scholarly journals Assessment of efficiency and safety of application of the reproduced drug of Mertenil® according to MSCT-coronary angiography

2016 ◽  
Vol 13 (2) ◽  
pp. 24-27
Author(s):  
A A Malov ◽  
L I Feiskhanova
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Computer Tomography ◽  
Low Density ◽  
Msct Coronary Angiography

In article possibility of an assessment of efficiency of therapy by the reproduced drug Mertenil of production of JSC Gideon Richter (Hungary) appointed for the purpose of primary prevention of the cardiovascular diseases. Increase of level of lipoproteid of the low density is one of the most powerful risk factors of death. Today therapy of a statin is carried out both for secondary and for primary prevention of cardiovascular diseases. For an assessment of dynamics of atherosclerotic processat patients with the diagnosis: CHD hypercholesterolemia without visual verification of defeat of the proximal coronary course possibility of use of a multispiral computer tomography of coronary arteries with calculation of a coronary calcic index is considered.

scholarly journals Peculiarities and Consequences of Different Angiographic Patterns of STEMI Patients Receiving Coronary Angiography Only: Data from a Large Primary PCI Registry

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Alexandru Burlacu ◽  
Grigore Tinica ◽  
Bogdan Artene ◽  
Paul Simion ◽  
Diana Savuc ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Angiography ◽  
Cardiovascular Risk Factors ◽  
Coronary Arteries ◽  
Univariate Analysis ◽  
Diagnostic Errors ◽  
High Volume ◽  
Process Efficiency ◽  
Primary Pci

Background. Inappropriate cardiac catheterization lab activation together with false-positive angiographies and no-culprit found coronary interventions are now reported as costly to the medical system, influencing STEMI process efficiency. We aimed to analyze data from a high-volume interventional centre (>1000 primary PCIs/year) exploring etiologies and reporting characteristics from all “blank” coronary angiographies in STEMI. Methods. In this retrospective observational single-centre cohort study, we reported two-year data from a primary PCI registry (2035 patients). “Angio-only” cases were assigned to one of these categories: (a) Takotsubo syndrome; (b) coronary embolisation; (c) myocardial infarction with nonobstructive coronary arteries; (d) myocarditis; (e) CABG-referred; (f) normal coronary arteries (mostly diagnostic errors); and (g)others (refusals and death prior angioplasty). Univariate analysis assessed correlations between each category and cardiovascular risk factors. Results. 412 STEMI patients received coronary angiography “only,” accounting for 20.2% of cath lab activations. Barely 77 patients had diagnostic errors (3.8% from all patients) implying false-activations. 40% of “angio-only” patients (n = 165) were referred to surgery due to severe atherosclerosis or mechanical complications. Patients with diagnostic errors and normal arteries displayed strong correlations with all cardiovascular risk factors. Probably, numerous risk factors “convinced” emergency department staff to call for an angio. Conclusions. STEMI network professionals often confront with coronary angiography “only” situations. We propose a classification according to etiologies. Next, STEMI guidelines should include audit recommendations and specific thresholds regarding “angio-only” patients, with specific focus on MINOCA, CABG referrals, and diagnostic errors. These measures will have a double impact: a better management of the patient, and a clearer perception about the usefulness of the investments.

scholarly journals Incidence of coronary artery disease before valvular replacement in isolated severe aortic stenosis patients in Western Rajasthan

2021 ◽  
Vol 9 (11) ◽  
pp. 3347
Author(s):  
Ramesh Patel ◽  
Sandeep Aggarwal
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Artery Disease

Background: The aim of the study was to evaluate the incidence of Coronary artery disease (CAD) and predictors of CAD in patients with severe AS in western Rajasthan population.Methods: Data from all consecutive patients with severe AS undergoing AVR at a major tertiary cardiac and vascular center in Udaipur were entered in a prospective registry beginning in 2015. Significant CAD was defined as one or more major coronary arteries having an estimated narrowing of ≥70% and left main coronary arteries having an estimated narrowing of ≥50% on coronary angiography. We excluded patients with multiple valve disease, significant aortic regurgitation, or prior CAD or valve surgery.Results: Mean age of 55 enrolled patients was 52.64±15.5 years. Diabetes mellitus and hypertension were present in 3.64% and 5.45% of patients, respectively. Moderate and severe Left ventricular ejection fraction (LVEF) was found in 16.36% and 10.91% patients, respectively. Only 5.45% patient had severe CAD and thus underwent AVR and coronary artery bypass grafting, and rest 94.55% patients underwent AVR. Mean age of patients who underwent AVR was 51.75±15.36 years and who underwent AVR and CABG was 68±11.14 years with no significant association (p=0.078). Proportion of patients requiring AVR and CABG was significantly higher in moderate (22.22%) and severe LVEF (16.67%) as compared to normal or mild (p=0.034).Conclusions: Coronary angiography before AVR will be considered in patients with multiple risk factors for cardiovascular disease or in patients above 68 years of age without risk factors for cardiovascular disease. However, larger studies on heterogeneous population are required to prove our findings. 

