Study of estimation of coronary artery calcium by multi-slice spiral CT scan in post myocardial infarction cases

Background: Strong relationship has been demonstrated between the presence of occlusive CAD and coronary artery calcification (CAC) detected at autopsy, fluoroscopy and computed tomography (CT scan). CT scan quantifies the relative burden of CAC deposits as a marker of atherosclerosis. Study explored utility of multi-slice spiral CT scan for detection of CAC in post myocardial infarction cases.Methods: Fifty-one post myocardial infarction cases were enrolled in the study. Detailed clinical history was recorded in every case regarding age, sex, history of risk factors for CAD like systemic hypertension, diabetes mellitus, smoking and family history of CAD. Every case was evaluated for fasting and postprandial blood sugar and fasting lipid profile. Body mass index (BMI) was also calculated. Coronary artery calcium was estimated in each patient by multi -slice spiral CT scan. Conventional angiography was also undertaken in 18 patients. Co-relation of coronary calcium with different age groups, sex, risk factors, electrocardiography and angiography was drawn.Results: Out of 51 cases scanned, 40 cases (78.4%) had detectable CAC. In 30 cases (58.8%), CAC score ranged from 1 to 100 (mild score); 6 cases (11.8%) had score between 101-400 (moderate score) while in 4 cases (7.8%) CAC score was more than 400 (severe score %). For detection of angiographically detectable disease, the sensitivity of multi-slice CT was 100% and the specificity was 33.3%.Conclusions: CAC is a valid measure of atherosclerotic plaque burden and is recommended as a screening tool for demonstrating significant atherosclerosis in susceptible subjects.

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Study of coronary artery calcium by multi-slice spiral CT as a tool for high risk cardiovascular screening

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20173723 ◽

2017 ◽

Vol 5 (9) ◽

pp. 3902

Author(s):

Rajesh V. Gosavi ◽

Madhuri P. Holey ◽

Umesh A. Giradkar

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

High Risk ◽

Ct Scan ◽

Coronary Artery Calcium ◽

Strong Relationship ◽

Spiral Ct ◽

Systemic Hypertension ◽

History Of ◽

Spiral Ct Scan

Background: Strong relationship has been demonstrated between the presence of occlusive CAD and coronary artery calcification (CAC) detected at autopsy, fluoroscopy and computed tomography (CT scan). CT scan quantifies the relative burden of CAC deposits as a marker of atherosclerosis. We explored utility of multi-slice spiral CT scan for detection of CAC as a tool for screening in asymptomatic high-risk cases above 40 years of age.Methods: Fifty-eight asymptomatic cardiovascular high-risk cases were included as per selection criteria. Detailed clinical history was recorded in every case regarding age, sex, history of risk factors for CAD like systemic hypertension, diabetes mellitus, smoking and family history of CAD. Every case was evaluated for fasting and postprandial blood sugar and fasting lipid profile. Body mass index (BMI) was calculated. An ECG was also recorded. Coronary artery calcium was estimated in each patient by multi -slice spiral CT scan. Fifty age and gender matched consenting participants were enrolled as controls and comparisons drawn.Results: Out of 58 cases scanned, 41 had no detectable CAC by multi-slice CT scan whereas in 17 cases (29.2%), calcium was detected. Mean CAC score was observed to increase as number of risk factors increased.Conclusions: Multi-slice CT scan is a useful tool for detection of coronary artery calcium (CAC) when utilised for high risk screening in older adults having one or more known cardiovascular risk factors.

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Estimation of coronary artery calcium by multislice spiral CT scan in asymptomatic high risk cases above forty (40) years of age

Indian Journal of Forensic and Community Medicine ◽

10.5958/2394-6776.2016.00048.5 ◽

2016 ◽

Vol 3 (3) ◽

pp. 220

Author(s):

Umesh Giradkar ◽

Sandesh Chaudhari ◽

Mandar Ramchandra Sane ◽

Anand B. Mugadlimath ◽

Naresh Kumar

Keyword(s):

Coronary Artery ◽

High Risk ◽

Ct Scan ◽

Coronary Artery Calcium ◽

Spiral Ct ◽

Multislice Spiral Ct ◽

Spiral Ct Scan

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Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

Journal of the American Society of Nephrology ◽

10.1681/asn.v1271516 ◽

2001 ◽

Vol 12 (7) ◽

pp. 1516-1523 ◽

Cited By ~ 1

Author(s):

AUSTIN G. STACK ◽

WENDY E. BLOEMBERGEN

Keyword(s):

