Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease

Artery Stenosis ◽

Significant Stenosis ◽

Whole Blood Viscosity ◽

Coronary Syndrome

Abstract Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) (p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17–2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19–2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001). Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.

Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10153341 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3341

Author(s):

Hyun-Jin Kim ◽

Min-Ho Lee ◽

Sang-Ho Jo ◽

Won-Woo Seo ◽

Hack-Lyoung Kim ◽

...

Keyword(s):

Coronary Artery ◽

Propensity Score ◽

Clinical Outcomes ◽

Study Data ◽

Artery Stenosis ◽

Vasospastic Angina ◽

Significant Stenosis ◽

Increased Risk

Vasospastic angina (VA) is a functional disease of the coronary artery and occurs in an angiographically normal coronary artery. However, it may also occur with coronary artery stenosis. We investigated the effect of coronary artery stenosis on clinical outcomes in VA patients. Study data were obtained from a prospective multicenter registry that included patients who had symptoms of VA. Patients were classified into two groups according to presence of significant coronary artery stenosis. Among 1920 patients with VA, 189 patients were classified in the “significant stenosis” group. The one-year composite clinical events rate was significantly higher in the significant stenosis group than in the “no significant stenosis” group (5.8% vs. 1.4%, respectively; p < 0.001). Additionally, the prevalence of ACS was significantly greater in the "significant stenosis" group (4.8% vs. 0.9%, respectively; p < 0.001). After propensity score matching, the adverse effects of significant stenosis remained. In addition, significant stenosis was independently associated with a 6.67-fold increased risk of ACS in VA patients. In conclusion, significant coronary artery stenosis can increase the adverse clinical outcomes in VA patients at long-term follow-up. Clinicians should manage traditional risk factors associated with atherosclerosis and control vasospasm as well as reduce the burden of atherosclerosis.

Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis

Biomarkers in Medicine ◽

10.2217/bmm-2020-0274 ◽

2020 ◽

Vol 14 (16) ◽

pp. 1553-1561

Author(s):

Mehmet Erdoğan ◽

Mehmet A Erdöl ◽

Selçuk Öztürk ◽

Tahir Durmaz

Keyword(s):

Coronary Artery ◽

Artery Stenosis ◽

Fractional Flow ◽

Predictive Capacity ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

Flow Reserve ◽

Immune Inflammation

Aim: The study aimed to investigate and compare the predictive capacity of a systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to determine a hemodynamically significant coronary artery stenosis assessed by fractional flow reserve (FFR). Patients & methods: A total of 207 chronic coronary syndrome patients with FFR measurement were enrolled in the study. NLR, PLR and SII levels were calculated. Results: The cut-off value of the SII (620) was associated with 78.4% sensitivity and 64.0% specificity to predict a hemodynamically significant stenosis. SII level independently predicted FFR ≤0.80. Conclusion: SII is an independent predictor of functionally significant coronary stenosis detected by FFR in chronic coronary syndrome patients. SII levels can predict hemodynamically severe obstruction better than NLR and PLR.

Lesion characteristics and prognosis of acute coronary syndrome without angiographically significant coronary artery stenosis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez079 ◽

2019 ◽

Cited By ~ 2

Author(s):

Akira Taruya ◽

Atsushi Tanaka ◽

Tsuyoshi Nishiguchi ◽

Yuichi Ozaki ◽

Manabu Kashiwagi ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Artery Stenosis ◽

Coronary Syndrome

Abstract 1900: Coronary MDCT based Detection of Coronary Stenosis and Plaque in the Assessment of Patients with Acute Chest Pain: Update from ROMICAT I

Circulation ◽

10.1161/circ.116.suppl_16.ii_408-a ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Udo Hoffmann ◽

Fabian Bamberg ◽

Sujith Seneviratne ◽

Ian S Rogers ◽

Quynh A Truong ◽

...

Keyword(s):

Chest Pain ◽

Coronary Artery ◽

Atherosclerotic Plaque ◽

Cardiac Ct ◽

Acute Chest Pain ◽

Artery Stenosis ◽

Coronary Syndrome ◽

Coronary Atherosclerotic Plaque

Objective : To determine CT angiographic patterns of coronary plaque and stenosis and diagnostic test characteristics of these findings to predict ACS in patients presenting with acute chest pain to the emergency department (ED). Methods : We conducted a blinded, prospective, observational cohort study in patients presenting with acute chest pain to the ED between May 2005 and July 2006, who were admitted to the hospital to rule out acute coronary syndrome (ACS) with no ischemic ECG changes and negative initial biomarkers. Contrast-enhanced 64-slice cardiac CT was performed immediately before admission and caregivers were blinded to the cardiac CT results. An expert panel determined the presence or absence of ACS (unstable angina pectoris [UAP], Non-ST-Elevation Myocardial Infarction [MI] according to AHA/ACC criteria). Two independent observers evaluated cardiac CT data sets for the presence of (1) coronary atherosclerotic plaque, and (2) significant coronary artery stenosis (>50%). Results: Of 221 consecutive patients (44% female, mean age 55±12 years), 31 patients had ACS (10 NSTEMI, 21 UAP). The presence of any coronary atherosclerotic plaque could be excluded in 82 patients (37%). None of these subjects was determined to have ACS (Sensitivity and NPV: 100%, (95% CI: 0.91–1.00 and 0.96–1.00; respectively). The presence of a significant coronary artery stenosis could be excluded in 152 subjects (69%). Overall, three of these patients had ACS during the index hospitalization (NPV, 98 %; 95% CI: 0.94–1.00). In 69 patients (31%), a significant stenosis was either detected or could not be completely excluded. Among them were 28/31 patients with ACS (specificity: 78%, 95% CI: 0.72– 0.84; PPV: 41% 95% CI: 0.29 – 0.53). Conclusions : These data extend initial observations that nearly 40% and 70% of patients with acute chest pain demonstrate no detectable CAD or no significant coronary artery stenosis on cardiac MDCT, respectively. Randomized diagnostic trials are warranted to determine how this information will be used by ED physicians and whether it will decrease the number of unnecessary admissions.