scholarly journals Relation between the ankle-brachial index and the complexity of coronary artery disease in older patients

2013 ◽  
pp. 1611 ◽  
Author(s):  
Felipe Falcao ◽  
Cláudia Alves ◽  
Adriano Caixeta ◽  
Leonardo Guimarães ◽  
Izo Helber ◽  
...  
Author(s):  
Eka Prasetya Budi Mulia ◽  
Kevin Yuwono ◽  
Raden Mohammad Budiarto

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xue-Ming Li ◽  
Zhong-Zhi Xu ◽  
Zhi-Peng Wen ◽  
Jiao Pei ◽  
Wei Dai ◽  
...  

Abstract Background Cumulative evidence has shown that the non-invasive modality of coronary computed tomography angiography (CCTA) has evolved as an alternative to invasive coronary angiography, which can be used to quantify plaque burden and stenosis and identify vulnerable plaque, assisting in diagnosis, prognosis and treatment. With the increasing elderly population, many patients scheduled for non-cardiovascular surgery may have concomitant coronary artery disease (CAD). The aim of this study was to investigate the usefulness of preoperative CCTA to rule out or detect significant CAD in this cohort of patients and the impact of CCTA results to clinical decision-making. Methods 841 older patients (age 69.5 ± 5.8 years, 74.6% males) with high risk non-cardiovascular surgery including 771 patients with unknown CAD and 70 patients with suspected CAD who underwent preoperative CCTA were retrospectively enrolled. Multivariate logistic regression analysis was performed to determine predictors of significant CAD and the event of cancelling scheduled surgery in patients with significant CAD. Results 677 (80.5%) patients had non-significant CAD and 164 (19.5%) patients had significant CAD. Single-, 2-, and 3- vessel disease was found in 103 (12.2%), 45 (5.4%) and 16 (1.9%) patients, respectively. Multivariate analysis demonstrated that positive ECG analysis and Agatston score were independently associated with significant CAD, and the optimal cutoff of Agatston score was 195.9. The event of cancelling scheduled surgery was increased consistently according to the severity of stenosis and number of obstructive major coronary artery. Multivariate analysis showed that the degree of stenosis was the only independent predictor for cancelling scheduled surgery. In addition, medication using at perioperative period increased consistently according to the severity of stenosis. Conclusions In older patients referred for high risk non-cardiovascular surgery, preoperative CCTA was useful to rule out or detect significant CAD and subsequently influence patient disposal. However, it might be unnecessary for patients with negative ECG and low Agatston score. Trial registration Retrospectively registered.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
So Young Shin ◽  
Ji Mi Mun

Abstract Purpose: The purpose of this study was to examine the effects of disease-related knowledge, depression, and family support on health behaviors of older patients with coronary artery disease. Methods: The subjects were 139 older patients with coronary artery disease who had visited the internal medicine outpatient clinic at one general hospital located in metropolitan city B, Korea. A set of self-reported questionnaire was administered to assess general characteristics, disease-related knowledge, depression, family support, and health behaviors of the subjects. Collected data was analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean (±SD) age of the subjects was 70.86 (±4.70) years. Health behaviors of the subjects had significant negative correlations with disease-related knowledge (r=-.17, p=.050) and depression (r=-.32, p&lt;.001) while having a significant positive correlation with family support (r=.67, p&lt;.001). In the final multiple regression analysis, factors influencing health behaviors of subjects were medication intake status (β=-.17, p=.009), depression (β=-.15, p=.017) and family support (β=.61, p&lt;.001). The explanatory power of the subjects’ medication intake status, disease-related knowledge, depression and family support on health behaviors was 48.9% (F=33.97, p&lt;.001). Conclusion: Medication intake status, depression, and family support had significant influences on health behaviors of older patients with coronary artery disease. Improvements in medication intake, depression, and family support for older patients with coronary artery disease may be beneficial for their health behaviors, and ultimately, have a positive effect on their recovery from the disease and well-being.


Author(s):  
BHARATH KUMAR A ◽  
UMASHANKAR MS

Objective: The objective of the study was to assess the clinical pharmacist interventions in the management of diabetes complicated coronary artery disease. Methods: In the present study, a case history of a 55-year-old female was suffering from diabetes with coronary artery disease was taken. The case was collected from the cardiology outpatient department in a tertiary care hospital. The case was analyzed from 1 to 3 months. The initial visit to the end of final visit her laboratory parameters was examined at the laboratory. Results: The test report of electrocardiogram revealed sinus rhythm. The patient was advised for an echocardiogram which confirmed coronary artery disease. The patient was subjected to a coronary angiogram, which revealed the presence of double-vessel disease. Her ankle-brachial index study test revealed peripheral artery disease. The patient was diagnosed with coronary artery disease, and she was prescribed with regular medications. The patient was monitored for 1-week duration and prescribed with coronary artery disease medications to normalize the condition. The patient was improved with the treatment and advised for regular follow-ups. Conclusion: The study concludes that there was an imperative need for regular health screening by the physician associated clinical pharmacist care services with an effective treatment modality that can reduce the coronary artery disease incidences in this patient.


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