scholarly journals Comparative evaluation of coronary disease burden: bicuspid valve disease is not atheroprotective

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001772
Author(s):  
Onur Baris Dolmaci ◽  
Antoine H G Driessen ◽  
Robert J M Klautz ◽  
Robert Poelmann ◽  
Jan H N Lindeman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
General Population ◽  
Disease Burden ◽  
Atherosclerotic Disease ◽  
Disease Spectrum ◽  
Age Cohort ◽  
Artery Disease ◽  
General Populations ◽  
Cad Risk

ObjectiveBicuspid aortic valve (BAV) has been associated with less atherosclerosis as compared with tricuspid aortic valve (TAV) patients. It, however, remains unclear whether this reflects the older age of TAV patients and/or accumulation of atherosclerotic risk factors or that the BAV phenotype is atheroprotective. Therefore, we compared the atherosclerotic disease burden of BAV and TAV patients, with that of the general (age-matched) population.MethodsThe prevalence of coronary artery disease (CAD) and CAD risk factors in BAV and TAV patients who underwent aortic valve surgery were compared with the Dutch general practitioners registry data. BAV (n=454) and TAV (n=1101) patients were divided into four groups: BAV with aortic valve stenosis (BAV-AoS), BAV with aortic valve regurgitation (BAV-AR), TAV with AoS (TAV-AoS) and TAV with AR (TAV-AR). The atherosclerotic disease burden of each group was compared with that of the corresponding age cohort for the general population.ResultsCAD risk factors hypertension and hypercholesterolaemia were more prevalent in the surgery groups than the age-matched general population (all p<0.001). All BAVs (BAV-AoS and BAV-AR) and TAV-AR had a similar incidence of CAD history as compared to the age-matched general populations (p=0.689, p=0.325 and p=0.617 respectively), whereas TAV-AoS had a higher incidence (21.6% versus 14.9% in the age-matched general population, p<0.001).ConclusionsStenotic TAV disease is part of the atherosclerotic disease spectrum, while regurgitant TAV and all BAVs are not. Although the prevalence of cardiovascular risk factors is higher in all BAV patients, the prevalence of CAD is similar to the general population.

scholarly journals Extent of Coronary Artery Disease in Patients With Stenotic Bicuspid Versus Tricuspid Aortic Valves

2021 ◽  
Author(s):  
Onur B. Dolmaci ◽  
Juno Legué ◽  
Jan H. N. Lindeman ◽  
Antoine H. G. Driessen ◽  
Robert J. M. Klautz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Revascularization ◽  
Scoring Method ◽  
Congenital Cardiac Malformation ◽  
Single Center Study ◽  
Artery Disease ◽  
Cad Risk

Background Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, which is often complicated by aortic valve stenosis (AoS). In tricuspid aortic valve (TAV), AoS strongly associates with coronary artery disease (CAD) with common pathophysiological factors. Yet, it remains unclear whether AoS in patients with BAV is also associated with CAD. This study investigated the association between the aortic valve morphological features and the extent of CAD. Methods and Results A single‐center study was performed, including all patients who underwent an aortic valve replacement attributable to AoS between 2006 and 2019. Coronary sclerosis was graded on preoperative coronary angiographies using the coronary artery greater even than scoring method, which divides the coronaries in 28 segments and scores nonobstructive (20%–49% sclerosis) and obstructive coronary sclerosis (>49% sclerosis) in each segment. Multivariate analyses were performed, controlling for age, sex, and CAD risk factors. A total of 1296 patients (931 TAV and 365 BAV) were included, resulting in 548 matched patients. Patients with TAV exhibited more CAD risk factors (odds ratio [OR], 2.66; 95% CI, 1.79–3.96; P <0.001). Patients with BAV had lower coronary artery greater even than 20 (1.61±2.35 versus 3.60±2.79) and coronary artery greater even than 50 (1.24±2.43 versus 3.37±3.49) scores ( P <0.001), even after correcting for CAD risk factors ( P <0.001). Patients with TAV more often needed concomitant coronary revascularization (OR, 3.50; 95% CI, 2.42–5.06; P <0.001). Conclusions Patients with BAV who are undergoing surgery for AoS carry a lower cardiovascular risk profile, correlating with less coronary sclerosis and a lower incidence of concomitant coronary revascularization compared with patients with TAV.

