scholarly journals Low correlation between biometric parameters, cardiovascular risk factors and aortic dimensions by computed tomography coronary angiography

Medicine ◽  
2020 ◽  
Vol 99 (35) ◽  
pp. e21891
Author(s):  
Ernesto Forte ◽  
Bruna Punzo ◽  
Marco Salvatore ◽  
Erica Maffei ◽  
Stefano Nistri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Cardiovascular Risk ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
Computed Tomography Coronary Angiography ◽  
Biometric Parameters ◽  
Low Correlation ◽  
Aortic Dimensions

scholarly journals Associations of Serum Cortisol with Cardiovascular Risk and Mortality in Patients Referred to Coronary Angiography

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Stefan Pilz ◽  
Verena Theiler-Schwetz ◽  
Christian Trummer ◽  
Martin H Keppel ◽  
Martin R Grübler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Natural Killer Cells ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
Natural Killer ◽  
Cardiovascular Mortality ◽  
Serum Cortisol ◽  
Killer Cells ◽  
Coronary Syndrome

Abstract Context Serum cortisol may be associated with cardiovascular risk factors and mortality in patients undergoing coronary angiography, but previous data on this topic are limited and controversial. Objective We evaluated whether morning serum cortisol is associated with cardiovascular risk factors, lymphocyte subtypes, and mortality. Methods This is a prospective cohort study performed at a tertiary care centre in south-west Germany between 1997 and 2000. We included 3052 study participants who underwent coronary angiography. The primary outcome measures were cardiovascular risk factors, lymphocyte subtypes, and all-cause and cardiovascular mortality. Results Serum cortisol was associated with an adverse cardiovascular risk profile, but there was no significant association with coronary artery disease or acute coronary syndrome. In a subsample of 2107 participants, serum cortisol was positively associated with certain lymphocyte subsets, including CD16+CD56+ (natural killer) cells (P < 0.001). Comparing the fourth versus the first serum cortisol quartile, the crude Cox proportional hazard ratios (with 95% CIs) were 1.22 (1.00-1.47) for all-cause and 1.32 (1.04-1.67) for cardiovascular mortality, respectively. After adjustments for various cardiovascular risk factors, these associations were attenuated to 0.93 (0.76-1.14) for all-cause, and 0.97 (0.76-1.25) for cardiovascular mortality, respectively. Conclusions Despite significant associations with classic cardiovascular risk factors and natural killer cells, serum cortisol was not a significant and independent predictor of mortality in patients referred to coronary angiography. These findings might reflect that adverse cardiovascular effects of cortisol could be counterbalanced by some cardiovascular protective actions.

Sensitivity, specificity of pre-test probability and their use in the relation to syntax score and cardiovascular risk factors

2021 ◽  
Author(s):  
Anh Binh Ho
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
European Society ◽  
Syntax Score ◽  
Model Group ◽  
European Society Of Cardiology ◽  
Test Probability

Overview: Coronary angiography is the gold standard for definitive diagnosis of obstructive ischemic coronary disease. However, this is an invasive, expensive test, and may have a number of complications. Models of pre-test probability (PTP) in the guideline of the European Society of Cardiology 2013 and 2019 are easy to use and apply even to doctors who are not cardiologists, and can be implemented at the medical facilities. We aim to assess the sensitivity and specificity of different PTP stratification models follow ESC2013 and 2019; and their use in the relation to SYNTAX score and cardiovascular risk factors. Materials and Methods: Patients (n=108) with chest pain had been treated at Ninh Thuan Provincial Hospital from January 2019 to May 2020. The PTP stratification models were calculated according to the recommendations of the European Society of Cardiology (ESC) 2013 and 2019. Coronary angiography was enrolled for the diagnosis, Quantitative coronary analyzed (QCA) - based stenosis assessment was used with a cut-off of ≥ 50% diameter reduction for significant lesions of coronary artery and SYNTAX score were calculated.Diagnostic accuracy was calculated by usingsensitivity, specificitywhich were analyzed by using statistical software SPSS version 20.0. Results: In the 2013 pre-test probability model,group withmedium PTP andhigh PTPhad the sensitivity of 57.14%, 100% respectively; the overall sensitivity for both groups (the medium and high pre-test) was 59.36%; and the specificity was 58.33%. In the 2019PTP model, group withmedium PTP and high PTP had the sensitivity of 41.67%, of 67.57% respectively;the overall sensitivity for both groups (the medium and high scores PTP) was 61.22%; and the specificity was 80%. The group of low SYNTAXscore (<23) had at most 93 cases, accounting for 86.1%; the lowest was the group of high SYNTAX score (≥ 33 points) accounting for 2.8%. There were statistically significant differences in patients with and without smoking, history of hypertension for both PTP model 2013 and 2019. Conclusion: Sensitivity and specificity of the 2013 and 2019 PTP were quite high in the relation to the severity of coronary artery which were evaluated by SYNTAX score.

