Do conventional risk factors predict subclinical coronary artery disease? Results from the Prospective Army Coronary Calcium Project

Coronary Artery disease (CAD) remains a major health problem. Stable angina, unstable angina and myocardial infarction are the major manifestations of CAD. This study is aimed to assess the coronary artery profile in these groups and its relation to the major conventional risk factors and the distribution of the disease in differant ethnic group of Napalase population.

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Using of questionnaire of European Society of Cardiology to identify non-conventional risk factors in patients with coronary artery disease in the Kyrgyz Republic

Russian Journal of Cardiology ◽

10.15829/1560-4071-2019-2-76-80 ◽

2019 ◽

pp. 76-80

Author(s):

Yu. V. Zalesskaya ◽

R. B. Kydyralieva

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Standard Treatment ◽

Treatment Goals ◽

Target Level ◽

Type D ◽

Artery Disease ◽

European Society Of Cardiology ◽

Conventional Risk Factors

Aim.To analyze the results of using of the European Society of Cardiology (ESC) questionnaire regarding the assessment of non-conventional risk factors in patients with coronary artery disease (CAD).Material and methods. Three hundred and ten patients with CAD (mean age 59,6±8,8 years, men 62,2) underwent a general clinical examination with the identification of conventional risk factors and assessing standard treatment goals. The cardiologist performed a two-stage assessment of non-conventional risk factors using the ESC questionnaire and validated questionnaires (DS-14, Hamilton Rating Scale for Depression and Anxiety) for clinical identification of anxiety, depression, type D personality.Results.In hospitalized patients, predominantly we noted severe clinical manifestations of the disease: acute coronary syndrome (51,6%), a decrease in the ejection fraction of less than 50% (40%), a history of acute myocardial infarction (29%), and a high frequency of conventional risk factors: arterial hypertension (75,8%), dyslipidemia (75,1%), obesity (40,9%). The majority of respondents did not reach the standard treatment goals: 13,8% of patients smoked, 30,9% did not follow the lipid-lowering diet, 81,3% did not follow recommendations regarding fish eating, 51,6% did not have recommended physical activity, 40,6% did not reached the target level of blood pressure, 59,3% — the target level of low-density lipoproteins, 59,8% — the target level of body mass index. We determined prevalence of following non-conventional risk factors: hostility (30,9%), type D personality (25,4%), low socio-economic status (12,2%) and anxiety (10%). Depression (5,1%), stress at work and in family life (4,5%), social exclusion (1,6%) were less common.Conclusion.The results are consistent with data obtained by foreign researchers. The use of the ESC questionnaire allows practitioners to focus on identifying nonconventional risk factors, receive data on the individual risk profile and expand the range of treatment and prevention strategies.

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Performance of coronary calcium score and epicardial fat volume in early diagnostic of coronary artery disease

European Heart Journal ◽

10.1093/ehjci/ehaa946.0177 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Agoston Coldea ◽

A Zlibut ◽

C Cionca ◽

I Muresan ◽

D Horvat ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Calcium Score ◽

Coronary Calcium ◽

Coronary Calcium Score ◽

Epicardial Fat Volume ◽

Artery Disease ◽

Fat Volume

Abstract Background Coronary artery disease (CAD) remains a world leading cause of death, despite the development of traditional risk scores based on the quantification of cardiovascular risk factors. Coronary calcium score (CCS) determined by cardiac computed tomography (CCT) is a noninvasive tool with major implications in early diagnosis and in outcome prediction in CAD patients. Epicardial fat volume (EFV) is a recently described CCT-based diagnostic and prognostic tool of CAD and outcome. Purpose This study sought to investigate the performance of coronary calcium score and EFV in early diagnosing CAD. Methods We conducted a prospective, single-center, cross-sectional study on patients suspected of CAD. All patients were submitted to detailed clinical data, 12-lead electrocardiogram, estimating pretest probability, stress test, echocardiography, CCT imaging. In the study subjects was assessed CCS, EFV and the number of calcified plaques (NoP). The total CCS load was then ranked in the following scoring groups: 0 (no evidence of coronary calcium; reference group), 1–99 (minimal to mild), 100–399 (moderate), and 400–999 (extensive) and ≥1000 (very extensive). The subjects in the study were classified according to the NoP derived from their CCS scans (no plaques, 1–5, 6–10 and more than 10 calcified plaques). CAD was defined as coronary stenosis over 50% of the vessel. Results Among 540 patients (55.8±11.2 years of age; 52% women) met the enrollment criteria, 98 patients presented CAD. Spearman correlation analysis revealed strong correlations between EFV index and CCS (r=0.45; p<0.0001) and between EFV index and NoP (r=0.44; p<0.0001), after adjustment for age, sex, body mass index, hypertension, diabetes and low-density lipoprotein cholesterol. The area under the curve of the receiver-operator curve for CAD prediction by CCS >70.3 UH (cut-off value) was significantly higher (AUC=0.927; p<0.0001) by comparison with EFV index >40.8 ml/m2 (AUC=0.816; p<0.0001) and NoP >4 (AUC=0.928; p<0.0001). The association of all three parameter, CCS, EFV and NoP, increases the prediction power of CAD, providing an AUC of 0.969 with a 0.70 sensibility and 0.95 specificity. Conclusion The combined use of EPV, CCS and NoP has a very high predictive capacity for CAD, regardless of the classic cardiovascular risk factors. This increases the diagnostic capacity of CAD beyond every parameter used alone. Funding Acknowledgement Type of funding source: None

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