scholarly journals Prevalence, Epidemiological Characteristics, and Pharmacotherapy of Coronary Artery Disease among Patients with Atrial Fibrillation: Data from Jo-Fib Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 605
Author(s):  
Hanna K. Al-Makhamreh ◽  
Mohammed Q. Al-Sabbagh ◽  
Ala’ E. Shaban ◽  
Abdelrahman F. Obiedat ◽  
Ayman J. Hammoudeh
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antiplatelet Agents ◽  
Retrospective Case ◽  
Increased Risk ◽  
Artery Disease ◽  
Epidemiological Characteristics ◽  
Cad Risk

Background and Objectives: Patients with AF are at increased risk for Coronary Artery Disease (CAD) owing to their shared etiologies and risk factors. This study aimed to assess the prevalence, cardiovascular risk factors, and used medications of CAD in AF patients. Materials and Methods: This retrospective, case-control study utilized data from the Jordanian Atrial Fibrillation (Jo-Fib) registry. Investigators collected clinical features, history of co-existing comorbidities, CHA2DS2-VASc, and HAS BLED scores for all AF patients aged >18 visiting 19 hospitals and 30 outpatient cardiology clinics. A multivariable binary logistic regression was used to asses for factors associated with higher odds of having CAD. Results: Out of 2000 patients with AF, 227 (11.35%) had CAD. Compared to the rest of the sample, those with CAD had significantly higher prevalence of hypertension (82.38%; p < 0.01), hypercholesterolemia (66.52%, p < 0.01), diabetes (56.83%, p < 0.01), and smoking (18.06%, p = 0.04). Patients with AF and CAD had higher use of anticoagulants/antiplatelet agents combination (p < 0.01) compared to the rest of the sample. Females had lower CAD risk than males (OR = 0.35, 95% CI: 0.24–0.50). AF Patients with dyslipidemia (OR = 2.5, 95% CI: 1.8–3.4), smoking (OR = 1.7, 95% CI: 1.1–2.6), higher CHA2DS2-VASc score (OR = 1.5, 95% CI: 1.4–1.7), and asymptomatic AF (OR = 1.9, 95% CI: 1.3–2.6) had higher risk for CAD. Conclusions: Owing to the increased prevalence of CAD in patients with AF, better control of cardiac risk factors is recommended for this special group. Future studies should investigate such interesting relationships to stratify CAD risk in AF patients. We believe that this study adds valuable information regarding the prevalence, epidemiological characteristics, and pharmacotherapy of CAD in patients with AF.

scholarly journals Mendelian randomization analyses reveal mediating factors of the causal effect of height on coronary artery disease

2021 ◽  
Author(s):  
Daniel Hui ◽  
Christopher S. Thom ◽  
Kimberly Lorenz ◽  
Scott M. Damrauer ◽  
Themistocles L. Assimes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Lung Function ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Multivariable Analysis ◽  
Inverse Correlation ◽  
Artery Disease ◽  
Cad Risk

An inverse correlation between stature and risk of coronary artery disease (CAD) has been observed in several epidemiologic studies, and recent Mendelian randomization (MR) experiments have suggested evidence that this association may be causal. However, the extent to which the effect estimated by MR can be explained by established cardiovascular risk factors is unclear, with a recent report suggesting that lung function traits could fully explain the height-CAD effect. To clarify this relationship, we utilized the largest set of genetic instruments for human stature to date, comprising >2,000 genetic variants for height and CAD. In univariable analysis, we confirmed that a one standard deviation decrease in height (~6.5 cm) was associated with a 12.0% increase in the risk of CAD, consistent with previous reports. In multivariable analysis accounting for effects from up to 12 established risk factors, we observed a >3-fold attenuation in the causal effect of height on CAD susceptibility (3.7%, p = 2.1x10-2). We observed minimal effects of lung function traits on CAD risk in our analyses, indicating that these traits are unlikely to explain the residual association between height and CAD risk. In sum, these results suggest that height does not add meaningful clinical impact on CAD risk prediction beyond established risk factors.

