Abstract 4508: Endothelial Dysfunction is Associated with Coronary Lesion Complexity in Patients with Coronary Artery Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Yasushi Matsuzawa ◽  
Seigo Sugiyama ◽  
Hitoshi Sumida ◽  
Koichi Sugamura ◽  
Toshimitsu Nozaki ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Coronary Plaque ◽  
Artery Stenosis ◽  
Control Group ◽  
Coronary Lesions ◽  
Artery Disease

Endothelial dysfunction is an important step in the atherosclerosis progression, and associates with future cardiovascular events. Reactive hyperemia peripheral arterial tonometry (RH-PAT) is a noninvasive, automatic, and objective tool to evaluate endothelial dysfunction. Angiographic complex coronary lesions are involved in plaque vulnerability. We investigated whether finger values of RH-PAT could correlate with angiographic coronary plaque complexity in patients with coronary artery disease (CAD). RH-PAT was measured using Endo-PAT2000 in 171 patients who were referred to Kumamoto University Hospital for cardiac catheterization. We defined the two group as below, Control group; coronary artery stenosis > 25% (n = 36, age 63 ± 11, male 25 %), and CAD group; coronary artery stenosis > 25 % (n = 135, age 68 ± 11, male 74 %). Coronary lesions (single-vessel; n = 29, multi-vessel disease; n = 106) were classified as of simple appearance (n = 43) or complex appearance (n = 92) by coronary angiography. Values of RH-PAT were significantly lower in patients with CAD than Control (1.65 [1.50 – 1.86] versus 1.92 [1.80 – 2.28], P < 0.01), and were significantly lower in CAD patients with complex coronary appearance than patients with simple coronary appearance (1.55 [1.45 – 1.76] versus 1.81 [1.66 – 1.95], P < 0.01). All patients underwent selective coronary angiography, and the extent of coronary stenosis was assessed using the scoring system. RH-PAT was significantly correlated with coronary plaque Extent Score (Rs = −0.33, P < 0.01). Single logistic regression analysis demonstrated that high-density lipoprotein cholesterol, triglycerides, and RH-PAT value significantly associated with the presence of complex coronary lesions, and multivariable analysis including cardiovascular risk factors identified that lower RH-PAT value was the only factor associated with the complex coronary lesions (odds ratio 1.45, 95% confidence interval 1.14 – 1.84; P < 0.01). Endothelial dysfunction was significantly associated with angiographic complex appearance of coronary plaques in patients with CAD. CAD patients with lower RH-PAT values might be vulnerable patients with vulnerable plaques and vulnerable endothelium.

scholarly journals Diagnostic Value of C-Reactive Protein in Patients with Angiographically Documented Coronary Heart Disease

2002 ◽  
Vol 45 (4) ◽  
pp. 155-160 ◽  
Author(s):  
Esin Eren ◽  
Necat Yılmaz ◽  
Sadrettin Pençe ◽  
Hasan Koçoğlu ◽  
Sıtkı Göksu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Diagnostic Value ◽  
Artery Stenosis ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Artery Disease

Aim: The aim of this study was to evaluate the diagnostic value of serum C-reactive protein (CRP) level measurement in predicting coronary artery disease (CAD) that can be shown angiographically. Methods: CRP levels were determined in the blood of 198 patients (patients group, PG) with angiographically documented coronary artery disease and compared with that of 85 patients (control group, CG) who had a clinical indication for coronary angiography but have no angiographically determined coronary artery stenosis, as well as with that of 41 healthy volunteers as a healthy control group (HG) who did not have any complaint and did not have coronary angiography. CRP levels were measured 24 hours prior to angiography in PG and CG patients, and in the morning after not having eaten for same time. Any coronary artery stenosis or plaque formation was defined as CAD. Severity of the disease was assessed by both the number of diseased vessels (0 to 3) and the degree of stenosis (<50 % mild, 50–70 % moderate and >70 % severe). Results: Receiver Operating Characteristics (ROC) curves of CRP in angiographically documented CAD group showed a diagnostic value of 0.659 in female patients, followed by 0.542 in male patients, in predicting CAD. CRP levels were found to be significantly different between groups, higher in PG (6.2 ± 0.86 mg/L) than those of CG (3.7 ± 0.92 mg/L) and HG (0.854 ± 0.2 mg/L) (p<0.05). CRP levels were not associated with the number of diseased vessels, neither with the degree of the occlusion (p>0.05). Multiple logistic regression analysis after adjustment for the established coronary risk factors showed CRP as an independent discriminating risk factor for CAD. Conclusion: It is concluded that CRP measurement has a value in predicting the presence of angiographically documented CAD. However, CRP levels were not associated with the degree or severity of CAD.

