Relationship between Aortic Atherosclerosis and Dental Loss in an Inner-City Population

Angiology ◽  
2008 ◽  
Vol 60 (3) ◽  
pp. 346-350 ◽  
Author(s):  
Ricardo Castillo ◽  
Aurora Fields ◽  
Ghazanfar Qureshi ◽  
Louis Salciccioli ◽  
John Kassotis ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Inner City ◽  
Univariate Analysis ◽  
Ethnically Diverse ◽  
Intima Media Thickness ◽  
City Population ◽  
History Of ◽  
Artery Disease ◽  
Aortic Intima

Prior studies have suggested an association between atherosclerosis and periodontal disease, both of which are more prevalent in certain minority and economically disadvantaged groups. Few studies have addressed the relationship between cardiovascular disease and dentition among ethnically diverse populations. We studied 131 subjects (60% females, age 59 ± 15 years) who were referred for clinically indicated transesophageal echocardiography. Dental loss was more severe in patients with hypertension ( P < .001), diabetes ( P = .05), coronary artery disease ( P = .04), and calcium channel blocker use ( P = .04). On univariate analysis, maximal aortic intima—media thickness (MAIMT) was significantly correlated with dental loss ( r = .40; P < .001). Age was correlated with MAIMT ( R = .41; P < .001) and with dental loss ( r = .57; P < .001). On multivariate analysis, dental loss ( P = .03) and history of coronary artery disease ( P = .04) were independent predictors of MAIMT ( R 2 = .44). In this inner-city predominantly African American population, atherosclerosis and dental loss are age dependent and are interrelated independent of age.

Abdominal Aortic Intima-Media Thickness Predicts Coronary Artery Disease Severity in Patients With Stable Angina Pectoris: A Prospective Study

Angiology ◽  
2021 ◽  
pp. 000331972199885
Author(s):  
Omer Faruk Cirakoglu ◽  
Ayşe Gül Karadeniz ◽  
Ali Riza Akyüz ◽  
Cihan Aydın ◽  
Sinan Şahin ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Predictive Value ◽  
Intima Media Thickness ◽  
Stable Angina Pectoris ◽  
Coronary Artery Disease Severity ◽  
Abdominal Aortic ◽  
Artery Disease ◽  
Aortic Intima

Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).

scholarly journals Predicting the outcome in confirmed COVID-19 patients with coronary artery disease: a key role for the first chest computed tomography

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Negar Omidi ◽  
Masoumeh Lotfi-Tokaldany ◽  
Shapour Shirani ◽  
Mojtaba Salarifar ◽  
Hamidreza Poorhosseini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Univariate Analysis ◽  
Chest Ct ◽  
Positive Real ◽  
Chest Computed Tomography ◽  
Reactive Protein ◽  
History Of ◽  
Artery Disease

Abstract Background Serial chest computed tomography (CT) scans are used to detect coronavirus disease 2019 (COVID-19) pneumonia and monitor the disease course. This study investigates relationship between total severity score by first chest CT and the outcome of coronavirus COVID-19 patients with coronary artery disease (CAD). Results A total of 48 patients with a history of CAD (mean age=60.83±3.06 years, 75% male) with positive real-time reverse transcription-polymerase chain reaction for COVID-19 were included. Outcome was defined as acute respiratory distress syndrome or death. The unadjusted and adjusted effects of the CT score on the outcome were reported through odds ratio (OR) with 95% confidence interval (CI). Outcome occurred in 17 (35.5%) patients (8 deaths). The CT score was directly and significantly correlated with the outcome in the univariate analysis (OR 1.38, 95% CI 1.12–1.70; P=0.003) and remained significant after adjustment for diabetes, hypertension, body mass index, and serum level of highly sensitive C-reactive protein (OR 1.51, 95% CI 1.11–2.05; P=0.009). Outcome rate was 24.1% in patients with a CT score <2.5, whereas it was 8.3% in patients with a CT score>2.5. Conclusions The first chest CT score could be a robust predictor of adverse events in confirmed COVID-19 patients with coronary artery disease.

