A Novel and Simply Calculated Cardiac Load Index Correlates With Coronary Artery Disease

Abstract Background: No cardiac load index (CLI) has been established for patients with coronary artery disease (CAD). We propose a simple method for calculating CLI and explore the association of CLI with CAD.Methods: We enrolled 4145 consecutive inpatients with suspected stable CAD from December 2011 to June 2017 at the Chengde Medical University Affiliated Hospital. All patients were divided into the CAD (n=2914) and the NCAD groups (n=1231) according to coronary computed tomography angiography. We retrospectively collected data and calculated the CLI values of all patients. The receiver operating characteristic diagnostic test analysis was performed with CLI≥77, CLI≥125, CLI≥171, CLI≥217, and CLI≥264, respectively. Multivariate logistic regression models were established to determine the risk factors of CAD. Results: The CLI was significantly higher in the CAD group than in the NCAD group and higher in the male than in the female subgroup (both P<0.001). CLI≥171 was the diagnostic cut-off value. The predictive power of CLI≥171 for CAD improved after considering other risk factors. CLI≥171 is a new independent risk factor for CAD, and is an independent risk factor for CAD in males and females (all P<0.001).Conclusions: Increased CLI is an independent risk factor for CAD, it may be used as a predictor for the prevalence for CAD to improve diagnosis and prevention.

Download Full-text

Pericardial adipose tissue is an independent risk factor of coronary artery disease and is associated with risk factors of coronary artery disease

Journal of International Medical Research ◽

10.1177/0300060520926737 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052092673

Author(s):

Yueqiao Si ◽

Zhixin Cui ◽

Jingyi Liu ◽

Zhenjiang Ding ◽

Chao Han ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Adipose Tissue ◽

Risk Factor ◽

Coronary Artery ◽

Independent Risk Factor ◽

Density Lipoprotein ◽

Pericardial Adipose Tissue ◽

Artery Disease ◽

Fat Volume

Objective Pericardial adipose tissue volume (PATV) is related to the mechanism of coronary artery disease (CAD), but its association with CAD risk factors is not clear. This study aimed to investigate the relationships between PATV and its associated factors. Methods A total of 682 inpatients were consecutively enrolled in this study. Patients were divided into the high PATV group (PATV ≥174.5 cm3; n = 506) and low PATV group (PATV < 174.5 cm3; n = 176). Multiple linear regression analysis was conducted to evaluate the related factors of PATV. Multivariable logistic regression was used to analyze the risk factors of CAD. Results Left ventricular fat volume, right ventricular fat volume, body mass index, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were significant and independent risk factors of enlargement of PATV. Increased PATV was identified as an independent risk factor of CAD, and increased pulse pressure was also independently and positively correlated with CAD. Conclusions PATV is significantly correlated with the classic risk factors of CAD. Pulse pressure is also correlated with PATV. PATV is an independent risk factor of CAD, and pericardial adipose tissue may alternatively be used in non-invasive diagnostic examination of CAD.

Download Full-text

Association of smoking with coronary artery disease in Nepalese populations: a case control study

Toxicology Research ◽

10.1039/c9tx00083f ◽

2019 ◽

Vol 8 (5) ◽

pp. 677-685

Author(s):

Til Bahadur Basnet ◽

Cheng Xu ◽

Manthar Ali Mallah ◽

Wiwik Indayati ◽

Cheng Shi ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Case Control Study ◽

