Tranexamic Acid Is Safe in Patients with a History of Coronary Artery Disease Undergoing Total Joint Arthroplasty

2021 ◽  
Vol 103 (10) ◽  
pp. 900-904
Author(s):  
Stephen G. Zak ◽  
Alex Tang ◽  
Mohamad Sharan ◽  
Daniel Waren ◽  
Joshua C. Rozell ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Tranexamic Acid ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
History Of ◽  
Artery Disease

scholarly journals Risk Factors for Infection Following Total Joint Arthroplasty in Rheumatoid Arthritis

2013 ◽  
Vol 7 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Ranjani Somayaji ◽  
Cheryl Barnabe ◽  
Liam Martin
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hospital Admission ◽  
Total Joint Arthroplasty ◽  
Surgical Site Infections ◽  
Joint Arthroplasty ◽  
Increased Risk ◽  
Artery Disease

Objectives: Determine risk factors for infection following hip or knee total joint arthroplasty in patients with rheumatoid arthritis. Methods: All rheumatoid arthritis patients with a hip or knee arthroplasty between years 2000 and 2010 were identified from population-based administrative data from the Calgary Zone of Alberta Health Services. Clinical data from patient charts during the hospital admission and during a one year follow-up period were extracted to identify incident infections. Results: We identified 381 eligible procedures performed in 259 patients (72.2% female, mean age 63.3 years, mean body mass index 27.6 kg/m2). Patient comorbidities were hypertension (43.2%), diabetes (10.4%), coronary artery disease (13.9%), smoking (10.8%) and obesity (32%). Few infectious complications occurred: surgical site infections occurred within the first year after 5 procedures (2 joint space infections, 3 deep incisional infections). Infections of non-surgical sites (urinary tract, skin or respiratory, n=4) complicated the hospital admission. The odds ratio for any post-arthroplasty infection was increased in patients using prednisone doses exceeding 15 mg/day (OR 21.0, 95%CI 3.5-127.2, p=<0.001), underweight patients (OR 6.0, 95%CI 1.2-30.9, p=0.033) and those with known coronary artery disease (OR 5.1, 95%CI 1.3-19.8, p=0.017). Types of disease-modifying therapy, age, sex, and other comorbidities were not associated with an increased risk for infection. Conclusion: Steroid doses over 15 mg/day, being underweight and having coronary artery disease were associated with significant increases in the risk of post-arthroplasty infection in rheumatoid arthritis. Maximal tapering of prednisone and comorbidity risk reduction must be addressed in the peri-operative management strategy.

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 %)

scholarly journals The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease

2020 ◽  
Author(s):  
Han-Young Jin ◽  
Jonathan R. Weir-McCall ◽  
Jonathon A. Leipsic ◽  
Jang-Won Son ◽  
Stephanie L. Sellers ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Natural History ◽  
Coronary Calcification ◽  
History Of ◽  
Artery Disease ◽  
The Relationship

Are hypertensive patients with history of coronary artery disease at risk for silent lower extremity artery disease?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Eka Prasetya Budi Mulia ◽  
Kevin Yuwono ◽  
Raden Mohammad Budiarto
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Lower Extremity ◽  
Pearson Correlation ◽  
Ankle Brachial Index ◽  
Chi Square ◽  
Hypertensive Patients ◽  
History Of ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Abstract Objectives We aimed to investigate the association between hypertension and asymptomatic lower extremity artery disease (LEAD) in outpatients with known history of coronary artery disease (CAD). Methods Patients with known history of CAD who have been undergone coronary angiography and have significant coronary artery stenosis (more than 60%) were included. LEAD was defined as ankle-brachial index (ABI) < 0.9 in either leg. The risk of LEAD in hypertensive group was analyzed using chi-square test, and correlation between blood pressure (BP) and ABI was analyzed using Pearson correlation test in SPSS v.25. Results One hundred and four patients were included. 82.7% of patients were male. Mean age was 57.05 ± 7.97. The prevalence of hypertension was 35.6%, and the prevalence of LEAD was 16.3%. A higher proportion of LEAD was found in hypertensive (18.9%) compared to non-hypertensive (14.9%), although not statistically significant (OR: 1.33; 95% CI: 0.46 to 3.85; p=0.598). There was an association between ABI and systolic BP (p=0.016), but not with diastolic BP (p=0.102). Conclusions Our study showed that the prevalence of LEAD in hypertension, especially in the CAD population, is relatively high. There was no association between hypertension and LEAD, but a higher prevalence of LEAD was found in hypertensive patients. Nevertheless, LEAD screening is still recommended in hypertensive patients, especially in the CAD population, given the fact that outcomes of health and mortality are worse for those with concomitants of these diseases.

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.

Platelet Survival Time in Coronary Artery Disease: Incidence and Significance

1975 ◽  
Author(s):  
P. Steele ◽  
E. Genton
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Survival Time ◽  
Saphenous Vein ◽  
Disease Incidence ◽  
Platelet Survival ◽  
Vein Bypass ◽  
History Of ◽  
Artery Disease ◽  
Or History

A role for platelets in the etiology of coronary artery disease (CAD) and its complications has been suggested. In 68 men with angiographically defined CAD platelet survival (SURV) (51Chromium) was shortened (3.2±.04 days; AVE±SEM; normal 3.7±.04 days; p < 0.001) and 41 (60%) had shortened SURV (< 3.3 days). SURV did not correlate with severity of CAD, angina, or history of infarction. Of 37 with hyperlipoproteinemia SURV was shortened (3.1 ±.12 days) in 27 (73%) and different from 31 with normal lipids (3.3±. 12 days; p < 0.05). SURV was performed in 35 following aorto-coronary saphenous vein bypass (ACB). Of 15 with all grafts open, SURV was normal (3.5±.11 days) in 10 (67%). Of 20 with one or more grafts occluded SURV was shortened (2.6±.08 days) in 19 (95%). In 11 with normal SURV, one of 23 (4%) grafts was occluded while in 24 with shortened SURV 26 of 46 (56%) grafts were occluded, Clofibrate prolonged shortened SURV (2.6 ±.09 to 3.4±14 days; p < 0.001) and altered lipids. Sulfinpyrazone prolonged shortened SURV (2.8 ±.12 to 3.6 ±.21 days; p < 0.001) and failed to alter lipids. Data suggest that shortened SURV is frequently present in CAD, can be altered by platelet suppressant agents and is associated with ACB occlusion.

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