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
Role of Multi-Detector CT Angiography in Assesmente of Athrosclerotic Coronary Artery Disease
...Show More Authors

Background:  Imaging has a critical role in the diagnosis and evaluation of cardiac diseases, beginning with chest radiography and fluoro-scopy and progressing to coronary angio-graphy, echocardiography, nuclear medicine and recently  multidetector computed tomo-graphy (MDCT) as well as magnetic resonance (MR) imaging

Objective: To highlight the role of Multi-detector CT in the evaluation of coronary artery disease and its importance of being noninvasive diagnostic technique.

Methods: A cross sectional study for 20 patients. Patients were asked to fast 6 hours prior to the examination and the patients with heart rates above 65 beats per minute were given cardio-

... Show More
View Publication Preview PDF
Crossref
Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of Serum Apelin in Acute Coronary Syndrome Patients
...Show More Authors

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

... Show More
View Publication Preview PDF
Crossref
Publication Date
Sun Oct 01 2023
Journal Name
Medical Journal Of Babylon
Prevalence of coronary artery disease in patients with left bundle branch block and its association with risk factors hypertension and diabetes mellitus
...Show More Authors
Abstract<sec> <title>Background:

Left bundle branch block (LBBB) is a common finding in electrocardiography, there are many causes of LBBB.

Objectives:

The aim of this study is to discuss the true prevalence of coronary artery disease (CAD) in patients with LBBB and associated risk factors in the form of hypertension and diabetes mellitus.

Materials and Methods:

Patients with LBBB were admitted to the Iraqi heart center for cardiac disea

... Show More
View Publication
Scopus Crossref
Publication Date
Sun Oct 03 2010
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Status of Some Trace Elementsin Idiopathic and Ischemic Cardiomyopathy and Coronary Artery Disease: Echocardiographic Correlation
...Show More Authors

Background: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

... Show More
View Publication Preview PDF
Crossref
Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning Healthy Lifestyle on Patients’ Attitudes after Percutaneous Coronary Intervention at Cardiac Centers in Baghdad City
...Show More Authors

Abstract:

Objective: The study’s aim to evaluate the effectiveness of instructional program about healthy lifestyle on patients’ attitudes after undergoing percutaneous coronary intervention.

Methodology: Quasi-experimental design/ has been utilized for the current study starting from December 2018 to March 2020 to achieve the objectives of the study. Non-probability (purposive) sample of 60 patients was divided into intervention and control groups. Data were analyzed by the application of descriptive and inferential statistical methods.

Results: findings reported that before intervention both study and control groups demonstrated low total mean of score relat

... Show More
View Publication Preview PDF
Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Postprandial Hyperglycemia as a Significant Risk Factor for Coronary Heart Disease
...Show More Authors

Background: The highest concentrations of
blood glucose during the day are usually found
postprandialy. Postprandial hyperglycemia (PPH)
is likely to promote or aggravate fasting
hyperglycemia. Evidence in recent years suggests
that PPH may play an important role in functional
& structural disturbances in different body organs
particularly the cardiovascular system.
Objective: To evaluate the effect of (PPH) as a
risk factor for coronary Heart disease in Type 2
diabetic patients.
Methods: Sixty-three type2 diabetic patients
were included in this study. All have controlled
fasting blood glucose, with HbA1c correlation.
They were all followed for five months period
(from May to October 2008)

... Show More
View Publication Preview PDF
Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Mental Disorder of mothers as a Mediating Variable Between Marital adjustment and Kindergarteners Development
...Show More Authors

This current study aimed to explore the mediation effects of mother's mental health symptoms between marital adjustment and child development aspects. (666) participants of mothers and their children were the sample of the study. The researchers used the marital adjustment scale prepared by Manson, Morse, Lerner, Arthur, as well as, a package of tests for some aspects of growth Kindergarten children prepared by Kenawi and Mohamed (1999). In addition, theyemployed a list of modified symptoms (Symptom Checklist-90- Revised (SCL) -90-, prepared by Derogatis, Lipman and Lipogun & Cov (1976), The results of the current study showed there is a statistically significant relationship between marital adjustment and the symptoms of mental diso

... Show More
View Publication Preview PDF