Cardiovascular diseases are the commonest cause of death globally and are the major contributor to the burden of premature mortality and morbidity. This study analyses various clinical presentations, conventional risk factors, pattern and severity of coronary heart disease on angiography among 637 patients with coronary heart disease and adult congenital heart disease who underwent cardiac evaluation at National Institute of Cardiovascular Disease (NICVD), Dhaka between January 2007 to December 2008. Among them 547 (85.9%) were male and 90 (14.1%) were female. All of them were between 22 to 76 years of age with mean age 50.15±8.8. One hundred sixty nine (25.9%) patients had chronic stable angina & 398 (62.48%) patients subjected for coronary angiography for acute coronary syndrome and or old myocardial infarction and 74 (11.62%) patients with vascular and adult congenital heart disease prior to surgical treatment. Most prevalent risk factors were smoking (60%) and dyslipidaemia (60%). Thirty five percent patients were hypertensive and 10% patient had diabetes. Normal epicardial coronaries were documented in 25.59% patients which includes the patients who underwent coronary angiography prior to surgical treatment. Ninety three (14.6%) had single vessel disease, 119 (18.68%) had double vessel disease, 259 (40.66%) had triple vessel disease and 3 (0.47%) had isolated left main disease. Key words: Coronary angiogram; Coronary artery disease. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9206 FMCJ 2011; 6(2): 82-85

Background: Few studies have assessed the relation of Serum creatinine and serum blood urea nitrogen (BUN) level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid BUN levels with the presence of Coronary artery disease. Materials and Methods: This study was designed as an observational cohort study. The study was composed of 170 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high serum creatinine were defined as serum creatinine concentration with in 80-105 ?mol/L and BUN level with in 10-20 ?mol/L. The presence of CAD has been defined as the Gensini score being >1. Results: Patients with or without CAD were similar in terms of age (45.22±6.80 years vs. 52.87±9.31 years, p<0.01) and significant age difference was found between patients. Male gender (p<0.001) and smoking habit (p=0.003) were more frequent and statistically significant in patients with CAD. There was a statistically significant difference between the mean serum creatinine levels (92.89±20.82 ?mol/L vs 108.68±23.62 ?mol/L respectively, p<0.05) and serum blood urea nitrogen level (10.59±6.15 ?mol/L vs. 20.37±6.73 ?mol/L respectively, p<0.01) of patients with or without CAD. While looking at the correlation coefficient of Gensini score with different factors; S. creatinine, ejection fraction and BUN were significantly correlated at<0.001 and <0.04 and <0.01 level respectively. Increased serum creatinine levels were found to be independent risk factors for the presence of CAD (for serum cretinine hazard ration 3.9, p<0.001 and in case BUN hazard ration 2.08, p<0.001). Conclusion: In conclusion, a significant association has been found between serum creatinine & BUN level and the presence of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of serum creatinine and BUN level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14282 Cardiovasc. j. 2013; 5(2): 141-145

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Background: About one-third of all elective PCI procedures are associated with significant myocardial injury termed peri-procedural myocardial injury (PMI), which has been associated with increased subsequent mortality. The stent length is one of the factors that can predict procedure related Troponon I release. Methods: This interventional study was carried out to evaluate the influence of stent length on peri– procedural myocardial injury by measuring post procedural release of Troponin I after percutaneous coronary intervention. Patients with e”70% stenosed single vessel disease undergoing percutaneous coronary intervention with single stent were considered. Exclusion criteria were pre-procedural elevation of cardiac Troponin I above the 99th percentile of upper reference, severely ill patients. Total 90 consecutive patients were included. Among them 45 patients had d” 20mm long stent (group A) and rest 45 patients had > 20mm long stent (group B). Blood samples for Troponin I were collected before procedure and 12 hours after procedure. Results: Baseline characteristics including age, sex, risk factor for ischaemic heart disease and clinical diagnoses were almost similar between the two groups. During procedure no complications concurred 93.3% patients in group A and 68.9% patients in group B (p<0.05). Post procedural Troponin I level in group A was 0.47 ± 0.54 and in group B was 0.99 ± 1.09 (p<0.05). The stent length and post procedural Troponin I level had moderate correlation (r=0.41) (p<0.05). In hospital complications in two groups include persistent angina (6.7% vs. 11.1%), new ischaemic episode (0.0% vs. 4.4%) (p>0.05). There were no myocardial infarction, acute left ventricular failure, emergency CABG, arrhythmia and death in both groups. Durations of hospital stay were significantly higher in group B then group (4.53 ± 0.63 vs. 4.07 ± 0.65, p<0.05). Conclusion: The incidence of procedural myocardial injury and procedural complications are more in longer stent group. So limiting the stent length by spot-stenting the lesions rather than covering the entire vessel between lesions may reduce peri-procedural release of cTnI and improve post procedural prognosis. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18358 Cardiovasc. j. 2014; 6(2): 143-148

Abstract:Background