The Comparison Between Management Versus Percutaneous Coronary Intervention (PCI) Patients With Coronary Artery Disease (CAD)

This study is based on the comparison between management versus PCI in patients with CAD. The prevalence of the major forms of cardiovascular disease (CVDs), mostly coronary artery disease (CAD), has changed dramatically in recent years. Cardiovascular disorders are now the one of the major cause of death and disability in the world.1 In 2015, 17.7 million individuals died from cardiovascular disease (CVD), which is around 31% of all deaths worldwide; 7.4 million pass away from coronary artery disease (CAD), and 6.7 million expired from stroke. 2 CAD is also the major cause of death, count for 13.2% of all deaths globally.3 It is responsible for one-quarter of all deaths in the United States of America (USA). About 75 percent of people with CAD in European countries are between the ages of 27 and 34.4 CAD was accountable for 16% of all man deaths and 10% of all female deaths in the England.5 Sudden death and CAD have a close connection. According to post-mortem reports and death certificates, 62-85 percent of patients who expired outside of the clinic have a past of CAD.6 As per informations from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, myocardial infraction affects 3.0% of the mature people in the USA (3.3 percent of males and 2.3 percent of females). An MI occurs every 40 seconds or so in the USA. In the USA, the mean age at 1st MI is 65.6 years for guys and 72.0 years for ladies.7 In this study the management and PCI are compared in patients with CVD.

Download Full-text

Abstract 15214: Food Insecurity and Cardiovascular Disease in NHANES (National Health and Nutrition Examination Survey) 2011-2016

Circulation ◽

10.1161/circ.142.suppl_3.15214 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

MONICA M DELSON ◽

Janice F Bell ◽

Tequila S Porter ◽

Julie T Bidwell

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Food Insecurity ◽

National Health ◽

The United States ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Artery Disease

Background: Adherence to a heart-healthy diet is foundational for the prevention, management, and treatment of cardiovascular disease (CVD). Despite the fact that adhering to dietary guidelines may be challenging in the context of food insecurity, little is known about the likelihood of food insecurity in persons with CVD. Hypothesis: We hypothesized that persons with CVD (hypertension, coronary artery disease, heart failure, or stroke) would have significantly higher odds of food insecurity. Methods: This was an analysis of data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional study of health in the United States. All adults aged 19 years or older with food insecurity data were included across 3 cycles of NHANES (2011-2016). Food insecurity was measured using the 10-item Food Security Scale. CVD diagnosis was measured by self-report. Risk for food insecurity by CVD diagnosis was examined using multivariable logistic regression models, incorporating NHANES sample and person weights, and controlling for common sociodemographic confounders (age, gender, race/ethnicity, education, marital status). Results: The sample consisted of 17,175 persons (weighted study N =229,247,659). Slightly more than half were male (51.9%), and most were non-Hispanic white (65.1%). Just under half (45.6%) were in early adulthood (19-44 years), 35.3% were in middle adulthood (45-64 years), and 18.6% were in late adulthood (≥65 years). One quarter (25.9%) were food insecure. Consistent with our hypothesis, diagnosis of any CVD (stroke, heart failure, coronary artery disease, or hypertension) was significantly associated with higher likelihood for food insecurity (stroke: OR=2.18; 95% CI 1.83-2.60; p<0.001; heart failure OR=1.94, 95% CI 1.46-2.57, p<0.001; coronary artery disease: OR=1.90, 95% CI 1.49-2.43, p<0.001; and hypertension: OR=1.25, 95% CI 1.10-1.42, p=0.001). Conclusions: Diagnoses of hypertension, stroke, coronary artery disease, and heart failure were all significantly associated with higher risk for food insecurity. Given the necessity of dietary modification in CVD, further efforts to study food insecurity in CVD alongside other social determinants of health are urgently needed.

Download Full-text

Abstract 264: Utilizing Risk Scoring for Prescribing Statins to Hospitalized Patients to Primarily Prevent Coronary Artery Disease

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.264 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Muhammed Atere ◽

William Lim ◽

Vishnuveni Leelaruban ◽

Bhavya Narala ◽

Stephanie Herrera ◽

...