United States ◽

Risk Factors ◽

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

The United States ◽

Comorbid Conditions ◽

Clinical Correlates ◽

History Of ◽

Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

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Myocardial Infarction under age 40: Risk factors and Coronary Arteriographic findings

Annals of King Edward Medical University ◽

10.21649/akemu.v9i4.1361 ◽

2016 ◽

Vol 9 (4) ◽

Author(s):

Ijaz Ahmad ◽

Qaiser Shafique

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Significant Coronary Artery Disease ◽

Young Patients ◽

Systemic Hypertension ◽

Premature Coronary Artery Disease ◽

Single Vessel ◽

Artery Disease

Objective: To evaluate risk factors and arteriography findings in young patients under 40 year of age admitted with first acute myocardial infarction (AMI). Design: A prospective descriptive study. Place and Duration of Study: Cardiology Department, Allama Iqbal Medical College/ Jinnah Hospital, Lahore from July 2002 to June 2003. Patients and Methods: During the study period, 274 patients with first AMI were admitted in our coronary care unit and 52 (19%) were under 40 year of age. These 52 patients underwent pre-discharge coronary arteriography. Results: Forty-five (87%) were male and seven (13%) were female. Risk factors in all study patients were smoking in 79%, systemic hypertension in 35%, diabetes mellitus in 31%, hyperlipidemia in 19% and family history of premature coronary artery disease in 17%. Risk factors were distinctly less frequent in patients without coronary atherosclerosis. Cigarette smoking was the main risk factor in male patients while diabetes and hypertension were main risk factors in female patients. Forty-six patients (88%) had significant CAD (greater than 50% diameter narrowing of at least one major coronary artery), 5(10%) had normal coronary arteries and one patient (2%) had marked coronary ectasia. In patients with significant coronary artery disease, the prevalence rate of one, two and three vessel disease was 52, 28 and 20 percent, respectively. No patient had congenital coronary anomaly or significant left main CAD. Conclusion: AMI in persons under the age of 40 years accounts for approximately 19% of AML In this age group, AMI is a disease of men who smoke & single vessel CAD predominates. Approximately half of the young patients have single vessel coronary disease, and in up to 10%, the cause is not related to atherosclerosis. Coronary angiography may be warranted in young patients with AMI to define the anatomy of the disease and to permit optimal management

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Screening for Premature Coronary Artery Disease (CAD) using Coronary Artery Calcium (CAC) Score: A Primary Prevention Pilot Study

Medicine & Health ◽

10.17576/mh.2021.1601.12 ◽

2021 ◽

Vol 16 (1) ◽

pp. 134-149

Author(s):

Hamat Hamdi Che Hassan ◽

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Family History ◽

Primary Prevention ◽

Coronary Artery Calcium ◽

Overweight And Obesity ◽

Premature Coronary Artery Disease ◽

History Of ◽

Artery Disease

Acute Coronary Syndrome (ACS) events can be accelerated by positive family history of young coronary artery disease (CAD). Risk factors assessment sometimes fail to predict ACS occurrence. Additional investigations with coronary artery calcium (CAC) score can be used independently in screening for primary prevention in some population. This was a cross-sectional study in asymptomatic population with first degree relatives (FDR) having premature CAD compared with a matched population with no family history of CAD from September 2017 to March 2018 at the Cardiology Clinic of Univeristi Kebangsaan Malaysia Medical Centre. A total of 36 subjects were recruited with equal number in each group. Female were the majority in each group (66.7%). The FDR group were slightly younger compared to the control group [mean (SD) age 36.9 (4.9) against 38 (3.8), respectively). Both groups represent high risk factors including overweight and obesity, abdominal obesity as well as dyslipidemia. Newly diagnosed dyslipidemia was significant in the group with family history (83.3% versus 44.4%, P<0.01). Both groups were screened either into the low or moderate risk Framingham Risk Score group. CAC score was higher in family history group (11.1% vs 0%, P>0.05). In conclusion, CAC may be irrelevant for screening in younger population. However, the yield of other risk factor is still alarming.