scholarly journals Apolipoprotein B/A1 Ratio Is Associated with Severity of Coronary Artery Stenosis in CAD Patients but Not in Non-CAD Patients Undergoing Percutaneous Coronary Intervention

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Rui Hua ◽  
Yijun Li ◽  
Wenyuan Li ◽  
Zhen Wei ◽  
Zuyi Yuan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Apolipoprotein B ◽  
Coronary Artery Stenosis ◽  
Coronary Intervention ◽  
Artery Stenosis ◽  
Gensini Score ◽  
Percutaneous Coronary ◽  
Coronary Lesions ◽  
Artery Disease

Background and Aims. Lipid metabolism plays important roles in atherosclerosis. Several studies have found that lipoprotein is associated with coronary artery disease (CAD) and hyperlipidemia. Although the roles of the apolipoprotein B/A1 ratio (ApoB/A1) were originally thought to be atherosclerotic, few studies have focused on the specific relationship between ApoB/A1 and severity of coronary artery stenosis with or without the presence of CAD. Methods. A total of 6956 consecutive patients aged 21–98 years with suspected CAD who had undergone coronary angiography were enrolled. The severity of coronary lesions was evaluated using the Gensini score (GS). The relationships between ApoB/A1 and severity of coronary artery stenosis were evaluated. Results. A total of 1795 non-CAD patients and 5161 CAD patients were included in the observational analysis. Patients with CAD had higher ApoB/A1 than individuals without CAD (0.67 (0.53-0.82) vs. 0.61 (0.49-0.75), p < 0.001 ). In CAD patients, the higher the ApoB/A1 was, the higher the proportion of patients with MI, triple-vessel lesions, and higher Gensini scores. ApoB/A1 was significantly positively correlated with HbA1c and Gensini scores in CAD patients but not in non-CAD patients (all p < 0.001 ). Logistic analyses showed that ApoB/A1 could be a risk factor for multivessel disease (OR: 2.768, 95% CI: 1.868-4.103, p < 0.001 ). ApoB/A1 was found to be significantly positively correlated with the Gensini score in CAD patients. Conclusions. ApoB/A1 is highly associated with the presence and severity of coronary artery stenosis in patients with CAD but not in non-CAD patients.

scholarly journals Prognostic Significance of Targeted Magnetic Resonance Coronary Angiography to Predict Cardiac Events in Patients with Known or Suspected Coronary Artery Disease

2021 ◽  
Vol 104 (10) ◽  
pp. 1711-1721
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Cardiac Events ◽  
Significant Coronary Artery Stenosis ◽  
Magnetic Resonance Coronary Angiography ◽  
Artery Disease

Background: Magnetic resonance coronary angiography (MRCA) is one of the most promising tools for noninvasive imaging of coronary arteries without radiation exposure or contrast media administration. However, knowledge about the prognostic value of MRCA is limited. Materials and Methods: The present study included 389 patients with known or suspected coronary artery disease (CAD) underwent clinical cardiac magnetic resonance (CMR) including MRCA imaging. The presence of a significant coronary artery stenosis was defined by visual estimation of ≥50% diameter reduction using targeted MRCA images. Patients were followed up for hard cardiac events (cardiac death or non-fatal myocardial infarction) and major adverse cardiac events (MACE) which also included hospitalization for heart failure and late revascularization (>180 days after the CMR study). Results: The average age was 68±11 years and 48% were male. One hundred and thirty-nine patients had significant stenosis on MRCA. During a median follow-up period of 53.9 months, 23 hard cardiac events and 52 MACE, occurred. Patients with significant coronary artery stenosis had higher rates of hard cardiac events (annual event rate 3.12% versus 0.56%, HR 5.52, 95% CI 2.17 to 14.01, p<0.001) and MACE (annual event rate 6.44% versus 1.83%, HR 3.49, 95% CI 1.98 to 6.14, p<0.001) than those without significant stenosis. Multivariable analyses identified significant coronary artery stenosis as an independent predictor of hard cardiac events (HR 3.35, 95% CI 1.13 to 9.96, p=0.03) and MACE (HR 2.00, 95% CI 1.02 to 3.90, p=0.04). MRCA presented an incremental prognostic value over clinical factors, left ventricular ejection fraction, and myocardial scarring to predict hard cardiac events (p=0.03). Conclusion: Targeted MRCA demonstrated independent and incremental prognostic values to predict future cardiac events in patients with known or suspected CAD. Keywords: Cardiac magnetic resonance imaging; Coronary artery disease; Magnetic resonance coronary angiography; Prognosis