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

High Risk ◽

Disease Risk ◽

The United States ◽

Intermediate Risk ◽

Peripheral Artery ◽

Artery Disease

Background: Cardiovascular disease is the leading cause of mortality in the United States. Approximately 25% of total deaths in the United States are attributed to cardiovascular diseases. Modification of risk factors has been shown to reduce mortality and morbidity in people with coronary artery disease. Medications such as statins are well known for reducing risks and recent data has shown that statins are beneficial in the primary prevention of coronary artery disease. The purpose of this study is to assess whether statins are being prescribed on discharge to patients who are identified as intermediate to high risk using the ACC/AHA Pooled Cohort Equations. Methodology: We reviewed and analyzed the charts of hospitalized patient’s ages 40 to 79 years who were discharged under the service of Internal Medicine at Richmond University Medical Center from September 2018 to August 2019. Exclusion criteria included: patients that expired before discharge or were admitted to the intensive or coronary care units, pregnancy, previous diagnosis of coronary/peripheral artery disease or stroke, already on statins or lipid-lowering medications, allergic to statins, discharged on statins for coronary/peripheral artery disease or stroke, and patients with liver disease or elevated liver enzymes. We used the ACC/AHA Pooled Cohort Equations risk to calculate the 10-year coronary artery disease risk for each patient. Results: The 10-year risk is grouped as low risk (<5%), borderline risk (5% to 7.4%), intermediate risk (7.5% to 19.9%) and high risk (≥20%). Among 898 patients, 10% had intermediate and high risk that were not discharged with statins. Among the 10%, about 6.6% were intermediate risk and 3.4% were high risk. Conclusions: A significant number of intermediate and high-risk patients were discharged without statins, although a CT coronary calcium may be helpful in further classifying the risk in some of them. We believe that a lipid profile should be checked in all hospitalized patients 40 years and older in order to calculate their atherosclerosis cardiovascular disease risk score and to possibly initiate statins after discussing the benefits and side effects, particularly in the intermediate risk group. The continuation of statins would be followed up by their primary care physicians. We plan to liaise with the information technology department in our facility to provide a link to the risk calculator in the electronic medical record so that the risk can be calculated and statins initiated as necessary. We will conduct a follow up review to assess for effectiveness.

Download Full-text

Are There Gender Differences in Coronary Artery Disease? The Malaysian National Cardiovascular Disease Database – Percutaneous Coronary Intervention (NCVD-PCI) Registry

PLoS ONE ◽

10.1371/journal.pone.0072382 ◽

2013 ◽

Vol 8 (8) ◽

pp. e72382 ◽

Cited By ~ 12

Author(s):

Chuey Yan Lee ◽

Noran N. Hairi ◽

Wan Azman Wan Ahmad ◽

Omar Ismail ◽

Houng Bang Liew ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Gender Differences ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

Artery Disease ◽

National Cardiovascular

Download Full-text

e-Health in Cardiovascular Medicine

Medical Sciences ◽

10.3390/medsci7060072 ◽

2019 ◽

Vol 7 (6) ◽

pp. 72

Author(s):

Julie Redfern ◽

Lis Neubeck

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cause Of Death ◽

Disease Burden ◽

Cardiovascular Medicine ◽

Artery Disease

Cardiovascular disease (CVD), including coronary artery disease (CHD) and stroke, is the leading cause of death and disease burden globally [...]

Download Full-text

De-risking primary prevention: role of imaging

Therapeutic Advances in Cardiovascular Disease ◽

10.1177/17539447211051248 ◽

2021 ◽

Vol 15 ◽

pp. 175394472110512

Author(s):