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Long-term prognostic value of whole-heart coronary magnetic resonance angiography

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-021-00749-w ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Satoshi Nakamura ◽

Masaki Ishida ◽

Kei Nakata ◽

Yasutaka Ichikawa ◽

Shinichi Takase ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Coronary Artery ◽

Cardiac Death ◽

Prognostic Value ◽

Vessel Disease ◽

History Of ◽

Whole Heart

Abstract Background Coronary magnetic resonance angiography (CMRA) allows non-ionizing visualization of luminal narrowing in coronary artery disease (CAD). Although a prior study showed the usefulness of CMRA for risk stratification in short-term follow-up, the long-term prognostic value of CMRA remains unclear. The purpose of this study was to evaluate the long-term prognostic value of CMRA. Methods A total of 506 patients without history of myocardial infarction or prior coronary artery revascularization underwent free-breathing whole-heart CMRA between 2009 and 2015. Images were acquired using a 1.5 T or 3 T scanner and visually evaluated as the consensus decisions of two observers. Obstructive CAD on CMRA was defined as luminal narrowing of ≥ 50% in at least one coronary artery. Major adverse cardiac events (MACE) comprised cardiac death, nonfatal myocardial infarction, and unstable angina. Results Obstructive CAD on CMRA was observed in 214 patients (42%). During follow-up (median, 5.6 years), 31 MACE occurred. Kaplan–Meier curve analysis revealed a significant difference in event-free survival between patients with and without obstructive CAD for MACE (log-rank, p = 0.003) and cardiac death (p = 0.012). Annualized event rates for MACE in patients with no obstructive CAD, 1-vessel disease, 2-vessel disease, and left-main or 3-vessel disease were 0.6%, 1.5%, 2.3%, and 3.6%, respectively (log-rank, p = 0.003). Cox proportional hazard regression analysis showed that, among obstructive CAD on CMRA and clinical risk factors (age, sex, hypertension, diabetes, dyslipidemia, smoking, and family history of CAD), obstructive CAD and diabetes were significant predictors of MACE (hazard ratios, 2.9 [p = 0.005] and 2.2 [p = 0.034], respectively). In multivariate analysis, obstructive CAD remained an independent predictor (adjusted hazard ratio, 2.6 [p = 0.010]) after adjusting for diabetes. Addition of obstructive CAD to clinical risk factors significantly increased the global chi-square result from 8.3 to 13.8 (p = 0.022). Conclusions In long-term follow-up, free breathing whole heart CMRA allows non-invasive risk stratification for MACE and cardiac death and provides incremental prognostic value over conventional risk factors in patients without a history of myocardial infarction or prior coronary artery revascularization. The presence and severity of obstructive CAD detected by CMRA were associated with worse prognosis. Importantly, patients without obstructive CAD on CMRA displayed favorable prognosis.

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Predictors of Coronary Artery Calcium and Long‐Term Risks of Death, Myocardial Infarction, and Stroke in Young Adults

Journal of the American Heart Association ◽

10.1161/jaha.121.022513 ◽

2021 ◽

Author(s):

Aamir Javaid ◽

Joshua D. Mitchell ◽

Todd C. Villines

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Disease ◽

Young Adults ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

All Cause Mortality

Background Coronary artery calcium (CAC) is well‐validated for cardiovascular disease risk stratification in middle to older–aged adults; however, the 2019 American College of Cardiology/American Heart Association guidelines state that more data are needed regarding the performance of CAC in low‐risk younger adults. Methods and Results We measured CAC in 13 397 patients aged 30 to 49 years without known cardiovascular disease or malignancy between 1997 and 2009. Outcomes of myocardial infarction (MI), stroke, major adverse cardiovascular events (MACE; MI, stroke, or cardiovascular death), and all‐cause mortality were assessed using Cox proportional hazard models, controlling for baseline risk factors (including atrial fibrillation for stroke and MACE) and the competing risk of death or noncardiac death as appropriate. The cohort (74% men, mean age 44 years, and 76% with ≤1 cardiovascular disease risk factor) had a 20.6% prevalence of any CAC. CAC was independently predicted by age, male sex, White race, and cardiovascular disease risk factors. Over a mean of 11 years of follow‐up, the relative adjusted subhazard ratio of CAC >0 was 2.9 for MI and 1.6 for MACE. CAC >100 was associated with significantly increased hazards of MI (adjusted subhazard ratio, 5.2), MACE (adjusted subhazard ratio, 3.1), stroke (adjusted subhazard ratio, 1.7), and all‐cause mortality (hazard ratio, 2.1). CAC significantly improved the prognostic accuracy of risk factors for MACE, MI, and all‐cause mortality by the likelihood ratio test ( P <0.05). Conclusions CAC was prevalent in a large sample of low‐risk young adults. Those with any CAC had significantly higher long‐term hazards of MACE and MI, while severe CAC increased hazards for all outcomes including death. CAC may have utility for clinical decision‐making among select young adults.

