151 Prevalence of Coronary Artery Disease and Major Adverse Cardiovascular Events in Patients with A Zero Calcium Score: A Prospective Cardiac CT Study

Abstract Background: The clinical predictors of inflammation in atherosclerosis remain controversial. The objective of this study was to compare the associations of metabolic factors vs. infectious burden (IB) with inflammation, the severity of coronary atherosclerosis, and major adverse cardiovascular events (MACEs). Design, Setting, and Patients: Coronary angiography with Gensini score was applied to assess the severity of coronary atherosclerosis in 568 patients with coronary artery disease. Metabolic syndrome (MS) score (0–5) was defined according to the modified criteria of National Cholesterol Education Program Adult Treatment Panel III. IB score (0–7) was defined as the number of seropositivities to several agents. Results: IB score was not associated with plasma C-reactive protein (CRP) concentration, Gensini score, or the risk of MACE. In contrast, MS score significantly correlated with both plasma CRP concentration and Gensini score (P < 0.001 for both). MS score and plasma CRP concentration were also significantly associated with the risk of MACE (hazard ratios 1.51, P < 0.001; and 1.90, P = 0.002, respectively). Conclusion: Compared with IB, metabolic abnormalities have a more prominent association with the degree of inflammation, the severity of coronary atherosclerosis, and the risk of MACE in patients with coronary artery disease.

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Distinct Characteristics of VEGF‐D and VEGF‐C to Predict Mortality in Patients With Suspected or Known Coronary Artery Disease

Journal of the American Heart Association ◽

10.1161/jaha.119.015761 ◽

2020 ◽

Vol 9 (9) ◽

Cited By ~ 2

Author(s):

Hiromichi Wada ◽

Masahiro Suzuki ◽

Morihiro Matsuda ◽

Yoichi Ajiro ◽

Tsuyoshi Shinozaki ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Cardiovascular Events ◽

Troponin I ◽

Cardiovascular Death ◽

Major Adverse Cardiovascular Events ◽

All Cause Mortality ◽

Artery Disease ◽

Cardiovascular Biomarkers

Background VEGF‐D (vascular endothelial growth factor D) and VEGF‐C are secreted glycoproteins that can induce lymphangiogenesis and angiogenesis. They exhibit structural homology but have differential receptor binding and regulatory mechanisms. We recently demonstrated that the serum VEGF‐C level is inversely and independently associated with all‐cause mortality in patients with suspected or known coronary artery disease. We investigated whether VEGF‐D had distinct relationships with mortality and cardiovascular events in those patients. Methods and Results We performed a multicenter, prospective cohort study of 2418 patients with suspected or known coronary artery disease undergoing elective coronary angiography. The serum level of VEGF‐D was measured. The primary outcome was all‐cause death. The secondary outcomes were cardiovascular death and major adverse cardiovascular events defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. During the 3‐year follow‐up, 254 patients died from any cause, 88 died from cardiovascular disease, and 165 developed major adverse cardiovascular events. After adjustment for possible clinical confounders, cardiovascular biomarkers (N‐terminal pro‐B‐type natriuretic peptide, cardiac troponin‐I, and high‐sensitivity C‐reactive protein), and VEGF‐C, the VEGF‐D level was significantly associated with all‐cause death and cardiovascular death but not with major adverse cardiovascular events.. Moreover, the addition of VEGF‐D, either alone or in combination with VEGF‐C, to the model with possible clinical confounders and cardiovascular biomarkers significantly improved the prediction of all‐cause death but not that of cardiovascular death or major adverse cardiovascular events. Consistent results were observed within patients over 75 years old. Conclusions In patients with suspected or known coronary artery disease undergoing elective coronary angiography, an elevated VEGF‐D value seems to independently predict all‐cause mortality.

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Abstract P213: Outcomes of a Postdischarge Coronary Artery Disease Management Program

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_2.ap213 ◽

2011 ◽

Vol 4 (suppl_2) ◽

Author(s):

Abiola Dele-Michael ◽

Brandon Henckel ◽

Sangeetha M Krishnan ◽

Susan Housholder-Hughes ◽

Eva Kline-Rogers ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Disease Management ◽

Cardiovascular Events ◽

Conventional Care ◽

Cost Of Care ◽

Major Adverse Cardiovascular Events ◽

Care Group ◽

Ed Visits ◽

Artery Disease

Background: The coronary artery disease management (DM) program was designed to improve patient care with the same or lower costs in patients discharged from a university hospital. We tested whether the DM program reduced emergency department (ED) visits, re-hospitalizations, and adverse cardiovascular outcomes. Methods: In this prospective study, we analyzed 141 subjects from the Global Registry of Acute Coronary Events (GRACE). There were 47 subjects that participated in the DM program and 94 subjects participated in GRACE alone with conventional care (CC). DM program subjects received a comprehensive risk assessment, education regarding medication, recognition of significant symptoms, emergency response, review of basic nutrition and exercise and psychosocial support. The primary end point was ED visits at 6 months. Secondary end points were re-hospitalization and incidence of major adverse cardiovascular events (MACE). Disease management subjects were matched 1:2 to controls based on age, gender and GRACE 6 month mortality risk score. Results: At 6 months, a significantly lower number of ED visits were associated with patients in the DM group compared to CC (17 vs 59 visits, p=0.04). There were a total of 6 adverse cardiovascular events (myocardial infarction, n = 4 and death, n = 2), all of which occurred in the conventional care group. There were no significant differences in hospitalization rates resulting from ED visits among the CC and DM groups [76% (45/59) vs 71% (12/17), p=0.75]. Conclusion: The DM program resulted in a significantly reduced number of ED visits, which would translate into lower cost of care. However, the program did not demonstrate a significant effect on the rate of re-hospitalization and MACE.

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