scholarly journals The significant role of coronary artery calcification score in asymptomatic patients with metabolic syndrome

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Temtem ◽  
M Serrao ◽  
M I Mendonca ◽  
M Santos ◽  
J A Sousa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Logistic Regression ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Cardiovascular Events

Abstract Background Metabolic syndrome (MetS) is a clinical condition composed of metabolic and cardiovascular risk factors, such as abdominal obesity, hyperglycemia, dyslipidemia and hypertension. Many patients with MetS suffer major adverse cardiovascular events (MACE) that are not adequately identified by traditional risk assessment, suggesting the need for early detection of subclinical coronary heart disease to identify those at high-risk. Coronary artery calcification (CAC) screening has added utility in categorizing patients with low, intermediate and high cardiovascular risk. Purpose Evaluate the prognostic role of CAC score in asymptomatic population patients with metabolic syndrome in cardiovascular events risk prediction. Methods A total of 1,122 asymptomatic individuals without known coronary heart disease, enrolled from GENEMACOR study, were followed for a mean of 5.3±3.4 years for the primary endpoint of all-cause of cardiovascular events. All were referred for computed tomography for the CAC scoring assessment. According to the Hoff's nomogram, 3 categories were created: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). In a subgroup of 507 individuals with MetS and 615 controls, CAC values were compared by T-student and association of CAC severity with events occurrence was evaluated. Finally, a logistic regression model adjusted for CAC severity was performed in patients with MetS. Results Among our population, the extent of CAC differs significantly between men and women in the same age group. Patients with Mets (23.2%, n=115) had higher CAC scores than controls (219.0±486.0 vs 115.8±370.8, p<0.0001). In this cohort, with higher CAC scores, 46.7% vs 22.5% had MACEs (p=0.049) during the follow-up. The logistic regression analysis revealed that CAC≥400 is a MACE predictor (OR=4.326, CI 95% 1.241–15.080, p=0.021) in patients with MetS. Conclusion Our results point to the importance of the inclusion of CAC screening in patients with MetS to further stratify those patients that, despite tight control of cardiovascular risk factors, may benefit from more intensive therapies. This tool is a useful and straightforward method that could have a significant impact on the prognosis of future cardiovascular disease in patients with MetS. FUNDunding Acknowledgement Type of funding sources: None.

Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

2019 ◽  
Vol 70 (10) ◽  
pp. 3582-3586
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it’s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (± 9.67) in all cases. It was higher in men (22.17% ± 9.24) compare to women (12.39% ± 6.92) and it was not significantly different by stages of OSAS severity (20.58% ±9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation. Keywords: obstructive sleep apnoea syndrome, cardiovascular events, risk factors, oxygen desaturation

scholarly journals Does coronary calcium scoring adds value to cardiovascular risk prediction in asymptomatic population?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Serrao ◽  
M Temtem ◽  
A Pereira ◽  
J Monteiro ◽  
M Santos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Risk Prediction ◽  
Cardiovascular Events ◽  
Cardiovascular Risk Prediction ◽  
Traditional Risk Factors ◽  
The Impact

Abstract Background Despite being a controversial subject, multiple guidelines mention the use of Coronary Artery Calcification (CAC) scoring in the cardiovascular risk prediction, in asymptomatic population. The inclusion of CAC scoring in traditional risk models may help in decision-make providing better cardiovascular risk stratification. Purpose The aim of our study is to estimate the impact of CAC scoring in cardiovascular events risk prediction in a model based on traditional risk factors (TRFs). Methods and results The study consisted of 1052 asymptomatic individuals free of known coronary heart disease, enrolled from GENEMACOR study and referred for computed tomography for the CAC scoring assessment. A cohort of 952 was followed for a mean of 5.2±3.2 years for the primary endpoint of all-cause of cardiovascular events. The following traditional risk factors were considered: (1) current cigarette smoking, (2) dyslipidemia, (3) diabetes mellitus, (4) hypertension and (5) family history of coronary heart disease. Among this population, the extent of CAC differs significantly between men and women in the same age group. Therefore, the distribution of CAC score by age and gender was done by using the Hoff's nomogram (a). According to this nomogram, 3 categories were created: low CAC (0≤CAC<100 and P<50); moderate CAC (100≤CAC<400 or P50–75) and high CAC (CAC≥400 or P>75). Two Cox regression models were created, the first only with TRFs and the second adding the CAC severity categories. When including CAC categories to the TRFs, the higher severity level presented a significant risk of MACE occurrence with an HR of 4.39 (95% CI 1.83–10.52; p=0.001). Conclusion Our results point to the importance of the inclusion of CAC in both primary and secondary prevention to an improved risk stratification. Larger prospective multicentre cohorts with longer follow-up should reproduce and validate these findings. Funding Acknowledgement Type of funding source: None