scholarly journals Lack of Association between Interarm Systolic Blood Pressure Difference and Coronary Artery Disease in Patients Undergoing Elective Coronary Angiography

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mohammad Hosein Mohamadi ◽  
Alireza Rai ◽  
Mansour Rezaei ◽  
Alireza Khatony
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Peripheral Vascular ◽  
Blood Pressure Difference ◽  
Artery Disease ◽  
The Relationship

Aim. Peripheral vascular disease (PVD) and coronary artery disease (CAD) are, in many cases, asymptomatic and not usually diagnosed. The timely diagnosis of peripheral vascular diseases can act as an indicator or practical evidence of CAD. Therefore, this study was conducted to determine the relationship between interarm systolic blood pressure difference (IASBPD) and severity and number of coronary artery stenosis. Methods. The samples in this cross-sectional study consisted of 578 patients who were candidates for coronary angiography, with an average age of 57.5 ± 10.5 years. Patients were classified according to CAD and number and severity of coronary artery stenosis. The relationship between IASBPD and presence or lack of CAD as well as the number and severity of coronary artery stenosis was studied. The sensitivity, specificity, and positive predictive value of IASBPD index were calculated for the detection of CAD using the Kappa coefficient. Results. There was no statistically significant relationship between IASBPD, CAD, and severity and number of coronary artery stenosis. This index had low sensitivity and predictive value in the diagnosis of CAD and stenosis in coronary arteries in comparison with angiography. Conclusion. The results showed that the IASBPD index cannot be a valid criterion for the diagnosis of CAD as well as the number and severity of coronary artery stenosis. More studies with larger sample sizes and different designs are needed in this regard to achieve more conclusive results.

scholarly journals The Correlation between Polymorphism of β Fibrinogen Gene -455 G/A and Serum Fibrinogen Level with The Severity of Coronary Artery Stenosis In Coronary Artery Disease Patient

2019 ◽  
Vol 18 (2) ◽  
pp. 379-384
Author(s):  
Taufik Indrajaya ◽  
Yudhi Fadilah ◽  
Mediarty Yuwono ◽  
Ali Ghanie
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Stenosis ◽  
Fibrinogen Level ◽  
Coronary Artery Stenosis ◽  
Disease Patient ◽  
Artery Stenosis ◽  
Gensini Score ◽  
Artery Disease

Background: Now a days coronary artery disease (CAD) becomes major cause of death. One among 7 deaths in America caused by CAD. CAD is an atherosclerosis process, which progresively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that high serum fibrinogen level is an independent and significant to the severity of artery coronary stenosis. Serum fibrinogen level determined by genetic factor. Polymorphism of fibrinogen gene β -455 G/A seem plays an important role in plasma fibrinogen level. Although some studies showed a significant correlation between polymorphism and cardiovascular diseases, but some other studies report inversely. Aim. To evaluate the correlation between the polymorphism of fibrinogen gene β -455 G/A and serum fibrinogen level with the severity of artery coronary stenosis. Method: This is an analytic correlative study with prospective approach without comparison. Coronary angiography was performed in catheterization labor in the department of internal medicine, while DNA analysis and PCR done in the department of microbiology in General Hospital dr Muhammad Husin Palembang- Indonesioa, since July 2015 until Agustus 2016. Samples are CAD patient who undergo for coronary angiography and fulfield the criterias. The severity of stenosis in coronary artery determined by Gensini score. This study included 31 patient. Results. Among 31 CAD patients, this study found severe stenosis of coronary artery in 17 patients (53,1%), moderate in 5 patients (15,6%) and mild in 10 patients (31,2%). Genetic analysis showed that serum fibrinogen level was controlled by polymorphism of fibrinogen gene β -455 G/A, concecutively by genotipe AA in 15 patients (48,4%), genotipe GA in 12 patient (38,7%) and by genotipe GG in 4 patients (12,9%). Chi Square test showed a significant correlation between polymorphism gene fibrinogen β -455 G/A and serum fibrinogen level (p=0,039). Spearman’s rho test found no significant correlation between serum fibrinogen level and severity of coronary artery stenosis based on Gensini score (r=0,142; p=0,447). And also this study found no significant correlation between polymorphism gene fibrinogen β -455 G/A with the severity of stenosis in coronary artery (p=0,512). Conclusion. Although this study succeded to prove that serum fibrinogen level was determined by polymorphism fibrinogen gene β -455 G/A, but there are no significant correlations between polymorphism fibrinogen gene β -455 G/A and serum fibrinogen level with severity of coronary artery stenosis in CAD patients. This study suggest to study other candidate gene to look for other cardiac risk beside this fibrinogen. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.379-384

