Association of Metabolic Phenotypes With Coronary Artery Disease and Cardiovascular Events in Patients With Stable Chest Pain

Diabetes Care ◽  
2021 ◽  
pp. dc201760
Author(s):  
Andreas A. Kammerlander ◽  
Thomas Mayrhofer ◽  
Maros Ferencik ◽  
Neha J. Pagidipati ◽  
Julia Karady ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Metabolic Phenotypes ◽  
Artery Disease ◽  
Stable Chest Pain

scholarly journals Association of Metabolic Phenotypes With Coronary Artery Disease and Cardiovascular Events in Patients With Stable Chest Pain

2021 ◽  
Author(s):  
Andreas A. Kammerlander ◽  
Thomas Mayrhofer ◽  
Maros Ferencik ◽  
Neha J. Pagidipati ◽  
Julia Karady ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Metabolic Phenotypes ◽  
Ct Findings ◽  
Metabolically Healthy ◽  
Artery Disease ◽  
Stable Chest Pain

<u>Objectives.</u> Determine the association of distinct metabolic phenotypes with coronary artery disease (CAD) and major adverse cardiovascular events (MACE). <p><u>Background</u>. Obesity and metabolic syndrome are associated with MACE. However, whether distinct metabolic phenotypes differ in risk for CAD and MACE is unknown. </p> <p><u>Methods.</u> We included patients from the <i>Prospective Multicenter Imaging Study for Evaluation of Chest Pain·(PROMISE) </i>who underwent coronary computed tomography (CT) angiography. Obesity was defined as a BMI≥30kg/m<sup>2</sup>, and metabolically healthy as ≤1 metabolic syndrome component except diabetes, distinguishing four metabolic phenotypes: metabolically healthy/unhealthy and non-obese/obese (MHN·<br> MHO·MUN·MUO). Differences in severe calcification (CAC≥400), severe CAD (≥70% stenosis), high-risk plaque (HRP), and MACE were assessed using adjusted logistic and Cox-regression models.</p> <p><u>Results.</u> Of 4,381 patients (48.4% male, 60.5±8.1y/o), 49.4% were metabolically healthy (30.7% MHN; 18.7% MHO) and 50.6% unhealthy (22.3% MUN; 28.4% MUO). MHO had similar coronary-CT findings as compared to MHN (severe CAC/CAD and HRP, p>0.36 for all). Among metabolically unhealthy patients, those with obesity had similar CT findings as compared to non-obese (p>0.10 for all). However, both MUN and MUO had unfavorable CAD characteristics as compared to MHN (p≤0.017 for all).</p> <p>130 events occurred during follow-up (median 26 months). Compared to MHN, MUN (HR 1.61·[1.02–2.53]) but not MHO (HR 1.06·[0.62–1.82) or MUO (HR 1.06·[0.66–1.72]) had higher risk for MACE. </p> <p><u>Conclusion.</u> In stable chest pain patients, four metabolic phenotypes exhibit distinctly different CAD characteristics and risk for MACE. Individuals who are metabolically unhealthy despite not being obese were at highest risk in our cohort.<b></b></p>

scholarly journals Association of Metabolic Phenotypes With Coronary Artery Disease and Cardiovascular Events in Patients With Stable Chest Pain

2021 ◽  
Author(s):  
Andreas A. Kammerlander ◽  
Thomas Mayrhofer ◽  
Maros Ferencik ◽  
Neha J. Pagidipati ◽  
Julia Karady ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Metabolic Syndrome ◽  
Chest Pain ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Metabolic Phenotypes ◽  
Ct Findings ◽  
Metabolically Healthy ◽  
Artery Disease ◽  
Stable Chest Pain