scholarly journals Coronary artery calcification score in migraine patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Filipp M. Filippopulos ◽  
Florian Schoeberl ◽  
Hans-Christoph Becker ◽  
Sandra Becker-Bense ◽  
Ozan Eren ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Pathophysiological Mechanism ◽  
Coronary Artery Calcification Score ◽  
Coronary Calcifications ◽  
Calcification Score ◽  
Increased Risk

Abstract Epidemiological studies have shown an increased risk of cardiovascular events in migraineurs. The pathophysiological mechanisms of this observation remain largely unknown. Recent genetic and epidemiologic studies suggest, that atherosclerosis might be the overlapping pathophysiological mechanism in migraine and coronary heart disease. The aim of the present study was to evaluate if the increased cardiovascular risk in migraineurs is attributed to an increased coronary artery calcification. For this the coronary artery calcium score was assessed by computed tomography of the heart in 1.437 patients of which 337 were migraineurs. All patients had a similar cardiovascular risk profile, so that the risk for coronary calcifications could be considered similar between migraineurs and non-migraineurs. The results showed no significant differences in the amount of coronary calcifications in patients with or without migraine. This suggests that a more pronounced coronary artery calcification, as a surrogate marker of coronary atherosclerosis, does not underlie the increased cardiovascular risk in migraineurs. A distinct common pathophysiological mechanism in migraine and coronary heart disease such as endothelial dysfunction or vasospasm should be discussed instead. However, it has to be considered, that the coronary artery calcification score does not indicate the total risk of atherosclerotic changes in the coronary arteries.

scholarly journals Growth Differentiation Factor 15, Its 12-Month Relative Change, and Risk of Cardiovascular Events and Total Mortality in Patients with Stable Coronary Heart Disease: 10-Year Follow-up of the KAROLA Study

2016 ◽  
Vol 62 (7) ◽  
pp. 982-992 ◽  
Author(s):  
Dhayana Dallmeier ◽  
Hermann Brenner ◽  
Ute Mons ◽  
Wolfgang Rottbauer ◽  
Wolfgang Koenig ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Events ◽  
Total Mortality ◽  
Growth Differentiation Factor 15 ◽  
Stable Coronary Heart Disease

Abstract BACKGROUND This study considered whether baseline concentrations and 12-month changes of growth differentiation factor 15 (GDF-15) are associated with subsequent cardiovascular events (CVEs) and total mortality in patients with stable coronary heart disease. METHODS Baseline GDF-15 serum concentrations were measured in 1073 participants in a cardiac rehabilitation program (median follow-up 10 years). GDF-15 associations with subsequent CVE and total mortality were evaluated by Cox-proportional hazards models adjusting for well-established cardiovascular risk factors (Model 2), plus N-terminal probrain natriuretic peptide, high-sensitivity (hs) CRP, and hs cardiac troponin T (Model 3). RESULTS In our study population [84.7% men, mean age 59 years, median baseline GDF-15 1232 ng/L (interquartile range, 916, 1674)] we observed 190 CVE and 162 deaths. Compared to participants with GDF-15 <1200 ng/L, increased risk for death was found in participants with GDF-15 ≥1200 and ≤1800 ng/L [hazard ratio (HR) 1.68 (95% CI, 1.08–2.62)] and with GDF-15 >1800 ng/L [HR 1.73 (1.02–2.94)], even in Model 3. The 12-month relative median change was −16.7%. As compared to participants with 12-month relative changes between −20% and 20%, GDF-15 increments >20% were associated with: a) an HR of 1.84 (1.04–3.26) for CVE in Model 2, but found nonsignificant in Model 3; (b) an HR of 2.26 (1.32–3.86) for death even in Model 3. CONCLUSIONS GDF-15 at baseline is independently associated with subsequent CVE and 10-year total mortality. Twelve-month relative changes remained associated with subsequent CVE when adjusting for well-established cardiovascular risk factors, and with total mortality even after further adjustment for established cardiac biomarkers.

scholarly journals Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

2019 ◽  
Vol 70 (10) ◽  
pp. 3582-3586
Author(s):  
Lavinia Davidescu ◽  
Ben Mansour Mohamed Azzedine ◽  
Milena Adina Man ◽  
Nicoleta Stefania Motoc ◽  
Ioan Anton Arghir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep ◽  
Increased Risk

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it�s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (� 9.67) in all cases. It was higher in men (22.17% � 9.24) compare to women (12.39% � 6.92) and it was not significantly different by stages of OSAS severity (20.58% �9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation.

