The dynamics of cardiovascular system parts synchronization in patients with coronary artery disease under the impact of metoprolol intake

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Siemens Healthineers Introduction Coronary CT angiography (CCTA) plays an increasing role in the detection and risk stratification of patients with coronary artery disease (CAD). The Coronary Artery Disease – Reporting and Data System (CAD-RADS) allows for standardized classification of CCTA results and, thus, may improve patient management. Purpose Aim of this study was to assess the impact of CCTA in combination with CAD-RADS on patient management and to identify the impact of cardiovascular risk factors (CVRF) on CAD severity. Methods CCTA was performed on a third-generation dual-source CT scanner in patients, who were referred to a radiology centre by their attending physicians. In a total of 4801 patients, CVRF were derived from medical reports and anamnesis. Results The study population consisted of 4770 patients (62.0 (54.0-69.0) years, 2841 males) with CAD (CAD-RADS 1-5), while 31 patients showed no CAD and were excluded from further analyses. Age, male gender and the number of CVRF were associated with more severe CAD stages (all p < 0.001). 3040 patients (63.7 %) showed minimal or mild CAD requiring optimization of CVRF i.e. medical therapy but no further assessment at his time. A group of 266 patients (5.6 %) had a severe CAD defined as CAD-RADS 4B/5. In the multivariate regression analysis, age, male gender, history of smoking, diabetes mellitus and hyperlipidaemia were significant predictors for severe CAD, whereas arterial hypertension and family history of CAD did not reach significance. Of note, a subgroup of 28 patients (10.5 %) with a severe CAD (68.5 (65.5-70.0) years, 26 males, both p = n.s.) had no CVRF. Conclusions CCTA in combination with the CAD-RADS allowed for effective risk stratification of CAD patients. The majority of the patients showed non-obstructive CAD and, thus, could be treated conservatively without the need for further CAD assessment. CVRF out of arterial hypertension and family history had an impact on CAD severity reflected in higher CAD-RADs gradings. Of note, a relevant fraction of patients with CAD did not have any CVRF and, thus, may not be covered by risk stratification models. CAD-RADS n Age (years) Males (%) 1 1453 56.0 (50.0-62.0) 623 (42.9 %) 2 1587 62.0 (55.0-69.0) 918 (57.8 %) 3 1067 66.0 (59.0-71.0) 749 (70.2 %) 4A 397 66.0 (59.0-72.0) 317 (79.8 %) 4B 162 67.0 (61.0-74.0) 139 (85.8 %) 5 104 66.0 (58.5.0-77.0) 95 (91.3 %)

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Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

Clinical Research in Cardiology ◽

10.1007/s00392-021-01922-y ◽

2021 ◽

Author(s):

Rutao Wang ◽

Scot Garg ◽

Chao Gao ◽

Hideyuki Kawashima ◽

Masafumi Ono ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Revascularization ◽

Long Term Outcomes ◽

Vital Status ◽

Increased Risk ◽

Artery Disease ◽

The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

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Impact of Coronary Artery Disease and Diabetes Mellitus on the Long-Term Follow-Up in Patients after Retrograde Recanalization of the Femoropopliteal Arterial Region

Journal of Diabetes Research ◽

10.1155/2019/6036359 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Joanna Wojtasik-Bakalarz ◽

Zoltan Ruzsa ◽

Tomasz Rakowski ◽

Andreas Nyerges ◽

Krzysztof Bartuś ◽

...

Keyword(s):

Diabetes Mellitus ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Risk Of Death ◽

Significant Difference ◽

Long Term Follow Up ◽

Artery Disease ◽

The Impact

The most relevant comorbidities in patients with peripheral artery disease (PAD) are coronary artery disease (CAD) and diabetes mellitus (DM). However, data of long-term follow-up of patients with chronic total occlusion (CTO) are scarce. The aim of the study was to assess the impact of CAD and DM on long-term follow-up patients after superficial femoral artery (SFA) CTO retrograde recanalization. In this study, eighty-six patients with PAD with diagnosed CTO in the femoropopliteal region and at least one unsuccessful attempt of antegrade recanalization were enrolled in 2 clinical centers. Mean time of follow-up in all patients was 47.5 months (±40 months). Patients were divided into two groups depending on the presence of CAD (CAD group: n=45 vs. non-CAD group: n=41) and DM (DM group: n=50 vs. non-DM group: n=36). In long-term follow-up, major adverse peripheral events (MAPE) occurred in 66.6% of patients with CAD vs. 36.5% of patients without CAD and in 50% of patients with DM vs. 55% of non-DM subjects. There were no statistical differences in peripheral endpoints in both groups. However, there was a statistically significant difference in all-cause mortality: in the DM group, there were 6 deaths (12%) (P value = 0.038). To conclude, patients after retrograde recanalization, with coexisting CTO and DM, are at higher risk of death in long-term follow-up.

