scholarly journals Double Product as a Predictor of Coronary Artery Disease in Males with Normal Blood Pressure

2021 ◽  
Vol 4 (2) ◽  
pp. 81
Author(s):  
Indrit Temali ◽  
Ahmet Kamberi
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stress Test ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Double Product ◽  
Normal Coronary Arteries ◽  
Artery Disease

Aim: This study investigates whether in males with normal blood pressure that underwent exercise stress test Double Product (DB) or Double Product Ratios to workload (DPR) are self-sufficient in predicting the presence of coronary artery disease (CAD). Method: 78 male patients with normal blood pressure went through bicycle exercise stress test (EST) and within four weeks they underwent coronary angiography. 34 of them resulted with normal coronary arteries and 44 of them were diagnosed with one or multiple vessel CAD. Pressure rate double product was calculated in rest, in the first stage of the exercise test, in the peak of exercise, and also in the second, fourth, and sixth minutes of recovery of the stress test. Also, the ratios of pressure rate double product with the workload, which reflects the relative growth of double product to the workload, were calculated. The results were compared between the two groups, the one with normal coronary arteries, and those with abnormal coronary angiography. Results: DP in rest and in the first stage of the exercise are not significantly different for normotensive males with or without CAD, while the peak DB value of the exercise, as well as the econd and sixth minutes of the recovery are significantly lower for the group of patients with CAD. The starting peak workloads were significantly lower in the patients' group with CAD (p=0.0002 and p 0.0001). On the other hand, the double product to workload ratio at the first stage was significantly lower in males with normal blood pressure and CAD. Significant lower DPR are detected also in the fourth and sixth minutes of recovery. Conclusion: The values of DP in the peak exercise and at the second and sixth minutes of the recovery phase are significantly lower in normotensive males with abnormal coronary angiography compared to those with normal coronary arteries, and these findings can be used to detect the presence of CAD despite the ECG changes and they are not affected by the baseline characteristics of the patients. The ratios between DP and workload at the first stage, and in the fourth and sixth minutes of recovery are significantly lower in normotensive male patients with coronary artery disease compared to those without CAD and can be independent predictive parameters for the disease.

Cost analysis of amlodipine versus enalapril in patients with coronary artery disease and normal blood pressure

2008 ◽  
Vol 6 (2-3) ◽  
pp. 157-162
Author(s):  
Joseph Menzin ◽  
Luke Boulanger ◽  
Simon Tang ◽  
Kamlesh Thakker ◽  
Steven E. Nissen
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cost Analysis ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Artery Disease

scholarly journals Coronary angiography finding of exercise tread mill test positive patients in a tertiary care center

2017 ◽  
Vol 14 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Amit Shrestha ◽  
Sanjeev Thapa ◽  
Sheelendra Shakya ◽  
Ravi Shahi ◽  
Chandra Mani Paudel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stress Test ◽  
Tertiary Care ◽  
P Value ◽  
Vessel Disease ◽  
Mill Test ◽  
Artery Disease

Background and Aims: The use of coronary angiography in diagnosing coronary artery disease is limited by its invasive property. In the other hand correct interpretation of tread mill test data and its use as a key diagnostic modality also has been a problem. The study was thus aimed to see the diagnostic accuracy of treadmill test to rule out coronary artery disease.Methods: We included all the patients who had positive tread mill stress test and underwent coronary angiography and were subsequently analyzed for presence of coronary artery disease.Results: A total of 303 patients were included with 119 males and 184 females with mean age of 53.6±10.5 yrs and 51.7±8.6 yrs respectively. Normal coronaries was seen in 114(54.0%), borderline lesion in 29 (13.7%) and significant lesion in 68 (32.2%) with 48(22.7%) having single vessel disease, 29(13.7%) double vessel disease and 14(6.6%) triple vessel disease. Coronary artery diseases was highest among diabetics (57.7%, OR 1.72 (95 % CI: 0.92 to 3.20), p value-0.08).Similarly the risk of coronary artery disease was significantly highest among patient with ≥2 risk factor (OR: 8.10,95 % CI: 4.96 to 13.24, P < 0.0001). Gender distribution showed that coronary artery disease was significantly higher in males than females (53% vs 35% respectively, OR: 2.08, 95 % CI: 1.30 to 3.32, p value-0.002).Conclusion: The value of tread mill test to predict coronary artery disease is highest in patients with two or more risk factor especially in those with diabetes with significance increased among males.

scholarly journals A Whole-Food Plant-Based Diet Reversed Angina without Medications or Procedures

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Daniele Massera ◽  
Tarique Zaman ◽  
Grace E. Farren ◽  
Robert J. Ostfeld
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Drug Therapy ◽  
Coronary Artery ◽  
Plasma Lipids ◽  
Stress Test ◽  
Whole Grains ◽  
Food Plant ◽  
Cholesterol Levels ◽  
Artery Disease

A 60-year-old man presented with typical angina and had a positive stress test. He declined both drug therapy and invasive testing. Instead, he chose to adopt a whole-food plant-based diet, which consisted primarily of vegetables, fruits, whole grains, potatoes, beans, legumes, and nuts. His symptoms improved rapidly, as well as his weight, blood pressure, and cholesterol levels. Plant-based diets have been associated with improved plasma lipids, diabetes control, coronary artery disease and with a reduction in mortality. Adoption of this form of lifestyle therapy should be among the first recommendations for patients with atherosclerosis.