Insulin resistance associated with metabolic syndrome as an indicator of cardiovascular risk

2016 ◽  
Vol 94 (3) ◽  
pp. 189-193
Author(s):  
Aleksandr V. Dontsov ◽  
L. V. Vasil’eva
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Healthy Subjects ◽  
Tumour Necrosis ◽  
Insulin Level ◽  
Necrosis Factor

Aim. To study blood insulin level in patients with coronary heart disease (CHD) with and without metabolic syndrome (MS) and its relation to cardiovascular risk factors. Materials and methods. We examined 127 patients with stable coronary heart disease (mean age 59.4±5.7 yr) including 63 with MS and 64 without it. The control group consisted of 80 practically healthy subjects. Bloods insulin was determined by immunochemoluminescence, glycated hemoglobin (HbA) by immunoturbidimetry, total cholesterol, HDLP cholesterol, and triglycerides by enzymatic colorimetric method, oxidized LDLP, IL-1β, IL-6, and tumour necrosis factor-a by enzyme immunoassay. The degree of depression was estimated using the Zung scale. Results. Blood insulin level in healthy subjects, CHD patients with and without MS was 6.3 (6.20;6.62), 15.5 (13.96, 16.3) and 9.5 (9.2, 10.1) mcIE/ml respectively (p<0.001). HOMA-IR directly correlated with MBI, waist circumference, HbA total cholesterol, triglyceride, oxidized LDLP, IL-1β, IL-6, and tumour necrosis factor-a levels and negatively with the HDLP cholesterol level. Conclusion. In patients with CHD, metabolic syndrome is associated with a set of additional cardiovascular risk factors, viz. hyperinsulinemia, insulin resistance, increased HbA level, dyslipidemia, oxidative modification of LDLP, activation of proinflammatory cytokines, and depressive disorders. Close correlation of HOMA-IR with certain pathogenetic factors of CHD allow to use it as an indicator of cardiovascular risk in patients with CHD and MS.

scholarly journals Effect of Serum Homocysteine on Coronary Artery Disease in Younger and Older Ischaemic Heart Disease Patients

2016 ◽  
Vol 8 (2) ◽  
pp. 138-142
Author(s):  
Kazi Nazrul Islam ◽  
Abdul Wadud Chowdhury ◽  
Azizul Hasan Khondoker ◽  
Md Serajul Haque ◽  
KMN Sabah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Homocysteine Level ◽  
Serum Homocysteine ◽  
Artery Disease

Background: Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis. But the probable role of Hyperhomocysteinemia in Premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of serum homocysteine on angiographically documented CAD in younger and older ischaemic heart disease (IHD) patients.Methods: Total 120 patients with IHD admitted in the Department of Cardiology, Dhaka Medical College Hospital for CAG were selected by purposive sampling method and divided into two groups. 60 patients in Group-I, d” 40 years of age (Younger); 60 patients in Group-II, >40 years of age (Older). Homocysteine was measured in all patients and other demographical and clinical data were collected. Homocysteine level was correlated with the presence and severity of CAD.Results: Smoking, positive family history of IHD, dyslipidaemia and hyper homocysteinemia were important risk factors in younger IHD patients. Whereas, hypertension, diabetes mellitus and dyslipidaemia were important cardiovascular risk factors in older age group. Obesity was not an important risk factors as evidenced by mean BMI. Serum homocysteine was not well related to presence of CAD or extent of CAD in older IHD patients. However in younger patients hyperhomocysteinemia was related to both presence and severity of CAD.Conclusion: In younger IHD patients hyperhomocysteinemia is an important cardiovascular risk factor. But in older patients it loses its significance. So serum homocysteine level should be screened routinely in younger IHD patients.Cardiovasc. j. 2016; 8(2): 138-142

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