ABSTRACT
BACKGROUND: Galectin-3 is a new biomarker assumed to reflect fibrogenesis and inflammation. We aimed to investigate the relation of Gal-3 with the severity of coronary artery disease in patients with ST elevation myocardial infarction. METHODS: The prospective study enrolled 62 patients with ST elevation myocardial infarction who underwent coronary angiography. The burden of atherosclerosis was assessed by the number of involved vessels, the number of coronary lesions with a stenosis diameter more than 50% and the Gensini score. Gal-3 levels were measured on admission on miniVIDAS (BioMérieux). RESULTS: The mean age of the patients was 56±11 years old; 93.5% were males. Diabetes, hypertension and hyperlipidemia were respectively 29%, 35.5% and 24.2%. Among patients, 80.6% were active smokers. Mean level of Gal-3was 17±11 ng/ml and didn't differ significantly from the number of involved coronary vessels (p=0.82) and the Gensini score (p=0.4). There was a positive correlation between the number of coronary lesions with a stenosis diameter greater than 50% and Gal-3 (p=0.04). CONCLUSION: In patient with ST elevation myocardial infarction we found a positive correlation between the number of coronary stenosis and Gal-3 level.
Subject(s)
Coronary Artery Disease , ST Elevation Myocardial Infarction , Aged , Coronary Angiography , Coronary Artery Disease/diagnosis , Coronary Artery Disease/epidemiology , Female , Galectin 3 , Humans , Male , Middle Aged , Prospective Studies , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/epidemiologyABSTRACT
BACKGROUND: Coronarography presents some limits in assessing intermediate stenosis. Intravascular ultrasound provides tridimensional measurements of the artery, with more reliable data guiding revascularization decision. AIMS: to evaluate the impact of intravascular ultrasound measurements on revascularization decision of intermediate and ambiguous coronary lesions. METHODS: We prospectively analysed 40 patients' coronary arteries from March 2009 to November 2011 by both quantitative coronary angiography (QCA) then intravascular ultrasound, and compared our decision before and after intravascular ultrasound. RESULTS: in the final revascularization decision after intravascular ultrasound, medical treatment rate raised from 22% to 25%, percutaneous coronary intervention dropped from 55% to 50%, and coronary artery bypass graft slightly raised from 23% to 25%. Therapeutic decision changed after intravascular ultrasound in 47% of patients (p=0,01), which reflects an important impact of this technique in management of intermediate coronary lesions. CONCLUSION: Intravascular ultrasound provided more accurate measurements which permitted a better detection of ischemia and influenced notably our therapeutic strategies.
Subject(s)
Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/surgery , Ultrasonography, Interventional , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
BACKGROUND: Although coronarography is still the gold standard to evaluate coronary lesions, it remains a bidimensional representation of a tridimensional complex structure, which can represent a source of error in measurements. AIMS: to perform a correlation and concordance study between quantitative coronary angiography (QCA) and intravascular ultrasound measurements for intermediate and ambiguous lesions. METHODS: We analysed 40 patients' coronary arteries from March 2009 to November 2011 by both QCA and intravascular ultrasound to perform then a correlation and concordance study. RESULTS: the correlation study confirmed the limits of the angiogram in providing accurate measurements. The correlation coefficient was yet high in reference diameters (r=0,78, p<0,001) and minimal lumen diameters (r=0,58, p<0,001), but was middling for stenosis percentages (r=0,23, p=0,03). This coefficient was also high for lesions lengths (r=0,51, p=0,01). Bland &Altaman diagrams showed however wide limits of agreement, reflecting possibility of large measurements error and confirming the absence of concordance between the two techniques. CONCLUSION: Coronarography though being the most widespread mean of evaluating coronary lesions lacks to provide accurate measurements, which can influence patient's management, especially in case of intermediate lesions.