stable coronary artery disease
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Author(s):  
Shilpa Atwal ◽  
Jitender Thakur

Background: To determine the indications for which statins are being prescribed Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD,Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: In our study, out of 243 prescriptions, 55.1%(n=134) were prescribed statins for secondary prevention and 44.9%(n=109) had statins prescribed for primary prevention. Overall coronary artery disease (37.03%) was the leading indication followed by Diabetes mellitus without ASCVD(70.64%).Other indications of secondary preventionincluded newly diagnosed statin naïve patients diagnosed with stable coronary artery disease ,unstable coronary artery disease /acute coronary artery disease , ischemic cardiovascular accidentsand peripheral arterial disease .64.22 percent patients in primary prevention group were diabetics in our study . Concluded: We concluded that secondary prevention was found to the more common indication of statin prescription than primary prevention (ratio 1.22:1). Keywords: Statin, CAD, Prevention


2022 ◽  
Vol 20 (8) ◽  
pp. 3069
Author(s):  
S. B. Fitilev ◽  
A. V. Vozzhaev ◽  
D. A. Klyuev ◽  
I. I. Shkrebniova ◽  
N. N. Shindryaeva ◽  
...  

Aim. To assess the effects of the Pharmacy Care Program on medication adherence in outpatients with stable coronary artery disease (SCAD).Material and methods. An open randomized controlled study was conducted in primary care clinic over the period of 2019-2020. All subjects (n=126) were randomized at visit 1 into the multifaceted intervention group (n=63) or control group (n=63) and invited 12 months after to visit 2. Patients of intervention group were included into the Pharmacy Care Program, which consisted of the following components: pharmacist-led counseling, provision of education materials and 7-day pillbox, weekly SMS-reminders. Medication adherence was measured initially and at the end of the study period by means of eight-item Morisky Medication Adherence Scale (MMAS-8) and Self-Efficacy for Appropriate Medication Use Scale (SEAMS).Results. The implementation of the Pharmacy Care Program improved medication adherence in SCAD outpatients with MMAS-8 median score of 7,0-8,0 (p<0,001) and SEAMS median score of 35,0-36,0 (p=0,017). In the control group, no changes (p=0,123) in MMAS-8 score were revealed, while SEAMS score decreased from 35,0 down to 34,5 (p=0,003). The reduction in systolic blood pressure (p=0,049) and risk of urgent hospital admission (OR=0,28; 95% CI, 0,08-0,99; p=0,041) was registered in the intervention group in contrast to the control group over the 12-month period.Conclusion. The multicomponent intervention within the Pharmacy Care Program contributed to an increase in the adherence to pharmacotherapy of outpatients with stable CAD.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ying Shen ◽  
Muladili Aihemaiti ◽  
Xin Yi Shu ◽  
Chen Die Yang ◽  
Jia Wei Chen ◽  
...  

Background: Chromogranin B (CgB) is increased in heart failure and proportionate to disease severity. We investigated whether circulating CgB level is associated with left ventricular (LV) functional recovery potential after successful recanalization of chronic total occlusion (CTO).Methods: Serum levels of CgB were assayed in 53 patients with stable angina with LV functional recovery [an absolute increase in LV ejection fraction (EF) of ≥5%] and 53 age- and sex-matched non-recovery controls after successful recanalization of CTO during 12-month follow-up.Results: We found that CgB level was significantly lower in the recovery group than in the non-recovery group (593 [IQR 454–934] vs. 1,108 [IQR 696–2020] pg/ml, P &lt; 0.001), and that it was inversely correlated with changes in LVEF (Spearman's r = −0.31, P = 0.001). Receiver operating characteristic (ROC) analysis showed that the area under the curve of CgB for predicting LVEF improvement was 0.76 (95% CI 0.664–0.856), and that the optimal cutoff value was 972.5 pg/ml. In multivariate analyses, after adjusting for confounding factors, high CgB level remained an independent determinant of impaired LV functional recovery after CTO recanalization. LV functional improvement appeared to be more responsive to CgB in patients with poor than with good coronary collaterals.Conclusions: Elevated circulating CgB level confers an increased risk of impaired LV functional recovery after successful recanalization of CTO in patients with stable coronary artery disease.


