Abstract 15484: Combined Coronary and Carotid Artery Involvement in a Caucasian Patient With Moyamoya Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmed H Qavi
Keyword(s):  
Coronary Artery ◽  
Moyamoya Disease ◽  
Coronary Artery Stenosis ◽  
Young Patients ◽  
Artery Stenosis ◽  
Medical Attention ◽  
Caucasian Patient ◽  
Left Circumflex Artery ◽  
Cardiac Symptoms ◽  
History Of

Introduction: Moyamoya disease (MMD) is a rare, progressive steno-occlusive disease of the intracranial carotid arteries. This is primarily a cerebrovascular disease and is mostly seen in young Japanese patients. We report a case of severe stenosis in the distal left circumflex artery (dLCx) in a non-Japanese patient with previously diagnosed MMD. Case presentation: A 33-year-old Caucasian female with history of MMD and 2 CVAs presented with chest pain for 2 days. Her only medication at home was aspirin. There was no history of hypertension, diabetes mellitus, or tobacco use. There was no family history of early CAD. Physical examination was positive for tachycardia but negative for carotid or femoral bruits. Neurologic examination revealed decreased touch sensation and diminished deep tendon reflexes on the left side. ECG demonstrated tachycardia with T wave inversions in leads III and ST depression in lead II. Acute CVA was ruled out with an MRI. Cardiac troponins were minimally elevated with peak of 0.12 ng/dl. An initial diagnosis of NSTEMI was made; patient was loaded with aspirin, clopidogrel and started on a heparin drip. Cardiac catheterization on the following day revealed single vessel CAD in the dLCx, with 80% stenosis and TIMI flow 2. A drug eluting stent was successfully placed in the dLCx. Angiogram post-stent placement showed optimal angiographic result with TIMI 3 flow. The patient was discharged home on dual antiplatelet therapy, statin, beta-blocker and ACE inhibitor. Discussion: MMD is thought to affect the coronary arteries from fibrous intimal thickening and histopathology of these coronary lesions show a homogenous, soft intimal proliferation with minimum lipid deposition and without substantial inflammatory cell infiltration. Although the combined involvement of carotid and coronary artery stenosis is rare, coronary involvement should be considered as one of the causes of ischemic heart disease in young patients with MMD. To the best of our knowledge, this is the first reported case of combined involvement of carotid and coronary artery stenosis in a Caucasian patient with previously diagnosed MMD. It is imperative to educate patients with MMD about possible CAD so that they seek immediate medical attention if cardiac symptoms occur.

Left Main Coronary Artery Stenosis in Young Patients

CHEST Journal ◽  
1979 ◽  
Vol 76 (5) ◽  
pp. 508-513 ◽  
Author(s):  
Jean Crittin ◽  
David D. Waters ◽  
Pierre Théroux ◽  
Henry F. Mizgala
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Young Patients ◽  
Artery Stenosis ◽  
Left Main ◽  
Main Coronary Artery Stenosis

scholarly journals Coronary Artery Stenosis in Moyamoya Disease

Circulation ◽  
2013 ◽  
Vol 127 (20) ◽  
pp. 2063-2065 ◽  
Author(s):  
Ju-Hee Lee ◽  
Tae-Jin Youn ◽  
Yeonyee E. Yoon ◽  
Jin Joo Park ◽  
Su Jin Hong ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Moyamoya Disease ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis

scholarly journals STABLE ANGINA

2009 ◽  
Vol 16 (01) ◽  
pp. 94-99
Author(s):  
SHAFIQUE AHMED ◽  
MUHAMMAD BILAL AHSAN ◽  
EHSAN ULLAH ◽  
Raees Abbas
Keyword(s):  
Coronary Artery ◽  
Stable Angina ◽  
Coronary Artery Stenosis ◽  
Case Series ◽  
Artery Stenosis ◽  
P Value ◽  
Significant Difference ◽  
History Of ◽  
Male Patients ◽  
Artery Disease

Objective: To see the frequency of coronary artery stenosis in the patients of stable angina having left bundle branchblock, and to see the effects of gender and age on this correlation. Design: Experimental case series. Setting: Bahawal Victoria Hospital,Bahawalpur. Period: June 2006 to May 2008. Methods: One hundred and forty one (141) patients of Stable Angina presenting with atypicalchest pain, both male and female of 30—70 years age, positive for LBBB and with normal Cardio-Thoracic Ratio, normal echocardiographyand negative for conventional risk factors and family history of Coronary Artery Disease were taken. All patients were angiographied .Results: A total of 141 patients were investigated through coronary angiogram to see the frequency of coronary artery stenosis in thesepatients. Ninety five (67.4%) patients proved to have coronary artery stenosis. The male patients showed higher frequency (87.4%) ofharboring coronary vessel blockade as compared to that (35.2%) in females (P value <0.0005). There was no relation between age and thefrequency of coronary stenosis (P value >0.05). Conclusions: There is significant difference (P value <0.0005) in coronary artery stenosisamong men and women having LBBB.

