scholarly journals 0074: The stress test as a diagnostic toolfor coronary artery disease in hypertensive patients

2015 ◽  
Vol 7 (1) ◽  
pp. 76
Author(s):  
Samia Benghazi ◽  
Dalila Baghdadi ◽  
Rachida Habbal
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Test ◽  
Hypertensive Patients ◽  
Artery Disease

Are hypertensive patients with history of coronary artery disease at risk for silent lower extremity artery disease?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Eka Prasetya Budi Mulia ◽  
Kevin Yuwono ◽  
Raden Mohammad Budiarto
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Lower Extremity ◽  
Pearson Correlation ◽  
Ankle Brachial Index ◽  
Chi Square ◽  
Hypertensive Patients ◽  
History Of ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Abstract Objectives We aimed to investigate the association between hypertension and asymptomatic lower extremity artery disease (LEAD) in outpatients with known history of coronary artery disease (CAD). Methods Patients with known history of CAD who have been undergone coronary angiography and have significant coronary artery stenosis (more than 60%) were included. LEAD was defined as ankle-brachial index (ABI) < 0.9 in either leg. The risk of LEAD in hypertensive group was analyzed using chi-square test, and correlation between blood pressure (BP) and ABI was analyzed using Pearson correlation test in SPSS v.25. Results One hundred and four patients were included. 82.7% of patients were male. Mean age was 57.05 ± 7.97. The prevalence of hypertension was 35.6%, and the prevalence of LEAD was 16.3%. A higher proportion of LEAD was found in hypertensive (18.9%) compared to non-hypertensive (14.9%), although not statistically significant (OR: 1.33; 95% CI: 0.46 to 3.85; p=0.598). There was an association between ABI and systolic BP (p=0.016), but not with diastolic BP (p=0.102). Conclusions Our study showed that the prevalence of LEAD in hypertension, especially in the CAD population, is relatively high. There was no association between hypertension and LEAD, but a higher prevalence of LEAD was found in hypertensive patients. Nevertheless, LEAD screening is still recommended in hypertensive patients, especially in the CAD population, given the fact that outcomes of health and mortality are worse for those with concomitants of these diseases.

scholarly journals Original paper: A new type of polyphenols-containing dietary supplement for correction of lipids and inflammatory markers in patients with coronary artery disease

2018 ◽  
Vol 24 (1) ◽  
pp. 22-28
Author(s):  
Kristaps Erglis ◽  
Iveta Mintale ◽  
Ieva Briede ◽  
Aldis Rozenbergs ◽  
Sanda Jegere ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Lipid Profile ◽  
Dietary Supplement ◽  
Linseed Oil ◽  
Stress Test ◽  
Reactive Protein ◽  
Artery Disease ◽  
Design And Methods ◽  
The Impact

Abstract Objective: To evaluate the impact of two original compositions of polyphenols-containing dietary supplement on lipid profile and level of C-reactive protein (CRP) in patients with angiographycally verified coronary artery disease (CAD). Design and methods: 167 patients were selected during their scheduled post-event elective bicycle stress-test examination. All patients received standard CAD therapy and permanent statin therapy and had elevated total cholesterol (TC > 5.0 mmol/L) and/or CRP (>3.5 mg/L) levels. The study consisted of 2 days of polyphenol depletion followed by a 12-week supplementation period in a randomized, blinded, placebo-uncontrolled parallel design. Two different compositions SILVA 1 (Quercetine, linseed oil and Resveratrol), and SILVA 2 (Quercetine, linseed oil and Pycnogenol) were tested. Results: All parameters changed compared baseline and 1 and 3 months in both groups. CRP decreased from 2.48 ± 1.62 mg/L at baseline to 1.97 ± 1.15 mg/L, high density cholesterol (HDL-C) increased from 1.18 ± 0.31 to 1.38 ± 0.34 mmol/L, also decrease of triglycerides (TG) from 1.5 to 1.29 mmol/L after 3 months treatment in SILVA I group was statistically significant (p < 0.001). Changes of parameters between baseline and 1 or 3 months in SILVA II group were not statistically significant. Hovewer, decrease of CRP (from 2.6 ± 1.28 to 2.41 ± 1.68), decrease of low density cholesterol (LDL-C from 2.95 ± 1.2 to 2.88 ± 1.21), increase of HDL-C (from 1.25 ± 0.22 to 1.34 ± 0.23), decrease of TC (from 5.2 ± 1.3 to 5.1 ± 1.28) and decrease of TG (from 1.4 ± 0.41 to 1.3 ± 0.38) can be counted as tendency of changes. Conclusion: This study reveals the superiority of treatment with statins in combination with composition containing Resveratrol for correction of lipid profile and inflamation marker CRP of patients with CAD

scholarly journals Evalution of the effect of obesity-associated inflammation on the response to complex therapy in hypertensive elderly patients with coronary artery disease