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The Cardiovascular System, Coronary Artery Disease, and Calcium: A Hypothesis

The Cambridge World History of Food ◽

10.1017/chol9780521402149.121 ◽

2000 ◽

pp. 1109-1120

Author(s):

Stephen Seely

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiovascular System ◽

Artery Disease

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The impact of the family and lay others on care-seeking during life-threatening episodes of suspected coronary artery disease

Social Science & Medicine ◽

10.1016/0277-9536(86)90093-6 ◽

1986 ◽

Vol 22 (12) ◽

pp. 1297-1311 ◽

Cited By ~ 106

Author(s):

Angelo A. Alonzo

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Suspected Coronary Artery Disease ◽

Care Seeking ◽

The Family ◽

Life Threatening ◽

Artery Disease ◽

The Impact

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THE IMPACT OF SERUM TRANS FATTY ACIDS CONCENTRATION ON PLAQUE VULNERABILITY IN PATIENTS WITH CORONARY ARTERY DISEASE UNDER MANAGEMENT OF CONVENTIONAL RISK FACTORS: ASSESSMENT VIA OPTICAL COHERENCE TOMOGRAPHY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)30362-x ◽

2016 ◽

Vol 67 (13) ◽

pp. 361

Author(s):

Yoshinori Nagasawa ◽

Toshiro Shinke ◽

Ryuji Toh ◽

Hiromasa Otake ◽

Tomofumi Takaya ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Fatty Acids ◽

Optical Coherence Tomography ◽

Coronary Artery ◽

Trans Fatty Acids ◽

Plaque Vulnerability ◽

Artery Disease ◽

The Impact ◽

Conventional Risk Factors

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Impact of premature ovarian insufficiency on cardiovascular health

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183804 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3837

Author(s):

Kavitha Abraham ◽

Vaibhav Londhe ◽

Tunny Sebastian ◽

Thomas Paul ◽

Aruna Kekre

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiovascular Health ◽

Menopausal Symptoms ◽

Premature Ovarian Insufficiency ◽

P Value ◽

Ovarian Insufficiency ◽

Hs Crp ◽

Artery Disease ◽

The Impact

Background: The objectives of the study were to identify the causes of premature ovarian insufficiency (POI) and to assess the severity of menopausal symptoms as well as the impact on cardiovascular health in these patients.Methods: Authors did a cross sectional case control study with 100 cases and 100 age matched controls. Women <40years of age with amenorrhoea >4months and FSH >25mIU/ml were identified with POI. Women <40years with normal cycles were the controls. Causes were identified from medical records and menopausal symptoms were categorized using menopause rating score questionnaire. Hypercholesterolemia (≥200mg/dl), hypoalbuminemia (<3.5g/dl) and high sensitive C reactive protein (HS-CRP ≥3mg/dl) were assessed as the early markers of coronary artery disease. Statistical methods included Chi square test and logistic regression analysis. P value <0.05 was considered significant.Results: 64% of the patients were between 31-40 years. 66% of them were into menopause for <5 years. The cause was idiopathic in 62%. 91% had no or minimal menopausal symptoms. Hypoalbuminemia (6 versus 1, 95% CI 1.8-2.4, OR 2.1, p=0.01) and hypercholesterolemia (75 versus 51, 95%CI 2.5-3.1, OR 2.8, p= 0.001) were significantly high in cases. HS-CRP was not found to be different between the groups (59 versus 49, OR 1.5, 95%CI 0.8-2.6, p=0.2).Conclusions: In majority with POI the cause is idiopathic and menopausal symptoms are minimal. Hypoalbuminemia and hypercholesterolemia, markers of coronary artery disease, were significantly elevated in POI. Early screening for these variables within 5 years of menopause would reduce the cardiovascular mortality in these patients.

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