scholarly journals Correlation of Coronary Artery Calcium and Invasive Coronary Angiographically in Patients with Atypical Angina Pectoris (CACICA - Trial)

2019 ◽  
Vol 2 (3) ◽  
pp. 01-06
Author(s):  
Majed Elshenat ◽  
Mohammed Balosha ◽  
Mohammed Habib
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Invasive Coronary Angiography ◽  
Significant Coronary Artery Disease ◽  
Artery Stenosis ◽  
Coronary Calcium ◽  
Significant Coronary Artery Stenosis

OBJECTIVES This study correlated the multi - detector computed tomography (MDCT) calcium scores with the results of coronary angiography in diabatic and/or hypertensive patients with atypical angina pectoris in order to assess its value to predict or exclude significant coronary artery disease (CAD). BACKGROUND Muti-detector computed tomography is a sensitive method to detect coronary calcium. However, it is unclear whether it may play a role as a filter before invasive procedures in patients with atypical angina pectoris. METHODS A total of 150 patients (116 men and 34 women) with diabetic and/or hypertension for at least 5 years and atypical angina pectoris from a single center were included in our study. patients underwent calcium screening with MDCT and have calcium score more than 100 , then all patient underwent invasive coronary angiography. RESULTS The Mean age was 62±5.7 and 77.3% were male, 78% of men and 88.2 % of women revealed significant coronary stenoses (> 50% lumen narrowing of left main trunk stenosis and > 70% stenosis of any epicardial coronary artery). Significant correlation between calcium scoring and significant coronary artery stenosis was seen (P: 0001). A 70% were DM, 90% were hypertensive and 61.3% were HTN and DM. The LAD artery was the most stenotic artery by 53.3% followed by RCA (37.3%) and finally LCX (30.7%). one significant coronary artery was 42% followed by two significant CAD (26.7%), while 9.3% included three-vessel disease. The significant coronary artery diseases was increased with age ( P: 0003). CONCLUSIONS Coronary calcium proved to have good diagnostic performance for significant coronary artery stenosis in patient with atypical angina pectoris.

Abstract 1631: Exclusion of Coronary Artery Stenosis by Non-invasive Coronary Angiography Using Multislice Computed Tomography Determines a Good Long-term Prognosis in Patients With Chest Pain - Follow-Up Study in 1017 Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Peter Steinbigler ◽  
Eike Böhme ◽  
Carla Weber ◽  
Andreas Czernik ◽  
Jürgen Buck ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Multislice Computed Tomography ◽  
Coronary Artery Stenosis ◽  
Invasive Coronary Angiography ◽  
Artery Stenosis ◽  
Noninvasive Coronary Angiography

Long-term prognosis following exclusion of coronary artery stenosis by noninvasive coronary angiography using multislice computed tomography (MSCT) up to now has not been determined. We therefore performed noninvasive coronary angiography using MSCT (Philips Brilliance, 4 – 64 slices, retrospective ECG gating, 0.625mm collimation, 0.4sec gantry rotation time) in 1017 consecutive patients (657 male, 360 female, age 64±11years, 240 patients with known coronary artery disease (CAD)) referred to MSCT-study with chest pain. Patients with acute coronary syndromes, stents, atrial fibrillation and calcium scores > 1500 were not included. Based on MSCT results invasive study was recommended or not. All patients or the referring clinician were contacted by telephone or mail at least 6 months after their scan. Diagnostic image quality could be obtained in 992/1017 (98%) patients. In 620 of 992 patients (=63%) coronary artery stenosis could be excluded and invasive study was not recommended. Despite these recommendations invasive study was performed due to other clinical indications in 83/620 patients within < 30 days and in 43/537 patients within > 30days after the scan. Only in 13/126 patients stenoses >50% were found but no treatment was necessary. During the mean follow-up period of 612±192days 7/620 patients died but no patient suffered from cardiac death or acute myocardial infarction. In 372 of 992 patients invasive coronary angiography was recommended and performed in 230 patients (n=167 within < 30days, n=63 within >30days). In 165/230 patients stenoses >50% were found, treated by angioplasty or stents in 139/165 patients. During the mean follow-up period of 602±161days 11/372 patients died, two patients suffered from sudden, two patients from non-sudden cardiac death and one patient survived acute myocardial infarction. Thus, exclusion of coronary artery stenoses by noninvasive coronary angiography using multislice computed tomography determines a good lomg-term prognosis in patients with chest pain.

scholarly journals Rapid atrial fibrillation increases cardiac biomarkers: decision to perform coronary angiography based on novel high-sensitivity Troponin I peak

