ASSOCIATION BETWEEN INFLAMMATORY MARKERS, HEMOSTATIC MARKERS AND TRADITIONAL RISK FACTORS ON CORONARY ARTERY SPASM IN PATIENTS WITH NORMAL CORONARY ANGIOGRAPHY

Abstract Funding Acknowledgements Type of funding sources: None. The widespread use of coronary angiography (CAG) in patients with acute coronary syndrome led to the understanding that in some patients myocardial infarction (MI) occurs against angiographically unchanged or slightly modified coronary arteries (CA). In such cases, the so-called "type 2 IM" is diagnosed in some patients, however, to determine the true cause of MI, a modern method of investigation such as optical coherence tomography (OCT) is needed to visualize the intima of the CA and detect a minimal atherosclerotic process. The purpose of the study was to establish the etiology of MI without obstructive coronary artery disease (MINOCA) using OCT. Materials and methods 160 conclusions of the OCT were analyzed. In 9 (6%) cases, the study was conducted in patients who underwent proven MI (mean age 43,1 ± 13,2, 8 males, 1 female) who had no hemodynamically significant CA stenosis according to CAG data. Results in 2 cases (22%) patients had ST-elevation MI, thrombotic occlusion of the CA (in one case, thrombaspiration was performed). In both patients, spontaneous dissection of the intima of the unmodified CA was detected in the OCT. The remaining 7 patients had non-ST-elevation MI, and in 2 cases, a diagnosis of type 2 MI was established: in both patients, the atherosclerotic plaque was visualized, narrowing the lumen of the CA less than 50%, in one case MI developed against a background of the hypertensive crisis, in another - against a background of spasm of CA. In the remaining 5 patients, OCT revealed subintimal atheromatous, with elements of local dissection of the intima. Thus, in 78% of patients atherosclerosis of CA of different severity (from the subintimal deposition of lipids to the development of atherosclerotic plaque, narrowing the clearance of the SC by less than 50%) was diagnosed. In the analysis of risk factors for coronary heart disease (CHD), 57% of patients with atheromatous CA had more than 2 risk factors for CHD: 3 (42%) smoked, 5 (71%) - obesity, 4 (57% ) - had arterial hypertension, 3 (42%) had dyslipidemia, 1 (14%) had type 2 diabetes. In the group of patients with spontaneous intima dissection of the CA, 1 patient (woman) did not have CHD risk factors, the 2-nd suffered from obesity and hypertension. For all patients a lifestyle correction was recommended; statins, antiplatelets were prescribed, patients with spontaneous dissection of CA had the recommendation of examination in the medical-genetic center. Conclusion Based on the results of the study, in most cases, the cause of IMBOC development was an atherosclerotic lesion of the coronary arteries, which is not always visualized with standard coronary angiography. Basically, the patients were young and middle-aged. Most patients had different risk factors for coronary heart disease.

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Association of Plasma MiRNA-204 and the Presence and Severity of Coronary Artery Calcification in Patients With Type 2 Diabetes

Angiology ◽

10.1177/0003319720984592 ◽

2021 ◽

pp. 000331972098459

Author(s):

Yao-dong Ding ◽

Yu-qiang Pei ◽

Rui-Wang ◽

Jia-xin Yang ◽

Ying-xin Zhao ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Characteristic Curve ◽

Glycosylated Hemoglobin ◽

The United Kingdom ◽

Traditional Risk Factors ◽

Plasma Microrna

We investigated the association between plasma microRNA (miR)-204 and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus (T2DM). We consecutively enrolled 179 individuals with T2DM who underwent coronary computed tomography at Anzhen Hospital from January 2015 to September 2016. The CAC score (CACS) was expressed in Agatston units and >10 Hounsfield units were defined as CAC-positive status. Significant CAC was observed in 98 (54.7%) patients. Plasma miR-204 levels (relative expression) were significantly lower in patients with significant CAC than controls (1.001 ± 0.100 vs 0.634 ± 0.211, P < .001). Plasma miR-204 levels were also negatively correlated with the glycosylated hemoglobin A1c (HbA1c) level (r = −0.702, P < .001), CACS (r = −0.710, P < .001), and the United Kingdom Prospective Diabetes Study (UKPDS) score (r = −0.355, P < .001). After multivariate logistic analyses, plasma miR-204 levels were still significantly and independently associated with the presence of CAC (odds ratio = 0.103, CI = 0.018-0.583, P < .001) after adjustment for conventional risk factors. Receiver operating characteristic curve analysis showed that plasma miR-204 levels can predict the severity and extent of CAC, and the specificity was higher than that of the traditional risk factors UKPDS score and HbA1c. In conclusion, the downregulation of miR-204 was independently associated with CAC in patients with T2DM.

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Incremental prognostic value of visually estimated coronary artery calcium in patients undergoing positron emission tomography imaging

Open Heart ◽

10.1136/openhrt-2021-001648 ◽

2021 ◽

Vol 8 (1) ◽

pp. e001648

Author(s):

Senthil Selvaraj ◽

Muhammad Shoaib Khan ◽

Mahesh K Vidula ◽

Philip C Wiener ◽

Alejandro E de Feria ◽

...