<u>Objectives.</u> Determine the association of distinct metabolic phenotypes with coronary artery disease (CAD) and major adverse cardiovascular events (MACE). <p><u>Background</u>. Obesity and metabolic syndrome are associated with MACE. However, whether distinct metabolic phenotypes differ in risk for CAD and MACE is unknown. </p> <p><u>Methods.</u> We included patients from the <i>Prospective Multicenter Imaging Study for Evaluation of Chest Pain·(PROMISE) </i>who underwent coronary computed tomography (CT) angiography. Obesity was defined as a BMI≥30kg/m<sup>2</sup>, and metabolically healthy as ≤1 metabolic syndrome component except diabetes, distinguishing four metabolic phenotypes: metabolically healthy/unhealthy and non-obese/obese (MHN·<br> MHO·MUN·MUO). Differences in severe calcification (CAC≥400), severe CAD (≥70% stenosis), high-risk plaque (HRP), and MACE were assessed using adjusted logistic and Cox-regression models.</p> <p><u>Results.</u> Of 4,381 patients (48.4% male, 60.5±8.1y/o), 49.4% were metabolically healthy (30.7% MHN; 18.7% MHO) and 50.6% unhealthy (22.3% MUN; 28.4% MUO). MHO had similar coronary-CT findings as compared to MHN (severe CAC/CAD and HRP, p>0.36 for all). Among metabolically unhealthy patients, those with obesity had similar CT findings as compared to non-obese (p>0.10 for all). However, both MUN and MUO had unfavorable CAD characteristics as compared to MHN (p≤0.017 for all).</p> <p>130 events occurred during follow-up (median 26 months). Compared to MHN, MUN (HR 1.61·[1.02–2.53]) but not MHO (HR 1.06·[0.62–1.82) or MUO (HR 1.06·[0.66–1.72]) had higher risk for MACE. </p> <p><u>Conclusion.</u> In stable chest pain patients, four metabolic phenotypes exhibit distinctly different CAD characteristics and risk for MACE. Individuals who are metabolically unhealthy despite not being obese were at highest risk in our cohort.<b></b></p>

scholarly journals Correction to: Health-related qualify of life, angina type and coronary artery disease in patients with stable chest pain

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Nina Rieckmann ◽  
Konrad Neumann ◽  
Sarah Feger ◽  
Paolo Ibes ◽  
Adriane Napp ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Health Related ◽  
Artery Disease ◽  
Stable Chest Pain

scholarly journals Is there a role for stress CMR in stable chest pain with >60% predicted risk of coronary artery disease?

QJM ◽  
2012 ◽  
Vol 105 (12) ◽  
pp. 1231-1231 ◽  
Author(s):  
A. G. Dastidar ◽  
F. Pugliese ◽  
C. Davies ◽  
M. Westwood ◽  
A. Timmis ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Artery Disease ◽  
Stable Chest Pain ◽  
Stress Cmr ◽  
Predicted Risk

scholarly journals MRI perfusion in patients with stable chest-pain

2020 ◽  
Vol 93 (1113) ◽  
pp. 20190881 ◽  
Author(s):  
Marly van Assen ◽  
Dirk Jan Kuijpers ◽  
Juerg Schwitter
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Cardiac Events ◽  
Non Invasive ◽  
Cardiovascular Mr ◽  
Esc Guidelines ◽  
Artery Disease ◽  
Stable Chest Pain ◽  
Cmr Imaging

Perfusion-cardiovascular MR (CMR) imaging has been shown to reliably identify patients with suspected or known coronary artery disease (CAD), who are at risk for future cardiac events and thus, allows for guiding therapy including revascularizations. Accordingly, it is an ideal test to exclude prognostically relevant coronary artery disease. Several guidelines, such as the ESC guidelines, currently recommend CMR as non-invasive testing in patients with stable chest pain. CMR has as an advantage over the more conventional pathways as it lacks radiation and it potentially reduces costs.

scholarly journals Inter-observer agreement of the Coronary Artery Disease Reporting and Data System (CAD-RADS TM ) in patients with stable chest pain

2018 ◽  
Vol 83 ◽  
pp. 151-159 ◽  
Author(s):  
Ahmed Abdel Khalek Abdel Razek ◽  
Mohamed Magdy Elrakhawy ◽  
Mahmoud Mohamed Yossof ◽  
Hadeer Mohamed Nageb
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Data System ◽  
Observer Agreement ◽  
Disease Reporting ◽  
Artery Disease ◽  
Stable Chest Pain

scholarly journals Computed Tomography-Derived Fractional Flow Reserve for the Diagnosis of Coronary Artery Disease

2021 ◽  
Vol 1 (11) ◽  
Author(s):  
Yi-Sheng Chao ◽  
Jennifer Horton
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Adult Patients ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease ◽  
Stable Chest Pain

Computed tomography-derived fractional flow reserve (CT-FFR) may predict coronary artery disease or flow-limiting stenosis in adult patients with stable chest pain better than coronary CT angiography alone, based on the relevant studies in 2 systematic reviews. CT-FFR is associated with a decreased need for invasive coronary angiography and revascularization in adult patients with stable chest pain, based on findings from 1 systematic review. In the US settings, CT-FFR was dominant (i.e., less costly and more effective) compared to stress testing for the evaluation of low-risk stable chest pain, based on findings from 1 cost-effectiveness study.

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