P873Plasma PCSK9 levels and atherosclerosis burden in the coronary arteries of patients undergoing coronary angiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Panahi ◽  
M S Ghahrodi ◽  
M S Jamshir ◽  
M A Safarpour ◽  
M Pirro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Stenosis ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Vessel Disease ◽  
Coronary Calcifications ◽  
Triple Vessel Disease

Abstract Background Plasma PCSK9 levels, a novel and effective therapeutic target for CVD prevention, have been associated with CVD events irrespective of traditional risk factors. Whether PCSK9 levels predict coronary artery disease (CAD) burden and severity is a matter of dispute. Purpose To investigate the association between plasma PCSK9 levels and CAD characteristics, including number of major diseased vessels, severity of coronary stenosis, and the burden of coronary calcifications. Methods One hundred and one patients undergoing coronary angiography were recruited for this cross-sectional study. The number of major coronary diseased vessels was defined as the presence of ≥1 stenoses ≥50% in diameter of at least one major coronary artery. CAD severity was defined as either the absence of coronary stenosis (no-CAD), CAD<50% or CAD≥50% in one or more coronary arteries. The burden of coronary calcifications was estimated by angiography visual inspection and classified as absent, mild, moderate or severe. Results Coronary angiography showed single, double and triple vessel disease in 26 (25.7%), 23 (22.8%) and 21 (20.8%) patients, respectively; 20 (19.8%) and 11 (10.9%) pts had either minimal CAD (<50%) or normal angiographic findings. Also, calcifications were absent in 65 patients (64.4%), and mild, moderate and severe in 23 (22.8%), 11 (10.9%) and 2 (2%) patients, respectively. Plasma PCSK9 levels were significantly associated with age (rho=0.22, p=0.025) and SBP (rho=0.21, p=0.034), and were almost doubled in patients with chronic kidney disease (CKD) as compared to those without CKD [164.6 ng/mL (104.6–187.0) vs 94.8 ng/mL (86.8–114.9), p=0.006]. Among patients without CKD, those with CAD≥50% had higher plasma PCSK9 levels than those without [97.1 ng/mL (87.8–143.0) vs 83.2 ng/mL (73.4–102.6), p=0.04]. In the overall population, higher plasma PCSK9 levels were found in pts with triple vessel disease [165.7 ng/mL (121.3–180.5)] than in those with double/single vessel involvement [97.9 ng/mL (87.6–99.8) and 88.4 ng/mL (87.3–97.4), p<0.001 for both comparisons] or without CAD [87.5 ng/mL (74.3–114.9), p<0.001]. Also, a trend toward an increase of plasma PCSK9 levels was found with higher CAD severity [no-CAD: 87.5 ng/mL (74.3–114.9), CAD<50%: 89.1 ng/mL (78.9–105.3), CAD≥50%: 97.6 ng/mL (87.9–155.3), p=0.051], which turned significant after exclusion of CKD patients (p=0.042). Adjustment for age, sex, plasma LDL-cholesterol levels, statin use and CKD abolished the association between PCSK9 and CAD severity but not with the number of significantly diseased vessels and the burden of coronary calcifications. Conclusions Circulating PCSK9, whose plasma levels are significantly influenced by the presence of CKD, discriminates patients with significant coronary artery stenosis from those without CAD. In addition, both the number of diseased coronary vessels and total coronary calcifications are independently predicted by an elevated plasma PCSK9 level. Acknowledgement/Funding None

scholarly journals Analysis of the effectiveness of selection of women for coronarography in real clinical practice

The Clinician ◽  
2019 ◽  
Vol 13 (1-2) ◽  
pp. 34-40
Author(s):  
N. V. Izmozherova ◽  
A. A. Popov ◽  
V. E. Sherstobitov
Keyword(s):  
Coronary Angiography ◽  
Coronary Arteries ◽  
Odds Ratio ◽  
Coronary Atherosclerosis ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Functional Class ◽  
Cross Sectional ◽  
Clinically Significant ◽  
Artery Disease

