scholarly journals Body composition in coronary artery disease in KONKAN region of India-Is non- obesity an indicator of Coronary Artery Disease?

2021 ◽  
pp. 11-15
Author(s):  
Suvarna Netaji Patil ◽  
Pranav Shamraj ◽  
Charudatta Vaman Joglekar ◽  
Amitkumar Bhalerao ◽  
Sagar Nanaware ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Body Composition ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Body Fat ◽  
Lean Mass ◽  
Independent Risk Factor ◽  
Syntax Score ◽  
Artery Disease

 Background India is witnessing a rising prevalence of non communicable diseases like diabetes, hypertension, coronary artery disease. This is attributed to rapid nutrition and lifestyle transition taking place since last 2 decades. Obesity is a well known independent risk factor   but very little information is available about role of leanness (low BMI). We investigated whether non-obesity could be an independent risk factor for Coronary artery disease in a rural clinic in KONKAN.    Methods  In a cross sectional study we studied body composition of 300 patients (207 men) who underwent Coronary angiography in a rural hospital in KONKAN region.  History of diabetes, hypertension and history smoking, tobacco chewing was recorded. Body composition was estimated using bio-impedance analyser. Based on results of coronary angiography, we generated a SYNTAX score derived by number of vessels involved and classified them into groups of severity of coronary artery disease (CAD).     Results There were 95 (31 %) diabetes and 189 (63%) hypertensive patients in the sample and 60% of them smoked or chewed tobacco. There were 43 (28 males) patients with SYNTAX score of zero. Among those with coronary artery disease (n=257) increasing severity of CAD   was associated with lower body weight, BMI, body fat percentage, and body fat mass and ejection fraction as against positive trend for lean mass and visceral fat.   Conclusion BMI, fat mass decreased with severity of CAD while lean mass and visceral fat increased. We observed high proportion of CAD in underweight and lean KONKAN adults. These findings need further investigations  

Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry

2018 ◽  
Vol 118 (12) ◽  
pp. 2162-2170 ◽  
Author(s):  
Kamilla Steensig ◽  
Kevin Olesen ◽  
Troels Thim ◽  
Jens Nielsen ◽  
Svend Jensen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Ischaemic Stroke ◽  
Independent Risk Factor ◽  
Oral Anticoagulants ◽  
Increased Risk ◽  
Artery Disease

Background Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. Objectives This article explores whether CAD per se or extent provides independent prognostic information of future stroke among patients with AF. Materials and Methods Consecutive patients with AF and coronary angiography performed between 2004 and 2012 were included. The endpoint was a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. The risk of ischaemic events was estimated according to the presence and extent of CAD. Incidence rate ratios (IRR) were calculated in reference to patients without CAD and adjusted for parameters included in the CHA2DS2-VASc score and treatment with anti-platelet agents and/or oral anticoagulants. Results Of 96,430 patients undergoing coronary angiography, 12,690 had AF. Among patients with AF, 7,533 (59.4%) had CAD. Mean follow-up was 3 years. While presence of CAD was an independent risk factor for the composite endpoint (adjusted IRR, 1.25; 1.06–1.47), extent of CAD defined as 1-, 2-, 3- or diffuse vessel disease did not add additional independent risk information. Conclusion Presence, but not extent, of CAD was an independent risk factor of the composite thromboembolic endpoint beyond the components already included in the CHA2DS2-VASc score. Consequently, we suggest that significant angiographically proven CAD should be included in the vascular disease criterion in the CHA2DS2-VASc score.

scholarly journals A comprehensive, contemporary assessment of the association between the presence of hepatosteatosis and the incidence of coronary artery disease on CT coronary angiography

