Coronary calcium score is superior to exercise tolerance testing in predicting significant coronary artery stenosis

OBJECTIVES This study correlated the multi - detector computed tomography (MDCT) calcium scores with the results of coronary angiography in diabatic and/or hypertensive patients with atypical angina pectoris in order to assess its value to predict or exclude significant coronary artery disease (CAD). BACKGROUND Muti-detector computed tomography is a sensitive method to detect coronary calcium. However, it is unclear whether it may play a role as a filter before invasive procedures in patients with atypical angina pectoris. METHODS A total of 150 patients (116 men and 34 women) with diabetic and/or hypertension for at least 5 years and atypical angina pectoris from a single center were included in our study. patients underwent calcium screening with MDCT and have calcium score more than 100 , then all patient underwent invasive coronary angiography. RESULTS The Mean age was 62±5.7 and 77.3% were male, 78% of men and 88.2 % of women revealed significant coronary stenoses (> 50% lumen narrowing of left main trunk stenosis and > 70% stenosis of any epicardial coronary artery). Significant correlation between calcium scoring and significant coronary artery stenosis was seen (P: 0001). A 70% were DM, 90% were hypertensive and 61.3% were HTN and DM. The LAD artery was the most stenotic artery by 53.3% followed by RCA (37.3%) and finally LCX (30.7%). one significant coronary artery was 42% followed by two significant CAD (26.7%), while 9.3% included three-vessel disease. The significant coronary artery diseases was increased with age ( P: 0003). CONCLUSIONS Coronary calcium proved to have good diagnostic performance for significant coronary artery stenosis in patient with atypical angina pectoris.

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399 Myocardial contrast stress echocardiography detects functionally significant coronary artery stenosis: Comparison with dobutamin stress echocardiography in a porcine model

European Journal of Echocardiography ◽

10.1016/s1525-2167(99)80234-0 ◽

1999 ◽

Vol 1 ◽

pp. S67-S67

Author(s):

I PEKRUL ◽

S HARDT ◽

A HANSEN ◽

M GEBHARDT ◽

W KUEBLER ◽

...

Keyword(s):

Coronary Artery ◽

Stress Echocardiography ◽

Porcine Model ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Coronary Artery Stenosis

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Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease

International Journal of Angiology ◽

10.1055/s-0040-1720968 ◽

2021 ◽

Author(s):

Gökhan Ceyhun ◽

Oğuzhan Birdal

Keyword(s):

Coronary Artery ◽

Shear Rate ◽

Confidence Interval ◽

Odds Ratio ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Stenosis ◽

Whole Blood Viscosity ◽

Significant Coronary Artery Stenosis ◽

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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Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10153341 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3341

Author(s):

Hyun-Jin Kim ◽

Min-Ho Lee ◽

Sang-Ho Jo ◽

Won-Woo Seo ◽

Hack-Lyoung Kim ◽

...

Keyword(s):

Coronary Artery ◽

Propensity Score ◽

Clinical Outcomes ◽

Coronary Artery Stenosis ◽

Study Data ◽

Artery Stenosis ◽

Vasospastic Angina ◽

Significant Stenosis ◽

Significant Coronary Artery Stenosis ◽

Increased Risk

Vasospastic angina (VA) is a functional disease of the coronary artery and occurs in an angiographically normal coronary artery. However, it may also occur with coronary artery stenosis. We investigated the effect of coronary artery stenosis on clinical outcomes in VA patients. Study data were obtained from a prospective multicenter registry that included patients who had symptoms of VA. Patients were classified into two groups according to presence of significant coronary artery stenosis. Among 1920 patients with VA, 189 patients were classified in the “significant stenosis” group. The one-year composite clinical events rate was significantly higher in the significant stenosis group than in the “no significant stenosis” group (5.8% vs. 1.4%, respectively; p < 0.001). Additionally, the prevalence of ACS was significantly greater in the "significant stenosis" group (4.8% vs. 0.9%, respectively; p < 0.001). After propensity score matching, the adverse effects of significant stenosis remained. In addition, significant stenosis was independently associated with a 6.67-fold increased risk of ACS in VA patients. In conclusion, significant coronary artery stenosis can increase the adverse clinical outcomes in VA patients at long-term follow-up. Clinicians should manage traditional risk factors associated with atherosclerosis and control vasospasm as well as reduce the burden of atherosclerosis.

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