Case Control ◽

Psychosocial Risk ◽

Psychosocial Risk Factor ◽

Artery Disease ◽

Control Study

Abstract There are well-known traditional risk factors for coronary artery disease (CAD). Among them, smoking is one of the most prominent and modifiable risk factors. This study aims to determine the magnitude of smoking as a risk factor for CAD in the Nepalese population. A hospital-based age- and sex-matched case–control study was carried out with a total of 612 respondents. Bivariate analysis showed that the risk of developing CAD in ex-smokers and current smokers was higher (odds ratio (OR): 1.81 (confidence interval (CI): 1.21–2.7) and OR: 5.2 (CI: 3.4–7.97)), with p-values less than 0.004 and <0.00001, respectively, compared to the risk in never smokers. From stratified socio-demographic, cardio-metabolic, behavioural and psychosocial risk factor analysis, smoking was found to be associated with CAD in almost all subgroups. In the subsequent multivariate analysis, adjustment for socio-demographic, cardio-metabolic and psychosocial risk factors showed a steady increase in risk. However, further adjustment for behavioural risk factors (alcohol use and physical activity) showed that the risk was attenuated by 59% in current smokers. After adjusting for the covariates, current smokers and ex-smokers had an increased risk of CAD (OR: 6.64, 95% CI: 3.64–12.12, p < 0.00001; OR: 1.89, 95% CI: 1.08–3.31, p < 0.012, respectively) compared with non-smokers. In conclusion, smoking was found to increase the risk of CAD in the Nepalese population.

Download Full-text

Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry

Thrombosis and Haemostasis ◽

10.1055/s-0038-1675401 ◽

2018 ◽

Vol 118 (12) ◽

pp. 2162-2170 ◽

Cited By ~ 11

Author(s):

Kamilla Steensig ◽

Kevin Olesen ◽

Troels Thim ◽

Jens Nielsen ◽

Svend Jensen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Coronary Angiography ◽

Ischaemic Stroke ◽

Independent Risk Factor ◽

Oral Anticoagulants ◽

Increased Risk ◽

Artery Disease

Background Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. Objectives This article explores whether CAD per se or extent provides independent prognostic information of future stroke among patients with AF. Materials and Methods Consecutive patients with AF and coronary angiography performed between 2004 and 2012 were included. The endpoint was a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. The risk of ischaemic events was estimated according to the presence and extent of CAD. Incidence rate ratios (IRR) were calculated in reference to patients without CAD and adjusted for parameters included in the CHA2DS2-VASc score and treatment with anti-platelet agents and/or oral anticoagulants. Results Of 96,430 patients undergoing coronary angiography, 12,690 had AF. Among patients with AF, 7,533 (59.4%) had CAD. Mean follow-up was 3 years. While presence of CAD was an independent risk factor for the composite endpoint (adjusted IRR, 1.25; 1.06–1.47), extent of CAD defined as 1-, 2-, 3- or diffuse vessel disease did not add additional independent risk information. Conclusion Presence, but not extent, of CAD was an independent risk factor of the composite thromboembolic endpoint beyond the components already included in the CHA2DS2-VASc score. Consequently, we suggest that significant angiographically proven CAD should be included in the vascular disease criterion in the CHA2DS2-VASc score.

Download Full-text

Sex differences in clinical outcomes of patients with stable coronary artery disease after percutaneous coronary intervention

Current Pharmaceutical Design ◽

10.2174/1381612827666210303142901 ◽

2021 ◽

Vol 27 ◽

Author(s):

Emmanuel P. Vardas ◽

Evangelos Oikonomou ◽

Gerasimos Siasos ◽

Panagiotis Theofilis ◽

Polychronis Dilaveris ◽

...

Keyword(s):

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Independent Risk Factor ◽

Stable Coronary Artery Disease ◽

Coronary Intervention ◽

Female Sex ◽

Percutaneous Coronary ◽

Artery Disease

: Potential sex-related differences in the periprocedural and long-term postprocedural outcomes of coronary angioplasty in patients with stable coronary artery disease have been studied thoroughly over the last few decades, to determine whether female sex should be regarded as an independent risk factor that affects clinical outcomes. Based on a significant number of observational studies and meta-analyses, sex has not yet emerged as an independent risk factor for either mortality or major cardiac and cerebrovascular events, despite the fact that in the early 1980s, for several reasons, female sex was associated with unfavourable outcomes. Therefore, it remains debatable whether female sex should be considered as an independent risk factor for periprocedural and long-term bleeding events. The pharmacological and technological advancements that support current coronary angioplasty procedures, as well as the non-delayed treatment of coronary artery disease in females have certainly lessened the outcome differences between the two sexes. However, females show fluctuations in blood coagulability through their lifetime and higher prevalence of bleeding episodes associated with the antithrombotic treatment, following transcatheter coronary reperfusion interventions. In conclusion, the clinical results of percutaneous coronary intervention in patients with stable coronary artery disease, during the periprocedural and long-term postprocedural periods, appear to show no significant differences between the two sexes, except for bleeding rates, which seem to be higher in females, a difference that mandates further systematic research.