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
T Heseltine ◽  
E Hughes ◽  
M Packer ◽  
T Dunne ◽  
R Jones ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Independent Risk Factor ◽  
Current Smoking ◽  
Clinical Covariates ◽  
Male Sex ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Background The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing exponentially. The overall prevalence of NAFLD in the United States is predicted to increase to 33.5% of the adult population by 2030. Hepatosteatosis (HS) has been previously shown to be an independent risk factor for cardiovascular disease events. We sought to investigate the association of clinical covariates and the presence of HS and coronary artery disease (CAD) in patients referred for computed tomography coronary angiography (CTCA). Methods We performed a retrospective, observational analysis at a high-volume cardiac CT centre analysing consecutive CTCA studies. All patients referred for investigation of chest pain over a 28-month period (June 2014 to November 2016) were included. Covariates in those with CAD and patients without CAD were compared using compared using student"s t-test for continuous variables and chi-squared test for categorical variables. Logistic regression models were constructed for the multivariate analysis. Results In total there were 1499 patients referred for CTCA without prior evidence of CAD. Age, male sex, presence of hypertension and diabetes were significantly higher in those with CAD (table 1). HS evaluation was assessed in 1195 (79.7%). In the multivariate analysis significant predictors of CAD were male sex (OR 3.40, p < 0.001), family history (OR 1.90, p = 0.003), current smoking (OR 1.80, p = 0.03) and increasing age (OR 1.12, p < 0.001). The presence of HS was not associated with CAD when adjusted for risk factors (OR 1.05 CI:0.70-1.60, p = 0.80). Conclusion We found a significant association between the increasing age, presence of hypertension, male sex, diabetes and current smoking with presence of CAD as detected by CTCA. In contrast to recent evidence HS may not be an independent risk factor for the development of the development of CAD. Summary statistics of the cohort No CAD (n = 881) CAD (n = 618) P Age (mean (SD)) 48.86 (±12.1) 57.9(±10.6) <0.005* Male Sex (%) 343 (38.6%) 326 (51.1%) <0.005* Hypertension (%) 193(21.9%) 239 (38.7%) <0.005* Diabetes (%) 59 (6.7%) 86 (13.9%) <0.005* Current Smoking (%) 139 (15.8%) 108 (17.5%) 0.423 FHx (%) 239 (27.1%) 167 (27%) 1 HS (%) 291 (33%) 247 (40%) 0.007* A comparison of clinical covariates for the cohort stratified by the presence of coronary artery disease. Statistical significance was assumed when p < 0.05 and is denoted with *.

Atherogenic Index of Plasma Is an Independent Risk Factor for Coronary Artery Disease and a Higher SYNTAX Score

Angiology ◽  
2020 ◽  
pp. 000331972094980
Author(s):  
Luzhao Wang ◽  
Fangyao Chen ◽  
Chai Xiaoqi ◽  
Chen Yujun ◽  
Li Zijie
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Independent Risk Factor ◽  
Density Lipoprotein ◽  
Atherogenic Index ◽  
Syntax Score ◽  
Atherogenic Index Of Plasma ◽  
Cutoff Value ◽  
Artery Disease

We aimed to identify the best diagnostic cutoff value of the atherogenic index of plasma (AIP) for coronary artery disease (CAD) and its correlation with the SYNTAX score (SS). From January 2016 to December 2019, 2253 patients with CAD and 1347 non-CAD patients with complete data were included in the study. Coronary angiography was performed using the Judkins technique, and the SS was calculated using network software. There were differences in age, body mass index, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol levels, and AIP between groups (all P < .01). Multivariate logistic regression analysis showed that AIP was an independent risk factor for CAD and a high SS (SS ≥ 23) with adjusted odds ratios of 2.248 (95% CI: 1.666-3.032, P < .01) and 1.623 (95% CI: 1.118-2.358, P < .01) per standard deviation increase. Receiver operating characteristic curve analysis revealed that the best diagnostic cutoff value of AIP for the prediction of CAD and SS ≥ 23 was 2.035 and 2.23, the specificity was 61.8% and 65.7%, the sensitivity was 76.4% and 54.9%, the Youden index was 0.382 and 0.206, and the area under the curve was 0.733 (95% CI: 0.717-0.750, P < .01) and 0.653 (95% CI: 0.630-0.676, P < .01). Atherogenic index of plasma, as a biomarker, may assist in the prevention of CAD in the Chinese population.