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Comparing the risk factors of coronary artery diseases in patients with stenotic and ectatic lesions

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20175313 ◽

2017 ◽

Vol 4 (12) ◽

pp. 4411

Author(s):

Bijan Zamani ◽

Behzad Babapour ◽

Firouz Amani ◽

Mohsen Ghasemian

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Systemic Hypertension ◽

City Hospital ◽

History Of ◽

The Mean ◽

Artery Disease ◽

Stenotic Lesions

Background: Coronary artery ectatic usually have relation with hyperlipidemia, systemic hypertension and male gender and its diagnosis done by angiography. Due to lack of proved risk factors for incidence of coronary artery ectatic lesions and also its important. The aim of this study was to compare the risk factors of coronary artery in patients with ectatic and stenotic lesions. Methods: This is a descriptive and analytical study that has been done on 300 patients hospitalized in Ardabil city hospital. Patients were enrolled according to the criteria and undergone to angiography. According to result of angiography, patients who have ectatic lesions as the first group and patients whose lesions were stenotic were named as the second group. Information obtained from patients entered in the checklist and analyzed by statistical methods in SPSS.16. Results: 22% of patients with ectatic lesions and 78% with stenotic lesions in patients with ectatic lesions. The mean age was 58.7 years and 74.2% were male and in patients with lesions stenotic the mean age was 60.7 years and 54.3% were male. Based on angiography results, in patients with ectatic lesions 42.4% have engaged in a carotid and 44.4% were two clashes coronary arteries in group stenotic. 34.7% of patients have history of previous mi, 32.9% history of coronary artery disease, 54.7% history of smoking, 56% had diabetes mellitus and 56% had hypertension. History of previous MI (p=0.028), smoking (p=0.04) and diabetes mellitus (p=0.001) and history of coronary artery disease are effective risk factors in two groups. Conclusions: The results showed that previous history of myocardial infarction, smoking and DM have significant relation with type of lesions.

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Romanian Patients Who Experience in-Stent Restenosis After St-Elevation Myocardial Infarction: The Experience of a Tertiary Center

Internal Medicine ◽

10.2478/inmed-2021-0154 ◽

2021 ◽

Vol 18 (2) ◽

pp. 7-13

Author(s):

Alice Elena Munteanu ◽

Liviu Chiriac ◽

Filip Romi Bolohan ◽

Daniel Niţă ◽

Ruxandra Constantinescu ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Coronary Artery ◽

St Elevation Myocardial Infarction ◽

Warning Sign ◽

Stent Restenosis ◽

Tertiary Center ◽

History Of ◽

St Elevation ◽

In Stent Restenosis

Abstract Background and aim. Coronary artery disease (CAD) is one of the most important causes of death worldwide. ST-elevation myocardial infarction (STEMI) is an acute form of presentation in patients with CAD. Percutaneous coronary intervention (PCI) is the treatment of choice in STEMI patients. Generally, a stent is placed after the culprit lesion is dilated in order to ensure the patency of the coronary artery. In-stent restenosis (ISR) is a possible chronic complication in this setting. The following study is one of the few of its kind, since it investigates ISR in a cohort of Romanian patients who underwent PCI in the setting of STEMI. Our current descriptive study aims at highlighting the characteristics of these patients and identifying potential risk factors in this specific population, which could be validated by a further larger study. Methods. We studied 68 patients from “Dr. Carol Davila” Central Military Emergency University Hospital in Bucharest, Romania, who presented with STEMI in 2016. The mean time for angiographic reevaluation was 111 days. Results. 94% (64) of the patients underwent primary PCI, while in 6% (4) of the cases thrombolysis was initially attempted before PCI. The most prevalent risk factors that we identified were: arterial hypertension (61%), dyslipidemia (60%) and smoking or history of smoking (47%). The anterior myocardial infarction was the most prevalent (49%). Only 6% of the patients had a documented history of CAD, while on the other hand chronic occlusions were observed in most patients (85%). Of note is that only 11% of the patients reported recurrent angina before the angiographic reevaluation. Conclusion. Common cardiovascular risk factors are also involved in ISR. Their poor management in the case of Romanian patients with STEMI increases the risk of ISR. The lack of symptoms in patients with ISR constitutes a warning sign for clinicians and shows that ISR is a complication which can be easily omitted. Therefore, its incidence is probably underestimated.

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