scholarly journals Relationship Between Duke Treadmill Score and Coronary Artery Lesion Complexity

2012 ◽  
Vol 35 (6) ◽  
pp. 365 ◽  
Author(s):  
Zeydin Acar ◽  
Levent Korkmaz ◽  
Mustafa T Agac ◽  
Hakan Erkan ◽  
Ihsan Dursun ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Negative Correlation ◽  
Invasive Coronary Angiography ◽  
Coronary Artery Lesion ◽  
Syntax Score ◽  
Strong Negative Correlation ◽  
Artery Disease ◽  
The Relationship

Purpose: The purpose of this study was to investigate the relationship between the Duke Treadmil Score (DTS) and coronary artery disease (CAD) complexity in patients with suspected coronary artery disease (CAD). Methods: Sixty five patients who had positive exercise testing for CAD were enrolled. Coronary angiography was performed and Syntax score (SxScore), a marker of CAD complexity, was determined. The relationship between DTC and SxScore then evaluated. Results: There was a strong negative correlation between DTS and SxScore (r= - 0.91, p < 0.001). In addition, patients with higher and intermediate risk as evaluated by DTS had increased SxScore compare to those that were low risk (23 ± 6, 6 ± 5 and 0 ± 0 respectively). Conclusions: A strong negative correlation was seen between DTS and coronary lesion complexity. By assessing DTS important information about coronary artery lesion complexity can be obtained before invasive coronary angiography.

Epicardial fat study-AG: relationship between echocardiographic epicardial fat and coronary artery disease in patients after invasive coronary artery angiography

2020 ◽  
Author(s):  
Ilenia Alessandra Di Liberto ◽  
Gerlando Pilato ◽  
Sergio Buccheri ◽  
Salvatore Geraci ◽  
Diego Milazzo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Invasive Coronary Angiography ◽  
Epicardial Fat ◽  
Clear Correlation ◽  
Syntax Score ◽  
Gensini Score ◽  
Coronary Artery Angiography ◽  
Artery Disease

Background: Epicardial fat increase has not yet a clear correlation with coronary artery disease (CAD). Aim: This study had as goal to demonstrate a relationship between an increase of epicardial fat thickness (EFT) and CAD. Materials & methods: In this observational study, we included 234 patients who underwent invasive coronary angiography. Before invasive coronary angiography, all patients underwent echocardiographic-2D for evaluation of EFT and they were divided into groups based on Gensini score and also on Syntax score. Results: EFT was significantly correlated to the presence and severity of CAD assessed by Gensini score with a cut-off value of 5.2 mm (sensitivity of 90.9%-specificity of 87.3%- area under the ROC curve = 92.1%). Conclusion: EFT increase (fat index ≥5.2 mm) evaluated by echocardiographic-2D could be considered as a risk factor for predicting CAD.

scholarly journals The Relationship between Inter-Arm Blood Pressure Difference and Coronary Artery Disease Severity Calculated by the SYNTAX Score

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Gündüz Durmuş ◽  
Erdal Belen ◽  
Akif Bayyigit ◽  
Muhsin Kalyoncuoğlu ◽  
Mehmet Mustafa Can
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Pressure Difference ◽  
Syntax Score ◽  
Pressure Measurements ◽  
Blood Pressure Difference ◽  
Artery Disease ◽  
The Relationship

Objectives. The inter-arm systolic blood pressure difference (IASBPD) is closely related to cardiovascular mortality and morbidity. The SYNTAX score indicates the extent and complexity of coronary artery disease, which are determined by coronary angiography. The aim of our study is to examine the relationship between the IASBPD (which is easily calculated in routine practice) and the SYNTAX score. Methods. 104 patients were included in this cross-sectional study. The IASBPD was calculated by blood pressure measurements obtained simultaneously from both arms. The SYNTAX score was calculated by coronary angiography. Results. Patients were divided into two groups: those with a high SYNTAX score (≥20) and those with a low SYNTAX score (<20). The mean IASBPD values were significantly higher in the group with a high SYNTAX score (≥20) (p<0.001). The patients with IASBPD≥10 were more likely to have a high SYNTAX score compared to the patients with IASBPD<10 (p<0.001). Multiple logistic regression analysis revealed that only the IASBPD values were found to be independently associated with high SYNTAX score (OR: 1.717 (CI: 1.307-2.257), p<0.001). Conclusion. The IASBPD values obtained by only blood pressure measurements are closely related to the extent of coronary artery disease.

scholarly journals Diagnostic and prognostic value of coronary artery calcium score of zero: is it time for guidelines to change?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Arbas Redondo ◽  
D Tebar Marquez ◽  
I.D Poveda Pinedo ◽  
R Dalmau Gonzalez-Gallarza ◽  
S.C Valbuena Lopez ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Invasive Coronary Angiography ◽  
Agatston Score ◽  
Non Invasive ◽  
Artery Disease