Family History of Coronary Artery Disease and Cholesterol: Screening Children in a Disadvantaged Inner-City Population

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 109-113
Author(s):  
Stephen J. Wadowski ◽  
Robert J. Karp ◽  
Renee Murray-Bachmann ◽  
Carl Senft
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Family History ◽  
Inner City ◽  
Predictive Value ◽  
Screening Tool ◽  
History Of ◽  
Artery Disease

Background and purpose. Little information relating to cholesterol levels and screening for hypercholesterolemia in inner-city children exists. For this study, given the disrupted family backgrounds of many of our patients and the unreliability of family histories, our hypothesis was that in comparison with other samples, family history of coronary heart disease would be a poor screening tool for the identification of children with elevations in total serum cholesterol (TSC). Subjects and methods. During 15 months, more than 400 pediatric outpatients, 2 through 14 years old, were screened for a family history of atherosclerotic disease. These children were attending a clinic serving a disadvantaged black and Hispanic population at Kings County Hospital Center. Nonfasting TSC levels were measured in 300 children. Positive risk for coronary heart disease was determined by the presence of a family history of coronary heart disease (defined as angina, stroke, or myocardial infarction in any parent or grandparent) at less than 55 years age. Results. The mean TSC level was 4.27 mmol/L (SD ± 0.85) (165.0 mg/dL [SD ± 32.81]). The 29.4% of this population with a history suggestive of high risk for hypercholesterolemia had a mean TSC of 4.48 mmol/L (SD ± 0.971) (173.2 mg/dL [SD ± 37.5]), and those with no risk history had a mean TSC of 4.18 mmol/L (SD ± 0.750) (161.4 mg/dL [SD ± 29.91) (P &lt; .005). Use of family history of coronary artery disease as a screening tool had a sensitivity of 39.3%, a specificity of 74.5%, and a positive predictive value of 39.8% for detection of moderate hypercholesterolemia (TSC ≥ 4.66 mmollL [180 mg/dL]). Conclusions. This population's mean TSC level did not differ (P &gt; .10) from those obtained in multiple large studies of average North American populations, and the predictive value and sensitivity of family history as a screening tool was comparable, although the prevalence of a positive family history was greater. The findings may be due to a greater prevalence of coronary artery disease at a young age in these families. In this population, a positive risk history is an important indicator for further evaluation of these children.

Abstract 63: The Smoking Paradox in Patients Hospitalized with Coronary Artery Disease: Findings from Get With The Guidelines - CAD

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Syed F Ali ◽  
Eric E Smith ◽  
Deepak L Bhatt ◽  
Wenqin Pan ◽  
Gregg C Fonarow ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Hospital Mortality ◽  
Univariate Analysis ◽  
Multivariable Model ◽  
History Of ◽  
Artery Disease ◽  
Get With The Guidelines

Introduction: Despite evidence of smoking as a potent risk factor for coronary artery disease (CAD), there have been reports of lower in-hospital mortality among smokers hospitalized for CAD events. Method: We analyzed all consecutive CAD admissions (n=158,054) without a prior history of Stroke/TIA from 2002-2008 in Get With The Guidelines (GWTG)-CAD. Categorical data were analyzed by Pearson Chi-square and continuous data by Wilcoxon test. Multivariable models with generalized estimating equations for in-hospital clustering were used to estimate odds ratios of in-hospital mortality. All significant predictors on univariate analysis were included in the multivariable model. Results: Among all CAD patients, 30.4% were current smokers, defined as any cigarette use in the past year. Smokers were substantially younger (12 years), more often male and less often had pre-existing hypertension, dyslipidemia, heart failure, renal failure and atrial fibrillation, and more often had COPD/Asthma. Smokers were more likely to be admitted to large, academic hospitals, and more often in the South. Smokers had shorter length of stay in hospital and were more often discharged home. In-hospital mortality was lower in smokers as compared to non-smokers (Table 1). The significant univariate mortality difference attenuated dramatically after adjusting for age and other covariates in the multivariable model, OR increased from 0.57 (0.53, 0.61) on univariate analysis to 0.88 (0.81, 0.95) on multivariable model. Other independent predictors of mortality were increasing age [1.51 (1.46, 1.56)], history of diabetes mellitus [1.25 (1.18, 1.33)], Asthma/COPD [1.30 (1.23, 1.38)], peripheral vascular disease [1.34 (1.24, 1.44)], heart failure [1.48 (1.38, 1.58)] and renal insufficiency [1.61 (1.48, 1.74)]. Conclusion: Smoking continues to be a major risk factor for presenting with CAD at a much younger age and with fewer risk factors. It is likely that the continued modest association with lower in-hospital mortality in smokers in this analysis after adjustment reflects residual or unmeasured confounding. This apparent smoker’s paradox in CAD should not be interpreted as a benefit of cigarette smoking.

