FAMILY HISTORY OF PREMATURE CAD AND TRADITIONAL CLINICAL RISK FACTORS IN PREDICTING OBSTRUCTIVE CORONARY ATHEROSCLEROSIS IN YOUNG PATIENTS REFERRED FOR CORONARY CT ANGIOGRAPHY

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary atherosclerosis has a long subclinical period. It’s early detection may offer a possibility of timely initiation of preventive interventions Purpose To develop a diagnostic rule for detection of patients (pts) with high probability of subclinical atherosclerosis among those with high or very high cardiovascular (CV) risk. Methods This cross-sectional study enrolled 52 pts (32 men [62%]), aged 40 to 65 years [mean age 54.6 ± 8.0]) with high or very high CV risk (5-9 and ≥10% by The Systematic Coronary Risk Estimation Scale [SCORE], respectively). All participants underwent cardiac computed tomography (CT) angiography and calcium scoring. Traditional risk factors (RFs) (family history of premature CVD, smoking, overweight/obesity and abdominal obesity, hypertension, type 2 diabetes mellitus, lipids parameters (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) and lipids-related markers (apolipoprotein A1, apolipoprotein B, ApoB/ApoA1 ratio), biomarkers of inflammation (high-sensitivity C-reactive protein [hs CRP], fibrinogen), indicator carbohydrate metabolism (glucose), ankle-brachial index, stress-test, carotid plaques according to ultrasound were evaluated in all pts. Psychological RFs were evaluated using Hospital Anxiety and Depression Scale and DS-14 for type D personality. Results All pts were divided into 2 groups according to the CT angiography results: pts in the main group (n = 21) had any non-obstructive lesions or calcium score >0, pts in the control group (n = 31) had intact coronary arteries. The groups did not differ in age or gender. 26 multiple linear logistic models for any subclinical atherosclerosis were developed based on obtained diagnostic features. Taking into account R-square = 0.344 (p = 0.0008), the best fitting model was follows: subclinical coronary atherosclerosis= -1.576 + 0.234 x SCORE ≥5% + 0.541 x hs CRP >2 g/l + 0.015 x heart rate (bpm) + 0.311 family history of premature CVD. The developed algorithm had sensitivity of 63% and specificity of 80%. Conclusions The created diagnostic model diagnostic model suggests the presence of subclinical coronary atherosclerosis in patients with high / very high CV risk with a high degree of probability. This easy-to-use method can be used in routine clinical practice to improve risk stratification and management choices in high-risk pts.

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Coronary Atherosclerosis Imaging by Coronary CT Angiography

Atherosclerosis: Clinical Perspectives Through Imaging ◽

10.1007/978-1-4471-4288-1_9 ◽

2012 ◽

pp. 127-161

Author(s):

Todd C. Villines ◽

Sarah Rinehart ◽

Zhen Qian ◽

Szilard Voros

Keyword(s):

Ct Angiography ◽

Coronary Atherosclerosis ◽

Coronary Ct Angiography ◽

Coronary Ct ◽

Atherosclerosis Imaging

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Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.05.3397 ◽

2020 ◽

Vol 27 (05) ◽

pp. 891-894

Author(s):

Shahid Ishaq ◽

Ejaz Mazari ◽

Fazal ur Rehman

Keyword(s):

Risk Factors ◽

Family History ◽

Febrile Seizures ◽

Study Groups ◽

Clinical Risk Factors ◽

P Value ◽

Chi Square ◽

Clinical Risk ◽

Significant Difference ◽

History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

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Natural History of Untreated Coronary Total Occlusions Revealed with Follow-Up Semi-Automated Quantitative Coronary CT Angiography: The Morphological Characteristics of Initial CT Predict Occlusion Shortening

Korean Journal of Radiology ◽

10.3348/kjr.2018.19.2.256 ◽

2018 ◽

Vol 19 (2) ◽

pp. 256 ◽

Cited By ~ 2

Author(s):

Qian Wu ◽

Mengmeng Yu ◽

Yuehua Li ◽

Wenbin Li ◽

Zhigang Lu ◽

...

Keyword(s):

Natural History ◽

Ct Angiography ◽

Coronary Ct Angiography ◽

Morphological Characteristics ◽

Coronary Ct ◽

History Of

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High prevalence of ascending aortic dilatation in a consecutive coronary CT angiography patient population

European Radiology ◽

10.1007/s00330-019-06433-z ◽

2019 ◽

Vol 30 (2) ◽

pp. 1079-1087 ◽

Cited By ~ 1

Author(s):

S. Petteri Kauhanen ◽

Petri Saari ◽

Pekka Jaakkola ◽

Miika Korhonen ◽

Johannes Parkkonen ◽

...

Keyword(s):

Risk Factors ◽

Body Size ◽

Coronary Artery ◽

Ct Angiography ◽

Coronary Ct Angiography ◽

Computed Tomographic Angiography ◽

Aortic Dilatation ◽

Aortic Diseases ◽

Tubular Part ◽

Coronary Ct

Abstract Objectives To clarify the prevalence and risk factors of ascending aortic (AA) dilatation according to ESC 2014 guidelines. Methods This study included 1000 consecutive patients scheduled for diagnostic coronary artery computed tomographic angiography. AA diameter was retrospectively measured in 3 planes: sinus valsalva, sinotubular junction, and tubular part. The threshold for AA dilatation was set to > 40 mm which has been suggested as an upper normal limit for AA diameter in ESC 2014 guidelines on aortic diseases. Aortic size index (ASI) using the ratio between aortic diameter and body surface area (BSA) was applied as a comparative measurement. The threshold for AA dilatation was set to the upper limit of normal distribution exceeding two standard deviations (95%). Risk factors for AA dilatation were collected from medical records. Results The patients’ mean age was 52.9 ± 9.8 years (66.5% women). The prevalence of AA dilatation was 23.0% in the overall study population (52.5% males) and 15.1% in the subgroup of patients with no coronary artery disease or bicuspid (BAV)/mechanical aortic valve (n = 365). According to the normal-distributed ASI values, the threshold for sinus valsalva was defined as 23.2 mm/m2 and for tubular part 22.2 mm/m2 in the subgroup. Higher BSA was associated with larger AA dimensions (r = 0.407, p < 0.001). Male gender (p < 0.001), BAV (p < 0.001), hypertension (p = 0.009) in males, and smoking (p < 0.001) appeared as risk factors for AA dilatation. Conclusions The prevalence of AA dilatation is high with current ESC guidelines for normal AA dimension, especially in males. Body size is strongly associated with AA dimensions; it would be more reliable to use BSA-adjusted AA diameters for the definition of AA dilatation. Key Points • The prevalence of AA dilatation is high in patients who are candidates for coronary CT angiography. • Body size is strongly associated with AA dimensions.

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