Abstract 14953: Temporal Trends in Non-invasive Diagnostic Tests for Ischemic Heart Disease Among Us Adults Age 64 Years or Younger: Results From the Marketscan Survey, 2010-2018

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Soyoun Park ◽  
Yuling Hong ◽  
Cathleen Gillespie ◽  
Robert Merritt ◽  
Laurence Sperling
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Ischemic Heart Disease ◽  
Single Photon ◽  
Adult Population ◽  
Photon Emission ◽  
Temporal Trends ◽  
Ischemic Heart ◽  
Non Invasive ◽  
Exercise Ecg

Introduction: Heart disease is the leading cause of death in the U.S. Ischemic heart disease (IHD) accounts for two thirds of heart disease deaths. Non-invasive cardiovascular tests (NITs) are often the first step to establish an IHD diagnosis. Methods: We analyzed 2010-2018 IBM® MarketScan® Commercial Databases. NITs including exercise ECG, stress echocardiography, CT coronary artery calcification score (CT-CAC), single-photon emission computerized tomography (SPECT), cardiac CT angiography (CTA), nuclear positron emission tomography/myocardial perfusion imaging (PET/MPI), stress MRI, were identified using current procedural terminology (CPT) codes. IHD using ICD 9/10 codes (410-414, 429.2/I20-I25) and chest pain (786.59/R07.89) or unspecified chest pain (786.50/R07.9) were identified. The 2000 Census population was used to calculate the age standardized prevalence. Results: The data included 20,726,587 individuals (48.1% men, mean age (standard deviation) of 49.1 (13.5) years), among which 67,339 had a diagnosis of IHD or chest pain in 2018. The age standardized prevalence of the overall population that had at least one of the 7 tests is 1.60% in 2018, down from 2.47% in 2010. The responding prevalence for those with IHD or chest pain was 54.3% in 2018 and 61.6% in 2010. Exercise ECG was the most utilized test for the overall population: 0.94% in 2018 down from 1.31% in 2010; SPECT was second most often used with 0.75% in 2018 and 1.24% in 2010. However, SPECT was the most often utilized test among those with CHD or chest pain: 38.2% in 2018, down from 45.0% in 2010, and exercise ECG second most often with 32.6% in 2018 and 34.9% in 2010. An increase in use of CT-CAC, PET/MPI, and CTA tests was observed since 2010, but the prevalence of all were low in 2018. 0.02%. 0.01%, and 0.04% for the overall population and 0.20%, 0.95% and 3.20% for those with IHD or chest pain, respectively. Conclusions: Almost 2% of the general younger US adult population and over half of those with IHD or chest pain had undergone at least one of 7 NITs in 2018. While the utilization of overall NITs for both the general population and those with IHD or chest pain has declined since 2010, it has increased for CT-CAC, PET/MPI, and CTA but still less than 1% for CT-CAC and PET/MPI..

scholarly journals Myocardial perfusion single-photon emission computer tomography and coronary angiography results in patients with different pretest probability of ischemic heart disease

2020 ◽  
Vol 92 (4) ◽  
pp. 30-36
Author(s):  
A. A. Ansheles ◽  
I. V. Sergienko ◽  
E. I. Denisenko-Kankiya ◽  
V. B. Sergienko
Keyword(s):  
Heart Disease ◽  
Coronary Angiography ◽  
Ischemic Heart Disease ◽  
Single Photon ◽  
Photon Emission ◽  
Pretest Probability ◽  
Russian Population ◽  
Ischemic Heart ◽  
Single Photon Emission ◽  
Obstructive Lesion