Sex differences in clinical outcomes of patients with stable coronary artery disease after percutaneous coronary intervention

2021 ◽  
Vol 27 ◽  
Author(s):  
Emmanuel P. Vardas ◽  
Evangelos Oikonomou ◽  
Gerasimos Siasos ◽  
Panagiotis Theofilis ◽  
Polychronis Dilaveris ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Independent Risk Factor ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Female Sex ◽  
Percutaneous Coronary ◽  
Artery Disease

: Potential sex-related differences in the periprocedural and long-term postprocedural outcomes of coronary angioplasty in patients with stable coronary artery disease have been studied thoroughly over the last few decades, to determine whether female sex should be regarded as an independent risk factor that affects clinical outcomes. Based on a significant number of observational studies and meta-analyses, sex has not yet emerged as an independent risk factor for either mortality or major cardiac and cerebrovascular events, despite the fact that in the early 1980s, for several reasons, female sex was associated with unfavourable outcomes. Therefore, it remains debatable whether female sex should be considered as an independent risk factor for periprocedural and long-term bleeding events. The pharmacological and technological advancements that support current coronary angioplasty procedures, as well as the non-delayed treatment of coronary artery disease in females have certainly lessened the outcome differences between the two sexes. However, females show fluctuations in blood coagulability through their lifetime and higher prevalence of bleeding episodes associated with the antithrombotic treatment, following transcatheter coronary reperfusion interventions. In conclusion, the clinical results of percutaneous coronary intervention in patients with stable coronary artery disease, during the periprocedural and long-term postprocedural periods, appear to show no significant differences between the two sexes, except for bleeding rates, which seem to be higher in females, a difference that mandates further systematic research.

scholarly journals Association of Lipoprotein-Associated Phospholipase A2 with Coronary Artery Disease in African-Americans and Caucasians

2010 ◽  
Vol 95 (5) ◽  
pp. 2376-2383 ◽  
Author(s):  
Erdembileg Anuurad ◽  
Zeynep Ozturk ◽  
Byambaa Enkhmaa ◽  
Thomas A. Pearson ◽  
Lars Berglund
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
African American ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
African Americans ◽  
Coronary Angiography ◽  
Pla2 Activity ◽  
Artery Disease

Abstract Context: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is bound predominately to low-density lipoprotein and has been implicated as a risk factor for coronary artery disease (CAD). Objective: We investigated the association between Lp-PLA2 and CAD in a biethnic African-American and Caucasian population. Design: Lp-PLA2 mass, activity, and index, an integrated measure of mass and activity, and other cardiovascular risk factors were determined in 224 African-Americans and 336 Caucasians undergoing coronary angiography. Main Outcome Measures: We assessed the distribution of Lp-PLA2 levels and determined the predictive role of Lp-PLA2 as a risk factor for CAD. Results: Levels of Lp-PLA2 mass and activity were higher among Caucasians compared with African-Americans (293 ± 75 vs. 232 ± 76 ng/ml, P &lt; 0.001 for mass and 173 ± 41 vs. 141 ± 39 nmol/min/ml, P &lt; 0.001 for activity, respectively). However, Lp-PLA2 index was similar in the two groups (0.61 ± 0.17 vs. 0.64 ± 0.19, P = NS). In both ethnic groups, Lp-PLA2 activity and index was significantly higher among subjects with CAD. African-American subjects with CAD had significantly higher Lp-PLA2 index than corresponding Caucasian subjects (0.69 ± 0.20 vs. 0.63 ± 0.18, P = 0.028). In multivariate regression analyses, after adjusting for other risk factors, Lp-PLA2 index was independently (odds ratio 6.7, P = 0.047) associated with CAD in African-Americans but not Caucasians. Conclusions: Lp-PLA2 activity and index was associated with presence of CAD among African-Americans and Caucasians undergoing coronary angiography. The findings suggest an independent impact of vascular inflammation among African-Americans as contributory to CAD risk and underscore the importance of Lp-PLA2 as a cardiovascular risk factor.

