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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
Thu Apr 27 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence and Demographic characteristics of Metabolic Syndrome in Iraqi Patients with Acute Coronary Syndrome
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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

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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
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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-

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Publication Date
Thu Oct 07 2021
Journal Name
Romanian Neurosurgery
Indirect revascularization in an Iraqi child with Moyamoya Disease
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Background: Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by bilateral stenosis starting at the supraclinoid internal carotid artery (ICA), with the development of a collateral network of vessels. It is an established cause of stroke in the pediatric age group. Despite its increasing prevalence in various parts of the world, it remains largely underrecognized in the Middle East, particularly in Iraq. This is the first case of MMD in an Iraqi patient undergoing surgery. Case description: A 12-year-old boy presents with a 3-months history of progressive behavioural changes. MRI revealed diffuse infarcts of different ages. MRA and CT angiography revealed extensive asymmetrical steno-occlusive changes of t

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Coronary Angiographic Findings in Diabetic Patients Versus non-Diabetics with Coronary Heart Disease
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Background :Atherosclerosis is the most
frequent underlying cause of ischemic heart
disease and a major cause of death all over the
world. This study was carried out to analyze and
compare the angiographic findings in patients
with diabetes mellitus versus non diabetics with
coronary heart disease , and to correlate these
findings with some risk factors for coronary
heart disease.
Methods: A total of 100 patients were studied,
50 with diabetes mellitus, and 50 non diabetics.
This study was carried out at Al-Sadr teaching
hospital in Basrah, Southern Iraq during the
period April 2009- September 2009. All patients
were known to have coronary heart disease. Risk
factors for coronary heart disease

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Publication Date
Sun Jul 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Classification of anemia in hemodialysis patients in relation to vascular access and its correlation with hepcidin and ferritin
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Background: Anemia is very common in patients with chronic kidney disease, and becoming almost universal in end stage renal disease, where dialysis or renal transplantation becoming the treatment of choice. High levels of hepcidin appear to accompany reduced renal function and serum ferritin may also be elevated.
Objectives: To classify anemia in hemodialysis patients and to display the correlations between the types of anemia and inflammatory parameters like hepcidin and ferritin according to vascular access of hemodialysis.
Patients and methods: This case-control study was conducted at Al-Hayat center for hemodialysis, and included 60 adult patients on hemodialysis. Also 20 healthy individuals were recruited as control group. Mea

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Publication Date
Tue Jul 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Histopathological Study of Coronary Atherosclerosis Using Special Stains and CD 34 Immunohistochemical Marker A Postmortem Study
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Background: The coronary atherosclerosis received a great concern from the clinical aspect, but its pathological aspect is deficient in Iraq.  

Objectives: To find a correlation between the type of the lesions that were grossly identified and their corresponding microscopical grades and Studying the effect of remodeling on preservation of the luminal area, 3) demonstrate the endothelial dysfunction in atherosclerosis.

Methods: fifty cases were gathered from the Medico-legal institute in Baghdad during the period from January to July 2004.The left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) from 50 postmortem cases were biopsied.

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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
Thu Oct 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Ankle- Brachial Pressure Index AS A Predictor of Coronary Artery Disease Severity
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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 non invasive test proved to be sensitive and specific in detecting and assessing the severity of peripheral arterial disease.
Patients and Methods: One hundred fifty patients (150) were enrolled in this study, from January - June 2007; all were referred to the Iraqi Centre for Heart Diseases (I.C.H.D.) for further evaluation, with request for further assessment of CAD or lower extremity peripheral arterial disease. Clinical data and physical examination were performed; ABI was calculated by measurement of systolic pressure on both ankl

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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
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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

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Publication Date
Sun Oct 01 2006
Journal Name
Journal Of The Faculty Of Medicine Baghdad
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). Pati

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