scholarly journals Peculiarities and Consequences of Different Angiographic Patterns of STEMI Patients Receiving Coronary Angiography Only: Data from a Large Primary PCI Registry

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Alexandru Burlacu ◽  
Grigore Tinica ◽  
Bogdan Artene ◽  
Paul Simion ◽  
Diana Savuc ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
Coronary Arteries ◽  
Univariate Analysis ◽  
Diagnostic Errors ◽  
High Volume ◽  
Process Efficiency ◽  
Primary Pci

Background. Inappropriate cardiac catheterization lab activation together with false-positive angiographies and no-culprit found coronary interventions are now reported as costly to the medical system, influencing STEMI process efficiency. We aimed to analyze data from a high-volume interventional centre (>1000 primary PCIs/year) exploring etiologies and reporting characteristics from all “blank” coronary angiographies in STEMI. Methods. In this retrospective observational single-centre cohort study, we reported two-year data from a primary PCI registry (2035 patients). “Angio-only” cases were assigned to one of these categories: (a) Takotsubo syndrome; (b) coronary embolisation; (c) myocardial infarction with nonobstructive coronary arteries; (d) myocarditis; (e) CABG-referred; (f) normal coronary arteries (mostly diagnostic errors); and (g)others (refusals and death prior angioplasty). Univariate analysis assessed correlations between each category and cardiovascular risk factors. Results. 412 STEMI patients received coronary angiography “only,” accounting for 20.2% of cath lab activations. Barely 77 patients had diagnostic errors (3.8% from all patients) implying false-activations. 40% of “angio-only” patients (n = 165) were referred to surgery due to severe atherosclerosis or mechanical complications. Patients with diagnostic errors and normal arteries displayed strong correlations with all cardiovascular risk factors. Probably, numerous risk factors “convinced” emergency department staff to call for an angio. Conclusions. STEMI network professionals often confront with coronary angiography “only” situations. We propose a classification according to etiologies. Next, STEMI guidelines should include audit recommendations and specific thresholds regarding “angio-only” patients, with specific focus on MINOCA, CABG referrals, and diagnostic errors. These measures will have a double impact: a better management of the patient, and a clearer perception about the usefulness of the investments.

Abstract 301: Aortic Segmental Diameters are Influenced by Both Common and Segment-specific Factors

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Xiaofeng Chen ◽  
Xinan Yang ◽  
Jianjun Jiang ◽  
Baohui Xu ◽  
Lijiang Tang
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Abdominal Aorta ◽  
Arterial Disease ◽  
Aortic Diameter ◽  
Aortic Dilatation ◽  
Coronary Arterial Disease ◽  
Specific Factors ◽  
Aortic Dimensions

Background and Objective: Aortic diameter is a critical parameter for the diagnosis of aortic aneurysm. In non-aneurysm patients, a large infrarenal aortic diameter are also a risk for all-cause mortality. Additionally, aortic dimension is associated with several risk factors of coronary artery disease; the measure of subclinical disease; a predictor of incident congestive heart failure; stroke risk; and all-cause and cardiovascular disease mortality. The purpose of this study was to explore the risk factors and potential alternative pathogenic mechanisms of aortic dilatation. Methods and Results: Five hundred and twenty patients with clinically evident arterial disease or cardiovascular risk factors were prospectively recruited. Comprehensive transthoracic M-mode, 2-dimensional, and Doppler echocardiographic studies were performed using commercially and clinical diagnostic ultrasonography technique. The aortic dimensions were assessed at end-diastole at the different levels: (1) the annulus, (2) the mid-point of the sinuses of Valsalva, (3) the sinotubular junction, (4) the ascending aorta at the level of its largest diameter, (5) the transverse arch, (6) the descending aorta posterior to the left atrium, and (7) the abdominal aorta just distal to the origin of the renal arteries. The relationships of aortic dimensions with clinical characteristics were assessed by linear multiple regression analysis. Variables analyzed included common cardiovascular risk factors, co-morbidities, lipid profile, hematological parameters. Age and diastolic blood pressure were positively associated with the diameters of arch, descending, ascending and abdominal aorta. In contrast, female gender and hypertension were negatively associated with the diameters of arch, descending, ascending and abdominal aorta. The presence of coronary arterial disease were positively associated with arch diameter, whereas High-density lipoprotein cholesterol levels were positively associated with the diameters of ascending, descending and abdominal aorta. Effects from other factors varied among aortic segments. Conclusion: Aortic segmental diameters are influenced by both common and segment-specific factors.

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