Objective: evaluation of the effectiveness of selection for coronary angiography of women who have applied to a cardiologist for thoracalgia and dorsalgia and regarded primarily as having a clinic of stable angina.Materials and methods. 108 women (median age 59.5) applying to cardiologist due to chest pain were included in a cross-sectional study and underwent coronary angiography. Subjects with identified clinically significant atherosclerotic coronary lesions were compared to persons with intact coronary arteries.Results. One-, two- and three-vessel lesions were diagnosed in accordingly 16; 21 and 26 % of patients. Intact coronary arteries were detected in 37 % subjects. In 17 of 40 persons with intact structure of the coronary arteries spasm of the coronary arteries was diagnosed. Odds ratio for atherosclerotic coronary arteries lesions in type 2 diabetic persons were 7.91 (1.74–36.00), for hypertension odds ratio 4.79 (1.52–15.01). Severe angina (3 and 4 functional class) was significantly more often diagnosed in women with identified coronary atherosclerosis. Severe coronary atherosclerosis was associated with absence of negative or doubtful results, whereas intact coronary vessels, negative and questionable results revealed more than half of the women. The obtained data reflect the relevance of the development of more effective algorithms for diagnosis of coronary artery disease in women, since the gender peculiarities of the formation of coronary atherosclerosis have been clearly confirmed in a number of large studies.Conclusion. Medical history, physical load tests results, and subject’s emotional status should be evaluated to assess the feasibility of coronary angiography.

scholarly journals Atrial fibrillation is a predictor of nonobstructive coronary artery disease in elective angiography in old age: a cross-sectional study in Poland and Russia

2021 ◽  
Author(s):  
Ewelina Rogalska ◽  
Łukasz Kuźma ◽  
Zyta B. Wojszel ◽  
Anna Kurasz ◽  
Dmitry Napalkov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nonobstructive Coronary Artery Disease ◽  
Artery Disease

Abstract Background Significant changes in the coronary vessels are not confirmed in a large proportion of patients undergoing cardiac catheterization. Aims The present study aimed to determine correlates and independent predictors of nonobstructive coronary artery disease (CAD) in older adults referred for elective coronary angiography. Methods A cross-sectional study was conducted involving 2,214 patients referred to two medical centers (in Poland and Russia) between 2014 and 2016 for elective coronary angiography due to exacerbated angina, despite undergoing optimal therapy for CAD. The median age was 72 years (IQR: 68–76), and 49.5% patients were women. Results Significant stenosis (defined as stenosis of 50% or more of the diameter of the left main coronary artery stem or stenosis of 70% or more of the diameter of the remaining major epicardial vessels) was diagnosed only in 1135 (51.3%) patients. Female sex (odds ratio [OR], 3.01; 95% confidence interval [CI], 2.44–3.72; p < 0.001) and atrial fibrillation (OR, 1.87; 95% CI 1.45–2.40; p < 0.001) were the main independent predictors of nonobstructive CAD. Significantly lower ORs were observed for diabetes (OR, 0.75; 95% CI 0.59–0.95; p = 0.02), chronic kidney disease (OR, 0.76; 95% CI 0.61–0.96; p = 0.02), and anemia (OR, 0.69; 95% CI 0.50–0.95; p = 0.02) after controlling for age, chronic heart failure, BMI, and study center. Discussion and conclusions The results confirmed that nonobstructive CAD occurs in a high percentage of older patients referred for elective coronary angiography. This suggests the need to improve patient stratification for invasive diagnosis of CAD, especially for older women and patients with atrial fibrillation. Trial registration number and date of registration: NCT04537507, September 3, 2020.

Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography

2005 ◽  
Vol 8 (1) ◽  
pp. 42 ◽  
Author(s):  
C. Probst ◽  
A. Kovacs ◽  
C. Schmitz ◽  
W. Schiller ◽  
H. Schild ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Invasive Coronary Angiography ◽  
Bypass Graft ◽  
Heart Association ◽  
Artery Stenosis ◽  
Vessel Disease ◽  
Selective Coronary Angiography

