The assessment of atherosclerosis on vascular structures in patients with acute coronary syndrome

Introduction: Endothelial dysfunction plays a crucial role in the process of atherosclerotic diseases and has been accepted as an early stage of atherosclerosis. Carotid intima-media-thickness (CIMT) and flow-mediated-dilatation (FMD) of the brachial artery have been recommended as noninvasive methods to assess endothelial structure and function. Angiographic properties of patients with acute coronary syndrome (ACS) are closely associated with cardiovascular events. In this study, we investigated the relation of atherosclerotic properties of coronary, brachial and carotid arteries with CIMT, FMD and coronary angiography in patients with ACS. Methods: We enrolled 133 patients who were diagnosed with ACS into this study. Exclusion criteria were known coronary artery disease, diabetes mellitus and hypertension. Coronary angiography, CIMT and FMD were measured in all patients. The numbers of major stenotic coronary vessels with ?50% or ?70% were defined as diseased vessel. Gensini score was used to evaluate the severity of atherosclerosis. Morphologic properties of stenotic lesion were defined. Cutoff levels were 7% for FMD and 0.9 mm for CIMT. Results: Mean age was 59.7±11.8 years. FMD, CIMT and Gensini score were 8.3±5.9%, 0.80±0.19 mm and 7.8±3.5, respectively. Only 44% of patients with ACS had impaired FMD. Gensini score, number of diseased vessels and number of critical lesions were higher in patients with impaired FMD. (Gensini: 8.7±3.6 vs. 7.0±3.1, p=0.009, diseased vessels: 2.7±0.4 vs. 2.3±0.7, p < 0.0001, critical lesions: 3.0±2.1 vs. 2.2±1.4, p=0.02). Increased CIMT was found in only 33% of patients. Gensini score and number of diseased vessels were significantly higher in patients with increased CIMT. Significant but weak correlations were found between CIMT, FMD and angiographic severity of coronary atherosclerosis. Angiographic properties and lesion morphology were similar between CIMT and FMD groups. Conclusion: There appears to be a relationship between CIMT, FMD and severity of coronary atherosclerosis in patients with ACS. However, in patients with ACS, morphologic properties of stenotic lesions are not associated with CIMT and FMD in brachial artery.

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Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Angiology ◽

10.1177/0003319718772420 ◽

2018 ◽

Vol 70 (2) ◽

pp. 174-180 ◽

Cited By ~ 15

Author(s):

Burak Açar ◽

Ozcan Ozeke ◽

Mustafa Karakurt ◽

Yasin Ozen ◽

Mustafa Bilal Özbay ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Angiography ◽

Coronary Atherosclerosis ◽

Scoring Systems ◽

Diabetic Patients ◽

Coronary Syndrome ◽

Atherosclerotic Burden ◽

First Occurrence ◽

And Control ◽

The Impact

Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.

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Correlation between Serum High Sensitivity C-reactive Protein Level and Severity of Coronary Atherosclerosis Assessed by Angiographic Gensini Score in Patients with Acute Coronary Syndrome

Journal of Cardiovascular Medicine and Surgery ◽

10.21088/jcms.2454.7123.4218.5 ◽

2018 ◽

Vol 4 (2) ◽

pp. 100-107

Author(s):

Mayank Jain ◽

◽

Priyanka Kiyawat ◽

Surbhi Kiyawat ◽

◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Protein Level ◽

Coronary Atherosclerosis ◽

High Sensitivity ◽

Gensini Score ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome

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P261 The relationship between carotid intime-media thickness and modified gensini score in patients with acute coronary syndrome

European Heart Journal ◽

10.1093/ehjci/ehz872.086 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

Author(s):

M Y Nguyen Hoang Tai ◽

PHUONG Huynh Kim ◽

NGHIA Nguyen Thuong

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Atherosclerosis ◽

Surrogate Marker ◽

Duplex Ultrasound ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Gensini Score ◽

