Comprehensive Evaluation of Coronary Artery Disease and Aortic Atherosclerosis in Acute Ischemic Stroke Patients: Usefulness Based on Framingham Risk Score and Stroke Subtype

2011 ◽  
Vol 31 (6) ◽  
pp. 592-600 ◽  
Author(s):  
Hyun-Ji Cho ◽  
Joon-Hwa Lee ◽  
Young-Jin Kim ◽  
Yeonsil Moon ◽  
Sung-Min Ko ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Framingham Risk Score ◽  
Comprehensive Evaluation ◽  
Aortic Atherosclerosis ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Framingham Risk ◽  
Artery Disease

Framingham risk score and severity of coronary artery disease

Herz ◽  
2013 ◽  
Vol 39 (5) ◽  
pp. 638-643 ◽  
Author(s):  
M.R. Sayin ◽  
M.A. Cetiner ◽  
T. Karabag ◽  
I. Akpinar ◽  
E. Sayin ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Framingham Risk ◽  
Artery Disease

scholarly journals Coronary Artery Disease in Patients Presenting With Acute Ischemic Stroke or Transient Ischemic Attack and Elevated Troponin Levels

2022 ◽  
Vol 12 ◽  
Author(s):  
Mathieu Kruska ◽  
Anna Kolb ◽  
Christian Fastner ◽  
Iris Mildenberger ◽  
Svetlana Hetjens ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Large Artery ◽  
Elevated Troponin ◽  
Stroke Patients ◽  
Artery Disease ◽  
Ischemic Attack

Background: There is little information concerning the invasive coronary angiography (ICA) findings of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) with elevated troponin levels and suspected myocardial infarction (MI). This study analyzed patient characteristics associated with ICA outcomes.Methods: A total of 8,322 patients with AIS or TIA, treated between March 2010 and May 2020, were retrospectively screened for elevated serum troponin I at hospital admission. Patients in whom ICA was performed, due to suspected type 1 MI based on symptoms, echocardiography, and ECG, were categorized according to ICA results (non-obstructive coronary artery disease (CAD): ≥1 stenosis ≥50% but no stenosis ≥80%; obstructive CAD: any stenosis ≥80% or hemodynamically relevant stenosis assessed by FFR/iwFR).Results: Elevated troponin levels were detected in 2,205 (22.5%) patients, of whom 123 (5.6%) underwent ICA (mean age 71 ± 12 years; 67% male). CAD was present in 98 (80%) patients, of whom 51 (41%) were diagnosed with obstructive CAD. Thus, ICA findings of obstructive CAD accounted for 2.3% of patients with troponin elevation and 0.6% of all stroke patients. The clinical hallmarks of myocardial ischemia, including angina pectoris (31 vs. 15%, p < 0.05) and regional wall motion abnormalities (49 vs. 32%, p = 0.07), and increased cardiovascular risk indicated obstructive CAD. While there was no association between lesion site or stroke severity and ICA findings, causal large-artery atherosclerosis was significantly more common in patients with obstructive coronary disease (p < 0.05).Conclusion: The rate of obstructive CAD in patients with stroke or TIA and elevated troponin levels with suspected concomitant type I MI is low. The cumulation of several cardiovascular risk factors and clinical signs of MI were predictive. AIS patients with large-artery atherosclerosis and elevated troponin may represent an especially vulnerable subgroup of stroke patients with risk for obstructive CAD.

Mortality in Individuals Without Known Coronary Artery Disease but With Discordance Between the Framingham Risk Score and Coronary Artery Calcium

2011 ◽  
Vol 107 (6) ◽  
pp. 799-804 ◽  
Author(s):  
Naser Ahmadi ◽  
Fereshteh Hajsadeghi ◽  
Roger S. Blumenthal ◽  
Matthew J. Budoff ◽  
Gregg W. Stone ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Score ◽  
Coronary Artery Calcium ◽  
Framingham Risk Score ◽  
Framingham Risk ◽  
Artery Disease

scholarly journals Comparison of carotid artery ultrasound and Framingham risk score for discriminating coronary artery disease in patients with psoriatic arthritis

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001364 ◽  
Author(s):  
Isaac T Cheng ◽  
Ka Tak Wong ◽  
Edmund K Li ◽  
Priscilla C H Wong ◽  
Billy T Lai ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Psoriatic Arthritis ◽  
Coronary Artery ◽  
Risk Score ◽  
Carotid Plaque ◽  
Framingham Risk Score ◽  
Multivariate Logistic Regression Analysis ◽  
Intima Media Thickness ◽  
Framingham Risk ◽  
Artery Disease

ObjectivesThis study aimed to assess the performance of carotid ultrasound (US) parameters alone or in combination with Framingham Risk Score (FRS) in discriminating patients with psoriatic arthritis (PsA) with and without coronary artery disease (CAD).MethodsNinety-one patients with PsA (56 males; age: 50±11 years, disease duration: 9.4±9.2 years) without overt cardiovascular (CV) diseases were recruited. Carotid intima-media thickness (cIMT), the presence of plaque and total plaque area (TPA) was determined by high-resolution US. CAD was defined as the presence of any coronary plaque on coronary CT angiography (CCTA). Obstructive-CAD (O-CAD) was defined as >50% stenosis of the lumen.ResultsThirty-five (38%) patients had carotid plaque. Fifty-four (59%) patients had CAD (CAD+) and 9 (10%) patients had O-CAD (O-CAD+). No significant associations between the presence of carotid plaque and CAD were found. However, cIMT and TPA were higher in both the CAD+ and O-CAD+ group compared with the CAD− or O-CAD− groups, respectively. Multivariate logistic regression analysis revealed that mean cIMT was an independent explanatory variable associated with CAD and O-CAD, while maximum cIMT and TPA were independent explanatory variables associated with O-CAD after adjusting for covariates. The optimal cut-offs for detecting the presence of CAD were FRS >5% and mean cIMT at 0.62 mm (AUC: 0.71; sensitivity: 67%; specificity: 76%), while the optimal cut-offs for detecting the presence of O-CAD were FRS >10% in combination with mean cIMT at 0.73 mm (AUC: 0.71; sensitivity: 56%; specificity: 85%).ConclusionUS parameters including cIMT and TPA may be considered in addition to FRS for CV risk stratification in patients with PsA.