Aim. To study the relationship between pretest probability (PTP) of ischemic heart disease (IHD), calculated according to the recommendations of the European Society of Cardiology (ESC) of 2013 and 2019, with the perfusion of the left ventricle of the myocardium according to the single-photon emission tomography (SPECT) and the results of the invasive coronary angiography (CAG). Material and methods. The study included 220 patients with a preliminary diagnosis of ischemic heart disease and planned invasive CAG. All patients underwent rest-stress perfusion myocardial SPECT within 1 month prior to or after CAG, standard quantitative parameters of left ventricular perfusion were assessed. Retrospectively clinical data was analyzed and PTP of IHD was assessed according to ESC recommendations for 2013 and 2019. Results. Invasive CAG revealed obstructive lesion of one or more coromary arteries in 204 of the 220 patients (92.7%). In a retrospective analysis, taking into account gender, age and nature of the complaints, as recommended by ESC in 2013, PTP was rated as low (15%) in 13 patients (5.9%), as intermediate (1585%) in 207 patients (94.1%). Following the comprehensive survey (SPECT and CAG) 8 patients with low PTP (61.5%) underwent coronary revascularization. Among patients with intermediate PTP significant transient ischemia according to SPECT was detected in 31 (15.0%), initial at 107 (51.7%). According CAG among patients with intermediate PTP obstructive lesion was found in 192 (92.7%), 113 patients (58.8%) underwent revascularization. According to ESC recommendations of 2019, PTP was rated as low (15%) in 117 patients (53.2%), including 514% in 98 (44.5%). According to a survey (SPECT and CAG) 68 of them (58.1%) underwent revascularization. Conclusion. PTP measurements proposed by ESC can not be applied to patients of the Russian population with suspected ischemic heart disease without significant corrections. 2013 ESC recommendations with higher PTP values for all categories of patients reflect Russian population better, while 2019 recommendations mistakenly attribute patients to low PTP in at least 58% of cases. These results are preliminary and will be expanded in subsequent studies with more detailed analysis of PTP in included patients with suspected IHD.

scholarly journals Selection of non-invasive load procedure in diagnosis of ischemic heart disease (review)

2018 ◽  
pp. 62-70 ◽  
Author(s):  
V. P. Lupanov
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Clinical Examination ◽  
Ischemic Heart ◽  
Non Invasive ◽  
Careful Clinical Examination ◽  
Very High ◽  
Selection Of ◽  
High Pretest Probability

The diagnosis of stable ischemic heart disease begins with a careful clinical examination of the patient and non-invasive testing to identify the disease. Patients with very low and very high pretest probability should not undergo various non-invasive tests. Various non-invasive tests are available to assess the presence of coronary heart disease in patients with an intermediate probability of ischemic heart disease (15–65%). The combination of anatomical with functional non-invasive tests helps improve diagnostic capabili of the disease.

A study on the clinical profile and risk factors of ischemic heart disease in women

2021 ◽  
Vol 19 (3) ◽  
pp. 130-132
Author(s):  
Sarath Kumar Reddy B ◽  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Chest Pain ◽  
Ischemic Heart Disease ◽  
Stable Angina ◽  
Heart Diseases ◽  
Chronic Stable Angina ◽  
Clinical Profile ◽  
Ischemic Heart ◽  
Ischemic Heart Diseases

Background: Ischemic heart disease (IHD) is one of the principle causes of morbidity and of mortality in women1. Ischemic heart disease may manifest clinically as either chronic stable angina or acute coronary syndrome2 (ACS). Traditional risk factors (hypertension, diabetes, etc.) contribute to the development of IHD in both women and men. Some risk factors are unique to women (e.g., pregnancy-related complications, menopause), which cause increased mortality in women Aim: To study the risk factors and clinical profile of ischemic heart disease in women. Materials And Methods: Hospital-based prospective, cross-sectional study done in 50 patients with ischemic heart disease. Patients with a history of Chest pain suggestive of ischemic heart diseases and Electrocardiogram and cardiac biomarkers suggestive of ischemic heart disease were included in the study. Results: Maximum incidence of ischemic heart diseases is seen in the 6th decade. Mean age is 58.92 + 2.8years. 64%of the patients presented with chest pain, and 36% patients presented without any chest pain. After chest pain, the most common symptom was palpitations, seen in 56% patients, followed by sweating (44%). 30% presented to the medical facility within 3hours. 88% were diagnosed with acute coronary syndrome, and 12% were diagnosed with chronic stable angina. Women specific risk factors include the pregnancy-related complications seen in 10% patients, menopause attained in 86% patients, PCOS seen in 08% patients, use of oral contraceptive pills noticed in 08% patients, Other risk factors identified were hypothyroidism in 16% patients, connective tissue disorders like rheumatoid arthritis seen in 12% of the patients. Conclusion: Awareness regarding atypical symptoms as well as other symptoms of IHD should be created among women to avoid delayed complications. Simple lifestyle modifications like physical activity, diet modifications, etc., will reduce the number of women at risk for IHD.

scholarly journals ST/HR variables in firefighter exercise ECG - relation to ischemic heart disease

2019 ◽  
Vol 7 (2) ◽  
pp. e13968 ◽  
Author(s):  
Anna Carlén ◽  
Eva Nylander ◽  
Meriam Åström Aneq ◽  
Mikael Gustafsson
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Exercise Ecg

Evaluation of Cardiovascular Comorbidities Among Patients with Multiple Myeloma in the United States

