Abstract 17128: Pathophysiology of Coronary Artery Disease in Hiv-infected Patients: Dissociation Between Anatomy and Function

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Massimo Mancone ◽  
Alessandra Cinque ◽  
Noemi Bruno ◽  
Alessandra Armato ◽  
Nicolò Salvi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Score ◽  
Coronary Atherosclerosis ◽  
Framingham Risk Score ◽  
Microvascular Function ◽  
Hiv Patients ◽  
Coronary Syndrome ◽  
Framingham Risk ◽  
Artery Disease

Introduction: Numerous reports suggest, among HIV+ patients (pts), an increased rate of acute coronary syndrome and cardiac death. Several data suggest that endothelial dysfunction is a major mechanisms in the development of coronary atherosclerosis in non-HIV infected patients. Hypothesis: The aim of our study is to assess coronary microvascular function using Doppler-flow wire in HIV+ patients in therapy with HAART. Methods: Thirteen HIV-infected patients were enrolled from the Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences of the “Sapienza” University of Rome (Italy). The main inclusion criteria were: Framingham risk score <10%, absence of metabolic syndrome (according to the definition of Adult Treatment Panel III e ATPIII12), negative echocardiographic and ECG stress-test and negative for anti-HCV antibodies. Diagnostic coronary angiography was performed via percutaneous radial approach. Microvascular function was assessed by measuring coronary flow velocity reserve (CFR). Intracoronary functional tests were performed to evaluate both endothelium-dependent microvascular function [via intracoronary (IC) infusion of acetylcholine (2.5[[Unable to Display Character: &#8211;]]10 μg)] and non-endothelium-dependent microvascular function [via IC infusion of adenosine (5 μg) ]. Results: All the patients presented a Framingham risk score <10%. The medium age was 53.3±4.1 years. The mean duration of highly active antiretroviral therapy was 12.9±2.4 years. Thirteen patients presented 23 coronary atherosclerotic plaques; while endothelium and non endothelium-dependent microvascular function was quite normal in our population (CFR after adenosine 2.37±0.4; CFR after Achetylcholine 2.43±0.4). Conclusion: Microvascular function is not compromised in HIV + pts who presented coronary atherosclerotic plaque. Microvascular dysfunction, involved in pathophysiology of coronary artery disease in general population, seems to be not implicated in coronary atherosclerosis in HIV + pts. These data suggest a peculiar pathophysiological mechanisms for HIV related atherosclerosis.

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

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

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