Predictive value of the atherogenic index of plasma for chronic total occlusion before coronary angiography

AbstractCoronary computed tomography angiography (CCTA) offers high-resolution anatomic characterization of the coronary vasculature but may be suboptimal for lesions dependent on real-time visualization of flow including chronic total occlusion (CTO). In CTOs, heavy calcification and distal vessel opacification from collateralization may confound luminal assessment. Several studies have examined the role of CCTA in characterizing known CTOs to guide percutaneous coronary intervention (PCI). However, the efficacy of CCTA in the de novo diagnosis of CTOs prior to coronary angiography (CAG) has not been demonstrated. A total of 233 consecutive patients who presented for CAG within a 3-month period of having CCTA were retrospectively reviewed. Those patients with prior diagnosis of CTO or prior bypass of the occluded vessels were excluded. Sensitivity and specificity analysis of CCTA in identifying CTOs using CAG as the gold standard was performed. The prevalence of CTO was 21.11% in the population that met criteria for analysis (n = 199). The sensitivity of CCTA in predicting CTO was 57.1%, while the specificity was 96.8%. The positive predictive value and negative predictive value of CCTA in detection of CTO were 82.8 and 89.4%, respectively. Our study shows that CCTA has excellent specificity but poor sensitivity in the detection of CTO thus limiting its clinical use in de novo diagnosis. Further studies to determine the effect of de novo CTO diagnosis on clinically important procedural factors, such as radiation exposure, contrast use, and need for repeat procedures, are warranted and may implicate a role for CCTA in this setting.

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The atherogenic index of plasma and its impact on recanalization of chronic total occlusion

Cardiology Journal ◽

10.5603/cj.a2018.0064 ◽

2020 ◽

Vol 27 (6) ◽

pp. 756-761 ◽

Cited By ~ 1

Author(s):

Jan-Erik Guelker ◽

Alexander Bufe ◽

Christian Blockhaus ◽

Knut Kroeger ◽

Thomas Rock ◽

...

Keyword(s):

Chronic Total Occlusion ◽

Atherogenic Index ◽

Total Occlusion ◽

Atherogenic Index Of Plasma

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Antegrade Approach of Percutaneous Coronary Intervention for Chronic Total Occlusion

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0041-1728184 ◽

2021 ◽

Author(s):

C. Raghu ◽

Rahul K. Ghogre ◽

Alekhya Mandepudi

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Chronic Total Occlusion ◽

Bypass Surgery ◽

Coronary Intervention ◽

Technical Expertise ◽

Total Occlusion ◽

Antegrade Approach ◽

Percutaneous Coronary ◽

Coronary Lesions

AbstractChronic total occlusion (CTO) is a common challenge accounting for 10% of coronary lesions found on coronary angiography. Patients are frequently referred for bypass surgery because percutaneous coronary intervention is challenging in this subset. Recent advances in the hardware as well as the technical expertise and an algorithm approach have improved the success to more than 90%.Antegrade approach is the cornerstone for managing CTO and has two distinct strategies: antegrade wire escalation, and antegrade dissection and reentry strategy. Step-wise approach to perform these procedures and the use of adjunct imaging are discussed.

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Correlation between Atherogenic index and the severity of coronary artery disease in diabetic patients undergoing elective coronary angiography using Gensini score

QJM ◽

10.1093/qjmed/hcaa041.002 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A S Elyamani ◽

M A Elnozahi ◽

A M Abdelmoteleb

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Significant Positive Correlation ◽

Atherogenic Index ◽

Diabetic Patients ◽

Gensini Score ◽

Atherogenic Index Of Plasma ◽

Positive Correlation ◽

Artery Disease

Abstract Background Dyslipidemia is one of the most important factors for CAD. Atherogenic index of plasma (AIP) is a new indicator involved in dyslipidemia. However, its relation with CAD severity in diabetic patients is not well established yet. Aim of the Study To study the relationship between atherogenic index of plasma and severity of coronary artery disease (CAD) in the diabetic patients. Methods Our study was conducted on 150 diabetic patient with stable CAD undergoing elective coronary angiography in Al-Agoza Hospital from april 2016 to august 2018. Atherogenic index was calculated from the logarithmically transformed ratio of concentrations of TGs to HDL-C obtained from the patient’s lipid profile. correlation of the AIP and the severity of CAD according to Gensini scoring system was done. Results AIP had a statistically significant positive relation with IDDM (p = 0.033), NIDDM (p = 0.033), HTN (p = 0.024), dyslipedemia (p = 0.042). And a highly significant positive correlation with FBS (p < 0.001, r = 0.479) and HbA1c (p < 0.001, r = 0.538), proximal LAD lesions (p = 0.002), LCX (p < 0.001), and the number of vessls affected (p = 0.005). AIP Also had a highly significant positive correlation with severity of CAD in terms of Gensini score (p < 0.001, r = 0.692). Conclusion AIP is considered a good predictor of CAD severity and multivessel affection in diabetic patients.

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10-YEAR SURVIVAL OF PATIENTS WITH A CHRONIC TOTAL OCCLUSION ON CORONARY ANGIOGRAPHY IS POOR PARTICULARLY IN THOSE WITHOUT EVIDENCE OF MYOCARDIAL VIABILITY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61630-6 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1630 ◽

Cited By ~ 2

Author(s):

Angela Hoye ◽

Nisar Shah ◽

Hussein Ismail ◽

Fayaz Khan ◽

Daniyal Ahmed ◽

...

Keyword(s):

Coronary Angiography ◽

Myocardial Viability ◽

Chronic Total Occlusion ◽

Total Occlusion

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Successful treatment of chronic total occlusion of the coronary arteries through the femoral vein: a novel approach

Heart Vessels and Transplantation ◽

10.24969/hvt.2021.283 ◽

2021 ◽

Vol 0 (Ahead of Print) ◽

Author(s):

Marat Aripov ◽

Alexey Goncharov ◽

Ayan Abdrakhmanov ◽

Philip la Fleur

Keyword(s):

Coronary Angiography ◽

Coronary Arteries ◽

Successful Treatment ◽

Chronic Total Occlusion ◽

Treatment Approach ◽

Femoral Vein ◽

Transseptal Puncture ◽

Total Occlusion ◽

Novel Approach ◽

Viable Treatment

Despite the vessel’s inaccessibility to dual coronary angiography and the use of classical routes for retrograde treatment of chronic total occlusion (CTO), the approach through the femoral vein and subsequent transseptal puncture with catheterization of ostium of coronary arteries is a viable treatment approach.

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