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
AF Esteves ◽  
L Parreira ◽  
M Fonseca ◽  
JM Farinha ◽  
A Pinheiro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Troponin I ◽  
Coronary Artery Stenosis ◽  
Significant Coronary Artery Disease ◽  
High Sensitivity ◽  
Artery Stenosis ◽  
Cardiac Biomarkers ◽  
P Value ◽  
Significant Coronary Artery Stenosis

Abstract Funding Acknowledgements Type of funding sources: None. Background Since January 2018 the availability of high sensitivity Troponin I (hsTnI) has improved ischemia diagnosis. In patients with rapid atrial fibrillation (AF), the decision to undergo coronary angiography is usually due to elevated cardiac biomarkers. However, evidence to support the rentability of this approach is sparse. Purpose Evaluate if hsTnI in patients with rapid AF and elevated cardiac biomarkers has a good discriminative power to predict a positive coronary angiography. Methods We retrospectively studied consecutive patients admitted to the emergency department (ED) between January 2018 and December 2019 with rapid AF that underwent coronary angiography and had multiple hsTnI values obtained. We analysed risk factors, initial and peak hsTnI, time from ED admission to peak hsTnI and ST-T segment abnormalities (ST depression and/or T wave inversion). We evaluated the presence of significant coronary artery stenosis with the need of revascularization at coronary angiography. Univariable and multivariable analysis was performed to obtain the Odds Ratio (OR, 95% CI, p-value) for significant coronary artery disease (CAD). Receiver operator characteristics (ROC) curve and area under the curve (AUC) were obtained to determine the discriminative power of peak hsTnI as predictor of a positive coronary angiography. Optimal cut-point value was obtained (Youden index) and patients were divided according to this value. Results From 1407 patients admitted to the ED with rapid AF, 30 patients, 60% male, median age 74 (IQR 61.25-80.75) years, were submitted to coronary angiography. Significant coronary artery stenosis was present in 17 (57%) patients. Age, ST-T segment abnormalities and peak hsTnI were predictors of significant CAD, respectively 1.203, 1.064-1.361, 0.003; 25.00, 3.522-177.477, 0.001; and 1.000, 1.000-1.001, 0.015. Optimal cut-point value for predicting the presence of significant coronary artery stenosis at coronary angiography was a peak hsTnI of 359 pg/mL (AUC 0.869, p-value 0.001, 95% CI 0.742-0.995). The two groups with hsTnI &lt; 359 and hsTnI &gt;359 differed in age and ST-T segment abnormalities (see Table). After adjustment, peak hsTnI &gt;359 pg/mL was the only independent predictor of significant CAD (23.894, 1.310-435.669, 0.032). Conclusion In this group of patients with rapid AF, peak hsTnI &gt;359 pg/mL was the only independent predictor of significant coronary artery disease. Therefore, those patients should undergo coronary angiography. Abstract Figure.

Prevalence of Factor V Leiden in Patients with Myocardial Infarction and Normal Coronary Angiography

2000 ◽  
Vol 83 (06) ◽  
pp. 822-825 ◽  
Author(s):  
Antoine Da Costa ◽  
Stéphane Munier ◽  
Bernard Mercier ◽  
Brigitte Tardy ◽  
Claude Ferec ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Factor V Leiden ◽  
Artery Stenosis ◽  
Factor V ◽  
Significant Coronary Artery Stenosis ◽  
Increased Risk ◽  
Normal Coronary Angiography

SummaryFactor V Leiden is associated with an increased risk of venous thrombosis and myocardial infarction in young women, but not in men in this latter case. The aim of this study was to evaluate the prevalence of this mutation in patients with myocardial infarction but normal coronary angiography.We compared 3 groups of patients: one group consisted of 107 patients with premature myocardial infarction but no significant coronary artery stenosis; another group of 244 patients with myocardial infarction and significant coronary artery stenosis; a third group of 400 healthy controls.Factor V Leiden was found in 13 patients (12.1%) who had a myocardial infarction without significant coronary artery stenosis, 11 patients (4.5%) who had a myocardial infarction with significant coronary artery stenosis (p = 0.01) and in 20 controls (5%) (p = 0.01). Odds ratio associated with factor V Leiden were respectively 2.93 (CI95 : 1.18-7.31) and 2.63 (CI95 : 1.19-5.78) when we compared myocardial infarction patients without significant coronary artery stenosis to controls or to patients with significant coronary artery stenosis.In myocardial infarction patients without significant coronary artery stenosis, prevalence of factor V Leiden is significantly higher than in controls. This new finding supports the hypothesis that thrombosis plays a key role in this selected situation.

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