Abstract 5070: Progression of Urine Albumin Excretion Despite of Optimized Therapies to Reduce Atherosclerotic Risk Factors has an Adverse Outcome in Patients with Coronary Artery Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Yoshinobu Kitta ◽  
Mitsumasa Hirano ◽  
Takamitsu Nakamura ◽  
Yasushi Kodama ◽  
Keita Sano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Adverse Outcome ◽  
Coronary Risk Factors ◽  
Urine Albumin Excretion ◽  
Albumin Excretion ◽  
Urine Albumin ◽  
Artery Disease ◽  
Cad Risk

Although microalbuminuria is considered a strong risk factor of future cardiovascular disease (CVD), it remains unclear whether changes in urine albumin excretion (UAE) in response to a reduction of coronary risk factors may provide prognostic information in patients with coronary artery disease (CAD). Thus, this study assessed the hypothesis that changes in UAE in response to optimized therapy for reduction of CAD risk may predict future CVD events in patients with CAD. This study enrolled of 213 patients with newly diagnosed CAD who had microalbuminuria (30 mg/day ≤ UAE < 300 mg/day) at entry. Patients with late-stage chronic kidney disease (GFR < 60 ml/min/1.73 m 2 ) at entry were excluded. All patients had individualized, optimized therapies including medications and recommended life style changes to reduce risk factors for CAD according to AHA guidelines. All patients had a repeated test of UAE at 6 months (2 nd test) after the 1 st UAE test. Thereafter, all patients were prospectively followed up for 3 years or until the occurrence of 1 of the following events: CVD death, nonfatal myocardial infarction, unstable angina pectoris requiring revascularization, or ischemic stroke. Progression of UAE at the 2 nd test was defined as > 50% increase from the UAE at the 1 st test. UAE at 2 nd test was progressed in 62 (29%) patients, while it was not progressed in the remaining 151 (71%) patients. UAE at entry was comparable between patients with and without progression of UAE (52 ± 6.2 vs.61 ± 4.7 mg/day, respectively, p = ns). During follow-up period, events occurred in 15 (24%) of the 62 patients with progression of UAE and in 16 (10%) of the 151 patients without progression of UAE (p < 0.01 by chi-square test). Using a multivariate Cox hazards analysis, progression of UAE was a predictor of future CVD events that was independent of UAE at 1 st test, use of medications, age, and traditional CAD risk factors (HR 2.5, 95%CI 1.2 – 4.8, p = 0.01). Progression of urine albumin excretion despite individualized and optimized therapies to reduce CAD risk factors represents an adverse outcome in CAD patients. Periodic measurement of urine albumin excretion may be useful for risk stratification in CAD.

A new model to implement a structured enhanced education and follow-up program in primary prevention for coronary artery disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O Soran ◽  
P.G Karadeniz ◽  
I.G Aktas ◽  
C.C Genc ◽  
M.H Ilkaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medical Students ◽  
Primary Prevention ◽  
Behavioral Outcomes ◽  
Prevention Measures ◽  
Artery Disease ◽  
Cad Risk

Abstract Background Primary prevention programs for coronary artery disease (CAD) may be effective in improving health-related behavioral outcomes. However, the implementation and especially the maintanance of these programs can be very challenging mainly due to staffing cost. Thus, the present study was designed to assess the feasibility and effectiveness of a longitudinally structured, enhanced education and follow-up program for CAD prevention in an area where the diverse population and economy are major problems. Methods SANKO Coronary Artery Disesae Prevention Project (SCAD-PPI) was designed as a longitudinal study and utilized medical school students to conduct the entire project under the supervision of professors. It started in 2014 and had 2 different education and training phases. In the first phase; every school year, 2nd year Medical students underwent a one-year, specially designed training program on primary prevention for CAD. In the second phase, which took place in the 2nd year of the study, a series of conferences on primary prevention for CAD were organized by the University and local municipalities for underserved populations. Participants were prospectively assigned to an intervention where pre and post conference knowledge were collected and assessed. Every intervention was conducted by specially trained 3rd year Medical students and an education booklet which was specifically designed for this study was given to the participants. Every other month thereafter, for 6 months, each participant was followed by phone. At the 6 month follow -up, data was collected to assess the impact of enhanced education and follow-up program on behavioral outcomes. Results A total of 135 participant were enrolled; 79% were women, mean age was 41±13 years, only 29% had a graduate school degree; 56% were not working. Mean BMI was 28.3±5.1kg/m2. Overall knowledge on CAD risk factors, primary prevention measures, diet and daily exercise habits were very poor. After the enhanced education and follow-up program there was a significant improvement on the knowledge of CAD risk factors and primary prevention measures (p&lt;0.001). More importantly, the follow-up program led participants to implement those positive changes into their lives and maintain a healthy life style. A separate cost analysis showed significant savings. Conclusion This is the first study which showed that a longitudinally structured training program of medical students could be utilized to implement an enhanced education and follow–up program for primary prevention of CAD in an economically challenged, underserved population with successful outcomes. This model program is not only cost-effective and beneficial for public interest but also enhances active interaction of medical students with patients at a very early stage of their career. Funding Acknowledgement Type of funding source: None

scholarly journals Relationship Between Cardiovascular Risk Factors and Atherosclerotic Disease Burden Measured by Intravascular Ultrasound