Abstract P180: Comparison of the Framingham Risk Score With Coronary Artery Disease Burden in Hispanics

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
George R Marzouka ◽  
Leonardo Tamariz ◽  
Ana Palacio ◽  
Hermes Florez ◽  
David Seo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Self Report ◽  
P Value ◽  
Cross Sectional ◽  
Framingham Risk ◽  
Artery Disease

Background: The Framingham risk score (FRS) predicts the 10-year risk of having a myocardial infarction (MI). However, the accuracy of the FRS in hispanics has not been throughly evaluated. We compared coronary artery disease (CAD) severity with FRS by ethnic groups in patients undergoing cardiac catheterization. Methods: We performed a cross-sectional analysis of 178 consecutive patients who were referred for elective coronary angiography at Jackson Memorial Hospital in Miami. We measured the components of the FRS and evaluated ethnicity by self-report. We evaluated CAD severity based on the coronary angiography results. We defined severe CAD if the patients had >= 70% luminal obstruction in a vessel or >=50% in the left main coronary artery. We also evalauted severity as a continuos score of the number of vessels with narrowings>=50%. We calculated the median and interquartile range (IQR) of FRS and correlated with the CAD severity and the p-value for trend as well as analysis of variance to determine if FRS differed by ethnicity adjusted for confounders. Results: We identified 110 patients who identified as Hispanic and 68 patients identified as non-hispanics. At baseline, Hispanics had a mean FRS of 10.0±3.8 and non-Hispanics had a mean FRS of 10.3±5.9 (p=0.70). In Hispanics the median FRS for patients with >= 70% stenosis was 10% (IQR 8.5-13) compared to <70% stenosis 9 % (IQR 5-13). In non-Hispanics with >= 70% stenosis the median FRS was 12.5% (IQR 10-16) compared to those with <70% stenosis 8 % (IQR 4-11). The same differences were seen when using >=50% stenosis (table). Conclusions: The FRS does not correlate with coronary artery disease severity in Hispanics but does correlate with CAD severity in non-Hispanics. Median and IQR of FRS by degree of stenosis and ethnicity Severity of stenosis * Hispanics Non-Hispanics >=70% 10 (8.5-13) 12.5 (10-16) >=60% 9 (5-13) 8 (4-11) >=50% 10 (9-13) 12 (9-15) <50% 9 (6-13) 8 (5-14) * p<0.01 for comparisons between severe CAD and non-severe CAD by ethnicity

Abstract P121: Multidimensional Allostatic Load Score Directly Associates With Coronary Artery Disease Burden in Psoriasis

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Sundus S Lateef ◽  
Mariyam Batool ◽  
Nina Prakash ◽  
Domingo E Uceda ◽  
Amit K Dey ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Stress ◽  
Allostatic Load ◽  
Disease Burden ◽  
Framingham Risk Score ◽  
Framingham Risk ◽  
Traditional Risk Factors ◽  
Artery Disease ◽  
Allostatic Load Score

Introduction: Psoriasis is a chronic inflammatory skin disease associated with accelerated development of asymptomatic coronary artery disease (CAD) by coronary computed tomography angiography (CCTA). Allostatic load score is a multidimensional measure related to chronic stress which incorporates cardiovascular, metabolic and inflammatory indices. To better understand the physiologic impact of chronic stress in psoriasis, we studied the association between allostatic load score and subclinical CAD. Hypothesis: We hypothesized that allostatic load score would associate with coronary artery disease burden beyond traditional risk factors in an ongoing psoriasis cohort study. Methods: Consecutive psoriasis patients (n=275) underwent CCTA for assessment of coronary artery disease burden (QAngio, Medis). Allostatic load score was determined using established methods (see Table 1 footnote). The association between coronary artery disease burden and allostatic load score was characterized by multivariable regression (STATA 12). Results: Psoriasis patients were middle-aged, predominantly male and white, with low cardiovascular risk by Framingham risk score and moderate-severe psoriasis severity (Table 1) . Allostatic load score associated with total coronary burden (β=0.39; p<0.001) and non-calcified coronary burden (β=0.40; p<0.001) in unadjusted analyses. In multivariable models, allostatic load score was still associated with total coronary burden (β=0.30; p<0.001) and non-calcified coronary burden (β=0.31; p<0.001) independent of race, Framingham risk score and waist-hip ratio. Conclusions: Allostatic load score positively associated with both total and non-calcified coronary artery burden beyond traditional risk factors, suggesting multisystem physiologic dysregulation related to chronic stress may drive subclinical atherosclerosis in psoriasis. Efforts to understand stress effects and its reduction are critical in this population at high-risk for cardiovascular disease.

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