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A prospective observational study based on angiographic profile in coronary artery disease patients with coronary intervention
Corresponding Author(s) : Syeda Zaineb Kubra Hussaini
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 11 No. 3 (2023): 2023 Volume -11 - Issue 3
Abstract
Background: An enlargement of the coronary artery that restricts optimal blood flow to the heart tissue is called coronary artery disease. The most common cause is arteriosclerosis. Platelet aggregation inhibition is the mainstay of primary and secondary prevention of ischemic events associated with coronary artery atherosclerosis.
Objective: Study of the angiographic profile of patients with coronary artery disease undergoing percutaneous coronary intervention, coronary artery bypass graft and medical management.
Methods: This prospective observational study included all patients who underwent PCI, CABG and medical treatment at a tertiary hospital between August 2021 and February 2022. Demographic and angiographic data were collected for all patients. The details of the procedure, clinical symptoms, comorbidities, diagnostic tests such as coronary angiography, 2D echocardiography, and treatment, including anticoagulant therapy, of these patients were reviewed.
Results and discussion: A total of 100 patients (mean age - 58 years) with 71% males and 29% females were included in the study. Hypertension and Diabetes were the most common risk factors, present in 60% and 35% patients respectively. Smokers were observed in 16% patients respectively. Single vessel disease (SVD) was most common angiographic pattern, observed in 57% patients. Anterior wall MI was the most common mode of presentation (75%). Chest Pain was most common symptom, observed in 95% patients; PTCA was the most frequently employed procedure (71%) followed by CABG (10%) and Medical Management (19%); and Among 100 patients in 2DEcho Mild LV Dysfunction (Grade-1) were most prevalent (32%). The most commonly affected vessel was the right coronary artery (RCA) (51%). Drug-eluting stents were used in 71% of cases. Out of 100 patients, 51 patients received 1 stent and 20 patients received 2 stents.
Conclusion: This prospective study of percutaneous coronary intervention provides insight into the patterns of coronary artery disease with angiographic features. Our aim was to profile patients undergoing percutaneous coronary intervention to alleviate symptoms and improve survival in patients with coronary artery disease
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- Naghavi M, Wang H, Lozano R. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. doi: 10.1016/S0140-6736(14)61682-2, PMID 25530442.
- Pollack CV Jr., Reilly PA, Eikelboom J, Glund S, Verhamme P, Bernstein RA et al. Idarucizumab for dabigatran reversal. N Engl J Med. 2015;373(6):511-20. doi: 10.1056/NEJMoa1502000, PMID 26095746.
- Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/ AHA/ASNC 2009 appropriateness criteria for coronary revascularization: a report of the American College of Cardiology Foundation appropriateness criteria task force. Circulation. 2009;119(9):1330-52. doi: 10.1161/CIRCULATIONAHA.108.191768, PMID 19131581.
- Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, et al. 2014 ACC/AHA/AATS/ PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;64(18):1929-49. doi: 10.1016/j.jacc.2014.07.017, PMID 25077860.
- Morice MC, Serruys PW, Kappetein AP, Feldman TE, Ståhle E, Colombo A, et al. Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation. 2010;121(24):2645-53. doi: 10.1161/CIRCULATIONAHA.109.899211, PMID 20530001.
- Aldea GS, Mokadam NA, Melford R, Stewart D, Maynard C, Reisman M, et al. Changing volumes, risk profiles, and outcomes of coronary artery bypass grafting and percutaneous coronary interventions. Ann Thorac Surg. 2009;87(6):1828-38. doi: 10.1016/j.athoracsur.2009.03.067, PMID 19463603.
- American Diabetes Association. Standards of medical care in diabetes—2015 abridged for primary care providers. Clin Diabetes. 2015;33(2):97-111. doi: 10.2337/diaclin.33.2.97, PMID 25897193.
- Beig JR, Shah TR, Hafeez I, Dar MI, Rather HA, Tramboo NA et al. Clinico-angiographic profile and procedural outcomes in patients undergoing percutaneous coronary interventions: the Srinagar registry. Indian Heart J. 2017 Sep-Oct;69(5):589-96. doi: 10.1016/j.ihj.2017.01.021, PMID 29054181.
- Ramakrishnan S, Mishra S, Chakraborty R, Chandra KS, Mardikar HM. The report on the Indian coronary intervention data for the year 2011–National Interventional Council. Indian Heart J. 2013;65(5):518-21. doi: 10.1016/j.ihj.2013.08.009, PMID 24206874.
- Jayaram AA, Shah S. Risk factors, clinical features, angiographic characteristics and treatment outcomes of young myocardial infarction patients. J Indian Coll Cardiol. 2015;5(3):203-8. doi: 10.1016/j.jicc.2015.05.002.
References
Naghavi M, Wang H, Lozano R. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. doi: 10.1016/S0140-6736(14)61682-2, PMID 25530442.
Pollack CV Jr., Reilly PA, Eikelboom J, Glund S, Verhamme P, Bernstein RA et al. Idarucizumab for dabigatran reversal. N Engl J Med. 2015;373(6):511-20. doi: 10.1056/NEJMoa1502000, PMID 26095746.
Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/ AHA/ASNC 2009 appropriateness criteria for coronary revascularization: a report of the American College of Cardiology Foundation appropriateness criteria task force. Circulation. 2009;119(9):1330-52. doi: 10.1161/CIRCULATIONAHA.108.191768, PMID 19131581.
Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, et al. 2014 ACC/AHA/AATS/ PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;64(18):1929-49. doi: 10.1016/j.jacc.2014.07.017, PMID 25077860.
Morice MC, Serruys PW, Kappetein AP, Feldman TE, Ståhle E, Colombo A, et al. Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation. 2010;121(24):2645-53. doi: 10.1161/CIRCULATIONAHA.109.899211, PMID 20530001.
Aldea GS, Mokadam NA, Melford R, Stewart D, Maynard C, Reisman M, et al. Changing volumes, risk profiles, and outcomes of coronary artery bypass grafting and percutaneous coronary interventions. Ann Thorac Surg. 2009;87(6):1828-38. doi: 10.1016/j.athoracsur.2009.03.067, PMID 19463603.
American Diabetes Association. Standards of medical care in diabetes—2015 abridged for primary care providers. Clin Diabetes. 2015;33(2):97-111. doi: 10.2337/diaclin.33.2.97, PMID 25897193.
Beig JR, Shah TR, Hafeez I, Dar MI, Rather HA, Tramboo NA et al. Clinico-angiographic profile and procedural outcomes in patients undergoing percutaneous coronary interventions: the Srinagar registry. Indian Heart J. 2017 Sep-Oct;69(5):589-96. doi: 10.1016/j.ihj.2017.01.021, PMID 29054181.
Ramakrishnan S, Mishra S, Chakraborty R, Chandra KS, Mardikar HM. The report on the Indian coronary intervention data for the year 2011–National Interventional Council. Indian Heart J. 2013;65(5):518-21. doi: 10.1016/j.ihj.2013.08.009, PMID 24206874.
Jayaram AA, Shah S. Risk factors, clinical features, angiographic characteristics and treatment outcomes of young myocardial infarction patients. J Indian Coll Cardiol. 2015;5(3):203-8. doi: 10.1016/j.jicc.2015.05.002.