2006 ◽  
Vol 47 (10) ◽  
pp. 1967-1975 ◽  
Author(s):  
Stephen J. Nicholls ◽  
E. Murat Tuzcu ◽  
Tim Crowe ◽  
Ilke Sipahi ◽  
Paul Schoenhagen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Intravascular Ultrasound ◽  
Disease Burden ◽  
Atherosclerotic Disease

Breast artery calcium noted on screening mammography is predictive of high risk coronary calcium in asymptomatic women: a case control study

VASA ◽  
2013 ◽  
Vol 42 (6) ◽  
pp. 429-433 ◽  
Author(s):  
Martin E. Matsumura ◽  
Crystal Maksimik ◽  
Matthew W. Martinez ◽  
Michael Weiss ◽  
James Newcomb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Screening Mammography ◽  
Artery Disease ◽  
The Relationship ◽  
Asymptomatic Women ◽  
Cad Risk

Background: The relationship between breast artery calcification (BAC) noted on mammography and both coronary artery disease and cardiovascular risk remains controversial. Few studies have examined the clinical significance of BAC in asymptomatic women. In the present study we evaluated the relationship between BAC and coronary artery calcium (CAC) as identified by multi-slice CT scanning (MSCT). Patients and methods: Consecutive women (n = 98) with BAC noted on routine mammography but without known coronary artery disease (CAD) were assessed for CAD risk factors and had assessment of coronary calcium by MSCT. A control cohort of consecutive women who were BAC(-) (n = 104) underwent an identical assessment. Results: Women who were BAC(+) were older than those who were BAC(-); otherwise, there were no differences between the 2 groups with regard to traditional cardiac risk factors. Significantly more BAC(+) vs. BAC(-) women were found to have “high risk” CAC scores, defined as CAC > 400 (11.2 % vs. 1.0 %, p = 0.006). However, the rates of CAC scores of 0 were not different between the two groups (50.0 % vs. 54.8 % for BAC(+) and BAC(-) , respectively, p = 0.586). When examined in a multivariate model including the traditional risk factors of diabetes, increasing age, smoking, hyperlipidemia, and family history of CAD, the presence of BAC remained significantly associated with CAC > 400 (OR = 22.6, 95 % CI = 2.1 - 237.1). Conclusions: The presence of breast artery calcium on screening mammography was a strong independent predictor (odds ratio > 22) of high risk coronary artery calcium scores (defined as CAC > 400). The presence of BAC in those with significant CAD risk factors may warrant further evaluation.

scholarly journals Genetic risk for major depressive disorder and loneliness in gender-specific associations with coronary artery disease

2019 ◽  
Author(s):  
Jessica Dennis ◽  
Julia Sealock ◽  
Rebecca T Levinson ◽  
Eric Farber-Eger ◽  
Jacob Franco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Association Study ◽  
Genetic Risk ◽  
Genetic Risk Factors ◽  
Major Depressive ◽  
Polygenic Score ◽  
Polygenic Scores ◽  
Artery Disease ◽  
Cad Risk