Malnutrition is a major factor to affect prognosis of patients undergo percutaneous coronary intervention for coronary artery disease with calcified lesions

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Sonoda ◽  
D Kanda ◽  
K Anzaki ◽  
R Arikawa ◽  
A Tokushige ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Stable Angina ◽  
Independent Risk Factor ◽  
Proportional Hazards ◽  
Target Lesion ◽  
Cox Proportional Hazards ◽  
Hs Crp ◽  
Artery Disease

Abstract Background In patients undergo PCI for coronary artery disease, target lesion calcification is associated with major cardiac events. Malnutrition is the important factor to cause frailty and sarcopenia which affect prognosis of cardiovascular diseases. However, the relationship between morphology in target lesions and malnutrition in patients undergo PCI is still uncertain. Purpose The aim of the present study was to investigate how malnutrition affects prognosis of stable angina patients underwent PCI and morphology in target lesions. Methods The subject was 206 consecutive stable angina patients undergone successful PCI using second-generation drug eluting stents and intravascular ultrasound (IVUS). The study patients were divided into two groups based on malnutrition or non-malnutrition. Nutritional status was assessed by Geriatric Nutritional Risk Index (GNRI), and patients with GNRI&lt;92 at admission were defined as malnutrition group (MG). We investigated the association between malnutrition on admission and outcome, and morphology in target lesions assessed by IVUS. Target lesion morphology were divided into moderate/severe calcified group and none/mild calcified group. Results All-cause death and MACCE (major cardiovascular and cerebrovascular events) ≤3 years after PCI were 15 cases (7%) and 33 cases (16%). MG had higher rate of all-cause death (20 vs. 6%, p=0.001) and MACCE (37 vs. 10%, p&lt;0.001) than those of non-MG. Kaplan Meier analysis elucidated that survival rate was significantly lower in MG compared to that in non-MG (p&lt;0.001). As a result of cox proportional hazards analysis, all-cause death was associated with age [hazard ratio (HR): 1.05, 95% confidence interval (CI): 1.01–1.10, p=0.006)], hs-CRP (HR: 1.03, 95% CI: 1.03–1.12, p&lt;0.001), hemodialysis (HR: 2.25, 95% CI: 1.08–4.68, p=0.029), left ventricular ejection fraction (LVEF) (HR: 0.97, 95% CI: 0.95–0.99, p=0.017) and malnutrition (HR: 4.38, 95% CI: 2.11–9.09, p&lt;0.001) in the univariate analysis. Similarly, cox proportional hazards analysis revealed that age (HR: 1.04, 95% CI: 1.01–1.07, p=0.018), hs-CRP (HR: 1.08, 95% CI: 1.03–1.11, p&lt;0.001), hemodialysis (HR: 2.68, 95% CI: 1.45–4.94, p=0.002), LVEF (HR: 0.97, 95% CI: 0.95–0.99, p=0.002) and malnutrition (HR: 4.14, 95% CI: 2.23–7.67, p&lt;0.001) were significantly associated with MACCE. Multivariate analysis for all-cause death and MACCE revealed that malnutrition was an independent risk factor (HR: 3.47, 95% CI: 1.52–7.94, p=0.003, HR: 3.76, 95% CI: 1.87–7.58, p&lt;0.001). Furthermore, MG was significantly associated with moderate/severe target calcified lesions assessed by IVUS compared to those of patients in non-MG (67 vs. 27%, p&lt;0.001) regardless with or without hemodialysis. Conclusions Malnutrition was a crucial independent risk factor for stable angina patients who underwent PCI and was significantly associated with moderate/severe target calcified lesions. Funding Acknowledgement Type of funding source: None

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.

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.

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