Abstract Introduction Cardiac computed tomography (CT) use has progressively increased as the preferred initial test to rule out coronary artery disease (CAD) when clinical likelihood is low. Coronary artery calcium (CAC) detected by CT is a well-established marker for cardiovascular risk. However, it is not recommended for diagnosis of obstructive CAD. Absence of CAC, defined as an Agatston score of zero, has been associated to good prognosis despite underestimation of non-calcified plaques. Purpose To evaluate whether zero CAC score could help ruling out obstructive CAD in a safely manner. Methods Observational study based on a prospective database of patients (pts) referred to cardiac CT between 2017 and 2019. Pts with an Agatston score of zero were selected. Results We included 176 pts with zero CAC score and non-invasive coronary angiography performed. The median duration of follow-up was 23.9 months. Baseline characteristics of the population are shown in Table 1. In 117 pts (66.5%), cardiac CT was indicated as part of their chest pain evaluation. Mean age was 57.2 years old, 68.2% were women and only and 9.4% were active smokers. Normal coronary arteries were found in 173 pts (98.3%). Obstructive CAD, defined as ≥50% luminal diameter stenosis of a major vessel, was present in 1/176 (0.6%); while non-obstructive atherosclerotic plaques were found in 2 pts (1.1%). During follow-up, one patient died of out-of-hospital cardiac arrest. None either suffered from myocardial infarction or needed coronary revascularization. Conclusions In our cohort, a zero CAC score detected by cardiac CT rules out obstructive coronary artery disease in 98.3%, with only 1.7% of non-calcified atherosclerosis plaques and 0.6% of major adverse events. Although further research on this topic is needed, these results support the fact that non-invasive coronary angiography could be avoided in patients with low clinical likelihood of CAD and zero CAC score, facilitating the management of the increasing demand for coronary CT and reduction of radiation dose. Funding Acknowledgement Type of funding source: None

scholarly journals CT Coronary Angiography versus Coronary Angiography to Detect Specificity and Sensitivity of CT Coronary

2019 ◽  
pp. 1-6
Author(s):  
Sheref M Zaghloul ◽  
Walid Hassan ◽  
Ashraf M Reda ◽  
Ghada M Sultan ◽  
Mohamed A Salah ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Present Report ◽  
Invasive Coronary Angiography ◽  
Ct Coronary Angiography ◽  
Point Of View ◽  
Stent Restenosis ◽  
Specificity And Sensitivity ◽  
Artery Disease

Background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive Computed Tomography (CT) coronary angiography are used in the diagnosis of Coronary Artery Disease (CAD). Objective: The present report aims to evaluate the specificity and sensitivity of CT coronary angiography in diagnosis of coronary artery disease compared to the standard invasive coronary angiography. Methods: A retrospective study was done over 2 years started from May of 2015 up to May of 2017. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography and those with CT coronary angiogram. Data on special indications (bypass grafts, in-stent-restenosis) were also included in the evaluation. The CT scanners used with 320 slices. The study included patients with diabetes, hypertension, and data included age, glomerular filtration rate and ejection fraction. Results: Of the 99 patients included in the study, sensitivity of the total lesions were 87.1% which was highest for the graft lesions (100% sensitivity) and lowest for the Left Main (LM) lesions (83.3% sensitivity), on the other hand the specificity of the total lesion were high (98.1% specificity) which also was highest for the graft lesions (100% specificity) and lowest for the Left Anterior Descending (LAD) lesions (95% specificity). Regarding accuracy, CT coronary was 96.6% accurate for the whole lesions. Conclusions: From a medical point of view, CT coronary angiography using scanners with at least 320 slices should be recommended as a test to rule in obstructive coronary stenosis in order to avoid inappropriate invasive coronary angiography in patients with an intermediate pretest probability of CAD. Multi detector CT (MDCT) has reasonably high accuracy for detecting significant obstructive CAD when assessed at artery level.

P2722Optimizing diagnosis of obstrutive coronary artery disease by CT angiography and ischemia test: a randomized clinical trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J P Dias Ferreira Reis ◽  
R Ramos ◽  
P Modas Daniel ◽  
S Rosa Aguiar ◽  
L Almeida Morais ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Clinical Trial ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Invasive Coronary Angiography ◽  
Computed Tomographic Angiography ◽  
Functional Test ◽  
Computed Tomographic ◽  
Artery Disease ◽  
Tomographic Angiography

Abstract Aim In patients with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) may improve patient selection for invasive coronary angiography (ICA) as alternative to functional testing. However, the role of CTA in symptomatic patients after abnormal functional test is incompletely defined. Methods and results This randomized clinical trial conducted in single academic tertiary center selected 218 symptomatic patients (pts) with mild to moderately abnormal functional test referred to invasive coronary to receive either the originally intended ICA (n=103) or CTA (n=115). CTA interpretation and subsequent care decisions were made by the clinical team. Patients with high risk features on functional tests, previous acute coronary syndrome, previously documented CAD, chronic kidney disease (GFR <60 ml/min/1.73m2) or persistent atrial fibrillation were excluded. The primary endpoint was the percentage of ICA with no significant obstructive CAD (no stenosis ≥50%) in each group. Diagnostic and revascularization yields of ICA in either group were also assessed. Subjects averaged 68±9 years of age, 60% were male, 29% were diabetic. Nuclear perfusion stress test was used in 33.9% in CTA group and 31.1% in control group (p=0.655). Mean post (functional) test probability of obstructive CAD was 34%. Overall prevalence of obstructive CAD was 32.1%. In the CTA group, ICA angiography was cancelled by referring physicians in 83 of the pts (72.2%) after receiving CTA results. For those undergoing ICA, nonobstructive CAD was found in 5 pts (15.6%) in the CTA-guided arm and 60 (58.3%) in the usual care arm (P<0.001). Mean cumulative radiation exposure related to diagnostic work up was similar in both groups (6±14 vs 5±14mSv, P=0.152), but a greater cumulative contrast dose in the CTA-guided group (87.5±21 vs 77±40, p=0.026) was observed. Both diagnostic (84.4% vs 41.7, p<0.001) and revascularization (71.9% vs 38.8%, p=0.001) yields were significantly higher for CTA-guided ICA as compared to standard functional test-guided ICA. Conclusions In patients with suspected CAD and mild to moderately abnormal functional test, a diagnostic strategy including computed tomographic angiography as gatekeeper is effective and significantly improves diagnostic and revascularization yields of invasive coronary angiography.

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