scholarly journals Misuse of Aspirin and Associated Factors for the Primary Prevention of Cardiovascular Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yinong Chen ◽  
Chun Yin ◽  
Qing Li ◽  
Luyao Yu ◽  
Longyang Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
International Study ◽  
Chinese Patients ◽  
Cvd Risk ◽  
Elderly Age ◽  
Clinical Trial Registration ◽  
Logistic Regression Models ◽  
Factors Associated

Background: The value of aspirin for primary prevention continues to be debated. Data showing whether aspirin use for primary prevention adheres to established guidelines in real world practice are sparse.Methods: A total of 13,104 patients without cardiovascular diseases (CVD) were selected from the DYS-lipidemia International Study of China, a national survey of patients with dyslipidemia in 2012. The CVD risk of the participants were calculated using the 10-year risk of Ischemic Cardiovascular Diseases model. The misuse of aspirin for primary prevention was defined as having CVD risk <10% with daily aspirin. Multivariate logistic regression models were used to explore risk factors associated with aspirin misuse.Results: The proportion of the patients categorized as low, moderate and high risk for CVD were 52.9, 21.6, and 25.4% respectively. The misuse frequency of aspirin was 31.0% (2,147/6,933) in patients with low risk. The misuse of aspirin increased with aging for both men and women. In the multivariate analysis, the independent risk factors associated with aspirin misuse were hypertension, diabetes mellitus, a family history of premature CVD, and elderly age. Level of total cholesterol is negatively associated with aspirin misuse. Patients from low level hospitals are more likely to be taking aspirin inappropriately. Results remained consistent after including 2,837 patients having 10-year risk for CVD between 10 and <20%.Conclusion: The misuse of aspirin for primary prevention is common in patients having CVD risk <10%. There are important opportunities to improve evidence-based aspirin use for the primary prevention of CVD in Chinese patients.Clinical Trial Registration:https://clinicaltrials.gov/, identifier [NCT01732952].

Microvascular Angina : A Diagnosis Hidden in Plain Sight

2021 ◽  
Author(s):  
Curtis D. Samuels
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Diseases ◽  
Endothelial Dysfunction ◽  
Coronary Angiography ◽  
Coronary Disease ◽  
Microvascular Dysfunction ◽  
African Caribbean ◽  
Caribbean Population ◽  
Risk Factor Burden

