Coronary artery disease in the elderly patient

2004 ◽  
Vol 14 (2) ◽  
pp. 105-118
Author(s):  
S. Joanna Cowell ◽  
David E. Newby ◽  
Nicholas A. Boon
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Plaque Rupture ◽  
Chronic Stable Angina ◽  
The Elderly ◽  
Developed Countries ◽  
Coronary Syndrome ◽  
Chronic Therapy ◽  
Artery Disease

Coronary atherosclerosis is a nearly universal finding in people over 75 years old living in developed countries, but is often sub-clinical. Broadly speaking, symptomatic patients manifest coronary artery disease in two distinct ways: chronic stable angina or an acute coronary syndrome. Stable angina produces symptoms of exertional chest pain due to fixed atherosclerotic narrowing of the coronary artery, and requires chronic therapy. In contrast, the acute coronary syndromes, namely acute myocardial infarction (MI) and unstable angina, occur as a result of plaque rupture or erosion leading to acute coronary arterial thrombosis and occlusion that requires emergency hospitalization and treatment.

scholarly journals Evaluation of platelet indices in patients with acute coronary syndrome and chronic stable angina

2020 ◽  
Vol 8 (11) ◽  
pp. 3886
Author(s):  
Vijay Sai Chowdekar ◽  
Naveen Peddi
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Control Group ◽  
Distribution Width ◽  
Platelet Indices ◽  
Coronary Syndrome ◽  
Artery Disease

Background: The objective of the study was to evaluate the levels of platelet indices mean platelet volume (MPV) and platelet distribution width (PDW) in patients with acute coronary syndrome (ACS) and chronic stable angina (CSA) and to study its correlation with the occurrence of disease.Methods: This was a hospital-based, case-control, prospective observational study which included 333 patients who fulfilled inclusion and exclusion criteria. All the patients were divided into three groups after clinical investigations: i) 100 patients in ACS group, ii) 114 patients in CSA group and iii) 119 patients in control group. MPV and PDW levels were estimated in all the patients along with other routine investigations related to coronary artery disease. All the data were analyzed using independent sample t-test, ANOVA and Pearson correlation at 95% level of significance.Results: Troponin levels were significantly higher in ACS group compared to CSA and control group (p<0.0001). Mean MPV levels in ACS (15.57±2.11 fL) and CSA (11.27±1.7 fL) groups were significantly higher (p<0.0001) compared with controls (10.48±1.49 fL). A significant elevation in MPV levels was observed in patients with a greater number of diseased vessels. However, no statistically significant correlation was found between PDW and number of diseased vessels (p=0.246).Conclusions: The study concludes that MPV should be considered as an effective tool in predicting the magnitude of acute events in patients with coronary artery disease. However, larger studies with morphological and functional estimation of platelet indices are required to prove this.

Chronic Stable Angina

2017 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

scholarly journals Association between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease in Chronic Stable Angina

2018 ◽  
Vol 10 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Ratan Kumar Datta ◽  
Md Mamunur Rashid ◽  
MG Azam ◽  
Md Salahuddin Ulubbi ◽  
Mohammad Khalilur Rahman Siddiqui ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Neutrophil To Lymphocyte Ratio ◽  
Severe Coronary Artery Disease ◽  
Gensini Score ◽  
Severe Coronary Artery ◽  
Artery Disease ◽  
Vessel Score

Background: Neutrophil to lymphocyte ratio (NLR) has been proposed as a new prognostic marker in patients with chronic stable angina (CSA). NLR is a cheap, easily available, non-invasive and routinely done procedure to predict the severity of coronary artery disease.Methods: 110 patients with stable coronary artery disease were evaluated to calculate the NLR from January, 2016 to September, 2016. The patients were divided into two groups: Group I NLR>2.38 and group II NLRd”2.38. Coronary angiogram was done during index hospitalization. The severity of the coronary artery disease was assessed by vessel score and Gensini score and was compared between the groups.Results: NLR was significantly higher in the group of high vessel score and high Gensini score. We found significant weak association between NLR and vessel score (r=0.30, p=0.004) and a moderate positive correlation between NLR and Gensini score (r =0.65, P=0.001). With the increase of NLR, vessel score and Gensini score increases demonstrating more severe coronary artery disease. Univariate logistic regression analysis of variables of interest revealed that age, hypertension, dyslipidemia, serum creatinine, total WBC count and NLR were independent predictor of severe coronary artery disease with odds ratio (OR) being 1.88, 3.93, 5.01, 5.54, 4.05 and 5.70 respectively. In multivariate logistic regression analysis, after adjustment of factors NLR remain independent predictors of severe CSA (OR = 5.73; p = 0.002).Conclusion: Increased neutrophil to lymphocyte ratio is associated with angiographically severe coronary artery disease in chronic stable angina and this association is independent of conventional cardiovascular risk factors.Cardiovasc. j. 2018; 10(2): 164-170

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