Carotid artery intima-media thickness is associated with coronary artery disease

2008 ◽  
Vol 63 (3) ◽  
pp. 309-313 ◽  
Author(s):  
H. Heuten ◽  
I. Goovaerts ◽  
G. Ennekens ◽  
C. Vrints
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
Artery Disease

scholarly journals Impact of Coronary CT angiography in combination with CAD-RADS on the management of coronary artery disease patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Andre ◽  
S Seitz ◽  
P Fortner ◽  
R Sokiranski ◽  
F Gueckel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Ct Angiography ◽  
Patient Management ◽  
Male Gender ◽  
Coronary Ct ◽  
History Of ◽  
Artery Disease ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Siemens Healthineers Introduction Coronary CT angiography (CCTA) plays an increasing role in the detection and risk stratification of patients with coronary artery disease (CAD). The Coronary Artery Disease – Reporting and Data System (CAD-RADS) allows for standardized classification of CCTA results and, thus, may improve patient management. Purpose Aim of this study was to assess the impact of CCTA in combination with CAD-RADS on patient management and to identify the impact of cardiovascular risk factors (CVRF) on CAD severity. Methods CCTA was performed on a third-generation dual-source CT scanner in patients, who were referred to a radiology centre by their attending physicians. In a total of 4801 patients, CVRF were derived from medical reports and anamnesis. Results The study population consisted of 4770 patients (62.0 (54.0-69.0) years, 2841 males) with CAD (CAD-RADS 1-5), while 31 patients showed no CAD and were excluded from further analyses. Age, male gender and the number of CVRF were associated with more severe CAD stages (all p &lt; 0.001). 3040 patients (63.7 %) showed minimal or mild CAD requiring optimization of CVRF i.e. medical therapy but no further assessment at his time. A group of 266 patients (5.6 %) had a severe CAD defined as CAD-RADS 4B/5. In the multivariate regression analysis, age, male gender, history of smoking, diabetes mellitus and hyperlipidaemia were significant predictors for severe CAD, whereas arterial hypertension and family history of CAD did not reach significance. Of note, a subgroup of 28 patients (10.5 %) with a severe CAD (68.5 (65.5-70.0) years, 26 males, both p = n.s.) had no CVRF. Conclusions CCTA in combination with the CAD-RADS allowed for effective risk stratification of CAD patients. The majority of the patients showed non-obstructive CAD and, thus, could be treated conservatively without the need for further CAD assessment. CVRF out of arterial hypertension and family history had an impact on CAD severity reflected in higher CAD-RADs gradings. Of note, a relevant fraction of patients with CAD did not have any CVRF and, thus, may not be covered by risk stratification models. CAD-RADS n Age (years) Males (%) 1 1453 56.0 (50.0-62.0) 623 (42.9 %) 2 1587 62.0 (55.0-69.0) 918 (57.8 %) 3 1067 66.0 (59.0-71.0) 749 (70.2 %) 4A 397 66.0 (59.0-72.0) 317 (79.8 %) 4B 162 67.0 (61.0-74.0) 139 (85.8 %) 5 104 66.0 (58.5.0-77.0) 95 (91.3 %)

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