Ahmed M. Shafter ◽

Kashif Shaikh ◽

Amit Johanis ◽

Matthew J. Budoff

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Screening Method ◽

The United States ◽

Cochrane Library ◽

Common Disease ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk ◽

Artery Disease

Atherosclerotic cardiovascular disease (ASCVD) is a common disease among the general population, and includes four major areas: (1) coronary heart disease (CHD), manifested by stable angina, unstable angina, myocardial infarction (MI), heart failure, and coronary death; (2) cerebrovascular disease, manifested by transient ischemia attack and stroke; (3) peripheral vascular disease, manifested by claudication and critical limb ischemia; and (4) aortic atherosclerosis and aortic aneurysm (thoracic and abdominal). CHD remains the leading cause of death for both men and women in the United States. So, it is imperative to identify people at risk of CHD and provide appropriate medical treatment or intervention to prevent serious complications and outcomes including sudden cardiac death. Coronary artery calcification (CAC) is a marker of subclinical coronary artery disease. Therefore, coronary artery calcium score is an important screening method for Coronary artery disease (CAD). In this article, we performed a comprehensive review of current literatures and studies assessing the prognostic value of CAC for future cardiovascular disease (CVD) events. We searched PubMed, MEDLINE, Google Scholar, and Cochrane library. We also reviewed the 2018 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the assessment of CVD risk. A CAC score of zero corresponds to very low CVD event rates (∼1% per year) and hence a potent negative risk marker. This has been referred to as the ‘power of zero’ and affords the lowest risk of any method of risk calculation. It is now indicated in the 2018 ACC/AHA Cholesterol guidelines to be used to avoid statins for 5–10 years after a score of zero, and then re-assess the patient.

Download Full-text

Coronary artery bypass grafting in women

State of the Art Surgical Coronary Revascularization ◽

10.1093/med/9780198758785.003.0069 ◽

2021 ◽

pp. 405-410

Author(s):

Jessica Yu Rove ◽

Jennifer S. Lawton

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

The United States ◽

Bypass Grafting ◽

Artery Disease ◽

Developed World

Cardiovascular disease poses the greatest health threat to women in the developed world. Despite the fact that up until 2013 in the United States more women than men died annually of cardiovascular disease, women remain underdiagnosed and undertreated for cardiovascular disease. This chapter acknowledges perceived and actual differences in the manifestation of coronary artery disease between women and men. Further, it summarizes data on the modern performance and outcomes of coronary artery bypass surgery in women compared to men.

Download Full-text

Optimal medical therapy for coronary artery disease

State of the Art Surgical Coronary Revascularization ◽

10.1093/med/9780198758785.003.0022 ◽

2021 ◽

pp. 103-114

Author(s):

David R. Holmes ◽

Valentin Fuster

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Peripheral Arterial Disease ◽

Cause Of Death ◽

Disease Process ◽

Arterial Disease ◽

Developed Economies ◽

Artery Disease ◽

Peripheral Arterial

Cardiovascular disease remains the leading cause of death in the United States and the developed world and is becoming increasingly more prevalent globally. Indeed, in less developed nations, cardiovascular disease is now a relatively greater burden than in more developed economies. It is currently the number one cause of death worldwide, as a result of two phenomena, namely increased life expectancy due to successful treatment/prevention of infectious disease as well as increased exposure to known risk factors such as tobacco use, obesity, and a sedentary lifestyle. Cardiovascular disease is typically the result of atherosclerosis which can present as coronary heart disease, cerebrovascular disease, peripheral arterial disease, or aortic atherosclerosis. Given the generalized disease process, many individuals develop and present with more than one clinical manifestation. This has important implications for screening, for example, in patients presenting with clinically evident peripheral arterial disease, consideration should be given for screening to detect the presence of asymptomatic coronary artery disease.

Download Full-text

Integrated Polygenic Tool Substantially Enhances Coronary Artery Disease Prediction

Circulation Genomic and Precision Medicine ◽

10.1161/circgen.120.003304 ◽

2021 ◽

Vol 14 (2) ◽

Cited By ~ 1

Author(s):