Background: Patients who are initially suspected of having ischemic heart disease, but in whom normal coronaries are discovered at angiography, are frequently believed to have pain of a non-cardiac aetiology. Micro vascular angina is hardly ever diagnosed save in peri-menopausal women. Physicians traditionally tend to view coronary microvascular disease and obstructive coronary artery disease as two separate entities. Notwithstanding, recent studies have begun to focus on endothelial dysfunction as being a key component in all cardiovascular diseases, with or without obstructive coronary lesions. Hypothesis: Patients suspected of having obstructive coronary disease associated with a significant risk factor burden, but in whom normal coronaries are found at angiography, in reality possess microvascular dysfunction. Objectives: • To determine the prevalence of normal coronaries at elective angiography compared to subjects with significant obstructive lesions. • To examine the influence of risk factor burden in patients who present normal coronaries in comparison with those who demonstrate obstructive lesions at angiography. • To suggest endothelial dysfunction as the common nexus underlying the disparities in cardiovascular morbidity observed among population samples. Methods: A group of 90 patients were randomly selected from clinical files of those who underwent elective coronary angiography between January, 2013 and May, 2017. The study cohort was comprised of 55 males and 35 females between the ages of 43 to 84 years. All subjects presented chest pain suspected of being coronary in origin. Coronary risk factors were recorded for each patient and the results were compared with findings at coronary angiography and then correlated with those encountered in medical literature. Results: Normal coronary angiograms were more prevalent in the African-Caribbean population (54.16%), than within the Mestizo-Mayan population (37.5%) Conversely, the finding of an obstructive lesion was more common in the Mestizo-Mayan population (56.25%), than within the African-Caribbean group (31.25%). The African-Caribbean group generally possessed a greater risk factor burden than their Mestizo-Mayan counterparts. Mayan counterparts. The percentage of women with normal coronaries (52.94%) showed a slight increase over that of men (47.05%). Males possessed a prevalence for obstructive disease of almost 4 times greater (79.48% vs. 20.5%) than females, yet females demonstrated a greater risk factor burden than males in most risk parameters. Hypertension was the most prevalent risk factor followed by dyslipidaemia and diabetes mellitus but these factors were more commonly encountered in patients with “normal” coronaries, than in those with obstructive lesions. Conclusion: Our study reported a significant number (56.66%) of “normal” coronaries at angiography. The majority (54.16%) of this figure pertained to the African-Caribbean sub-group, which in other studies also appeared to have a lesser coronary disease morbidity and mortality than their white counterparts despite having a greater risk factor burden. This is particularly true in the female African-Caribbean population. Several research papers have made reference to racial, ethnic and gender disparities in the manifestation of cardiovascular diseases. Paradoxically in some cases risk factor burden may be higher in the non-obstructive group rather than in the obstructive population. Convincing research has led us to believe that the vascular endothelium in its state of dysfunction plays a key role in explaining these disparities. Wherever cardiovascular risk factors exert their damage, endothelial injury and dysfunction ensues. Therefore, having an established risk factor burden portends microvascular dysfunction independently of any angiographic result.

scholarly journals Multislice computed tomography in the evaluation of coronary atherosclerosis dynamics: data three-year observation in patients with myocardial infarction-segment elevation ST and stenting of coronary arteries

2021 ◽  
Vol 27 (6) ◽  
pp. 19-30
Author(s):  
L. M. Babii ◽  
V. O. Shumakov ◽  
O. P. Pogurelska ◽  
A. Yu. Rybak ◽  
I. E. Malynovska ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Multislice Computed Tomography ◽  
Atherosclerotic Lesions ◽  
Msct Coronary Angiography ◽  
Coronary Artery Stenting ◽  
Progression Of Atherosclerosis

The aim – to use multislice computed tomography (MSCT)-coronary angiography data to determine the presence of atherosclerotic process progression in coronary vessels in the dynamics of the three-year follow-up period in patients after STEMI and coronary artery stenting.Materials and methods. 66 MSCT-coronary angiography studies were performed in 19 men after primary myocardial infarction with ST-segment elevation (STEMI) and coronary artery stenting. All patients were male, ranging in age from 38 to 66 years, with a mean (Me 55.6; (Q1–Q3 (49–64)) years, and 18 of 19 (94.0 %) patients developed Q-MI. 1 patient (6 %) had non-Q-MI. A month after acute MI, patients underwent MSCT of the heart with coronary vascular contrast. Re-examination was performed one, two and three years after the development of STEMI. According to the results of MSCT coronary angiography determined the functional status of stents, as well as the presence or exclusion of signs of restenosis (about 50 % or more) or thrombosis 100 % – occlusion) in the stent coronary artery and in non-infarction-causing arteries. With the progression of atherosclerotic plaque, an increase in atherosclerotic plaque of more than 20 % was taken into account compared to the previous study.Results and discussion. By the end of the first year after MI in 11 of 19 (57.9 %) patients according to MSCT-coronary angiography, no progression of atherosclerotic lesions of the coronary arteries was observed. 1 patient (5.6 %) had stent restenosis, which was confirmed by CAG data. Progression of atherosclerotic lesions was observed in 7 patients (36.8 %), 3 of them (16.6 %) in the stent artery, and in 4 patients in the non-infarction-causing artery. In the second year after myocardial infarction, compared with the annual examination, in 6 of 14 (42.9 %) no progression of atherosclerosis was observed, and in 7 of 14 (50 %) progression of atherosclerotic lesions not in the stent artery, and only in 1 of 14 – progression of atherosclerosis in the stent artery. In the third year after the development of MI, 10 of 14 (71.4 %) had no progression of atherosclerosis, and 4 patients showed progression in both IOA and other arteries.Conclusions. MSCT coronary angiography is an informative method in assessing the functional status of stents and determining the progression of coronary atherosclerosis in the infarct-causing artery and other coronary arteries in patients after MI and coronary artery stenting in the dynamics of three-year follow-up. The lack of progression of atherosclerosis was accompanied by slightly lower levels of low-density lipoprotein cholesterol, compared with patients with progression of atherosclerosis.