Objective: Invasive, selective coronary angiography is the gold standard for evaluation of coronary artery disease (CAD) and degree of stenosis. The purpose of this study was to compare 3-dimensional (3D) reconstructed 16-slice multislice computed tomographic (MSCT) angiography and selective coronary angiography in patients before elective coronary artery bypass graft (CABG) procedure. Methods: Sixteen-slice MSCT scans (Philips Mx8000 IDT) were performed in 50 patients (42 male/8 female; mean age, 64.44 8.66 years) scheduled for elective CABG procedure. Scans were retrospectively electrocardiogram-gated 3D reconstructed. The images of the coronary arteries were evaluated for stenosis by 2 independent radiologists. The results were compared with the coronary angiography findings using the American Heart Association segmental classification for coronary arteries. Results: Four patients (8%) were excluded for technical reasons. Thirty-eight patients (82.6%) had 3-vessel disease, 4 (8.7 %) had 2-vessel disease, and 4 (8.7%) had an isolated left anterior descending artery stenosis. In the proximal segments all stenoses >50% (56/56) were detected by MSCT; medial segment sensitivity was 97% (73/75), specificity 90.3%; distal segment sensitivity was 90.7% (59/65), specificity 77%. Conclusion: Accurate quantification of coronary stenosis greater than 50% in the proximal and medial segments is possible with high sensitivity and specificity using the new generation of 16-slice MSCTs. There is still a tendency to overestimate stenosis in the distal segments. MSCT seems to be an excellent diagnostic tool for screening patients with possible CAD.

scholarly journals A Study on the Relationship between Iron Reserves and the Intensity of Coronary Artery Stenosisin Angiography Candidates

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Khalil Mahmoodi
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Transferrin Saturation ◽  
Intervention Group ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Coronary Artery Stenos ◽  
The Impact ◽  
The Relationship

Various risk factors including blood iron may create coronary artery diseases and lead to myocardial infarction. There are controversies with regard to the impact of blood iron on myocardial infarction. Therefore, the aim of this paper was to investigate the relationship between iron reserves and the intensity of coronary artery stenos is among angiographic candidates in Zanjan, Iran. This was a cross sectional study. Samples were consisted of patients who were hospitalized for diagnostic coronary angiography in hospitals in an urban area of Iran. A convenient sampling method was used to recruit samples via interviews and laboratory examinations for FBS, iron, TIBC, ferritin, creatinine serum, CBC, cholesterol, HDL and LDL. The samples were divided into control and intervention groups. After coronary angiography, the intervention group was evaluated by four different methods including the extent score, stenos is score, vessel score and Duke CAN Index. The samples were consisted of 89 men (60.1%) and 59 women (39.9%). The levels of ferritin (p=0.003) and iron (p=0.002), and transferrin saturation percent (p=0.002) showed significant differences between males and females (p=0.004)

scholarly journals Triple vessel coronary artery disease in a rural Nigerian: A reflection of poor diagnostic infrastructure or rarity in prevalence? A call for action

2019 ◽  
Vol 5 (3) ◽  
pp. 109-111
Author(s):  
Akintunde Adeseye A ◽  
◽  
Olafiranye Oladipupo ◽  
◽  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Good Effect ◽  
Vessel Disease ◽  
Diagnostic Facility ◽  
Triple Vessel Disease ◽  
Artery Disease ◽  
Angioplasty And Stenting ◽  
Vessel Coronary Artery

The need for provision of more diagnostic facility for coronary angiography to diagnose coronary artery disease among Africans cannot be overemphasized as there is the possibility that coronary artery disease may not be as uncommon as it is presently estimated but may be manifesting with different phenotypic presentations compared to the Caucasians. We present an otherwise stable adult rural Nigerian with hypertension and diabetes who was diagnosed with a triple vessel disease and subsequently had coronary angioplasty and stenting with good effect.

scholarly journals Leptin to Adiponectin ratio as Atherogenic Index in Ischemic Heart Disease Patients

2019 ◽  
Vol 7 (4) ◽  
pp. 285-290
Author(s):  
Muhammad Kashif Nisar ◽  
Erum Afaq ◽  
Humera Afaq ◽  
Anila Jaleel ◽  
Adnan Zuberi
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Venous Blood ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Ischemic Heart ◽  
Atherogenic Index ◽  
Hip Circumference ◽  
Cross Sectional ◽  
Vessel Disease

