Rest perfusion defects in patients with no history of myocardial infarction predict the presence of a critical coronary artery stenosis

Background: Restenosis after coronary angioplasty can have serious complications such as coronary artery bypass graft, myocardial infarction, and death. Objectives: The present study aimed at investigating the factors affecting the recurrence of coronary artery stenosis in patients undergoing angioplasty using the recurrent event data analysis. Methods: A cohort study was performed on patients undergoing coronary angioplasty from March 23, 2009, to January 21, 2011. All patients were followed up from angioplasty to January 21, 2015. First, each of the independent variables was entered into the univariate Cox model with a frailty component. Then, variables with p-values of less than 0.2 were entered into the multivariate analysis. The statistical analysis was done using R software, version 3.6, at the significance level of 0.05. Results: The present study was conducted on 1,000 patients who underwent coronary angioplasty. We found that 441 patients experienced restenosis at least once in the study period. The mean survival time to the first event of restenosis was 44.08 ± 1.06 months. Patients with a history of diabetes, unstable angina, and myocardial infarction had a significantly higher hazard of restenosis compared to other patients (P < 0.05). Conclusions: The results of the recurrent event survival analysis confirmed the significant role of risk factors such as a history of diabetes, unstable angina, and myocardial infarction. Therefore, training to enhance the patients’ awareness and attitude seems necessary to prevent them from exposing whit known risk factors. The periodic follow-up of patients with risk factors and more ongoing care are also necessary.

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5.3 Relation between the location of the most severe myocardial perfusion defects, the most severe coronary artery stenosis and the site of subsequent myocardial infarction

Journal of Nuclear Cardiology ◽

10.1016/s1071-3581(01)80568-7 ◽

2001 ◽

Vol 8 (1) ◽

pp. S37-S37

Author(s):

J CANDELLRIERA ◽

O PEREZTOLVALDES ◽

C SANTANABOADO ◽

G OLLERMARTINEZ ◽

S AGUADEBRUIX ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Myocardial Perfusion ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Severe Coronary Artery ◽

Perfusion Defects ◽

Myocardial Perfusion Defects

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Abstract 15484: Combined Coronary and Carotid Artery Involvement in a Caucasian Patient With Moyamoya Disease

Circulation ◽

10.1161/circ.142.suppl_3.15484 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Ahmed H Qavi

Keyword(s):

Coronary Artery ◽

Moyamoya Disease ◽

Coronary Artery Stenosis ◽

Young Patients ◽

Artery Stenosis ◽

Medical Attention ◽

Caucasian Patient ◽

Left Circumflex Artery ◽

Cardiac Symptoms ◽

History Of

Introduction: Moyamoya disease (MMD) is a rare, progressive steno-occlusive disease of the intracranial carotid arteries. This is primarily a cerebrovascular disease and is mostly seen in young Japanese patients. We report a case of severe stenosis in the distal left circumflex artery (dLCx) in a non-Japanese patient with previously diagnosed MMD. Case presentation: A 33-year-old Caucasian female with history of MMD and 2 CVAs presented with chest pain for 2 days. Her only medication at home was aspirin. There was no history of hypertension, diabetes mellitus, or tobacco use. There was no family history of early CAD. Physical examination was positive for tachycardia but negative for carotid or femoral bruits. Neurologic examination revealed decreased touch sensation and diminished deep tendon reflexes on the left side. ECG demonstrated tachycardia with T wave inversions in leads III and ST depression in lead II. Acute CVA was ruled out with an MRI. Cardiac troponins were minimally elevated with peak of 0.12 ng/dl. An initial diagnosis of NSTEMI was made; patient was loaded with aspirin, clopidogrel and started on a heparin drip. Cardiac catheterization on the following day revealed single vessel CAD in the dLCx, with 80% stenosis and TIMI flow 2. A drug eluting stent was successfully placed in the dLCx. Angiogram post-stent placement showed optimal angiographic result with TIMI 3 flow. The patient was discharged home on dual antiplatelet therapy, statin, beta-blocker and ACE inhibitor. Discussion: MMD is thought to affect the coronary arteries from fibrous intimal thickening and histopathology of these coronary lesions show a homogenous, soft intimal proliferation with minimum lipid deposition and without substantial inflammatory cell infiltration. Although the combined involvement of carotid and coronary artery stenosis is rare, coronary involvement should be considered as one of the causes of ischemic heart disease in young patients with MMD. To the best of our knowledge, this is the first reported case of combined involvement of carotid and coronary artery stenosis in a Caucasian patient with previously diagnosed MMD. It is imperative to educate patients with MMD about possible CAD so that they seek immediate medical attention if cardiac symptoms occur.

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Coronary Artery Calcification: Its Relationship to Coronary Artery Stenosis and Myocardial Infarction

Radiology ◽

10.1148/91.1.109 ◽

1968 ◽

Vol 91 (1) ◽

pp. 109-115 ◽

Cited By ~ 61

Author(s):

R. King Warburton ◽

John P. Tampas ◽

A. Bradley Soule ◽

Howard C. Taylor

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Coronary Artery Stenosis ◽

Artery Stenosis

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Prevalence of Factor V Leiden in Patients with Myocardial Infarction and Normal Coronary Angiography

Thrombosis and Haemostasis ◽

10.1055/s-0037-1613927 ◽

2000 ◽

Vol 83 (06) ◽

pp. 822-825 ◽

Cited By ~ 55

Author(s):

Antoine Da Costa ◽

Stéphane Munier ◽

Bernard Mercier ◽

Brigitte Tardy ◽

Claude Ferec ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Artery Stenosis ◽

Factor V Leiden ◽

Artery Stenosis ◽

Factor V ◽

Significant Coronary Artery Stenosis ◽

Increased Risk ◽

Normal Coronary Angiography

SummaryFactor V Leiden is associated with an increased risk of venous thrombosis and myocardial infarction in young women, but not in men in this latter case. The aim of this study was to evaluate the prevalence of this mutation in patients with myocardial infarction but normal coronary angiography.We compared 3 groups of patients: one group consisted of 107 patients with premature myocardial infarction but no significant coronary artery stenosis; another group of 244 patients with myocardial infarction and significant coronary artery stenosis; a third group of 400 healthy controls.Factor V Leiden was found in 13 patients (12.1%) who had a myocardial infarction without significant coronary artery stenosis, 11 patients (4.5%) who had a myocardial infarction with significant coronary artery stenosis (p = 0.01) and in 20 controls (5%) (p = 0.01). Odds ratio associated with factor V Leiden were respectively 2.93 (CI95 : 1.18-7.31) and 2.63 (CI95 : 1.19-5.78) when we compared myocardial infarction patients without significant coronary artery stenosis to controls or to patients with significant coronary artery stenosis.In myocardial infarction patients without significant coronary artery stenosis, prevalence of factor V Leiden is significantly higher than in controls. This new finding supports the hypothesis that thrombosis plays a key role in this selected situation.

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