The importance of serum lipoprotein (a) as an independent risk factor for premature coronary artery disease in middle‐aged black and white women from the United States

In 1962, 30 years after chemical structure discovery of homocysteine, Carson and Neil reported work in which they described cases of two young people with severe mental retardation and high homocysteinuria. In 1975 McCully emphasized the association between homocysteinuria and thrombus-occlusive vascular changes. Period 1991-98, is the time of very extensive comparative studies, with aim of establishing links between premature coronary artery disease and high homocysteine level in plasma. These results in a whole show that biochemical findings of a mild increase of homocysteine plasma levels in span of 15-45 mmol/L, are independent risk factor for premature coronary artery disease appearance. So far mechanism of direct homociysteine uninfluenced on endothelial vascular vessels cells, or influence of any other factor, which play role in methionine-homocysteine-cysteine path (vitamins B6, B12, folic acid) are not strictly elucidated.

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Opium As a Risk Factor for Coronary Artery Disease in Young Iranians: Results from the Premature Coronary Artery Disease Milano-Iran (MIran) Study

SSRN Electronic Journal ◽

10.2139/ssrn.3460662 ◽

2019 ◽

Author(s):

Alberto Maino ◽

Saeed Sadeghian ◽

Ilaria Mancini ◽

Seyed Hesameddin Abbasi ◽

Hamidreza Poorhosseini ◽

...

Keyword(s):

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Premature Coronary Artery Disease ◽

Artery Disease

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Clinical characteristics and prognosis in patients with premature coronary artery disease of different genders after intervention

European Heart Journal ◽

10.1093/ehjci/ehaa946.1315 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

X.F Tang ◽

Y Yao ◽

S.D Jia ◽

Y Liu ◽

B Xu ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Independent Risk Factor ◽

Coronary Intervention ◽

Premature Coronary Artery Disease ◽

Minor Bleeding ◽

Bleeding Events ◽

Cerebrovascular Events ◽

Independent Risk Factors ◽

Artery Disease

Abstract Objective To investigate the clinical characteristics and long-term prognosis of coronary intervention in patients with premature coronary artery disease (PCAD) between different genders. Methods From January 2013 to December 2013, 4 744 patients diagnosed as PCAD with percutaneous coronary intervention (PCI) in our hospital were enrolled. The general clinical data, laboratory results and interventional treatment data of all patients were collected, and the occurrence of major adverse cardio-cerebrovascular events (MACCE) within 2 years after PCI was followed up. Results Of the 4 744 patients undergoing PCI, 3 390 (71.5%) were males and 1 354 (28.5%) were females. The 2-year follow-up results showed that the incidence of BARC grade 1 hemorrhage in female patients was significantly higher than that in male patients (6.9% vs. 3.7%; P<0.001); however, there was no significant difference in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE), all-cause death, cardiac death, recurrent myocardial infarction, revascularization (target vessel revascularization and target lesion revascularization), stent thrombosis, stroke and BARC grade 2–5 hemorrhage between the two groups (P>0.05). Multivariate COX regression analysis showed that gender was an independent risk factor for BARC grade 1 bleeding events in PCAD patients (HR=2.180, 95% CI: 1.392–3.416, P<0.001), but it was not an independent risk factor for MACCE and BARC grade 2–5 bleeding. Hyperlipidemia, preoperative SYNTAX score, multivessel lesions and NSTE-ACS were the independent risk factors for MACCE in PCAD patients with PCI (HR=1.289, 95% CI: 1.052–1.580, P=0.014; HR=1.030, 95% CI: 1.019–1.042, P<0.001; HR=1.758, 95% CI: 1.365–2.264, P<0.001; HR=1.264, 95% CI: 1.040–1.537, P=0.019); gender, hyperlipidemia, anticoagulant drugs like low molecular weight heparin or sulfonate were the independent risk factors for bleeding events (HR=1.579,95% CI 1.085–2. 297, P=0.017; HR=1.305, 95% CI 1.005–1.695, P=0.046; HR=1.321, 95% CI 1.002–1.741, P=0.048; HR=1.659, 95% CI 1.198–2.298, P=0.002). Conclusion The incidence of minor bleeding in women with PCAD is significantly higher than that in men; After adjusting for various risk factors, gender is an independent risk factor for minor bleeding events, but not an independent risk factor for MACCE in patients with PCAD. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Science and Technology Support Program of China

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Hypothyroidism in Otherwise Healthy Hypercholesterolemic Children

PEDIATRICS ◽

10.1542/peds.88.2.332 ◽

1991 ◽

Vol 88 (2) ◽

pp. 332-334

Author(s):

ARTHUR LAVIN ◽

ALAN H. NAUSS

Keyword(s):

United States ◽

Coronary Artery Disease ◽

The United States ◽

Plaque Formation ◽

Preventive Cardiology ◽

Treatment Regimens ◽

Atherosclerotic Plaque Formation ◽

Symptomatic Coronary Artery Disease ◽

Artery Disease ◽

High Risk Screening

Atherosclerosis is the leading cause of death in the United States. Studies in adults have shown that intervention with combined diet and medication can reduce atherosclerotic plaque formation and, as a result, the incidence of symptomatic coronary artery disease.1-4 With a strong tradition of preventive medicine, the pediatric community has begun exploring the prevention of adult atherosclerosis through intervention in childhood. Although issues such as universal vs selective high-risk screening, ideal age for screening and intervention, and treatment regimens remain unresolved and controversial, many preventive cardiology clinics, as well as individual pediatricians, have been screening and treating children.5,6 As part of an initial evaluation of hypercholesterolemic children and prior to any intervention, it is important to determine whether other disease processes are contributing to the child's dyslipoproteinemia.

