THE PATIENT WITH CORONARY ARTERY DISEASE WITHOUT INFARCTION: CAN A HIGH-RISK GROUP BE IDENTIFIED?

1982 ◽  
Vol 382 (1 Sudden Corona) ◽  
pp. 438-449 ◽  
Author(s):  
Jan Erikssen ◽  
Reidar Mundal
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Artery Disease

scholarly journals Adiponectin and the development of diabetes in patients with coronary artery disease and impaired fasting glucose

2006 ◽  
Vol 154 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Hilla Knobler ◽  
Michal Benderly ◽  
Valentina Boyko ◽  
Shlomo Behar ◽  
Zipora Matas ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Risk Group ◽  
High Risk Group ◽  
High Rate ◽  
Artery Disease ◽  
Reduced Risk

Objectives: Adiponectin has insulin-sensitizing properties, and high adiponectin levels have been shown to be associated with reduced risk of developing diabetes. Patients with coronary artery disease (CAD) have relatively low adiponectin levels and high prevalence of glucose intolerance. The role of adiponectin in predicting the development of diabetes in this high-risk group has not been determined. The study aimed to determine whether baseline adiponectin levels predict the development of diabetes in a group of patients with CAD and impaired fasting glucose (IFG). Methods: A total of 588 patients who participated in the Bezafibrate Infarction Prevention (BIP) study and who had at baseline fasting glucose of 100–125 mg/dl were included and followed for 6.2±1.3 years. Adiponectin was determined in frozen plasma samples taken at baseline. Results: Of the patients with IFG at baseline, 256 (44%) developed diabetes during follow-up. The patients who developed diabetes had at baseline higher body-mass index, fasting glucose, C-reactive protein, triglycerides, homeostatic assessment of insulin resistance (HOMA-IR) and diastolic blood pressure than patients who did not develop diabetes. Adiponectin levels at baseline were significantly lower in patients who developed diabetes than in patients who did not develop diabetes (P = 0.009, nonparametric Kruskall–Wallis test). An increase of 1 unit of natural logarithm of adiponectin level was associated with a hazard ratio of 0.77 (95% CI, 0.61–0.96) for diabetes development. Conclusion: Patients with CAD and IFG have a very high rate of conversion to type 2 diabetes. Even in this high-risk group, high adiponectin levels are associated with reduced risk of developing diabetes.

scholarly journals Association between a Genetic Risk Score Based on Single Nucleotide Polymorphisms of Coronary Artery Disease-Related Genes and Left Main Coronary Artery Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Zhengxi Xu ◽  
Hanning Liu ◽  
Cheng Sun ◽  
Ke Si ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Risk Score ◽  
Genetic Risk ◽  
Risk Group ◽  
Genetic Risk Score ◽  
High Risk Group ◽  
Low Risk ◽  
Artery Disease

Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Left main coronary artery disease (LMCAD) is a severe phenotype of CAD and has a genetic component. Previous studies identified 3 inflammation-related single nucleotide polymorphisms (SNPs) contributing to the development of LMCAD. We integrated these SNPs into a genetic risk score for the prediction of LMCAD. We enrolled 1544 patients with CAD between 2007 and 2011. The individual associations of the 3 SNPs with LMCAD were assessed. We then calculated the genetic risk score for each patient and stratified patients into low-risk, intermediate-risk, and high-risk categories of genetic risk. In univariable logistic regression analysis, the odds of LMCAD for the high-risk group were 2.81 (95% confidence interval [CI]: 1.72-4.60; P = 0.02) times those of the low-risk group. After adjustment for CAD-related clinical variables, the high-risk group (adjusted OR: 2.78; 95% CI: 1.69-4.58; P = 0.02) had increased odds of LMCAD when compared with the low-risk group. Comparison of model c-statistics showed greater predictive value with regard to LMCAD for the genetic risk score model than the models including single SNPs.

Abstract 15844: Predicting the Risk of Significant Coronary Artery Disease in Liver Transplant Patients: The CAD-LT Score

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Rayan Jo Rachwan ◽  
Issa Kutkut ◽  
Lava R Timsina ◽  
Rody G Bou Chaaya ◽  
Edward El-Am ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Liver Transplant ◽  
Risk Group ◽  
Significant Coronary Artery Disease ◽  
Receiver Operating Curve ◽  
Smoking History ◽  
History Of ◽  
Artery Disease

Background: Patients with significant coronary artery disease (CAD) are more likely to develop post-liver transplant (LT) cardiac events. We developed the CAD-LT screening score and testing algorithm to predict the risk of significant CAD in LT candidates. Methods: Patients who underwent pre-LT evaluation at Indiana University (2010-2017) were studied retrospectively (n=1814). Stress tests (ST) (n=1677) and cardiac catheterization (CATH) reports (n=1300) were reviewed. CATH was performed in patients with predefined CAD risk factors. Significant CAD was defined as disease requiring percutaneous or surgical intervention. Multivariable estimates (Adjusted Odds Ratio i.e. AOR [95%CI]) with assessment of model performance using Receiver Operating Curve analysis were used to compute a point-based risk score and stratify patients. A 10-fold internal cross-validation (CV) model was done. Results: There were 950 LT and 864 no-LT patients. The risk-adjusted predictors of significant CAD were older age (AOR 1.06 [95%CI 1.03-1.09]), male gender (1.69 [1.13-2.50]), diabetes (1.44 [1.01-2.06]), hypertension (1.50 [1.05-2.15]), current smoking history (1.81 [1.16-2.82]), family history of CAD (1.76 [1.24-2.50]), and personal history of CAD (5.41 [3.48-8.43]). The CAD-LT score is shown in Table 1. Figure 1 is an algorithm for its use. The mean CV Area Under the Curve [95% CI] was 0.75 [0.71-0.79]. The algorithm detected 97% of the patients with significant CAD and would decrease the number of ST by 718 (43%; 671 in high-risk group and 47 in low-risk group) and CATH by 409 (30%). Conclusion: The CAD-LT score identifies LT candidates at high risk for significant CAD and guides pre-LT testing.

