Sex and Ethnic Differences in Outcomes of Acute Coronary Syndrome and Stable Angina Patients With Obstructive Coronary Artery Disease

2016 ◽  
Vol 9 (2 suppl 1) ◽  
pp. S26-S35 ◽  
Author(s):  
Mona Izadnegahdar ◽  
Martha Mackay ◽  
May K. Lee ◽  
Tara L. Sedlak ◽  
Min Gao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Ethnic Differences ◽  
Stable Angina ◽  
Obstructive Coronary Artery Disease ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract 20047: Validation of the Simple Acute Coronary Syndrome (SACS) Score for Identifying Obstructive Coronary Artery Disease

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Daniel Matta ◽  
Christina Marsalisi ◽  
Wayne Ruppert ◽  
Ravi Korabathina
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Cardiac Catheterization ◽  
Obstructive Coronary Artery Disease ◽  
Retrospective Chart Review ◽  
Study Endpoint ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
Scoring Tool

Background: Each year, up to 136,000 individuals suffering from acute coronary syndrome (ACS) are misdiagnosed and discharged from our nations’ emergency departments. We developed the Simple Acute Coronary Syndrome (SACS) score that tabulates a patient’s symptoms, ECG findings, risk factors, and cardiac markers (Figure 1). Our aim was to validate this novel scoring tool in its ability to identify the presence of obstructive coronary artery disease (CAD). Methods: A single-center retrospective chart review was performed after institutional review board approval. The charts of 42 consecutive patients who presented with ACS and who were treated with an invasive strategy were reviewed. Scores were calculated for each patient using the SACS tool as well as the Modified Thrombolysis in Myocardial Infarction (TIMI) ACS calculator. The study endpoint was the presence of at least one vessel obstructive CAD at cardiac catheterization. Descriptive statistics were employed. Results: The stratification of SACS and Modified TIMI scores for each of the 42 ACS patients is shown in Figure 2. In patients with a SACS score that was less than 3, none of these patients were found to have obstructive CAD at cardiac catheterization. For patients with a SACS score of 4 or higher, 100% of these patients were shown to have obstructive CAD. For patients with Modified TIMI scores of 1 and 2, 3/11 (27%) were found to have obstructive CAD. Conclusions: The novel SACS scoring system identifies ACS patients who will have obstructive CAD more reliably than more traditional scoring systems. The SACS scoring tool needs to be validated in larger scale studies.

scholarly journals Long-term survival and causes of death in patients with ST-elevation acute coronary syndrome without obstructive coronary artery disease

2017 ◽  
Vol 39 (2) ◽  
pp. 102-110 ◽  
Author(s):  
Hedvig Bille Andersson ◽  
Frants Pedersen ◽  
Thomas Engstrøm ◽  
Steffen Helqvist ◽  
Morten Kvistholm Jensen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Causes Of Death ◽  
Obstructive Coronary Artery Disease ◽  
Term Survival ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Artery Disease

scholarly journals Levels of pregnancy-associated plasma protein A in patients with coronary artery disease

2008 ◽  
Vol 31 (2) ◽  
pp. 85 ◽  
Author(s):  
Zhi-Yuan Liu ◽  
Jin-Ying Zhang ◽  
Tong-Wen Sun ◽  
Yan-Jun Zhang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Plasma Protein ◽  
Stable Angina ◽  
Protein A ◽  
Serum Levels ◽  
Control Group ◽  
Coronary Syndrome ◽  
Artery Disease

Purpose: To investigate the levels of pregnancy-associated plasma protein A (PAPP-A) or insulin-like growth factor -1 (IGF-1) in patients with acute coronary syndrome. Methods: Serum PAPP-A and IGF-1 was measured with biotin–tyramide-amplified enzyme immunoassay and Enzyme Linked Immuoserbent Assay, respectively, in patients with ST elevation acute myocardial infarction (STEMI, n=12), unstable angina (UAP, n=15), and stable angina (n=15). PAPP-A and IGF-1 was also measured in 16 healthy subjects (control group). Results: The serum levels of PAPP-A in the STEMI (16.9±10.3 mIU/L) and UAP group (15.2±10.5 mIU/L) were higher than in the stable angina (8.5±3.1 mIU/L) or control group (8.4±2.0 mIU/L, P < 0.01). The serum levels of IGF-1 in the STEMI (132.3±40.9 µg/L) and UAP group (127.3±36.0 µg/L) were also higher than in the stable angina (44.9±18.5 µg/L) or control group (67.7±24.5µg/L, P < 0.01). There were no differences in serum levels of PAPP-A or IGF-1 among the single, double and three vessel lesion groups. The serum levels of PAPP-A (19.9±10.1 mIU/L) and IGF-1 (153.2±52.4 µg/L) after PCI were higher than those before PCI (15.1±10.0 mIU/L and 91.4±51.0 µg/L, respectively, P < 0.01). A positive correlation was found between PAPP-A and IGF-1 levels in the STEMI and UAP group before PCI (r=0.48?P < 0.01). Conclusion: PAPP-A and IGF-1 are elevated in patients with acute coronary syndrome. They may be used as biomarkers for vulnerable plaques in patients with coronary artery disease. Whether post-PCI elevation of IGF-1 can be used to predict restenosis of coronary arteries remains to be seen.