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Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry

Thrombosis and Haemostasis ◽

10.1055/s-0038-1675401 ◽

2018 ◽

Vol 118 (12) ◽

pp. 2162-2170 ◽

Cited By ~ 11

Author(s):

Kamilla Steensig ◽

Kevin Olesen ◽

Troels Thim ◽

Jens Nielsen ◽

Svend Jensen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Coronary Angiography ◽

Ischaemic Stroke ◽

Independent Risk Factor ◽

Oral Anticoagulants ◽

Increased Risk ◽

Artery Disease

Background Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. Objectives This article explores whether CAD per se or extent provides independent prognostic information of future stroke among patients with AF. Materials and Methods Consecutive patients with AF and coronary angiography performed between 2004 and 2012 were included. The endpoint was a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. The risk of ischaemic events was estimated according to the presence and extent of CAD. Incidence rate ratios (IRR) were calculated in reference to patients without CAD and adjusted for parameters included in the CHA2DS2-VASc score and treatment with anti-platelet agents and/or oral anticoagulants. Results Of 96,430 patients undergoing coronary angiography, 12,690 had AF. Among patients with AF, 7,533 (59.4%) had CAD. Mean follow-up was 3 years. While presence of CAD was an independent risk factor for the composite endpoint (adjusted IRR, 1.25; 1.06–1.47), extent of CAD defined as 1-, 2-, 3- or diffuse vessel disease did not add additional independent risk information. Conclusion Presence, but not extent, of CAD was an independent risk factor of the composite thromboembolic endpoint beyond the components already included in the CHA2DS2-VASc score. Consequently, we suggest that significant angiographically proven CAD should be included in the vascular disease criterion in the CHA2DS2-VASc score.

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Inflammation in Relation to Cardiovascular Disease Risk: Comparison of Black and White Women in the United States, United Kingdom, and South Africa

Current Cardiovascular Risk Reports ◽

10.1007/s12170-011-0168-2 ◽

2011 ◽

Vol 5 (3) ◽

pp. 223-229 ◽

Cited By ~ 1

Author(s):

Juliet Evans ◽

Julia H. Goedecke

Keyword(s):

United States ◽

South Africa ◽

Cardiovascular Disease ◽

United Kingdom ◽

White Women ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

The United States ◽

Black And White

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Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

Journal of the American Society of Nephrology ◽

10.1681/asn.v1271516 ◽

2001 ◽

Vol 12 (7) ◽

pp. 1516-1523 ◽

Cited By ~ 1

Author(s):

AUSTIN G. STACK ◽

WENDY E. BLOEMBERGEN

Keyword(s):

United States ◽

Risk Factors ◽

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

The United States ◽

Comorbid Conditions ◽

Clinical Correlates ◽

History Of ◽

Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

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CORONARY ARTERY DISEASE

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.02.2894 ◽

2009 ◽

Vol 16 (02) ◽

pp. 192-197

Author(s):

FIDA MUHAMMAD ◽

Nadeem Hayat Mallick, ◽

ABDUL REHMAN ABID ◽

AJAZ AHMAD ◽

Shahid Imran

Keyword(s):

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Clinical Presentation ◽

Systolic Function ◽

Left Ventricular ◽

Premature Coronary Artery Disease ◽

Common Risk Factor ◽

Artery Disease ◽

Lv Systolic Function

Objectives: This study was designed to evaluate the pattern of clinical presentation, risk factors and angiographic findingsin young males presenting with acute myocardial infarction (AMI).Materials and methodsThis cross-sectional descriptive study wasconducted at the Cardiology Department, Punjab Institute of Cardiology, Lahore from May 2005 till February 2006. After fulfilling the inclusioncriteria 200 male patients <40 years with coronary artery disease (CAD) were studied. Results: Mean age of the study population was31.5±9.2 years with an age range of 31 to 40 years. Most common risk factor was smoking present in 60% patients. Family history ofischemic heart disease (IHD) was present in 44.5% patients, hyperlipidemia in 35.5% patients, hypertension in 25.5% and diabetes mellitusin 17.5% of patients.Common mode of clinical presentation was AMI 42.5% patients. Left anterior descending (LAD) was diseased in 73.5%,followed by Left Circumflex (LCx) 51% and Right Coronary Artery (RCA) in 39% patients. Left Main Stem (LMS) disease occurred in 9.5%patients. Good left ventricular (LV) systolic function was observed in 38%, moderate LV systolic function in 34% and poor LV systolic functionin 14.5% patients. Conclusion: Patients with premature coronary artery disease have unheralded acute onset of symptoms. Smoking isthe most common risk factor. Young patients have single vessel CAD with frequent involvement of LAD and commonly have good leftventricular systolic function.

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