Cross Sectional ◽

Coronary Syndrome ◽

Media Thickness

Abstract Introduction Detection of extent and severity of atherosclerosis using easy, non-invasive methods is of great importance. Coronary atherosclerotic burden may be evaluated with the modified Gensini score (mGSS) while carotid intima media thickness (CIMT) is well known as a surrogate marker of atherosclerosis. Aim To investigate whether CIMT is a predictor of coronary atherosclerosis in Vietnamese patients. Methods This is a cross-sectional study of 276 patients who was diagnosed index acute coronary syndrome and underwent coronary angiography. mGSS was used to determine the extent and severity of coronary atherosclerosis. CIMT was estimated by carotid duplex ultrasound. Results In 276 patients, there were 192 men and 84 women, with ages ranging from 24 to 90 years. Median CIMT was 0.76mm (IQT 0.26mm); median mGSS was 140 (IQT 70). CIMT and mGSS were correlated with age (r= 0.269, p< 0.001 and r= 0.134, p< 0.001). CIMT were also correlated with vessels score (r= 0.222, p< 0.001), with stenosis score (r= 0.214, p< 0.001) and with the mGSS (r= 0.216, p< 0.001). This correlation were significantly recognized between groups with or without elevated CIMT. Conclusion Our data suggests that CIMT correlates positively with the extent and severity of coronary atherosclerosis. CIMT may be useful as a screening tool for the presence of CAD in Vietnamese population.

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Indicators of coronary angiography in patients with acute coronary syndrome and atrial fibrillation

Ukrainian Journal of Cardiology ◽

10.31928/1608-635x-2019.2.2331 ◽

2019 ◽

Vol 26 (2) ◽

pp. 23-31

Author(s):

V. Y. Tseluyko ◽

F Ben Salem ◽

N. A. Lopina

Keyword(s):

Atrial Fibrillation ◽

Acute Coronary Syndrome ◽

Coronary Angiography ◽

Coronary Vessels ◽

First Episode ◽

Coronary Syndrome ◽

Single Vessel ◽

Atherosclerotic Lesions ◽

Group 2 ◽

Atherosclerotic Process

The aim – to study the features of coronary artery (CA) deficiency (according to the results of selective coronary angiography) in patients with acute coronary syndrome (ACS) and atrial fibrillation (AF). Materials and methods. 125 patients who were hospitalized with ACS at the center of percutaneous coronary interventions during four years (2015–2018) were examined. 65 of them had AF. The criterion for inclusion in the study was the presence of ACS; exclusion criteria were the presence of severe concomitant diseases (active oncological processes, chronic renal failure grade IV, etc.), heart disease, refusal of the patient to participate in the study. The patients were divided into groups according to the presence of AF. Group 1 included patients with AF. Those of them who had the first AF onset during the hospitalization with ACS constituted subgroup 1a (n=41). Patients in whom AF was observed prior to the development of ACS composed subgroups 1b (n=24). Group 2 included patients without AF in anamnesis and during hospitalization (n=60). Results and discussion. The presence of AF in the development of ACS is associated with widespread atherosclerotic damage to CA, a multicentric lesion, statistically significantly greater than the average number of plaques per patient (2.87±0.46 vs. 2.31±0.34; p=0.00001), greater average number of affected segments per patient (2.78±0.42 vs. 2.43±0.37; p=0.0015), higher average number of hemodynamically significant stenoses of CA (2.22±0.33 vs. 1.60±0.24; p=0.00001) and damage to the proximal parts of CA (p=0.0001). Conclusions. The complication of the course of ACS by the development of the first episode of atrial fibrillation is more common in patients with angiographically intact coronary vessels, under condition of single-vessel atherosclerotic lesions of CA and involvement of the left CA in the atherosclerotic process. In patients with ACS and AF emerging for the first time, the level of NT-proBNP is higher compared to the group of patients without AF and to the group of patients with AF preceding the development of ACS, especially in patients with single-vessel CA damage.

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