18 research outputs found
Myocardial bridging and coronary artery anomalies detected by ECG-gated 64-row multidetector computed tomography angiography in symptomatic patients
Advances in 64-row multidetector computed tomography have provided noninvasive
imaging of coronary arteries. The aim of this study was to evaluate the
prevalence of coronary artery anomalies in Iranian symptomatic patients and
to determine the presence of anomalies resulting in myocardial ischaemia without
atherosclerotic plaque.
This study was carried out in Tabriz University of medical sciences on 534 patients
with suggestive symptoms for coronary artery diseases. Original slices
were reconstructed from data achieved by using a ECG-gated multidetector
computed tomography scanner, and reconstructed 3-dimentional images of
the heart were reviewed. Congenital angiography was performed in 36.3% of
patients. The prevalence of myocardial bridging in symptomatic patients was
6.0% by multidetector computed tomography while conventional angiography
could detect 20% of them. The most prevalent site was the middle portion
of the left anterior descending artery. Anomalous origin or course of coronary
arteries and AV fistula was detected by multidetector computed tomography
coronary angiography in 2.6% of cases while conventional angiography could
detect 44.4% of these anomalies. The prevalence of atherosclerotic plaques in
patients with myocardial bridging was 53.1%. In 46.9% of these patients, myocardial
bridging was held responsible for signs and symptoms of myocardial
ischaemia as no atherosclerotic plaque was evident. This rate was 64.3% in symptomatic
patients with other anomalies in origin or course of coronary arteries.
This study gives the prevalence of coronary artery anomalies and myocardial
bridging in the Iranian population. The results suggest multidetector computed
tomography coronary angiography as the preferred utility for diagnosing
such anomalies
Prevalence, risk factors, and outcome of myocardial infarction with angiographically normal and near-normal coronary arteries: A systematic review and meta-analysis
Context: Coronary artery diseases are mostly detected using angiographic methods demonstrating arteries status. Nevertheless, Myocardial Infarction (MI) may occur in the presence of angiographically normal coronary arteries. Therefore, this study aimed to investigate the prevalence of MI with normal angiography and its possible etiologies in a systematic review. Evidence Acquisition: In this meta-analysis, the required data were collected from PubMed, Science Direct, Google Scholar, Scopus, Magiran, Scientific Information Database, and Medlib databases using the following keywords: �coronary angiograph�, �normal coronary arteries�, �near-normal coronary arteries�, �heart diseases�, �coronary artery disease�, �coronary disease�, �cardiac troponin I�, �Myocardial infarction�, �risk factor�, �prevalence�, �outcome�, and their Persian equivalents. Then, Comprehensive Meta-Analysis software, version 2 using randomized model was employed to determine the prevalence of each complication and perform the meta-analysis. P values less than 0.05 were considered to be statistically significant. Results: Totally, 20 studies including 139957 patients were entered into the analysis. The patients� mean age was 47.62 � 6.63 years and 64.4 of the patients were male. The prevalence of MI with normal or near-normal coronary arteries was 3.5 (CI = 95, min = 2.2, and max = 5.7). Additionally, smoking and family history of cardiovascular diseases were the most important risk factors. The results showed no significant difference between MIs with normal angiography and 1- or 2-vessel involvement regarding the frequency of major adverse cardiac events (5.4 vs. 7.3, P = 0.32). However, a significant difference was found between the patients with normal angiography and those with 3-vessel involvement in this regard (5.4 vs. 20.2, P < 0.001). Conclusions: Although angiographic studies are required to assess the underlying etiology of MI, physicians facing patients presenting with the clinical features of MI in presence of normal or near-normal coronary arteries should consider the prevalence and risk factors of MI with normal or near-normal coronary arteries. � 2016, Iranian Cardiovascular Research Journal. All rights reserved