Browsing by Author "Ružičić, Dušan (37039868200)"

Introduction A single coronary artery (SCA) is defined as a coronary artery that arises from the sinus of Valsalva and supplies the entire heart. This is a rare congenital anomaly occurring in approximately 0.04-0.13% of the population. SCA can be diagnosed during life by coronary angiography and multislice cardiac computed tomography. There are many anatomical variations of single coronary arteries. Case outline A 50-year-old man presented with acute ST elevation myocardial infarction (STEMI). Coronary angiography revealed the case of an SCA with left anterior descending artery and circumflex artery arising separately from the right coronary artery which was occluded proximally to their taking-off. Successful primary percutaneous coronary intervention was performed and is reported here in details. This is the first described case of an SCA (classified as R-III and R-III-C by Lipton and Yamanaka, respectively) with a clinical presentation as STEMI. A description of the undertaken management is also provided. Conclusion Coronary artery anomalies require accurate recognition in order to help cardiologists plan appropriate management of these patients. © 2017, Serbia Medical Society. All rights reserved.

Background/Aim. Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) have an increased risk of major adverse cardiovascular events (MACE) after percuta-neous coronary intervention (PCI), which is not estimated sufficiently-multidimensionally in terms of type and severity of the ACS and/or DM and angiographic findings. The study was intended to validate and develop an index of met-abolic, angiographic, anatomic and clinical risk factors for one-year MACE after conducted PCI in patients with ACS and DM. Methods. A prospective cross-sectional study was performed in patients with DM and ACS. In the PCI period the following risk factors were recorded: 1) age and meta-bolic variables - glycosylated hemoglobin (HbA1c), total cholesterol, and triglycerides levels in the blood; 2) endo-crinological variables - DM therapy and type of DM; 3) ACS modality; 4) radiological/anatomical variable - SYN-TAX score, and 5) clinical variables in modified age, creati-nine, ejection fraction (ACEF) score. One-year MACE were recorded. Results. From a total of 136 consecutive patients, 55 of them developed at least one MACE in one-year follow-up. A high predictive risk index was evaluated that assessed particular or associated risks for one-year MACE (c statistic = 0.879) in the study population, defined by: SYNTAX score > 21, modified ACEF score > 1.38, HbA1c - 8%, triglyceridemia - 2.3 mmol/L in patients with insulin therapy, and ACS modality - unstable angina pectoris. The constructed risk index for one-year MACE (MACERI) had better predictive characteristics than SYN-TAX score (c statistic = 0.798), as well as ACF score (c sta-tistic = 0.744). Conclusion. MACERI can potentially have great application in future risk factors studies for one-year MACE in patients with DM and ACS who underwent PCI, because with it the effects of these factors are measured multidimensionally at valid and accurate manner. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.