Keyword(s):

Risk Factors ◽

Positron Emission Tomography ◽

Coronary Artery ◽

Pet Imaging ◽

Prognostic Value ◽

Primary Outcome ◽

Chest Ct ◽

Emission Tomography ◽

Positron Emission ◽

Traditional Risk Factors

ObjectiveVisually estimated coronary artery calcium (VECAC) from chest CT or attenuation correction (AC)/CT obtained during positron emission tomography (PET)–myocardial perfusion imaging (MPI) is feasible. Our aim was to determine the prognostic value of VECAC beyond conventional risk factors and PET imaging parameters, including coronary flow reserve (CFR).MethodsWe analysed 608 patients without known coronary artery disease who underwent PET–MPI between 2012 and 2016 and had AC/CT and/or chest CT images. We used Cox regression to estimate the association of VECAC categories (≤10, 11–400, >400 Agatston units (AU)) with the primary outcome of all-cause death, acute coronary syndrome or stroke (mean follow-up 4.3±1.8 years). C-statistics assessed the relationship between PET parameters and VECAC with the primary outcome.ResultsMean age was 58±11 years, 65% were women and 67% were black. VECAC ≤10, 11–400 and >400 AU was observed in 68%, 12% and 20% of subjects, respectively. Compared with VECAC ≤10, VECAC categories 11–400 (HR 2.25, 95% CI 1.24 to 4.08) and >400 AU (HR 3.05, 95% CI 1.87 to 4.98) were associated with the primary outcome after adjusting for traditional risk factors, MPI findings and CFR. Adding VECAC to a model that included PET–MPI, CFR and clinical risk factors improved the prognostic value for the primary outcomes (c-statistic 0.71 to 0.75 with VECAC, p=0.01).ConclusionsVECAC is a potent predictor of events beyond traditional risk factors and PET imaging markers, including CFR. These data further support the importance for routine VECAC implementation.

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TCT-180: Relationship Between Coronary Atherosclerotic Plaques and Traditional Risk Factors in People with No History of Cardiovascular Disease Undergoing Multi-Detector Computed Coronary Angiography

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.08.200 ◽

2009 ◽

Vol 104 (6) ◽

pp. 70D

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Angiography ◽

Atherosclerotic Plaques ◽

History Of ◽

Traditional Risk Factors ◽

Computed Coronary Angiography

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Limited utilities of N-terminal pro B-type natriuretic peptide and other newer risk markers compared with traditional risk factors for prediction of significant angiographic lesions in stable coronary artery disease

Heart ◽

10.1136/hrt.2008.145425 ◽

2008 ◽

Vol 95 (4) ◽

pp. 297-303 ◽

Cited By ~ 17

Author(s):

A Peer ◽

G Falkensammer ◽

H Alber ◽

A Kroiss ◽

A Griesmacher ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Natriuretic Peptide ◽

Stable Coronary Artery Disease ◽

Risk Markers ◽

Traditional Risk Factors ◽

Artery Disease

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W09.266 Relation between insulin resistance and traditional risk factors for coronary artery disease in obese type 2 diabetics

Atherosclerosis Supplements ◽

10.1016/s1567-5688(04)90265-1 ◽

2004 ◽

Vol 5 (1) ◽

pp. 62

Author(s):

M. Zamaklar ◽

K. Lalic ◽

N. Rajkovic ◽

D. Trifunovic ◽

L. Popovic

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Type 2 Diabetics ◽

Traditional Risk Factors ◽

Artery Disease

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Abstract P122: Racial/Ethnic Variation in Incidence and Progression of Coronary Artery Calcification: Implications for Understanding the Hispanic Paradox

Circulation ◽

10.1161/circ.137.suppl_1.p122 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Sandra S Albrecht ◽

Pamela L Lutsey ◽

Matthew Allison ◽

Teresa Seeman ◽

Martha L Daviglus ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Future Research ◽

Foreign Born ◽

Hispanic Health ◽

Current Cigarette Smoking ◽

Current Cigarette ◽

Traditional Risk Factors ◽

Adjusted Incidence

Background: Previous studies show that Hispanic persons have similar or lower levels of coronary artery calcium (CAC) and slower progression than non-Hispanic whites (NHW), even after adjustment for traditional risk factors. We examined whether this health advantage in CAC incidence and progression among Hispanic adults extends across all levels of risk factor (RF) burden, and whether associations vary by nativity (foreign-born, US-born) and by heritage group (Mexican, non-Mexican). Methods: We analyzed data on Hispanic and NHW participants aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (MESA). Follow-up CAC measurements and complete covariate data were available for 3694 participants with an average of 6.6 years between the follow-up and baseline scans (2000-2002). Baseline measures of the following traditional RFs were considered: current cigarette smoking, high total cholesterol, hypertension, diabetes, and obesity, with RF burden scores ranging from 0-5. Outcomes were incident CAC (any follow-up CAC >0 Agatston units) among individuals without detectable CAC at baseline, and CAC progression (any positive increase in CAC) among all participants estimated using relative risk regression. All models were adjusted for age, sex, RF burden, race/ethnicity, education, income, and time between scans Results: Although a higher proportion of Hispanics had RF burden scores ≥3 compared to NHW (14.6% vs 8.9%, p<0.0001), Hispanics had a lower adjusted incidence (risk ratio (RR) = 0.83, 95% CI: 0.72-0.96) and less progression of CAC (RR=0.90, 95% CI: 0.86-0.95) than NHW. However, there was evidence of heterogeneity in this pattern. For example, among individuals with no detectable baseline CAC, a Hispanic health advantage was only seen among individuals with RF burden scores of 0 (RR=0.66, 95% CI: 0.48-0.91 for Hispanics vs. NHW at RF=0), with race/ethnic differences getting progressively smaller with increasing RF burden (for RF ≥3: RR=1.01, 95% CI: 0.69-1.48). Compared to NHW, lower adjusted incidence and progression of CAC was evident to an even greater extent among foreign-born Hispanics, but a health advantage was still present for US-born Hispanics, and for both Hispanic heritage groups. However, these patterns also only remained among individuals with lower RF burden scores. Conclusions: The Hispanic health advantage in CAC incidence and progression was primarily evident among individuals with fewer traditional risk factors for CVD, but was present among different Hispanics groups. Future research is necessary to identify the factors underlying this advantage, and the dynamics that erode it as RF burden increases.

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