Fernando Riveros-Mckay ◽

Michael E. Weale ◽

Rachel Moore ◽

Saskia Selzam ◽

Eva Krapohl ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Risk Score ◽

Disease Risk ◽

The United States ◽

Polygenic Risk Score ◽

Uk Biobank ◽

Polygenic Risk ◽

Artery Disease

Background: There is considerable interest in whether genetic data can be used to improve standard cardiovascular disease risk calculators, as the latter are routinely used in clinical practice to manage preventative treatment. Methods: Using the UK Biobank resource, we developed our own polygenic risk score for coronary artery disease (CAD). We used an additional 60 000 UK Biobank individuals to develop an integrated risk tool (IRT) that combined our polygenic risk score with established risk tools (either the American Heart Association/American College of Cardiology pooled cohort equations [PCE] or UK QRISK3), and we tested our IRT in an additional, independent set of 186 451 UK Biobank individuals. Results: The novel CAD polygenic risk score shows superior predictive power for CAD events, compared with other published polygenic risk scores, and is largely uncorrelated with PCE and QRISK3. When combined with PCE into an IRT, it has superior predictive accuracy. Overall, 10.4% of incident CAD cases were misclassified as low risk by PCE and correctly classified as high risk by the IRT, compared with 4.4% misclassified by the IRT and correctly classified by PCE. The overall net reclassification improvement for the IRT was 5.9% (95% CI, 4.7–7.0). When individuals were stratified into age-by-sex subgroups, the improvement was larger for all subgroups (range, 8.3%–15.4%), with the best performance in 40- to 54-year-old men (15.4% [95% CI, 11.6–19.3]). Comparable results were found using a different risk tool (QRISK3) and also a broader definition of cardiovascular disease. Use of the IRT is estimated to avoid up to 12 000 deaths in the United States over a 5-year period. Conclusions: An IRT that includes polygenic risk outperforms current risk stratification tools and offers greater opportunity for early interventions. Given the plummeting costs of genetic tests, future iterations of CAD risk tools would be enhanced with the addition of a person’s polygenic risk.

Download Full-text

Impact of hostility on mortality of patients with coronary artery disease after percutaneous coronary intervention

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2018-2-39-46 ◽

2018 ◽

Vol 22 (2) ◽

pp. 39

Author(s):

Georgiy S. Pushkarev ◽

Vadim A. Kuznetsov

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Reference Group ◽

Coronary Intervention ◽

Risk Of Death ◽

Percutaneous Coronary ◽

Artery Disease ◽

High Level

Aim. The study focuses on the assessment of associations of hostility with clinical and instrumental variables in patients with coronary artery disease after percutaneous coronary intervention, as well as on its effect on the risk of death for the patients in one year after surgery. Methods. The prospective study included 1,018 patients with coronary artery disease (764 men and 254 women, mean age 58.9±9.7 years) who had undergone percutaneous coronary intervention. Mean duration of follow-up was 12.0±1.8 months. Hostility was assessed by Russian version of Cook and Medley hostility scale. To investigate the relative risk (RR) of death from all causes and cardiovascular disease was used Cox's multivariate regression model of proportional risk. Results. The mean score on the Cook-Medley hostility scale was 15.1±3.9. A high level of hostility was observed in 189 patients (20.0%). There was no difference in age, gender and main clinical and instrumental variables between reference group and group of patients with a high level of hostility. No difference was found in echocardiographic parameters and coronary angiographic data between the groups. At admission, acute coronary syndrome was more often observed in patients with a high level of hostility as compared to those in the reference group (39.2% vs. 31.0%, p = 0.03). During the follow-up, 24 patients (2.4%) died from all causes and 21 patients (2.2%) died from cardiovascular disease. Depending on the level of hostility, RR of death from all causes was 1.10 (95% confidence interval [CI] 0.99–1.22, p = 0.09) and 1.12 (95% CI 1.01–1.27, p = 0.04) from cardiac causes. When analyzing categorical indicators, in patients with a high level of hostility, the relative risk of death, both for all causes (RR = 2.65, 95% CI 1.09–6.45, p = 0.03) and cardiovascular disease (RR = 3.38, 95% CI 1.29–8.82, p = 0.01), was significantly higher in comparison with patients in the reference group. Conclusion. PAcute coronary syndrome was more frequently diagnosed in patients with a high level of hostility. The hostility was significantly and independently associated with the risk of death from cardiovascular disease in patients with coronary artery disease after percutaneous coronary interventions. In patients with high levels of hostility, the risk of all-cause and cardiovascular mortality was significantly higher.Received 30 May 2018. Revised 5 July 2018. Accepted 9 July 2018.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

Download Full-text