Coronary Artery Disease
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PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259153
Jun-Jun Yeh ◽  
Cheng-Li Lin ◽  
Nai-Hua Hsu ◽  
Chia-Hung Kao

Purpose To determine the effects of statins and steroids on the risk of coronary artery disease (CAD) and stroke in patients with interstitial lung disease and pulmonary fibrosis (ILD-PF). Methods We retrospectively enrolled patients with ILD-PF who were using statins (statin cohort, N = 11,567) and not using statins (nonstatin cohort, N = 26,159). Cox proportional regression was performed to analyze the cumulative incidence of CAD and stroke. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of CAD and stroke were determined after sex, age, and comorbidities, as well as the use of inhaler corticosteroids (ICSs), oral steroids (OSs), and statins, were controlled for. Results Compared with those of patients without statin use, the aHRs (95% CIs) of patients with statin use for CAD and ischemic stroke were 0.72 (0.65–0.79) and 0.52 (0.38–0.72), respectively. For patients taking single-use statins but not ICSs/OSs, the aHRs (95% CIs) for CAD and ischemic stroke were 0.72 (0.65–0.79)/0.69 (0.61–0.79) and 0.54 (0.39–0.74)/0.50 (0.32–0.79), respectively. For patients using ICSs/OSs, the aHRs (95% CIs) for CAD and ischemic stroke were 0.71 (0.42–1.18)/0.74 (0.64–0.85) and 0.23 (0.03–1.59)/0.54 (0.35–0.85), respectively. Conclusions The findings demonstrate that statin use, either alone or in combination with OS use, plays an auxiliary role in the management of CAD and ischemic stroke in patients with ILD-PF.

2021 ◽  
Yong Li ◽  
Lei Chen ◽  
Min Zhang ◽  
Wensu Chen

Abstract Background This study is the first to explore the influence of the apolipoprotein E gene (APOE) and blood lipid metabolism on coronary artery disease (CAD) with atrial fibrillation.Methods In this study, there were a total of 2048 participants, including 400 patients in the control group (CAD- AF-), 126 AF patients without CAD (CAD- AF+), 1294 CAD patients without AF (CAD+ AF-) and 228 CAD patients with AF (CAD+ AF+). Blood lipid levels and APOE genotypes were determined by collecting blood samples from the patients.Results Compared with CAD patients without AF, the age and Lp (a) levels of CAD patients with AF were significantly higher. Among CAD patients, the frequencies of E3/E3 and ε3 genotypes in patients with AF were significantly lower than those in patients without AF, and the frequencies of E4/E4 and ε4 genotypes were significantly increased. Spearman correlation analysis showed that in CAD patients, Lp(a) levels in the ε4 group were significantly higher than those in the group of patients without ε4, and there was a significant correlation between ε4 and Lp (a) levels (p<0.001, r=0.106). Multivariate logistic regression analysis found that the increase in Lp (a) levels (p=0.023) and age (p=0.01) were independent risk factors for CAD patients who develop AF.Conclusion Patients with AF had increased age, ε4 frequencies and Lp (a) levels among CAD patients, age and Lp (a) levels may be independent risk factors for CAD patients to develop AF.

2021 ◽  
Vol 601 (10) ◽  
pp. 12-16
Joanna Bugajska ◽  
Elżbieta Łastowiecka-Moras

Chronic diseases are progressively limiting the functioning of persons suffering from them in everyday life, including work activity. They have a great impact on the ability to perform work, and thus the earnings. The etiology of chronic diseases is multifactorial. Occupational factors and lifestyle play an important role in their formation. Influencing these factors is one of the most important measures supporting the employment of people suffering from chronic diseases. The article discusses the main activities in promoting a healthy lifestyle and adjusting working conditions to the needs of people with osteoarthritis, selected diseases of the cardiovascular system (coronary artery disease and hypertension), and diabetes.

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Yinna Yao ◽  
Gunan Yang ◽  
Yanling Chen

Objective. To investigate the correlation between carotid intima-media thickness (IMT), ankle-brachial index (ABI), and coronary artery dilatation (CAD) in children with Kawasaki disease (KD) and to evaluate the effectiveness of CAD. Methods. A total of 68 children diagnosed with KD from January 2019 to January 2021 in our hospital were included. According to the results of cardiac color Doppler ultrasound, the children with KD were divided into a noncoronary artery dilation group (NCAD), with 41 children with KD who did not have coronary artery lesions, and a coronary artery dilation group (CAD), with 27 children with KD who had coronary artery dilation. 27 healthy children undergoing physical examination in our hospital at the same time were selected as the normal control group. Laboratory index of all subjects was measured individually. The carotid IMT, ABI, and coronary artery diameter of all subjects were measured and compared. Pearson correlation was used to analyze the correlation between carotid IMT, ABI, and the severity of coronary artery disease. The ROC curve was used to evaluate the efficacy of carotid IMT and ABI in predicting coronary artery disease. Results. The ALB of children in the CAD group was lower than that in the NCAD group P < 0.05 . The IMT of carotid artery and the diameter of coronary artery in children of the CAD group and the NCAD group were higher than those of the normal control group, and the IMT of the CAD group was higher than that of the NCAD group. The ABI of children in the CAD group and the NCAD group was lower than that of the normal control group, and the ABI of children in the CAD group was lower than that of the NCAD group P < 0.05 . Correlation analysis showed that carotid artery IMT of children with KD was positively correlated with coronary artery diameter, while ABI was negatively correlated with coronary artery diameter. The AUC of carotid IMT for CAD in children with KD was 0.668 (95% CI: 0.538–0.797), that of ABI for CAD in children with KD was 0.646 (95% CI: 0.513–0.780), and that of the combination of carotid IMT and ABI for CAD was 0.874 (95% CI: 0.785–0.963). Conclusion. The changes of carotid artery IMT and ABI in children with KD have a certain correlation with CAD, and the joint detection of carotid artery IMT and ABI can provide clinical reference value for predicting the degree of coronary artery disease in children with KD.