scholarly journals Primary prevention strategy for cardiovascular disease in Lithuania

2019 ◽  
Vol 25 (1) ◽  
pp. 14-39 ◽  
Author(s):  
Aleksandras Laucevičius ◽  
Egidija Rinkūnienė ◽  
Ligita Ryliškytė ◽  
Vytautas Kasiulevičius ◽  
Dalius Jatužis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Premature Death ◽  
Smoking Prevention ◽  
Potential Health ◽  
Prevention Programmes

Summary Cardiovascular diseases are the main cause of premature death worldwide. More than half of deaths were caused by cardiovascular diseases in 2017 in Lithuania. Primary prevention programmes encourage both medical staff and general population to pay attention to potential health issues as well as attempt to eradicate risk factors causing cardiovascular diseases. “A Funding Programme for the Screening and Preventive Management of the High Cardiovascular Risk Individuals” published in Lithuania has been implemented as of 2006. Analysis of the results of the programme shows that the prevalent cases of arterial hypertension are gradually declining. However, the prevalence of dyslipidaemia is still not decreasing. The prevalence of other modifiable cardiovascular disease risk factors has erratic trends with a slight overall decline. Consequently, mortality rate of cardiovascular diseases has decreased by more than one third among middle-age population over the past 10 years. Having higher availability of the anti-hypertensive and anti-lipid medications already achieved, the future plans include the aim of further reducing elevated blood pressure and effectively treating dyslipidaemia. In order to implement a strategy that focuses on smoking prevention, promotion of healthy nutrition and physical activity, a significant contribution is required from the state authorities.

scholarly journals ASSOCIATION OF ADRA2B POLYMORPHISM WITH RISK FACTORS FOR CARDIOVASCULAR DISEASES IN NATIVE POPULATION OF MOUNTAIN SHORIA

2015 ◽  
Vol 14 (2) ◽  
pp. 29-34
Author(s):  
T. A. Mulerova ◽  
A. Yu. Yankin ◽  
Ye. V. Rubtsova ◽  
A. A. Kuzmina ◽  
P. S. Orlov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Native People ◽  
Atherogenic Index ◽  
Low Density ◽  
Lipid Levels ◽  
Native Population ◽  
Anthropometric Characteristics ◽  
Homozygous Deletions ◽  
Quetelet Index

Study objectives: examine the frequency of genotypes and alleles of I/D polymorphism of gene ADRA2B of native people living in Mountain Shoria (the Shors), as well as their association with risk factors for cardiovascular diseases.Material and methods. Overall 221 native people of Shoria were examined. The average age is51.07 ± 1.46 among males, 52.93 ± 0.96 among females (p = 0.286). Anthropometric characteristics, lipid levels of blood and I/D polymorphism of ADRA2B were studied.Results. DD genotype of the gene ADRA2B in the native population of the Shor people is associated with adiposis and high index of "waist/hip", hypertriglyceridemia. The average values of Quetelet index is higher in carriers of this genotype compared with carriers of genotype ID. Average waist indications in homozygous insertions were lower than those in homozygous deletions and heterozygotes. Patients with genotype DD have higher average levels of triglycerides, atherogenic index, cholesterol, very low density lipoproteins.Conclusion. DD allele ADRA2B genotype is responsible for adiposis and high levels of TG among native population of Shoria.

scholarly journals Implications of Gender Difference in Coronary Calcification as Assessed by CT Coronary Angiography

2014 ◽  
Vol 8s4 ◽  
pp. CMC.S18764 ◽  
Author(s):  
Amgad N. Makaryus ◽  
Cristina Sison ◽  
Michelle Kohansieh ◽  
John N. Makaryus
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Calcium Score ◽  
Coronary Calcification ◽  
Smoking History ◽  
Males And Females ◽  
Coronary Events

