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SYNTAX Scoring In Patients with Coronary Artery Disease and Its Effect on Mode of Revascularization , Single Center Experience.
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Background: revascularization therapy for patients with left main (LM) and/or three vessel coronary disease is a matter of argument for long a time whether bypercutaneous coronary angiography orcoronary artery bypass grafting. SYNTAX trial was designed to assess the optimal revascularization strategy between percutaneous coronary intervention and coronary artery bypass grafting, for patients with left main stem coronary artery disease and/or 3-vessel coronary disease.

Aim: To estimate the complexity of coronary artery disease in patients referred to a tertiary Iraqi cardiac center and its effect on mode of revascularization.

Patients and Method: Ninety nine patients who were referred to Iraqi center for heart disease from July to December 2010 withthe diagnosis of CAD were included. Full history, clinical examination, biochemical tests ( blood sugar ,total cholesterol , blood urea and serum creatinine) were checked, electrocardiographic and echocardiographic characteristics were analyzed .All patients underwent diagnostic angiography andSYNTAX score calculator was applied and the SYNTAX score was recorded.Patients  were divided into two groups :  group A  , thosewho were  planned for PCI  and group B who were planned for  CABG .

Results: Mean age of the patients was 57.6±10.6, ranging 19-80 year, male were more than female (75.8% vs. 24.6%). Risk factors prevalencewas DM (42.6%), high blood pressure (52.8 %), smoking (42.4%), hypercholesterolemia (43.4%) and prior MI (32.3%).

Mean age of group A was 54.22±11.27 while group B was 62.37±7.47 (P value 0.0001) . There was no significant difference in risk factors prevalence between group A and B ( DM  36.2% vs.51.2% p=0.31), hypertension(53.4% vs.53.3% p=0.98),  smoking (41.3% vs.43.9% p=0.8), hypercholestoemia (31% vs. 60.9%),ejection fraction<50% ( 20.6% vs. 24.3% ) (p=0.66). All patient with left main steam disease 13 (31.7%) passed to CABG group.

Mean total SYNTAX score for all patients was 16.7±6.5. Mean SYNTAX score were (10.24±6, 26.01±7.7) for group A and B respectively (P value 0.00001).

Conclusion: Patients with lower SYNTAX score were managed by PCI. Iraqi patients treated with PCI have lower syntax score than that in SYNTAX study, while those who were treated by CABG,   were comparable to that in SYNTAX study.

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
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
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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 clinica

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Coronary Artery Spasm; Frequency and Angiographic Findings in the Iraqi center for heart diseases (Single Centre experience)
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Background: Coronary artery spasm occurs spontaneously leading to the syndrome of variant angina. It occurs in about 15 % of patients undergoing coronary angiography.
Objectives: This study sought to estimate the rate of coronary artery spasm that occurs during coronary angiography and percutaneous coronary intervention with their risk factors in patients admitted to the Iraqi center for heart disease.
Methods: This is a cross sectional observational study, We prospectively collected the data of patients over six months period (from August 2014 till February 2015 ) who developed coronary artery spasm during cardiac catheterization (diagnostic and therapeutic).
Results: Out of 1274 patients, 106 patients developed coronary artery

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Assessment of endothelial dysfunction by flow mediated dilatation in patients with Coronary Artery Disease
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Background: Endothelial dysfunction is thought to be a key event in the development of atherosclerosis. It is a systemic process that simultaneously affects different vascular territories including coronary arteries. It is recommended that noninvasive approaches assessing endothelial function in peripheral vessels like flow mediated dilatation are indirectly representative of coronary vascular function.
Objectives: This study is aimed to assess endothelial dysfunction by using flow mediated dilatation in patients with coronary artery disease
Patients and methods: 82 patients of either sex with an age range of 40-65years are involved in this study. Each patient was subjected to two tests; first test was the flow mediated dilatation

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence, risk factors and association of renal artery stenosis with coronary artery disease in patients undergoing coronary angiography in Ibn-Al Bitar center for cardiac surgery
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Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributions in a single patient. The increased prevalence of renal artery stenosis in association with coronary artery disease has been well documented.
Objectives:-To examine in detail the prevalence of renal artery stenosis in patients undergoing cardiac catheterization for suspected coronary artery disease.
Patients &methods:-Between April 2010 and February 2011, two hundred patients underwent coronary and renal angiography at the same session in Ibn Al-bitar Hospital for Cardiac Surgery. Clinical and procedural data for patients undergoing renal angiography were prospectively collected and entered into database specially designed for th

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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Satisfaction of Patients, Coronary Arteries in Related to Nursing and Medical Care
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Objectives of the study: The study aims to assess satisfy of the coronary artery patients for the care product from
the nurse and physician and to find out the relationship between patient satisfaction with the social and the
clinical characteristics of the patients.
Methodology: A descriptive design study conducted using the evaluation approach for the duration of June 3
rd
2012 to January 31, 2013. Non-probability sample of (60) patients who were visiting or admitted (inpatient or
outpatient) to the teaching hospital in Baquba with the diagnosis of coronary artery disease. A questionnaire have
been built and develop by the researcher based on review of literature and previous research, the form included of
(3) p

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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Off-Pump Coronary Artery Bypass Graft
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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

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Use of Retrograde Cardioplegia in Coronary Artery Bypass Graft Surgery
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Background: Retrograde Cardioplegia is a widespread method for myocardial protection in coronary bypass surgery and to abroad range of open heart surgical procedures in addition to antigrade Cardioplegia,
Objectives: Is to evaluate the use of retrograde cardioplegia and its advantages in coronary bypass surgery at Ibn Al-Nafees Teaching Hospital, Department of Cardiac Surgery,
Patients and methods: This is a retrospective study that was conducted at Ibn Al-Nafees Teaching Hospital from the first of January to the first of October 2015, fifty patients with coronary artery dieses were admitted to the hospital and coronary artery bypass graft (CABG) surgery was done under cardiopulmonary bypass using retrograde cardioplegic canula thr

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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
Wed Jan 05 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Early complications associated with obesity following coronary artery bypass graft surgery: Obesity and post-CABG morbidity
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Background: One of the major health concerns and possible risk factors in open heart surgery is the increasing prevalence of obesity among patients.

Methodology: Over a period of sixteen months (February 2017 to June 2018), 246 patients underwent coronary artery bypass graft surgery (CABG) in Slemani Cardiac Hospital (SCH). The patients were divided according to the WHO classification into two groups: The obese (BMI ≥ 30) and the non-obese  (BMI < 30) and were compared in regard to the rate of occurrence of early postoperative complications.

Objective: To evaluate the impact of obesity [body mass i

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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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