Download Full-text

Lifestyle related risk factors of coronary artery disease patients in Nepal

European Journal of Public Health ◽

10.1093/eurpub/ckz186.199 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

P Gaudel ◽

M Kaunonen ◽

S Neupane ◽

K Joronen ◽

A M Koivisto ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Categorical Variables ◽

Dietary Habit ◽

Total Study Population ◽

Related Risk ◽

Study Population ◽

Artery Disease

Abstract Background Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality and serious health problem worldwide. It is important to observe lifestyle related risk factors in patients with CAD for effective planning and implementation of secondary prevention strategies. The aim of this study is to describe the prevalence of lifestyle related risk factor habits among the patients with CAD. Methods A cross-sectional study was conducted among CAD patients in a tertiary care national heart center in Kathmandu, Nepal. Six lifestyle related factors (dietary habit, smoking, alcohol consumption, stress, physical activity and adherence to medication) and Body Mass Index were used as the risk factors of CAD in this study. Individual face-to-face structured interview was conducted using culturally validated standard instruments. The descriptive characteristics were presented as frequencies and percentages for categorical variables and as mean ± standard deviation (SD) or median and interquartile range (IQR) otherwise. Results In total study population, the mean age of the patients was 59.9 years and 76% were male. Patients having any three risk factors out of seven were the most common (36%) followed by two risk factors (25%) and four risk factors (22%). About 32% of study population were current smokers, whereas 29% were former smokers. Likewise, 31% of the total were physically inactive. Majority of the patients 95% had perceived moderate stress. Conclusions The prevalence of lifestyle related risk factors is high among CAD patients in study population. Combination of any three lifestyle related risk factors were the most common among patients. Therefore, studies focusing on lifestyle risk factor modification intervention on particular groups is recommended. Key messages Need to improve awareness about lifestyle related risk factors among CAD patients. Highlight the importance of lifestyle counselling.

Download Full-text

Association of Lipoprotein-Associated Phospholipase A2 with Coronary Artery Disease in African-Americans and Caucasians

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2009-2498 ◽

2010 ◽

Vol 95 (5) ◽

pp. 2376-2383 ◽

Cited By ~ 18

Author(s):

Erdembileg Anuurad ◽

Zeynep Ozturk ◽

Byambaa Enkhmaa ◽

Thomas A. Pearson ◽

Lars Berglund

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

African American ◽

Risk Factor ◽

Cardiovascular Risk ◽

Coronary Artery ◽

African Americans ◽

Coronary Angiography ◽

Pla2 Activity ◽

Artery Disease

Abstract Context: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is bound predominately to low-density lipoprotein and has been implicated as a risk factor for coronary artery disease (CAD). Objective: We investigated the association between Lp-PLA2 and CAD in a biethnic African-American and Caucasian population. Design: Lp-PLA2 mass, activity, and index, an integrated measure of mass and activity, and other cardiovascular risk factors were determined in 224 African-Americans and 336 Caucasians undergoing coronary angiography. Main Outcome Measures: We assessed the distribution of Lp-PLA2 levels and determined the predictive role of Lp-PLA2 as a risk factor for CAD. Results: Levels of Lp-PLA2 mass and activity were higher among Caucasians compared with African-Americans (293 ± 75 vs. 232 ± 76 ng/ml, P < 0.001 for mass and 173 ± 41 vs. 141 ± 39 nmol/min/ml, P < 0.001 for activity, respectively). However, Lp-PLA2 index was similar in the two groups (0.61 ± 0.17 vs. 0.64 ± 0.19, P = NS). In both ethnic groups, Lp-PLA2 activity and index was significantly higher among subjects with CAD. African-American subjects with CAD had significantly higher Lp-PLA2 index than corresponding Caucasian subjects (0.69 ± 0.20 vs. 0.63 ± 0.18, P = 0.028). In multivariate regression analyses, after adjusting for other risk factors, Lp-PLA2 index was independently (odds ratio 6.7, P = 0.047) associated with CAD in African-Americans but not Caucasians. Conclusions: Lp-PLA2 activity and index was associated with presence of CAD among African-Americans and Caucasians undergoing coronary angiography. The findings suggest an independent impact of vascular inflammation among African-Americans as contributory to CAD risk and underscore the importance of Lp-PLA2 as a cardiovascular risk factor.

