scholarly journals Habitual exercise provides better prognosis for cardiac arrest with coronary artery disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Kuroki ◽  
D Abe ◽  
K Hasegawa ◽  
R Nagatomo ◽  
M Okochi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Plaque Rupture ◽  
Exercise Group ◽  
Regular Exercise ◽  
Culprit Lesion ◽  
Kaplan Meier ◽  
Habitual Exercise ◽  
Artery Disease

Abstract Background Although regular physical activity has beneficial cardiovascular effects, exercise can trigger sudden cardiac arrest (SCA). Coronary artery disease (CAD) was identified as the most common cause of an exercise-related out-of-hospital cardiac arrest (OHCA). Regular exercise has been reported to reduce the risk of plaque rupture in animal studies and basic research. Therefore, we compared the coronary artery findings in CAD-OHCA patients with and without habitual exercise. There have been few reports on whether regular exercise changes the prognosis in OHCA due to CAD (CAD-OHCA). We investigated the association between the better clinical outcome and the regular exercise in patients with CAD-OHCA. Methods This is a single-center retrospective analysis from 2006 to 2019. The consecutive 397 patients with OHCA due to myocardial ischemia underwent coronary angiography (CAG). After excluding 73 patients with vasospastic angina, the remaining 324 patients with CAD were enrolled in this study. We divided these patients into two groups according to whether they were habitually exercising (Exercise group: N=37) or not/unknown (Non-Exercise group: N=287). Clinical outcome was a 30-day survival with minimal neurologic impairment represented by a Glasgow-Pittsburgh Cerebral Performance Categories Scale value 1 or 2. Results The patients in the Exercise Group were significantly younger (exercise vs. non-exercise, 57±12 vs. 64±12 years; P<0.01) than those in the non-exercise group. The Exercise group had a lower incidence of diabetes mellitus (22% vs. 42%; P=0.02) and a higher incidence of dyslipidemia (81% vs. 62%; P=0.02) than the non-exercise group. The time from collapse to cardiopulmonary resuscitation (1.4±4.0 vs. 3.0±4.8min) and from collapse to return of spontaneous circulation (11.9±10.0 vs. 28.0±25.3min) were shorter in Exercise group (all p<0.05). The ST-segment elevation was recorded on electrocardiography in fewer of the Exercise group (22% vs. 63%; P<0.01). The finding of culprit lesion in the coronary arteries on arrival resulted significant differences between the 2groups (good collateral and/or TIMI3 flow: 62% vs. 25%, the plaque rupture and/or thrombus: 22% vs. 73%) (all p<0.01) (Figure 1). Kaplan-Meier curve showed Exercise group has better neurological outcome at 30days compared than Non-Exercise (95% vs 51%; P<0.001, log-rank test) (Figure 2). Multivariable Cox proportional hazards models revealed that a habitual exercise was one of the predictors of a good neurological outcome (HR 0.21, 95% CI 0.05–0.92; P=0.039). Conclusions The patients with habitual exercise had less plaque rupture, less coronary thrombosis than non-exercise. The patients with regular exercise had better clinical outcomes than non-exercise after CAD-OHCA. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Tokyo Metropolitan Goverment Figure 1. Findings of the culprit lesion in coronar arteries Figure 2. Kaplan-Meier analysis

scholarly journals Infarct-related chronic total coronary occlusion and the risk of ventricular tachyarrhythmic events in out-of-hospital cardiac arrest survivors

2021 ◽  
Author(s):  
M. van der Graaf ◽  
L. S. D. Jewbali ◽  
J. S. Lemkes ◽  
E. M. Spoormans ◽  
M. van der Ent ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Coronary Occlusion ◽  
Independent Factor ◽  
St Segment Elevation ◽  
St Segment ◽  
Artery Disease ◽  
Chronic Total Coronary Occlusion ◽  
Hospital Cardiac Arrest

Abstract Introduction Chronic total coronary occlusion (CTO) has been identified as a risk factor for ventricular arrhythmias, especially a CTO in an infarct-related artery (IRA). This study aimed to evaluate the effect of an IRA-CTO on the occurrence of ventricular tachyarrhythmic events (VTEs) in out-of-hospital cardiac arrest survivors without ST-segment elevation. Methods We conducted a post hoc analysis of the COACT trial, a multicentre randomised controlled trial. Patients were included when they survived index hospitalisation after cardiac arrest and demonstrated coronary artery disease on coronary angiography. The primary endpoint was the occurrence of a VTE, defined as appropriate implantable cardioverter-defibrillator (ICD) therapy, sustained ventricular tachyarrhythmia or sudden cardiac death. Results A total of 163 patients from ten centres were included. Unrevascularised IRA-CTO in a main vessel was present in 43 patients (26%). Overall, 61% of the study population received an ICD for secondary prevention. During a follow-up of 1 year, 12 patients (7.4%) experienced at least one VTE. The cumulative incidence rate of VTEs was higher in patients with an IRA-CTO compared to patients without an IRA-CTO (17.4% vs 5.6%, log-rank p = 0.03). However, multivariable analysis only identified left ventricular ejection fraction < 35% as an independent factor associated with VTEs (adjusted hazard ratio 8.7, 95% confidence interval 2.2–35.4). A subanalysis focusing on CTO, with or without an infarct in the CTO territory, did not change the results. Conclusion In out-of-hospital cardiac arrest survivors with coronary artery disease without ST-segment elevation, an IRA-CTO was not an independent factor associated with VTEs in the 1st year after the index event.