Objective: To determine plasma adiponectin and leptin levels in subjects with and without ischemic heart disease (IHD) and to find the correlation between leptin, adiponectin to the number of coronary vessels disease-using angiography.Patients and Methods: This is a cross-sectional study conducted Ziauddin University. 80 subjects were recruited who were undergoing angiography. Height, weight, Waist and hip circumference were measured. BMI and WHR were calculated accordingly. Venous blood was drawn to measure adiponectin and leptin using ELISA.Results: Leptin to adiponectin ratio (LA ratio) was significantly increased in three and two vessel disease compared with single vessel and non-significant groups.Conclusion: The study shows that adiponectin decreases and leptin increases in multivessel disease. LA ratio has been found to correlate well in two and more than two vessel disease.

scholarly journals Epicardial Coronary Arteries in Khat Chewers Presenting with Myocardial Infarction

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmed Al-Motarreb ◽  
Adel Shabana ◽  
Ayman El-Menyar
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Negative Impact ◽  
Coronary Spasm ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Khat Chewing ◽  
Group 3 ◽  
The Impact

Background. Khat chewing is a common habit in Yemen despite increased evidence of its negative impact on the cardiovascular system.Aims. We aimed to study the epicardial coronary arteries in khat chewers presenting with myocardial infarction (AMI).Materials and Methods. A descriptive, cross-sectional study was conducted between November 2008 and May 2009 in Yemen. AMI patients who underwent coronary angiogram were enrolled and divided into groups (gp): gp1 (diabetic and khat chewers), gp2 (khat chewers and nondiabetic), and gp3 (diabetic and non-khat users).Results. Of 347 AMI patients 63%, 21%, and 16% were in gp 2, 3, and 1, respectively. Khat chewers were younger in comparison to non-khat users. Group 3 patients were more likely to have multivessel disease, severe left anterior descending (LAD), right coronary artery (RCA) stenosis and total RCA, and left circumflex (Lcx) occlusion compared to other groups. Group 1 patients were more likely to have total LAD occlusion and severe Lcx lesions. In multivariate analysis, age, diabetes mellitus, and smoking were significant independent predictors for significant coronary artery lesions; however, khat chewing did not show such association.Conclusions. Coronary spasm is the main mechanism of AMI in khat chewers. The impact of our finding for risk stratification and management warrants further studies.

scholarly journals Hyperuricemia as a risk factor for increase severity of coronary vessel occlusion disease: a cross-sectional study in North Indian population

2020 ◽  
Vol 8 (6) ◽  
pp. 1989
Author(s):  
Gaurav Singhal ◽  
Shilpa Bhardwaj ◽  
Ashok Kumar Ahirwar ◽  
Harish C. Sharma
Keyword(s):  
Uric Acid ◽  
Risk Factor ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Coronary Vessel ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Potential Biomarker

Background: Cardiovascular disease (CVD) is the most common cause of death worldwide. The present study was conducted to study uric acid as a potential biomarker in predicting the severity of CVD in terms of vessel involvement.Methods: A cross-sectional study, conducted at Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi. A total of 52 consecutive male and female patients age between 30 to 70 years was included in this study. Written informed consent was obtained from all the enrolled patients. Automated analysers were used for the analysis of blood glucose, lipid profile and serum uric acid level. IBM SPSS Statistics (Version 20.0, IBM SPSS, IL, USA) was used for the statistical analyses.Results: In this study, a total of 52 consecutive patients were divided into three groups; single-vessel disease (n=19), double vessel disease (n=19) and triple vessel disease (n=14). Biochemical profile of all the groups was calculated. A group of triple vessel disease patients showing higher amount (164±42 mg/dl) of cholesterol level as compared to the other two groups (157±34 mg/dl). The mean level of serum uric acid levels significantly differed and its mean levels increases as the severity of vessel diseases increases. The receiver operating characteristic curve shows the uric level has 71% sensitivity and 52.5% specificity for detecting the severity of coronary vessel disease.Conclusions: This study demonstrated an increased serum uric acid levels were associated with increased severity of vessel disease, and serum uric acid is an independent risk factor for coronary artery disease.

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