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

2019 ◽  
Author(s):  
Akira Taruya ◽  
Atsushi Tanaka ◽  
Tsuyoshi Nishiguchi ◽  
Yuichi Ozaki ◽  
Manabu Kashiwagi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Significant Coronary Artery Stenosis ◽  
Coronary Syndrome

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

2021 ◽  
Author(s):  
Gökhan Ceyhun ◽  
Oğuzhan Birdal
Keyword(s):  
Coronary Artery ◽  
Shear Rate ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Significant Stenosis ◽  
Whole Blood Viscosity ◽  
Significant Coronary Artery Stenosis ◽  
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.

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

2020 ◽  
Vol 14 (16) ◽  
pp. 1553-1561
Author(s):  
Mehmet Erdoğan ◽  
Mehmet A Erdöl ◽  
Selçuk Öztürk ◽  
Tahir Durmaz
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Fractional Flow ◽  
Predictive Capacity ◽  
Significant Coronary Artery Stenosis ◽  
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.

Serum exosomal miR-122-5p is a new biomarker for both acute coronary syndrome and underlying coronary artery stenosis

Biomarkers ◽  
2020 ◽  
Vol 25 (7) ◽  
pp. 539-547
Author(s):  
Hao Ling ◽  
Ziyuan Guo ◽  
Shuangshuang Du ◽  
Yinghong Liao ◽  
Yunyan Li ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
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 ◽  
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 ◽  
Coronary Artery Stenosis ◽  
Acute Chest Pain ◽  
Artery Stenosis ◽  
Significant Coronary 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.

scholarly journals Hyperhomocysteinemia and Acute Coronary Syndrome: A Hospital-Based Observational Study Among Very Young Adults ≤35 Years of Age

2020 ◽  
Author(s):  
Jiayin Sun ◽  
Wei Han ◽  
Sijing Wu ◽  
Shuo Jia ◽  
Zhenxian Yan ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Young Patients ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Left Ventricular Ejection ◽  
Gensini Score ◽  
Coronary Syndrome

Abstract Background: The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a crucial promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in very young adults.Methods: Very young patients (18-35years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. An equivalent age-matched population without CAD, as confirmed by CAG during the same period, was assigned to the non-CAD group. A serum HCY level>15µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis.Results: A total of 1,103 participants, including 828 ACS patients and 275 non-CAD subjects, were included in this study. Very young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93- 29.68) vs 12.50 (9.71- 17.42), P<0.001; for HHCY prevalence, 62.08% vs 26.18%, P<0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.393; 95% CI, 3.171-6.087; P<0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P=0.041), multi-vessel disease (P=0.036), and decreased value of left ventricular ejection fraction (LVEF) (P=0.01). Also, the HCY level was significantly correlated with Gensini Score in ACS patients (r=0.142, P<0.001).Conclusion: HHCY was significantly associated with the presence of ACS and the severity of coronary artery stenosis in very young patients ≤35 years of age.

Associations of Circulating microRNA-221 and 222 With the Severity of Coronary Artery Lesions in Acute Coronary Syndrome Patients

Angiology ◽  
2021 ◽  
pp. 000331972110342
Author(s):  
Xin Yu ◽  
Jian-feng Xu ◽  
Ming Song ◽  
Lei Zhang ◽  
Yi-hui Li ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Quantitative Polymerase Chain Reaction ◽  
Area Under The Curve ◽  
Artery Stenosis ◽  
Circulating Microrna ◽  
Coronary Artery Lesions ◽  
Expression Levels ◽  
Coronary Syndrome

Circulating levels of microRNA-221 and 222 (miR-221/222) in patients with coronary artery disease (CAD) are elevated, yet the relationship between circulating miR-221/222 and the severity of coronary lesions in patients with acute coronary syndrome (ACS) remains unknown. In this study, the relative expression levels of circulating miR-221/222 in patients with ACS (n = 267) and controls (n = 71) were compared by real-time fluorescence quantitative-polymerase chain reaction (RT-qPCR). The ACS group was further divided into unstable angina pectoris (UA) group (n = 191) and acute myocardial infarction (AMI) group (n = 76). Significant upregulation of circulating miR-221/222 was observed in ACS. A positive linear correlation between circulating miR-221/222 and Gensini scores was demonstrated. The area under the curve (AUC) of circulating miR-221/222 in the diagnosis of coronary artery stenosis ≥50% was 0.605 and 0.643, respectively. The circulating miRNA-221/222 expression levels in ACS patients were elevated and positively associated with the severity of the coronary artery lesions. Circulating miR-221/222 may be novel biomarkers for the diagnosis of coronary artery stenosis ≥50% and the occurrence of ACS.

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