scholarly journals Effect of empiric antiarrhythmic therapy in resuscitated out-of-hospital cardiac arrest victims with coronary artery disease

1990 ◽  
Vol 65 (18) ◽  
pp. 1192-1197 ◽  
Author(s):  
Ali R. Moosvi ◽  
Sidney Goldstein ◽  
Sharon VanderBrug Medendorp ◽  
J.Richard Landis ◽  
Robert A. Wolfe ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Antiarrhythmic Therapy ◽  
Artery Disease ◽  
Hospital Cardiac Arrest

The Prediction of High Echogenicity of Intimal Area in Carotid Artery for the Plaque Burden of Culprit Lesion in Coronary Artery Disease

2006 ◽  
Vol 36 (6) ◽  
pp. 458 ◽  
Author(s):  
Yun-Seok Choi ◽  
Ho-Joong Youn ◽  
Eun-Joo Hong ◽  
Yong-Won Choi ◽  
Dong-Hyun Lee ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Plaque Burden ◽  
Culprit Lesion ◽  
Artery Disease

scholarly journals Coronary Artery Disease in Patients With Out-of-Hospital Refractory Ventricular Fibrillation Cardiac Arrest

2017 ◽  
Vol 70 (9) ◽  
pp. 1109-1117 ◽  
Author(s):  
Demetris Yannopoulos ◽  
Jason A. Bartos ◽  
Ganesh Raveendran ◽  
Marc Conterato ◽  
Ralph J. Frascone ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Ventricular Fibrillation ◽  
Artery Disease

scholarly journals Prognostic value of fat attenuation index of pericoronary adipose tissue surrounding left anterior descending artery on coronary computed tomography angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Sugiyama ◽  
Y Kanaji ◽  
M Hoshino ◽  
M Yamaguchi ◽  
M Hada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Cta ◽  
Kaplan Meier ◽  
Attenuation Index ◽  
Artery Disease

Abstract Background Recent studies reported the association between elevated fat attenuation index (FAI) of pericoronary adipose tissue (PCAT) on coronary computed tomography angiography (CTA) and worse cardiac outcomes. Purpose We investigated the prognostic value of increased FAI-defined coronary inflammation status in patients with coronary artery disease. Methods Three-hundred fifty-eight patients (127 acute coronary syndromes [ACS], 231 stable coronary artery disease) with left anterior descending artery (LAD) as a culprit vessel who underwent coronary CTA were retrospectively studied. The FAI defined as the mean CT attenuation value of PCAT (−190 to −30 Hounsfield Unit [HU]) was measured at the proximal 40-mm segment of LAD. All subjects were divided into two groups according to the median value of FAI in the LAD. The association between the incidence of major adverse cardiac events (MACE) including all-cause death, myocardial infarction, heart failure, target and non-target vessel revascularization were evaluated. Results In a total of 358 patients, median FAI values surrounding the LAD was −71.46 (interquartile range, −77.10 to −66.34) HU. Thirty-eight patients (10.6%) experienced MACE during the follow-up period (median, 818 days). Kaplan-Meier analysis revealed that high FAI-LAD (&gt;−71.46 HU [median]) was significantly associated with the incidence of MACE (log-rank test, chi-square = 4.183, P=0.041) (Figure). Conclusions In patients with coronary artery disease with culprit LAD lesions, elevated FAI of PCAT surrounding the LAD was associated with worse clinical outcomes. Assessment of FAI may have a potential for potential for non-invasive risk-stratification by coronary CTA. Kaplan-Meier analysis for MACE Funding Acknowledgement Type of funding source: None

scholarly journals Effects of exercise training on sleep apnoea in patients with coronary artery disease: a randomised trial

2016 ◽  
Vol 48 (1) ◽  
pp. 142-150 ◽  
Author(s):  
Monique Mendelson ◽  
Owen D. Lyons ◽  
Azadeh Yadollahi ◽  
Toru Inami ◽  
Paul Oh ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Exercise Training ◽  
Randomised Trial ◽  
Exercise Group ◽  
Sleep Apnoea ◽  
Control Group ◽  
Fluid Shift ◽  
Obstructive Sleep ◽  
Artery Disease