scholarly journals Hyperhomocysteinemia and Acute Coronary Syndrome: A Hospital-Based Observational Study Among Very Young Adults ≤35 Years of Age

2020 ◽  
Author(s):  
Jiayin Sun ◽  
Wei Han ◽  
Sijing Wu ◽  
Shuo Jia ◽  
Zhenxian Yan ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Young Patients ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Left Ventricular Ejection ◽  
Gensini Score ◽  
Coronary Syndrome

Abstract Background: The prevalence of acute coronary syndrome (ACS) continues to increase among young Chinese adults. Homocysteine (HCY) has been suggested as a crucial promoter of atherosclerosis leading to coronary artery disease (CAD). Yet, it remains uncertain whether HCY is associated with the ACS and the severity of coronary artery stenosis in very young adults.Methods: Very young patients (18-35years of age) diagnosed with ACS who underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and June 2019 were assigned to the ACS group. An equivalent age-matched population without CAD, as confirmed by CAG during the same period, was assigned to the non-CAD group. A serum HCY level>15µmol/L was defined as hyperhomocysteinemia (HHCY). The Gensini score assessed the severity of coronary artery stenosis.Results: A total of 1,103 participants, including 828 ACS patients and 275 non-CAD subjects, were included in this study. Very young ACS patients had higher level of serum HCY and greater prevalence of HHCY compared with non-CAD subjects [for HCY, 16.55 (11.93- 29.68) vs 12.50 (9.71- 17.42), P<0.001; for HHCY prevalence, 62.08% vs 26.18%, P<0.001]. Multivariate logistic regression analysis with the stepwise method indicated that HHCY was an independent predictor associated with the presence of ACS, after adjusting for traditional confounders (OR, 4.393; 95% CI, 3.171-6.087; P<0.001). Moreover, young ACS patients with HHCY had increased prevalence of ST-segment elevation myocardial infarction (STEMI) (P=0.041), multi-vessel disease (P=0.036), and decreased value of left ventricular ejection fraction (LVEF) (P=0.01). Also, the HCY level was significantly correlated with Gensini Score in ACS patients (r=0.142, P<0.001).Conclusion: HHCY was significantly associated with the presence of ACS and the severity of coronary artery stenosis in very young patients ≤35 years of age.

Abstract TP137: The Association Between MRI-detected Carotid Vulnerable Plaque and Coronary Artery Stenosis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Manabu Nagata ◽  
Kazumichi Yoshida ◽  
Kazumichi Yoshida ◽  
Ryu Fukumitsu ◽  
Yohei Takenobu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Plaque ◽  
Coronary Artery Stenosis ◽  
Coronary Intervention ◽  
Artery Stenosis ◽  
Vulnerable Plaques ◽  
Carotid Mri ◽  
History Of

It is now accepted that carotid artery stenosis should be treated as a part of systemic atherothrombosis. However, little is known about the association in atherosclerosis between the carotid and coronary arteries. We retrospectively investigated the association between carotid plaque vulnerability diagnosed on carotid magnetic resonance imaging (MRI) and coexisting coronary artery stenosis in patients scheduled for carotid endarterectomy (CEA) or carotid artery stenting (CAS). Eighty-nine consecutive cases that underwent carotid reconstruction for carotid artery stenosis at Kyoto University Hospital between 2010 and 2015 were enrolled in this study. Ten cases that received neither coronary angiography (CAG) nor coronary computed tomography angiography (CCTA) as preoperative examinations, 6 cases with restenosis after CEA or CAS, and 2 cases that did not undergo carotid MRI were excluded. We evaluated relative overall signal intensity (roSI) of the carotid plaque on T1-weighted imaging and coronary artery stenosis detected on CAG or CCTA in the remaining 71 cases. Carotid plaques with roSI >1.5 were defined as MRI-detected vulnerable plaques. Thirty-one cases had a history of previous coronary intervention (stenting or bypass surgery), of which 26 (84%) showed carotid vulnerable plaques. In the cases with no history of coronary intervention, coronary artery stenosis was newly detected in 21 cases, and was not demonstrated in the other 19 cases. Fifteen of the 21 cases with coronary artery stenosis (71%) also showed carotid vulnerable plaques. On the other hand, only 4 of the 19 cases without coronary artery stenosis (21%) had carotid vulnerable plaques, representing a significant difference (P<0.05). Among the cases with no history of coronary intervention, prevalence of coronary artery stenosis in cases with carotid vulnerable plaques was 79%, significantly higher than that in cases without carotid vulnerable plaques (29%). In conclusion, this study demonstrated that patients with carotid vulnerable plaques are more likely to have advanced coronary artery stenosis. Plaque characterization by carotid MRI is useful not only for treatment of carotid artery stenosis, but also for predicting coronary artery stenosis.