2021 ◽  
Vol 17 (5) ◽  
pp. 362-368
Leonardo Calegari ◽  
Igor Moreira ◽  
Andrei Falkowski ◽  
José Basileu Caon Reolão ◽  
Marlus Karsten ◽  

The purpose of this study was to verify the accuracy of the agreement between heart rate at the first ventilatory threshold (HRVT1) and heart rate at the end of the 6-min walk test (HR6MWT) in coronary artery disease (CAD) patients on β-blockers treatment. This was a cross-sectional study with stable CAD patients, which performed a cardiopulmonary exercise test (CPET) on a treadmill and a 6-min walk test (6MWT) on nonconsecutive days. The accuracy of agreement between HRVT1 and HR6MWT was evaluated by Bland–Altman analysis and Lin’s concordance correlation coefficient (rc), mean absolute percentage error (MAPE), and standard error of estimate (SEE). Seventeen stable CAD patients on β-blockers treatment (male, 64.7%; age, 61± 10 years) were included in data analysis. The Bland–Altman analysis revealed a negative bias of -0.41 ± 6.4 bpm (95% limits of agreements, -13 to 12.2 bpm) between HRVT1 and HR6MWT. There was acceptable agreement between HRVT1 and HR6MWT (rc = 0.84; 95% confidence interval, 0.63 to 0.93; study power analysis= 0.79). The MAPE of the HR6MWT was 5.1% and SEE was 6.6 bpm. The ratio HRVT1/HRpeak and HR6MWT/HRpeak from CPET were not significantly different (81%± 5% vs. 81%± 6%, P= 0.85); respectively. There was a high correlation between HRVT1 and HR6MWT (r= 0.85, P< 0.0001). Finally, the results of the present study demonstrate that there was an acceptable agreement between HRVT1 and HR6MWT in CAD patients on β-blockers treatment and suggest that HR6MWT may be useful to prescribe and control aerobic exercise intensity in cardiac rehabilitation programs.

Marta González del Castillo ◽  
David Hernando ◽  
Michele Orini ◽  
Pablo Laguna ◽  
Jari Viik ◽  

Stress test electrocardiogram (ECG) analysis is widely used for coronary artery disease (CAD) diagnosis despite its limited accuracy. Alterations in autonomic modulation of cardiac electrical activity have been reported in CAD patients during acute ischemia. We hypothesized that those alterations could be reflected in changes in ventricular repolarization dynamics during stress testing that could be measured through QT interval variability (QTV). However, QTV is largely dependent on RR interval variability (RRV), which might hinder intrinsic ventricular repolarization dynamics. In this study, we investigated whether different markers accounting for low-frequency (LF) oscillations of QTV unrelated to RRV during stress testing could be used to separate patients with and without CAD. Power spectral density of QTV unrelated to RRV was obtained based on time-frequency coherence estimation. Instantaneous LF power of QTV and QTV unrelated to RRV were obtained. LF power of QTV unrelated to RRV normalized by LF power of QTV was also studied. Stress test ECG of 100 patients were analysed. Patients referred to coronary angiography were classified into non-CAD or CAD group. LF oscillations in QTV did not show significant differences between CAD and non-CAD groups. However, LF oscillations in QTV unrelated to RRV were significantly higher in the CAD group as compared with the non-CAD group when measured during the first phases of exercise and last phases of recovery. ROC analysis of these indices revealed area under the curve values ranging from 61 to 73%. Binomial logistic regression analysis revealed LF power of QTV unrelated to RRV, both during the first phase of exercise and last phase of recovery, as independent predictors of CAD. In conclusion, this study highlights the importance of removing the influence of RRV when measuring QTV during stress testing for CAD identification and supports the added value of LF oscillations of QTV unrelated to RRV to diagnose CAD from the first minutes of exercise. This article is part of the theme issue ‘Advanced computation in cardiovascular physiology: new challenges and opportunities’.

2021 ◽  
Vol 20 (1) ◽  
Ang Gao ◽  
Jinxing Liu ◽  
Chengping Hu ◽  
Yan Liu ◽  
Yong Zhu ◽  

Abstract Background Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions. Methods The study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed. Results Overall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P<0.001). After adjusting for various confounding factors, the TyG index remained correlated with the occurrence of impaired collateralization, with odds ratios (ORs) of 1.59 and 5.72 in the T2 and T3 group compared with the first tertile group (P<0.001). In addition, subgroup analysis showed that higher TyG index values remained strongly associated with increased risk of less developed collateralization. To compare the risk assessment efficacy for the formation of collateralization between the TyG index and other metabolic abnormality indicators, an area under the receiver-operating characteristic (ROC) curve (AUC) was obtained. A significant improvement in the risk assessment performance for impaired collateralization emerged when adding the TyG index into a baseline model. Conclusions The increased TyG index is strongly associated with less developed collateralization in CAD patients with CTO lesions and its risk assessment performance is better than single metabolic abnormality indicators.

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