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4794-4794 ◽  
Author(s):  
Daniel J. Lenihan ◽  
Ravi Potluri ◽  
Hitesh Bhandari ◽  
Sandip Ranjan ◽  
Clara Chen
Keyword(s):  
Multiple Myeloma ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiac Failure ◽  
Coronary Atherosclerosis ◽  
Research Funding ◽  
Adult Population ◽  
The United States ◽  
Baseline Period ◽  
Ischemic Heart

Abstract Background: Multiple myeloma (MM) is typically diagnosed in older adults, with a median age at diagnosis of 69 years and the majority diagnosed between ages 65 and 74 years. It might be expected that cardiovascular disease (CVD) would be common in this patient population but currently there is little data about CVD in this population. CVD events may be consequences of age-related comorbidities, CVD itself, or anti-MM treatment received. Anthracycline chemotherapy, certain proteasome inhibitors and immunomodulatory drugs have been reported to increase the risk of CVD complications. Objective: To determine the prevalence of CVD comorbidities among MM patients in the period prior to receiving anti-MM treatment as observed in a US claims database, in order to understand the magnitude of these risks in a 'real-world' practice setting. Methods: Patients with a diagnosis ICD-9 code for MM were identified in MarketScan Commercial and Medicare claims databases from 7/1/2012 to 9/30/2014. The index date was the first claim of an anti-MM drug in this period, which was preceded by a 6-month baseline period with continuous medical and prescription drug coverage and no claims for another anti-MM drug. CVD comorbidities included cardiac arrhythmia, cardiac failure, stroke, ischemic heart disease, hypertension, venous thromboembolism (VTE), angina, coronary atherosclerosis and myocardial infarction (MI). Descriptive statistics were used to measure and report demographics and patient characteristics. Prevalence of CVD in MM patients was adjusted for the age and sex profile of the general US population and compared with prevalence reported in the literature for the US population. Patients were also divided into subgroups according to the anti-MM regimen received, and the prevalence of CVD by subgroup was assessed. Results: 4,635 patients met the study eligibility criteria (median age 64 years, 57% male, 42% with Charlson Comorbidity Index ≥2). Of these, 28%, 21%, 32% and 18% were in the North Central, Northeast, South and West regions, respectively. During the baseline period, CVD was present in 66% (n=3,048) of patients with MM. Relative to the general US adult population, annual standardized prevalence rates in this MM population were 22.0, 12.0, 2.8, 2.1 and 1.1 times higher for arrhythmia, VTE, cardiac failure, coronary atherosclerosis and hypertension, respectively, while being 82%, 73% and 32% lower for angina, stroke and MI, respectively. It is possible that patients with a history of these acute CVD events were less likely to receive an anti-MM drug (Table). Further, the prevalence of baseline CVD events in patients receiving carfilzomib was 34%, 52%, 43%, 30% and 47% lower for arrhythmia, cardiac failure, ischemic heart disease, hypertension and coronary atherosclerosis, respectively, than in those not receiving carfilzomib. Conclusion: Compared with the general US adult population, patients with MM appear to have a higher prevalence of CVD comorbidities relevant to anti-MM treatment. The lower rates of baseline CVD events suggests clinicians may avoid using carfilzomib in MM patients who are at risk of CVD. Given the chronic nature of MM and the need for long-term care, CVD comorbidities should be ascertained and taken into consideration when selecting appropriate treatment to manage the clinical and economic burden associated with such conditions. Table Table. Disclosures Lenihan: BMS, Roche, Amgen (Consultancy); Takeda (Research Funding): Consultancy, Research Funding. Potluri:Janssen Research & Development, LLC: Other: Contracted to perform research; SmartAnalyst, Inc.: Employment. Bhandari:SmartAnalyst India Pvt. Ltd.: Employment. Ranjan:SmartAnalyst India Pvt. Ltd.: Employment. Chen:Bristol-Myers Squibb: Employment.

Strain Imaging for Non-Invasive Evaluation of Left Atrial Function: Comparative Study in Controls and Patients with Ischemic Heart Disease

2008 ◽  
Vol 14 (6) ◽  
pp. S25-S26
Author(s):  
Philip P.M. Claessens ◽  
Christophe C.W. Claessens ◽  
Marc M.M. Claessens ◽  
Maria C.F. Claessens ◽  
Jan E.J. Claessens
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Comparative Study ◽  
Left Atrial ◽  
Strain Imaging ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Ischemic Heart ◽  
Non Invasive ◽  
Invasive Evaluation
Sign in / Sign up

Export Citation Format

Share Document