Background Arterial calcium as measured by 64-slice computed tomography coronary angiography (64-CT) is a reliable predictor of cardiovascular disease risk. Lipid-rich plaques with lower degrees of calcification may pose greater risk for adverse coronary events than more stabilized calcified plaques as a result of the increased risk of plaque rupture, migration, and subsequent acute coronary syndrome. We sought to examine coronary artery calcium scores as measured via 64-CT to assess the extent of calcification and plaque distribution in women compared to men. Methods A total of 138 patients referred for 64-CT were evaluated. Computerized tomographic angiography was performed using the GE LightSpeed VCT. Subgroup analysis comparing male and female data (including demographic data) was performed. All major coronary arteries were analyzed for coronary stenosis/plaque characterization as well as total vessel calcium (Agatston) score quantification. Patient demographics and coronary risk factors were recorded. Results A total of 552 coronary arteries were evaluated in 138 patients (85 men, 53 women). The average age for females was 64.4 ± 10.8 years and for males 60.0 ± 12.8 years. The only demographic/cardiovascular risk factor in which the difference between men and women was significant was smoking history, where 23.5% of men had a history of smoking while only 9.6% of females endorsed having a smoking history ( P < 0.044). On comparison of all total vessel calcium scores, males had a higher total mean calcium score than females in each individual vessel. The results were as follows for males versus females, respectively: left main total vessel calcium score 46.49 versus 16.71 ( P = 0.167); left anterior descending 265.21 versus 109.6 ( P < 0.003); left circumflex 130.5 versus 39.7 ( P < 0.004); and right coronary 213.5 versus 73.8 ( P < 0.01). The odds of having a total calcium score >100 (versus not) was 3.62 times greater in males relative to females, given that all the other cardiovascular risk factors are adjusted for (95% confidence interval: 1.37-9.54). On average, men had an average of 2.1 ± 1.5 epicardial vessels with a calcium score ≥11 compared to 1.3 ± 1.4 for women ( P < 0.005). Conclusion There are clear differences between males and females regarding total vessel calcium scores and therefore risk of future adverse coronary events. Males tended to have higher average calcium scores in each coronary artery than females with a greater tendency to have multiple vessel involvement. Using this information, more large-scale, randomized controlled studies should be performed to correlate differences in the extent of coronary calcification with the observed variance in clinical presentation during coronary events between males and females as a means to potentially establish gender-specific therapeutic regimens.

Coronary vasomotor response is related to the angiographic extent of coronary sclerosis in patients with stable angina pectoris

2004 ◽  
Vol 106 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Folkert W. ASSELBERGS ◽  
Stefan H.J. MONNINK ◽  
Nic J.G.M. VEEGER ◽  
Ad J. VAN BOVEN ◽  
Paul L. VAN HAELST ◽  
...  
Keyword(s):  
Risk Factors ◽  
Angina Pectoris ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Stable Angina ◽  
Clinical Importance ◽  
Vasomotor Response ◽  
Stable Angina Pectoris ◽  
Vasomotor Function ◽  
Coronary Vasomotor Function

Disturbed vasomotor function in coronary arteries has clinical importance in early stages of coronary artery disease (CAD), as it may contribute to the potential risk for an ischaemic coronary event. In the present study, we have investigated the relationship between coronary vasomotor function and the extent of CAD. The response to acetylcholine and nitrate infusion was assessed by quantitative coronary angiography. The extent of CAD was categorized into two groups: minor CAD (normal coronary arteries and vessel wall irregularities) and significant CAD (one-, two- and three-vessel disease). A total of 277 patients with stable angina pectoris, referred for a first diagnostic coronary angiography, were eligible for analysis (mean age 57 years, 61% male). The response to nitrate was significantly impaired in patients with significant CAD (P<0.001). On the other hand, the response to acetylcholine was not different between the two groups (P=0.12); however, a trend between the response to acetylcholine and the extent of CAD was observed in patients without a previous infarction (P=0.07), which was a significant interaction variable. Furthermore, a significant relationship between coronary vasomotor response and the number of cardiovascular risk factors was observed (P<0.05). In conclusion, in a heterogeneous group of patients, coronary vasomotor function measured by nitrate infusion was more strongly associated with the extent of CAD and the number of risk factors than the response to acetylcholine. These data suggest that, in patients with advanced atherosclerosis or multiple risk factors, the vasomotor dysfunction is not solely restricted to the endothelium.

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