Early Assessment of Strain Echocardiography Can Accurately Exclude Significant Coronary Artery Stenosis in Suspected Non–ST-Segment Elevation Acute Coronary Syndrome

Abstract Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) (p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17–2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19–2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001). Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.

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IMPACT OF PRE-OPERATIVE CLOPIDOGREL USE IN PATIENTS WITH NON-ST SEGMENT ELEVATION ACUTE CORONARY SYNDROME REQUIRING CORONARY ARTERY BYPASS GRAFTING: A META-ANALYSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)61728-7 ◽

2010 ◽

Vol 55 (10) ◽

pp. A185.E1727

Author(s):

Rohit Bhuriya ◽

Pawan Patel ◽

Dhara Chaudhari ◽

Amol Bahekar ◽

Ankur Sethi ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Meta Analysis ◽

Artery Bypass ◽

Bypass Grafting ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment

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MI with Non-obstructive Coronary Artery Presenting with STEMI: A Review of Incidence, Aetiology, Assessment and Treatment

European Cardiology Review ◽

10.15420/ecr.2019.13 ◽

2020 ◽

Vol 15 ◽

Author(s):

Ying X Gue ◽

Rahim Kanji ◽

Sabiha Gati ◽

Diana A Gorog

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Correct Diagnosis ◽

Correct Treatment ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Plaque Disruption ◽

Methodical Approach ◽

St Segment ◽

Assessment And Treatment

MI with non-obstructive coronary artery (MINOCA) is a condition previously thought to be benign that has recently been shown to have comparable mortality to that of acute coronary syndrome with obstructive coronary disease. The heterogeneity of the underlying aetiology makes the assessment, investigation and treatment of patients with MINOCA challenging. The majority of patients with MINOCA presenting with ST-segment elevation MI generally have an underlying coronary or myocardial cause, predominantly plaque disruption or myocarditis. In order to make the correct diagnosis, in addition to the cause of the presentation, a meticulous and methodical approach is required, with targeted investigations. Stratification of patients to guide investigations that are more likely to provide the diagnosis will allow the correct treatment to be initiated promptly. In this article, the authors review the contemporary incidence, aetiology, recommended assessment and treatment of patients with MINOCA presenting with ST-segment elevation MI.

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Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis

Biomarkers in Medicine ◽

10.2217/bmm-2020-0274 ◽

2020 ◽

Vol 14 (16) ◽

pp. 1553-1561

Author(s):

Mehmet Erdoğan ◽

Mehmet A Erdöl ◽

Selçuk Öztürk ◽

Tahir Durmaz

Keyword(s):

Coronary Artery ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Fractional Flow ◽

Predictive Capacity ◽

Significant Coronary Artery Stenosis ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

Flow Reserve ◽

Immune Inflammation

Aim: The study aimed to investigate and compare the predictive capacity of a systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to determine a hemodynamically significant coronary artery stenosis assessed by fractional flow reserve (FFR). Patients & methods: A total of 207 chronic coronary syndrome patients with FFR measurement were enrolled in the study. NLR, PLR and SII levels were calculated. Results: The cut-off value of the SII (620) was associated with 78.4% sensitivity and 64.0% specificity to predict a hemodynamically significant stenosis. SII level independently predicted FFR ≤0.80. Conclusion: SII is an independent predictor of functionally significant coronary stenosis detected by FFR in chronic coronary syndrome patients. SII levels can predict hemodynamically severe obstruction better than NLR and PLR.

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