2021 ◽  
Vol 11 (6) ◽  
pp. 143-154
Author(s):  
N. Tofan ◽  
S. Tykhonova ◽  
V. Iablonska ◽  
O. Khyzhnyak
Keyword(s):  
Coronary Artery Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
Antihypertensive Therapy ◽  
Low Grade ◽  
Obese Patients ◽  
Hypertensive Patients ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Artery Disease

Object: to identify factors that limit the effectiveness of pharmacotherapy of hypertension (HT) with comorbid coronary artery disease (CAD) in elderly obese patients by determining laboratory and spectroscopy features related to inflammation. Material and methods: 60 patients (68.2 ± 5.9 y.o.) were observed and treated in Internal Medicine Department of University Clinic of Odessa National Medical University. Patients were divided into 2 groups. The 1st group included patients (n = 30) with body mass index (BMI) ≤25 kg/m2, HT and co-morbid CAD; the 2nd group (n = 30) - patients with BMI≥30 kg/m2, HT and with co-morbid CAD. For each patient’s group antihypertensive combination of Lisinopril and Bisoprolol was prescribed. The Laser correlation spectroscopy (LCS) was a special method for investigation. Results: before pharmacotherapy (PT) in both groups according to LCS 11-150 nm particles are prevailing. But in obese patients 75th percentile of 31-70 nm particles exceeds that one in non-obese group (56.7% vs 30.5%). During PT systolic blood pressure (SBP) value normalized in the patients of 1st group (without obesity), while in the obese patients (2nd group) SBP remained above target level. Creatinine level increased in patients of  1st group (without obesity) by 16.5 μmol / L (p <0.05) with a decrease in GFR by 17.1 ml/min/1.73 m2 (P <0.05). LCS data during PT show increase of 11-30 nm and decrease of 75-150 nm particles in non-obese patients, while in obese patients 71-150 nm particles are prevailing and 150 nm particles have appeared (p<0.05). Conclusions: 1. In elderly hypertensive patients with concomitant CAD, obesity is a factor limiting the effectiveness of complex antihypertensive therapy. 2. An increase of proportion of allergic-directed and appearance of autoimmune-directed homeostatic shifts in serum according to LCS are associated with a decrease of antihypertensive therapy efficacy in elderly hypertensive patients with CAD and obesity.  3. In hypertensive non-obese patients with CAD under the influence of complex antihypertensive therapy deteriorating of renal function is observed while in obesity renal function is not changed. 4. Homeostatic changes revealed in the second group by LCS values probably reflect manifestation of  low grade inflammatory process caused by excessive activity of adipose tissue.

Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

Cardiology ◽  
2015 ◽  
Vol 133 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Mathias Sørgaard ◽  
Jesper James Linde ◽  
Klaus Fuglsang Kofoed ◽  
Jørgen Tobias Kühl ◽  
Henning Kelbæk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Stress Test ◽  
Photon Emission ◽  
Acute Onset ◽  
Emission Computed Tomography ◽  
Artery Disease

Objectives: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. We investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. Methods: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We compared the diagnostic accuracy of PTP and stress testing assessed by the area under the receiver operating characteristic curve (AUC) to identify significant CAD, defined as at least 1 coronary artery branch with >70% diameter stenosis identified by CCTA. Results: The diagnostic accuracy of PTP was significantly higher than the stress test (AUC 0.80 vs. 0.69; p = 0.009), but the diagnostic accuracy of the combination of PTP and a stress test did not significantly increase when compared to PTP alone (AUC 0.86 vs. 0.80; p = 0.06). Conclusions: PTP using the updated Diamond and Forrester Score is a very useful tool in risk-stratifying patients with acute-onset chest pain at a low-to-intermediate risk of having CAD. Adding a stress test to PTP does not appear to offer significant diagnostic benefit.

scholarly journals Association between Polymorphisms of Antioxidant Gene (MnSOD, CAT, and GPx1) and Risk of Coronary Artery Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hseng-Long Yeh ◽  
Li-Tang Kuo ◽  
Fung-Chang Sung ◽  
Chih-Ching Yeh
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Manganese Superoxide Dismutase ◽  
Medical Center ◽  
Stress Test ◽  
Genetic Effect ◽  
Multivariate Logistic Regression Model ◽  
Increased Risk ◽  
Artery Disease ◽  
Cad Risk

