ABSTRACT
Background: The presence of ischemic ECG changes on admission has been shown to predict outcome, the relationship between the extent of ECG changes and the risk of cardiac events is still ill defined. The severity of ST-segment depression on admission ECG has a strong association with adverse in-hospital outcome in patients with non ST-segment elevation acute coronary syndrome. The study was done to observe the extent of ST-segment depression and in-hospital outcome in patients with non ST-segment elevation acute coronary syndrome. Methods: This study was conducted in the Department of Cardiology in NICVD Dhaka, from January 2006 to December 2007. Considering inclusion and exclusion criteria, a total of 183 patients were evaluated. All the patients were evaluated clinically after admission. ECG, blood biochemistry and echocardiography were done. Patients were categorized into three groups according to the extent of ST- segment depression. Results: In this study, analysis of the baseline parameters revealed no statistically significant difference among the three groups of patients (p>0.05). Mean sum of the ST-segment depression analysis was done and all mean values were more in group III patients. 41.0% patients developed complications during the study period. Acute LVF (22.9%) was the most common complication followed by arrhythmia (11.5%), cardiogenic shock (4.4%) and STEMI (2.2%). All the complications were more in group III patients. During this period 6% patients died and more death (12.3%) was observed in group III patients. Conclusion: The amount of ST-segment depression is a powerful predictor of adverse in-hospital outcome in patients with non ST-segment elevation acute coronary syndrome.
ABSTRACT
Background: Cardiac Scan (MP-SPECT) is a widely utilized noninvasive imaging modality for diagnosis, prognosis, and risk stratification of coronary artery disease. In Bangladesh it is a recently introduced test and there is no study upon it. Considering this ground the study is perform on Bangladeshi patients. Methods: 100 referral patients underwent MPI for evaluation of perfusion status of myocardium. The patients either of suspected IHD or diagnosed case of IHD were referred from different cardiology unit or surgery unit of NICVD. Technetium 99m (99"Tc) isotopes and tetrofosmin used in the same day stress and rest protocol. Result: The commonest findings observed in this present analysis were the early age group patients mostly of female having DCM, but the later age group of patients are of both male and female having Angina Pectoris, OMI and ICM. The referral patients by cardiologists or cardiac surgeons are mostly limited to the pre therapeutic evaluation rather than diagnostic indication. The most common indication is the evaluation of myocardial viability and aim of subsequent treatment. Conclusion: Analysis of perfusion status, decision of subsequent treatment either by medicine or CABG, conform the usually described pattern in western literature.