Overnight fluid shift from the legs to the neck and lungs may contribute to the pathogenesis of obstructive sleep apnoea (OSA) and central sleep apnoea (CSA). We hypothesised that exercise training will decrease the severity of OSA and CSA in patients with coronary artery disease (CAD) by decreasing daytime leg fluid accumulation and overnight rostral fluid shift.Patients with CAD and OSA or CSA (apnoea–hypopnoea index >15 events per h) were randomised to 4 weeks of aerobic exercise training or to a control group. Polysomnography, with measurement of leg, thoracic and neck fluid volumes and upper-airway cross-sectional area (UA-XSA) before and after sleep, was performed at baseline and follow-up.17 patients per group completed the study. Apnoea–hypopnoea index decreased significantly more in the exercise group than in the control group (31.1±12.9 to 20.5±9.4versus28.1±13.5 to 27.0±15.1 events per h, p=0.047), in association with a greater reduction in the overnight change in leg fluid volume (579±222 to 466±163versus453±164 to 434±141 mL, p=0.04) and by a significantly greater increase in the overnight change in UA-XSA in the exercise group (p=0.04).In patients with CAD and sleep apnoea, exercise training decreases sleep apnoea severityviaattenuation of overnight fluid shift and an increase in UA-XSA.

Serum FGF21 Is Associated with Future Cardiovascular Events in Patients with Coronary Artery Disease

Cardiology ◽  
2018 ◽  
Vol 139 (4) ◽  
pp. 212-218 ◽  
Author(s):  
Yun Shen ◽  
Xueli Zhang ◽  
Yiting Xu ◽  
Qin Xiong ◽  
Zhigang Lu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Kaplan Meier ◽  
Artery Disease

Objectives: To investigate whether serum fibroblast growth factor 21 (FGF21) levels can be used to predict the future development of major adverse cardiovascular events (MACEs). Methods: This study included 253 patients who received subsequent follow-up, and complete data were collected for 234 patients. Independent predictors of MACEs were identified by using the Cox proportional-hazards regression analysis. The prognostic value of FGF21 levels for MACEs was evaluated by Kaplan-Meier survival analysis. Results: Of 229 patients finally enrolled in the analysis, 27/60 without coronary artery disease (CAD) at baseline experienced a MACE, and 132/169 patients with CAD at baseline experienced a MACE. Among patients with CAD at baseline, serum FGF21 levels were significantly higher in patients with MACEs (p < 0.05) than in patients without MACEs. Kaplan-Meier survival analysis showed patients with a higher serum FGF21 had a significantly lower event-free survival (p = 0.001) than those with a lower level. Further Cox proportional-hazards regression analysis, including the traditional risk factors for cardiovascular disease, showed that serum FGF21 was an independent predictor of MACE occurrence. Conclusions: In patients with CAD at baseline, an elevated serum FGF21 level was associated with the development of a MACE in the future.

Familial clustering of cardiac conditions in patients with anomalous aortic origin of a coronary artery and myocardial bridges

2018 ◽  
Vol 28 (9) ◽  
pp. 1099-1105 ◽  
Author(s):  
Hitesh Agrawal ◽  
Carlos M. Mery ◽  
S. Kristen Sexson Tejtel ◽  
Charles D. Fraser ◽  
E. Dean McKenzie ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Family History ◽  
Positive Family History ◽  
Sudden Cardiac Arrest ◽  
Coronary Anomalies ◽  
Myocardial Bridge ◽  
Familial Clustering ◽  
Artery Disease

AbstractBackgroundAnomalous aortic origin of a coronary artery is the second leading cause of sudden cardiac arrest/death in young athletes in the United States of America. Limited data are available regarding family history in this patient population.MethodsPatients were evaluated prospectively from 12/2012 to 02/2017 in the Coronary Anomalies Program at Texas Children’s Hospital. Relevant family history included the presence of CHD, sudden cardiac arrest/death, arrhythmia/pacemaker use, cardiomyopathy, and atherosclerotic coronary artery disease before the age of 50 years. The presence of one or more of these in 1st- or 2nd-degree relatives was considered significant.ResultsOf 168 unrelated probands (171 patients total) included, 36 (21%) had significant family history involving 19 (53%) 1st-degree and 17 (47%) 2nd-degree relatives. Positive family history led to cardiology referral in nine (5%) patients and the presence of abnormal tests/symptoms in the remaining patients. Coronary anomalies in probands with positive family history were anomalous right (27), anomalous left (five), single right coronary artery (two), myocardial bridge (one), and anomalous circumflex coronary artery (one). Conditions present in their family members included sudden cardiac arrest/death (15, 42%), atherosclerotic coronary artery disease (14, 39%), cardiomyopathy (12, 33%), CHD (11, 31%), coronary anomalies (3, 8%), myocardial bridge (1, 3%), long-QT syndrome (2, 6%), and Wolff–Parkinson–White (1, 3%).ConclusionIn patients with anomalous aortic origin of a coronary artery and/or myocardial bridges, there appears to be familial clustering of cardiac diseases in approximately 20% of patients, half of these with early occurrence of sudden cardiac arrest/death in the family.

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