Objective. Reactive oxygen species (ROS) been cited as one of the major causes of atherosclerosis and coronary artery disease which are possible agents inducing DNA damage. Manganese superoxide dismutase (MnSOD), catalase (CAT), and glutathione peroxidase-1 (GPx1) have evolved to address primary defense against free radical mediated damage in mitochondria. The aim of this study was to delineate the association ofMnSOD,CAT, andGPx1polymorphisms and risk of CAD in Taiwan.Methods. We conducted a case-control study with 657 participants recruited at a medical center. All subjects were evaluated by noninvasive stress test and then quantitative coronary angiography to confirm the diagnosis of CAD. 447 CAD cases were defined as >50% stenosis of coronary artery and 210 controls were stenosed below 50%. Polymorphisms ofMnSOD(Val16Ala),CAT(C-262T), andGPx1(Pro198Leu) genes were determined by polymerase chain reaction methods. Multivariate logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs).Results. TheMnSODVal/Ala+Ala/Ala genotype was significantly associated with an increased risk of CAD compared to the Val/Val genotype (OR = 1.86, 95% CI = 1.15-3.01). This polymorphism was also associated with the severity of CAD of single and two vessel diseases. The corresponding ORs were 2.31 (95% CI = 1.32-4.03) and 1.92 (95% CI = 1.02-3.61), respectively. Among cigarette smokers, the harmful genetic effect ofMnSODAla allele on CAD risk was much higher (OR = 2.23, 95% CI = 1.02-4.88). However, the interaction betweenMnSODgenotype and cigarette smoking on CAD risk was not significant. No significant association betweenCATandGPx1polymorphisms and CAD risk was observed.Conclusion. Our results suggest thatMnSODpolymorphism is an independent risk factor for susceptibility to CAD in the Chinese population.

Abstract 13471: Additional Prognostic Value of Vasodilator Stress Cardiovascular Magnetic Resonance in Patients With Inconclusive Stress Test to Detect Coronary Artery Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Theo Pezel ◽  
Guillaume Bonnet ◽  
Francesca Sanguineti ◽  
Marine Kinnel ◽  
Anouk Asselin ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Stress Test ◽  
Multivariable Analysis ◽  
Myocardial Scar ◽  
Major Adverse Cardiovascular Events ◽  
Inducible Ischemia ◽  
Artery Disease ◽  
Stress Cmr

Introduction: Non-invasive testing for ischemia to diagnose coronary artery disease(CAD) are frequently inconclusive(25%). Hypothesis: To assess the prognostic value of stress CMR in patients with a first inconclusive stress test. Methods: Between 2008 and 2018, consecutive patients with inconclusive stress test, defined by stress echocardiography or nuclear testing with uncertain conclusion, prospectively referred for stress CMR with dipyridamole were followed for major adverse cardiovascular events(MACE): cardiac death or myocardial infarction. An unsupervised clustering analysis was performed. Results: Of 1502 patients (62±12yrs, 59%men), 1397 completed the follow-up (median 5.5±2.3yrs). Three clusters were identified: Cluster 1 (n=524) had the highest prevalence of previous PCI, the highest presence of a myocardial scar defined, the lowest LVEF (35±7%) and the highest LV dilatation. Cluster 2 (n=406) had the highest previous CABG prevalence, preserved LVEF, absence of LV dilatation, and presence of myocardial scar. This cluster comprised predominantly male patients, with the highest rate of hypertension. Cluster 3 (n=572) had the lowest rate of previous PCI/CABG, the lowest rate of myocardial scar, predominantly female, the highest atrial fibrillation rate and body mass index. Survival analysis found significant differences across clusters for the occurrence of MACE (p=0.02). Inducible ischemia was associated with MACE occurrence in each cluster (C1, HR 2.28; 95%CI[1.31-3.99]; p=0.0028; C2, HR 3.37; 95%CI[1.97-5.75]; p<0.0001; C3, HR 2.73; 95%CI[1.67-4.46]; p<0.0001). In multivariable analysis, inducible ischemia predicted MACE in each cluster (p<0.001 for all). Conclusions: Cluster analysis identified 3 different phenotypes with distinct clinical and prognostic profiles. Within these clusters, stress CMR has an additional prognostic value to predict MACE..

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