Recurrent Event Analysis of Coronary Artery Stenosis in Patients Undergoing Angioplasty

2020 ◽  
Vol 22 (5) ◽  
Author(s):  
Behrouz Beiranvand ◽  
Ebrahim Hajizadeh ◽  
Aliakbar Rasekhi ◽  
Abdollah Amirfarhangi ◽  
Javad Nasseryan
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery ◽  
Unstable Angina ◽  
Coronary Angioplasty ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Recurrent Event ◽  
Recurrent Event Data ◽  
History Of

Background: Restenosis after coronary angioplasty can have serious complications such as coronary artery bypass graft, myocardial infarction, and death. Objectives: The present study aimed at investigating the factors affecting the recurrence of coronary artery stenosis in patients undergoing angioplasty using the recurrent event data analysis. Methods: A cohort study was performed on patients undergoing coronary angioplasty from March 23, 2009, to January 21, 2011. All patients were followed up from angioplasty to January 21, 2015. First, each of the independent variables was entered into the univariate Cox model with a frailty component. Then, variables with p-values of less than 0.2 were entered into the multivariate analysis. The statistical analysis was done using R software, version 3.6, at the significance level of 0.05. Results: The present study was conducted on 1,000 patients who underwent coronary angioplasty. We found that 441 patients experienced restenosis at least once in the study period. The mean survival time to the first event of restenosis was 44.08 ± 1.06 months. Patients with a history of diabetes, unstable angina, and myocardial infarction had a significantly higher hazard of restenosis compared to other patients (P < 0.05). Conclusions: The results of the recurrent event survival analysis confirmed the significant role of risk factors such as a history of diabetes, unstable angina, and myocardial infarction. Therefore, training to enhance the patients’ awareness and attitude seems necessary to prevent them from exposing whit known risk factors. The periodic follow-up of patients with risk factors and more ongoing care are also necessary.

The Natural History of Coronary Artery Stenosis

Radiology ◽  
1976 ◽  
Vol 119 (3) ◽  
pp. 513-520 ◽  
Author(s):  
Josef Rösch ◽  
Ruza Antonovic ◽  
Roland S. Trenouth ◽  
Shabudin H. Rahimtoola ◽  
David N. Sim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Natural History ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
History Of

scholarly journals Combined effect of hyperhomocysteinemia and smoking on the severity of coronary artery disease in young adults ≤ 35 years of age: a hospital-based observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiayin Sun ◽  
Wei Han ◽  
Sijing Wu ◽  
Shuo Jia ◽  
Zhenxian Yan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Young Patients ◽  
Artery Stenosis ◽  
Combined Effect ◽  
Multivariate Linear Regression Analysis ◽  
Current Smoking ◽  
Artery Disease

Abstract Background The prevalence of coronary artery disease (CAD) continues to increase among young Chinese adults. Current smoking has been recognized as a major risk factor for premature CAD, and hyperhomocysteinaemia (HHcy) has also been suggested to be associated with CAD progression. However, the combined effect of current smoking and HHcy on the severity of coronary artery stenosis in young adults is still uncertain. Methods We consecutively collected young patients (18–35 years of age), diagnosed with CAD and underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and May 2020. HHcy was defined as serum homocysteine (Hcy) level > 15 µmol/L. The severity of coronary artery stenosis was evaluated by Gensini Score. The co-effect of current smoking and HHcy on CAD severity as well as the relationship between plasma Hcy, pack-years of smoking and CAD severity were assessed by multivariate linear regression analysis. Results A total of 989 participants (mean age, 33 years; 96.2% male) fulfilling the criteria were enrolled in this study. Patients with both HHcy and current smoking accounted for 39.1% of all the subjects. Multivariate liner analysis indicated both serum Hcy levels (β 0.302; 95% CI 0.141–0.462; P < 0.001) and pack-years of smoking (β 0.523; 95% CI 0.265–0.781; P < 0.001) were independently associated with the severity of coronary artery stenosis after adjusting for other traditional confounders. In addition, serum Hcy levels were correlated with pack-years of smoking in young CAD patients (r = 0.116, P = 0.001). Moreover, combination of HHcy and current smoking was suggested to have higher risk for CAD severity (β 17.892; 95% CI 11.314–24.469; P < 0.001), compared with HHcy (β 7.471; 95% CI 0.009–14.934; P = 0.048) or current smoking (β 7.421; 95% CI 0.608–14.233; P = 0.033) alone. Conclusion Combination of HHcy and smoking is independently associated with the severity of CAD in young patients ≤ 35 years of age.

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