Abstract 19638: A High Percentage of Patients Referred for Invasive Coronary Angiography Found to Have No Obstructive Coronary Artery Disease are Referred for Appropriate Indications

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Michelle Ouellette ◽  
Virginia Workman ◽  
Adrian Loffler ◽  
George A Beller ◽  
Jamieson M Bourque
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stress Test ◽  
Invasive Coronary Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Coronary Syndrome ◽  
Obstructive Disease ◽  
Number Of Patients ◽  
Artery Disease

Introduction: The incidence of normal coronary arteries in patients referred for invasive coronary angiography (ICA) ranges from 30-60%. We sought to evaluate patterns of referral, assess the rate of appropriate catheterization and determine the prevalence of coronary artery disease (CAD) in our population by appropriateness and indication. Methods: Retrospective analysis was performed on 930 consecutive patients undergoing diagnostic ICA. Indications for ICA were reviewed and appropriate use criteria (AUC) were applied to the cohort retrospectively. Patients with known CAD, prior MI, CHF, or indication for pre-transplant workup or cardiac surgery were excluded. Rates of non-obstructive (21-49% stenosis) and obstructive CAD (≥50%) were compared by appropriateness status using Fisher’s Exact Testing. Results: Of the 930 patients studied, 55.6% were male with median age of 62 and 10-year ASCVD risk score of 17.7%. Acute coronary syndrome (ACS) was the most prevalent indication for referral (48.5%) with a 68.6% prevalence of obstructive CAD. A positive stress test was the indication in 18.9% with a 51.4% rate of obstructive CAD. The rates of the remaining referral indications are given in Figure 1. In those referred appropriately for angiography (n=923), the prevalence of obstructive disease was 55.9% (n=516), non-obstructive disease 13.6% (n=125), and normal coronaries 30.6%(n=282). Inappropriate referral was identified in only 7 patients (0.8%), all of whom had normal coronaries with p<0.001. Conclusions: At a single quaternary care academic center the majority of coronary angiographies performed invasively are appropriate by AUC. Despite adherence to AUC, there continues to be a large number of patients with no evidence of obstructive disease, including in those with ACS. Further research is needed to further refine the AUC and its role in risk stratification for obstructive CAD.

scholarly journals Diagnostic Value Of Post Exercise Systolic Blood Pressure Response In Ischemic Heart Disease

2016 ◽  
Vol 12 (2) ◽  
pp. 1-10
Author(s):  
Ghazi Asi Jawhar ◽  
Amal N. AL- Marayati ◽  
Mahmood Riyadh Alhaleem
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Systolic Blood Pressure ◽  
Exercise Test ◽  
Treadmill Exercise ◽  
Pressure Ratio ◽  
Post Exercise ◽  
Artery Disease

 Background: The normal decline in systolic blood pressure during recovery phase of treadmill exercise dose not occur in most patients with coronary artery disease, in others recovery values systolic blood pressure may even exceed the peak exercise value. Objectives: Treadmill exercise test parameters indicating the presence and extent of coronary artery disease have traditionally included such as exercise duration, blood pressure and ST-segment response to exercise. The three –minute systolic blood pressure ratio is another important indicator of presence and significance of coronary artery disease is useful and obtainable measure that can be applied in all patients who are undergoing stress testing for evaluation of suspected ischemic heart disease and this increase the sensitivity of exercise test . Type of the study: A prospective study. Methods: Between April 2011 and April 2012 ,all patients underwent treadmill exercise test , echocardiography coronary angiography in Ibn Ab-bitar Hospital Cardiac Surgery. Clinical and procedural data for patients undergoing treadmill and coronary angiography were prospectively collected and entered into database specially designed for the present study.To calculate mean systolic blood pressure ratio for each , Measurement of blood pressure in the 3rd minute of recovery time and divided by peak systolic blood pressure during exercise test ,after excluding patients . Coronary angiography was done for all patients who under went treadmill exercise test and multiple views were taken accordingly to clarify the lesion and critical lesion defined as >50% stenosis in LMS and >70% stenosis in LAD,LCX and RCA. Results: We studied 100 patients In the period from April 2011 to April 2012, 78(78%) male and 22 (22%) a female with a mean age 55.49±7.60 who undergone treadmill exercise testing and coronary angiography to assess the chest pain, 32 patient had normal blood pressure 68 had hypertension and 24 patients had normal coronary angiography and 76 patients had abnormal coronary angiography. SBP/3 minute recovery blood pressure ratio was significantly higher in patient with coronary artery disease than patient without coronary artery disease (mean ±SD O.92±0.09 VS 0.81 SBP/3 minute recovery blood pressure ratio was significantly related with the severity of coronary artery disease its higher in three vessels than one vessel disease 0.95±0.10 vs0. 91 ±0.01 p-value 0.0001. Conclusions: post exercise blood pressure response in patients with coronary artery diseaseis higher than patients with normal coronary artery .post exercise blood pressure is related to the severity of coronary artery disease

scholarly journals Correlation of Treadmill stress test with coronary angiography in patients with coronary artery disease using Selzer's criteria

2015 ◽  
Vol 67 ◽  
pp. S24
Author(s):  
Chetan Sharma ◽  
C.P. Tripathi ◽  
Madhavi Tripathi ◽  
R.K. Pandey ◽  
Naveed Bisht ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stress Test ◽  
Artery Disease ◽  
Treadmill Stress Test ◽  
Treadmill Stress

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.

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