AbstractImportanceEpidemiological evidence indicates that major depressive disorder (MDD) and loneliness both reduce life expectancies, but mechanisms underlying the excess morbidity are unclear. Electronic health records (EHRs) linked to genetic data offer new opportunities to address this knowledge gap.ObjectiveTo determine the medical morbidity pattern associated with genetic risk factors for MDD and loneliness, two common psychological traits with adverse health outcomes.DesignPhenome-wide association study using EHRs spanning 1990 to 2017 from the Vanderbilt University Medical Center biobank, BioVU. Top associations with coronary artery disease (CAD) were replicated in the Atherosclerosis Risk in Communities (ARIC) cohort.SettingHospital-based EHR study, with replication in a population-based cohort study.Participants18,385 genotyped adult patients in BioVU. Replication in ARIC included 7,197 genotyped participants. All participants were of European ancestry.ExposuresPolygenic scores for MDD and loneliness were developed for each individual using previously published meta-GWAS summary statistics.Main Outcomes and MeasuresThe phenome-wide association study included 882 clinical diagnoses ascertained via billing codes in the EHR. ARIC included 1598 incident CAD cases.ResultsBioVU patients had a median EHR length of 9.91 years. In the phenome-wide association study, polygenic scores for MDD and loneliness were significantly associated with psychiatric and cardiac phenotypes. Targeted analyses of CAD in 3,893 cases and 4,197 controls in BioVU found odds ratios of 1.11 (95% CI, 1.04-1.18; P=8.43×10−4) and 1.13 (95% CI, 1.07-1.20; P=4.51×10−6) per 1-SD increase in the polygenic scores for MDD and loneliness, respectively. Comparable hazard ratios in ARIC were 1.07 (95% CI, 0.99-1.14; P=0.07) and 1.07 (1.01-1.15; P=0.03). Across both studies, the increased risk persisted in women after adjusting for multiple conventional risk factors, a polygenic score for CAD, and psychiatric symptoms (available in BioVU). Controlling for genetic risk factors shared between MDD and loneliness, the polygenic score for loneliness conditioned on MDD remained associated with CAD risk, but the polygenic score for MDD conditioned on loneliness did not.Conclusions and RelevanceGenetic risk factors for MDD and loneliness act pleiotropically to increase CAD risk in women. Continued research into the biological and clinical connections between the heart and mind is warranted.

scholarly journals The Association Between Coronary 18F-Sodium Fluoride Uptake With Pro-Atherosclerosis Factors in Patients With Multivessel Coronary Artery Disease: A Mono-Centric Pilot Study

2021 ◽  
Author(s):  
Wanwan Wen ◽  
Mingxin Gao ◽  
Mingkai Yun ◽  
Jingjing Meng ◽  
Ziwei Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sodium Fluoride ◽  
Troponin I ◽  
Cardiac Computed Tomography ◽  
Serum Biomarkers ◽  
Multivessel Coronary Artery Disease ◽  
Artery Disease ◽  
Cad Risk

Abstract Purpose: 18F-Sodium fluoride (18F-NaF) positron emission tomography (PET) is a novel approach to detect and quantify microcalcification in atherosclerosis. Peri-coronary adipose tissue (PCAT) is associated with vascular inflammation and high-risk atherosclerotic plaque. We aimed to assess the association between coronary 18F-NaF uptake with pro-atherosclerosis factors in patients with multivessel coronary artery disease (CAD) and to explore the systematic vascular osteogenesis in the coronary artery and aorta in these patients. Methods: Patients with multivessel CAD prospectively underwent cardiac computed tomography (CT) and 18F-NaF PET/CT. PCAT density was measured in the coronary artery and the average PCAT value was calculated from the three coronary arteries in each patient. 18F-NaF tissue-to-blood ratios (TBR) in the coronary artery (TBRCoronary) and aorta (TBRAorta) were calculated. Correlations between coronary 18F-NaF uptake with PCAT density, coronary artery calcium (CAC) burden, CAD risk factors, serum biomarkers, and aortic 18F-NaF uptake were evaluated, respectively. Patients were categorized by a median of TBRCoronary 2.49. Results: 100 multivessel CAD patients (64.00 [57.00 - 67.75] years; 76 men) were prospectively recruited. 6010 active aortic segments (TBR ≥ 1.6) were identified. TBRCoronary was significantly associated with the PCAT density (r = 0.56, p < 0.001) and CAC score (r = 0.45, p < 0.001). TBRCoronary was also significantly associated with the TBRAorta (r = 0.42, p < 0.001). In addition, patients with higher TBRCoronary showed elevated PCAT density (-75.89[-79.07 - -70.06] vs -84.54[-90.21 - -79.46]; p < 0.001) and CAC score (1495.20[619.80 - 2225.40] vs 273.75[116.73 - 1198.18]; p < 0.001) in comparsion patients with lower TBRCoronary. TBRCoronary was correlated with the age (r = 0.24, p = 0.019) and the serum troponin I levels (r = 0.22, p = 0.039). There were no significant correlations between TBRCoronary with other conventional CAD risk factors and other serum biomarkers.Conclusion: Coronary 18F-NaF uptake was correlated with the PCAT density. A significant correlation between 18F-NaF uptake in the coronary artery and aorta might indicate a systematic vascular osteogenesis in patients with multivessel CAD.

Sign in / Sign up

Export Citation Format

Share Document