Relation of vascular dilator function and cardiac autonomic function with coronary angiography findings in patients with non-ST segment elevation acute coronary syndrome

2020 ◽  
pp. 204887262091871
Author(s):  
Gaetano Antonio Lanza ◽  
Eleonora Ruscio ◽  
Gessica Ingrasciotta ◽  
Tamara Felici ◽  
Monica Filice ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Cardiac Autonomic Function ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome ◽  
Artery Disease

Background A sizeable number of patients with a diagnosis of non-ST segment elevation acute coronary syndrome show non-obstructive coronary artery disease. In this study we assessed whether differences in vascular and cardiac autonomic function exist between non-ST segment elevation acute coronary syndrome patients with obstructive or non-obstructive coronary artery disease. Methods and results Systemic endothelium-dependent and independent vascular dilator function (assessed by flow-mediated dilation and nitrate-mediated dilation of the brachial artery, respectively) and cardiac autonomic function (assessed by time-domain and frequency-domain heart rate variability parameters) were assessed on admission in 120 patients with a diagnosis of non-ST segment elevation acute coronary syndrome. Patients were divided into two groups according to coronary angiography findings: (a) 59 (49.2%) with obstructive coronary artery disease (≥50% stenosis in any epicardial arteries); (b) 61 (50.8%) with non-obstructive coronary artery disease. No significant differences between the two groups were found in both flow-mediated dilation (5.03 ± 2.6 vs. 5.40 ± 2.5%, respectively; P = 0.37) and nitrate-mediated dilatation (6.79 ± 2.8 vs. 7.30 ± 3.4%, respectively; P = 0.37). No significant differences were also observed between the two groups both in time-domain and frequency-domain heart rate variability variables, although the triangular index tended to be lower in obstructive coronary artery disease patients (30.2 ± 9.5 vs. 33.9 ± 11.6, respectively; P = 0.058). Neither vascular nor heart rate variability variables predicted the recurrence of angina, requiring emergency room admission or re-hospitalisation, during 11.3 months of follow-up. Conclusions Among patients admitted with a diagnosis of non-ST segment elevation acute coronary syndrome we found no significant differences in systemic vascular dilator function and cardiac autonomic function between those with obstructive coronary artery disease and those with non-obstructive coronary artery disease.

scholarly journals Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings

2021 ◽  
Vol 10 (9) ◽  
pp. 1863
Author(s):  
Jorge Rodríguez-Capitán ◽  
Andrés Sánchez-Pérez ◽  
Sara Ballesteros-Pradas ◽  
Mercedes Millán-Gómez ◽  
Rosa Cardenal-Piris ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Obstructive Coronary Artery Disease ◽  
Hazard Ratio ◽  
Coronary Syndrome ◽  
Cardiovascular Prognosis ◽  
Artery Disease

The clinical significance of non-obstructive coronary artery disease is the subject of debate. Our objective was to evaluate the long-term cardiovascular prognosis associated with non-obstructive coronary artery disease in patients undergoing coronary angiography, and to conduct a stratification by sex, diabetes, and clinical indication. We designed a multi-centre retrospective longitudinal observational study of 3265 patients that were classified into three groups: normal coronary arteries (lesion <20%, 1426 patients), non-obstructive coronary artery disease (20–50%, 643 patients), and obstructive coronary artery disease (>70%, 1196 patients). During a mean follow-up of 43 months, we evaluated a combined cardiovascular event: acute myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Multivariable-adjusted Cox proportional hazard models showed a worse prognosis in patients with non-obstructive coronary artery disease, in comparison with patients of normal coronary arteries group, in the total population (hazard ratio 1.72, 95% confidence interval 1.23–2.39; p for trend <0.001), in non-diabetics (hazard ratio 2.12, 95% confidence interval: 1.40–3.22), in women (hazard ratio 1.75, 95% confidence interval 1.10–2.77), and after acute coronary syndrome (hazard ratio 2.07, 95% confidence interval 1.25–3.44). In conclusion, non-obstructive coronary artery disease is associated with an impaired long-term cardiovascular prognosis. This association held for non-diabetics, women, and after acute coronary syndrome.

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