Download Full-text

Malnutrition is a major factor to affect prognosis of patients undergo percutaneous coronary intervention for coronary artery disease with calcified lesions

European Heart Journal ◽

10.1093/ehjci/ehaa946.1337 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Sonoda ◽

D Kanda ◽

K Anzaki ◽

R Arikawa ◽

A Tokushige ◽

...

Keyword(s):

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Stable Angina ◽

Independent Risk Factor ◽

Proportional Hazards ◽

Target Lesion ◽

Cox Proportional Hazards ◽

Hs Crp ◽

Artery Disease

Abstract Background In patients undergo PCI for coronary artery disease, target lesion calcification is associated with major cardiac events. Malnutrition is the important factor to cause frailty and sarcopenia which affect prognosis of cardiovascular diseases. However, the relationship between morphology in target lesions and malnutrition in patients undergo PCI is still uncertain. Purpose The aim of the present study was to investigate how malnutrition affects prognosis of stable angina patients underwent PCI and morphology in target lesions. Methods The subject was 206 consecutive stable angina patients undergone successful PCI using second-generation drug eluting stents and intravascular ultrasound (IVUS). The study patients were divided into two groups based on malnutrition or non-malnutrition. Nutritional status was assessed by Geriatric Nutritional Risk Index (GNRI), and patients with GNRI<92 at admission were defined as malnutrition group (MG). We investigated the association between malnutrition on admission and outcome, and morphology in target lesions assessed by IVUS. Target lesion morphology were divided into moderate/severe calcified group and none/mild calcified group. Results All-cause death and MACCE (major cardiovascular and cerebrovascular events) ≤3 years after PCI were 15 cases (7%) and 33 cases (16%). MG had higher rate of all-cause death (20 vs. 6%, p=0.001) and MACCE (37 vs. 10%, p<0.001) than those of non-MG. Kaplan Meier analysis elucidated that survival rate was significantly lower in MG compared to that in non-MG (p<0.001). As a result of cox proportional hazards analysis, all-cause death was associated with age [hazard ratio (HR): 1.05, 95% confidence interval (CI): 1.01–1.10, p=0.006)], hs-CRP (HR: 1.03, 95% CI: 1.03–1.12, p<0.001), hemodialysis (HR: 2.25, 95% CI: 1.08–4.68, p=0.029), left ventricular ejection fraction (LVEF) (HR: 0.97, 95% CI: 0.95–0.99, p=0.017) and malnutrition (HR: 4.38, 95% CI: 2.11–9.09, p<0.001) in the univariate analysis. Similarly, cox proportional hazards analysis revealed that age (HR: 1.04, 95% CI: 1.01–1.07, p=0.018), hs-CRP (HR: 1.08, 95% CI: 1.03–1.11, p<0.001), hemodialysis (HR: 2.68, 95% CI: 1.45–4.94, p=0.002), LVEF (HR: 0.97, 95% CI: 0.95–0.99, p=0.002) and malnutrition (HR: 4.14, 95% CI: 2.23–7.67, p<0.001) were significantly associated with MACCE. Multivariate analysis for all-cause death and MACCE revealed that malnutrition was an independent risk factor (HR: 3.47, 95% CI: 1.52–7.94, p=0.003, HR: 3.76, 95% CI: 1.87–7.58, p<0.001). Furthermore, MG was significantly associated with moderate/severe target calcified lesions assessed by IVUS compared to those of patients in non-MG (67 vs. 27%, p<0.001) regardless with or without hemodialysis. Conclusions Malnutrition was a crucial independent risk factor for stable angina patients who underwent PCI and was significantly associated with moderate/severe target calcified lesions. Funding Acknowledgement Type of funding source: None

Download Full-text