Morphological characteristics of clinically significant coronary artery stenosis in stable angina.

Aim. To conduct the prospective study assessing the biochemical laboratory parameters in patients with stable angina and hemodynamically significant coronary artery stenosis before and 12 months after transluminal balloon-catheter angioplasty. Methods. 40 patients (males and females), mean age 57,3±9,6 years with stable angina and chronic coronary artery disease were examined. Patients were divided into 2 groups based on the absence (1st group, 14 patients) or presence (2st group, 26 patients) of hemodynamically significant coronary artery stenosis on selective coronary angiography. Patients with hemodynamically significant coronary artery stenosis underwent percutaneous transluminal coronary angioplasty (PTCA) with stenting (drug-coated stents). Blood lipid profile, inflammatory markers and endothelial dysfunction markers were measured before the surgery and 12 months after treatment. Results. In patients with hemodynamically significant coronary artery stenosis statistically significant association of hemodynamically significant coronary artery stenosis presence with atherogenic lipid fractions levels, inflammatory markers (high-sensitivity C-reactive protein, tumor necrosis factor-alpha) and an endothelial function parameter (endothelin-1) were revealed. Long-term results of PTCA with stenting included the significant decrease of atherogenic and increase of anti-atherogenic fractions in lipid profile. There also was a prolonged inflammatory response characterized by high-sensitivity C-reactive protein (hs-CRP) level elevation, and the endothelin system dysfunction retaining. Conclusion. Persistent hs-CRP level increase as well as endothelin-1 level increase suggest a high risk of late stent thrombosis, it should be taken into account while following-up patients at the late stages after PTCA.

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The performance of non-invasive tests to rule-in and rule-out significant coronary artery stenosis in patients with stable angina: a meta-analysis focused on post-test disease probability

European Heart Journal ◽

10.1093/eurheartj/ehy267 ◽

2018 ◽

Vol 39 (35) ◽

pp. 3322-3330 ◽

Cited By ~ 84

Author(s):

Juhani Knuuti ◽

Haitham Ballo ◽

Luis Eduardo Juarez-Orozco ◽

Antti Saraste ◽

Philippe Kolh ◽

...

Keyword(s):

Coronary Artery ◽

Stable Angina ◽

Coronary Artery Stenosis ◽

Meta Analysis ◽

Artery Stenosis ◽

Significant Coronary Artery Stenosis ◽

Non Invasive ◽

Post Test ◽

Rule Out

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Exercise and pharmacologic stress-induced interlead T-wave heterogeneity analysis to detect clinically significant coronary artery stenosis

International Journal of Cardiology ◽

10.1016/j.ijcard.2019.07.066 ◽

2020 ◽

Vol 298 ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Anderson C. Silva ◽

Victor Z. de Antonio ◽

Jakub Sroubek ◽

Ernest Gervino ◽

Kalon Ho ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Stenosis ◽

Pharmacologic Stress ◽

Artery Stenosis ◽

Significant Coronary Artery Stenosis ◽

T Wave ◽

Heterogeneity Analysis ◽

Clinically Significant

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399 Myocardial contrast stress echocardiography detects functionally significant coronary artery stenosis: Comparison with dobutamin stress echocardiography in a porcine model

European Journal of Echocardiography ◽

10.1016/s1525-2167(99)80234-0 ◽

1999 ◽

Vol 1 ◽

pp. S67-S67

Author(s):

I PEKRUL ◽

S HARDT ◽

A HANSEN ◽

M GEBHARDT ◽

W KUEBLER ◽

...

Keyword(s):

Coronary Artery ◽

Stress Echocardiography ◽

Porcine Model ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Coronary Artery Stenosis

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Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease

International Journal of Angiology ◽

10.1055/s-0040-1720968 ◽

2021 ◽

Author(s):

Gökhan Ceyhun ◽

Oğuzhan Birdal

Keyword(s):

Coronary Artery ◽

Shear Rate ◽

Confidence Interval ◽

Odds Ratio ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Significant Stenosis ◽

Whole Blood Viscosity ◽

Significant Coronary Artery Stenosis ◽

Coronary Syndrome

Abstract Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) (p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17–2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19–2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001). Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.

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Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10153341 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3341

Author(s):

Hyun-Jin Kim ◽

Min-Ho Lee ◽

Sang-Ho Jo ◽

Won-Woo Seo ◽

Hack-Lyoung Kim ◽

...

Keyword(s):

Coronary Artery ◽

Propensity Score ◽

Clinical Outcomes ◽

Coronary Artery Stenosis ◽

Study Data ◽

Artery Stenosis ◽

Vasospastic Angina ◽

Significant Stenosis ◽

Significant Coronary Artery Stenosis ◽

Increased Risk

Vasospastic angina (VA) is a functional disease of the coronary artery and occurs in an angiographically normal coronary artery. However, it may also occur with coronary artery stenosis. We investigated the effect of coronary artery stenosis on clinical outcomes in VA patients. Study data were obtained from a prospective multicenter registry that included patients who had symptoms of VA. Patients were classified into two groups according to presence of significant coronary artery stenosis. Among 1920 patients with VA, 189 patients were classified in the “significant stenosis” group. The one-year composite clinical events rate was significantly higher in the significant stenosis group than in the “no significant stenosis” group (5.8% vs. 1.4%, respectively; p < 0.001). Additionally, the prevalence of ACS was significantly greater in the "significant stenosis" group (4.8% vs. 0.9%, respectively; p < 0.001). After propensity score matching, the adverse effects of significant stenosis remained. In addition, significant stenosis was independently associated with a 6.67-fold increased risk of ACS in VA patients. In conclusion, significant coronary artery stenosis can increase the adverse clinical outcomes in VA patients at long-term follow-up. Clinicians should manage traditional risk factors associated with atherosclerosis and control vasospasm as well as reduce the burden of atherosclerosis.

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