Author(s):  
Andrii Yu. Gavrylyshyn ◽  
Sergii V. Salo ◽  
Olena V. Levchyshyna ◽  
Andrii K. Logutov ◽  
Vasyl V. Lazoryshynets

When choosing tactics for the treatment of patients with stable coronary artery disease, invasive coronary angiography remains the gold standard for diagnosis and is a crucial method in choosing tactics and volume of revascularization. However, in the presence of borderline (>50-70%), multilevel lesions of the coronary artery, there is a need for additional assessment of the physiological significance of each stenosis. The aim. To develop an algorithm to optimize the use of fractional flow reserve (FFR) measurement in interventional treatment of borderline (>50-70%), multilevel lesions of coronary arteries, to show the safety of “functional revascula­ rization” in comparison with traditional angiography. Materials and methods. The study included 32 patients who were treated at the National Amosov Institute of Cardiovascular Surgery in the period from 2017 to 2021 (the vast majority were men – 25 patients (67%) and 7 (33%) women) aged 60.3±8.3 years who had >50-75% multilevel lesions of one of the main coronary arteries according to selective invasive coronary angiography. The patients were divided into two groups: 1) Angiographic group (n = 17, 53%), where the volume and tactics of revascularization were determined only by angiography (maximum complete anatomical revascularization); 2) Functional group (n=15, 47%) (combination of angiography data and FFR measurement, the so-called “functional revascularization”). Conclusions. An effective and safe algorithm for measuring FFR in multilevel lesions (reducing the number of implanted stents) is shown.


TH Open ◽  
2021 ◽  
Author(s):  
Shumpei Kosugi ◽  
Yasunori Ueda ◽  
Haruhiko Abe ◽  
Kuniyasu Ikeoka ◽  
Tsuyoshi Mishima ◽  
...  

Objective: Although blood thrombogenicity seems to be one of the determinant factors for the development of acute myocardial infarction (MI), it has not been dealt with in-depth. This study aimed to investigate blood thrombogenicity and its change in acute MI patients. Methods and Results: We designed a prospective, observational study that included 51 acute MI patients and 83 stable coronary artery disease (CAD) patients who underwent cardiac catheterization, comparing thrombogenicity of whole blood between: (1) acute MI patients and stable CAD patients; and (2) acute and chronic phase in MI patients. Blood thrombogenicity was evaluated by the Total Thrombus-Formation Analysis System (T-TAS) using the area under the flow pressure curve (AUC30) for the AR-chip. Acute MI patients had significantly higher AUC30 than stable CAD patients (median [interquartile range], 1771 [1585 - 1884] vs. 1677 [1527 - 1756], p = 0.010). Multivariate regression analysis identified acute MI with initial TIMI flow grade 0/1 as an independent determinant of high AUC30 (β = 0.211, p = 0.013). In acute MI patients, AUC30 decreased significantly from acute to chronic phase (1859 [1550 - 2008] to 1521 [1328 - 1745], p=0.001). Conclusion: Blood thrombogenicity was significantly higher in acute MI patients than in stable CAD patients. Acute MI with initial TIMI flow grade 0/1 was significantly associated with high blood thrombogenicity by multivariate analysis. In acute MI patients, blood thrombogenicity was temporarily higher in acute phase than in chronic phase.


Medicine ◽  
2021 ◽  
Vol 100 (48) ◽  
pp. e27973
Author(s):  
Wei-Ting Wang ◽  
Tao-Cheng Wu ◽  
Wei-Kung Tseng ◽  
Yen-Wen Wu ◽  
Tsung-Hsien Lin ◽  
...  

Medicine ◽  
2021 ◽  
Vol 100 (48) ◽  
pp. e27498
Author(s):  
Srikanth Malladi ◽  
Kewan Hamid ◽  
Nitin Chandra Pendyala ◽  
Vijaysai Veerapaneni ◽  
Smit Deliwala ◽  
...  

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Simone Circhetta ◽  
Fabio Mangiacapra ◽  
Michele Mattia Viscusi ◽  
Luca Paolucci ◽  
Roberta De Luca ◽  
...  

Abstract Aims The potential diurnal variations of platelet reactivity in patients on clopidogrel treated with elective percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) are currently unknown. Methods and results We prospectively enrolled 15 patients with stable CAD treated PCI and on clopidogrel therapy for at least eight days. All patients received their maintenance 75-mg clopidogrel dose at 8 AM. Platelet reactivity was assessed with the Verifynow P2Y12 assay at three different time points (10 AM, 6 PM, and 6 AM). Platelet reactivity is expressed as P2Y12 reaction units (PRU) and PRU thresholds ≥208 and ≥240 were used to define high platelet reactivity (HPR). A significant heterogeneity in diurnal levels of platelet reactivity was found (P = 0.0004), with a peak occurring at the 6 AM assessment. In addition, at the 6 AM evaluation patients showed the highest prevalence of HPR (53.3% of patients with PRU ≥240, 66.7% of patients with PRU ≥208). Conclusions Platelet reactivity in patients with stable CAD treated with PCI and taking clopidogrel in the morning follows a circadian rhythm, thus suggesting that platelet inhibition may not be constant and sufficient throughout the day. Whether an evening or a bis in die administration of clopidogrel may result in a constant and more reliable antiplatelet inhibition, should be investigated in dedicated studies.


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