scholarly journals Prognostic Value of Atherosclerotic Extent in Diabetic Patients with Non-Obstructive Coronary Artery Disease

2021 ◽  
Author(s):  
Yipu Ding ◽  
Zinuan Liu ◽  
Guanhua Dou ◽  
Xia Yang ◽  
Xi Wang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Prognostic Value ◽  
Obstructive Coronary Artery Disease ◽  
High Risk Group ◽  
Plaque Burden ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Artery Disease

Abstract Background and Objective: Atherosclerotic extent was approved to be associated with adverse cardiac events. Risk score derived by coronary computed tomography angiography (CCTA) could identify high-risk group among patients with non-obstructive coronary artery disease (CAD) but its ability is still uncertain in the presence of diabetes mellitus (DM). The purpose of this study was to investigate the prognostic value of the plaque burden shown by CCTA in diabetic patients with non-obstructive CAD.Methods and Results: 813 DM patients (age 58.9±9.9 years, 48.1% male) referred for CCTA due to suspect CAD in 2015-2017 were consecutively included. During a median follow-up of 31.77 months, 50 MACEs (6.15%) were experienced, including 2 cardiovascular deaths, 14 non-fatal myocardial infarction, 27 unstable angina requiring hospitalization and 7 strokes. 3 groups were defined based on coronary stenosis combined with Leidon score, as normal, non-obstructive Leidon<5, and non-obstructive Leidon≥5. Cox models was used to assess the prognosis of plaque burden within these groups. An incremental incidence of outcome event rates was observed. After adjustment for age, gender, and presence of high-risk plaque, the group of Leidon≥5 showed a higher risk than Leidon<5 in non-obstructive CAD (HR:1.88 95%CI:1.03-3.42, p＝0.039). Similar results were illustrated when segment involvement score was used for sensitivity analysis.Conclusion: Atherosclerotic extent was associated with the prognosis of DM patients with non-obstructive coronary disease, highlighting the importance of better risk stratification and management.

scholarly journals Assessment of the prognostic utility of the FIT treadmill score in coronary artery disease patients undergoing cardiac rehabilitation

2019 ◽  
Vol 11 (1) ◽  
pp. 8-13
Author(s):  
Lucky R. Cuenza ◽  
Emily Mae L. Yap ◽  
Edgardo Ebba
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Fitness ◽  
High Risk Group ◽  
Successful Outcome ◽  
Risk Category ◽  
All Cause Mortality ◽  
Artery Disease

Introduction: Cardiovascular fitness is an important goal in cardiac rehabilitation (CR) programs and is predictive of outcomes. We sought to determine the utility of a novel clinical treadmill score in determining prognosis of coronary artery disease (CAD) patients after CR. Methods: Demographic, clinical and exercise data of 262 patients (mean age 55.8 ± 10.1 years) who completed an outpatient CR program were analyzed. The FIT treadmill score was determined prior to program initiation and after completion. Patients were classified according to risk category using the FIT scores after CR completion and were followed up for the occurrence of 10 year all cause mortality. Results: On median follow up of 10.3 years, 52 patients died. An improvement of the FIT treadmill score by 18.2 points was associated with a 21% reduction in mortality (multivariate-adjusted Hazard Ratio 0.79, 95% CI 0.56-1.08, P≤0.05). Kaplan-Meier survival curves showed increased occurrence of mortality in the high-risk group. After adjustment for confounders a high-risk FIT score category on exit (HR: 2.7, 95% CI 1.41-5.17, P≤0.05) was predictive of increased mortality. Both an improvement in the FIT score (AUC=0.81) and the FIT score category on exit (AUC=0.92) had good discrimination in predicting mortality. Conclusion: The FIT treadmill score is predictive of all cause mortality in patients with CAD undergoing CR. An improvement in the FIT score after CR is associated with improved survival. The FIT score may be a useful prognostic marker of overall cardiovascular fitness and successful outcome for patients who participate in CR programs.

scholarly journals Use of extracorporeal membrane oxygenation as a bridge to transcatheter aortic valve replacement in a patient with aortic stenosis and severe coronary artery disease: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Majid Ahsan ◽  
Rolf Alexander Jánosi ◽  
Tienush Rassaf ◽  
Alexander Lind
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Artery Disease

Abstract Background Patients with severe aortic stenosis (AS) often present with multiple comorbidities and suffer from critical coronary artery disease (CAD). Transcatheter aortic valve replacement (TAVR) has become the therapy of choice for moderate to high-risk patients. Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) offers the possibility of temporary cardiac support to manage life-threatening critical situations. Case summary Here, we describe the management of a patient with severe AS and CAD with impaired left ventricular ejection fraction (LVEF). We used v-a-ECMO as an emergency strategy in cardiogenic shock during a high-risk coronary intervention to stabilize the patient, and as a further bridge to TAVR. Discussion Very high-risk patients with severe AS are unlikely to tolerate the added risk of surgical aortic valve replacement. Using ECMO may help them to benefit from TAVR as the only treatment option available.

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