scholarly journals Serum Zinc-α2-Glycoprotein Levels in Patients with or without Coronary Artery Disease in Chinese North Population

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Meijuan Liu ◽  
Zeyu Liu ◽  
Huijuan Zhu ◽  
Linjie Wang ◽  
Hongbo Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Serum Zinc ◽  
Artery Stenosis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Artery Disease

Coronary artery disease (CAD), the leading cause of morbidity and mortality, has imposed huge health and economic burdens globally. Zinc-α2-glycoprotein (ZAG) is a novel adipokine. Increasing evidence suggests the close relationship between serum ZAG levels and various cardiometabolic risk factors. However, the relationship between serum ZAG levels and CAD is still not fully clarified. We conducted this study to evaluate serum ZAG levels and its association with cardiovascular risk factors. A total of 129 patients with CAD, 99 patients with noncoronary artery disease (NCAD), and 121 controls were recruited in this retrospective study. CAD (coronary artery stenosis ≥50%) or NCAD (coronary artery stenosis <50%) patients who underwent coronary angiography were diagnosed according to the American Heart Association criteria. Serum ZAG levels were determined via commercial enzyme-linked immunosorbent assay (ELISA) kits. The results showed that serum ZAG levels in CAD and NCAD groups were significantly decreased when compared with those in the control group. Multiple stepwise regression analysis revealed that the grouping variable (control, NCAD, and CAD) was an independent determinant of serum ZAG levels (β = −0.328, P<0.001) after controlling other confounding factors. Further multivariate ordinary logistic regression analysis demonstrated that the risk of grouping at one level higher in subjects with the lowest tertile of ZAG levels was 2.28-fold higher than those with the highest tertile levels (OR = 3.281, 95% CI 1.782–6.038, P<0.001). The receiver-operating characteristic (ROC) curve analysis showed that serum ZAG could distinguish CAD patients (AUC = 0.706, 95% CI, 0.643–0.770, P<0.05), NCAD patients (AUC = 0.673, 95% CI, 0.602–0.743, P<0.05), and NCAD and CAD patients (AUC = 0.692, 95% CI, 0.633–0.750, P<0.05) from controls. In conclusion, serum ZAG levels were significantly decreased in NCAD/CAD patients. The decreased serum ZAG levels were independently associated with the presence of NCAD/CAD. ZAG might serve as a candidate diagnostic biomarker for NCAD/CAD.

scholarly journals Association between ceramides and coronary artery stenosis in patients with coronary artery disease

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chenchen Tu ◽  
Lan Xie ◽  
Zhenjie Wang ◽  
Lili Zhang ◽  
Hongmei Wu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Artery Disease

Abstract 2941: Combined Assessment of Coronary Artery Stenosis and Myocardial Ischemia by Rest-Dipyridamole Stress Multidetector Computed Tomography

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Patricia M Carrascosa ◽  
Carlos Capuñay ◽  
Jorge Carrascosa ◽  
Alejandro Deviggiano ◽  
Alejandro Goldsmit ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Contrast Enhancement ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Artery Disease ◽  
Mdct Coronary Angiography ◽  
Dipyridamole Stress

Introduction: MDCT coronary angiography has been evolving as a noninvasive method for the assessment of coronary artery disease (CAD). More recently, It has been demonstrated that MDCT identifies reduced contrast enhancement in ischemic and/or scarred myocardial segments. Objective: to determine the ability of rest-stress multidetector computed tomography (RS-MDCT) to detect myocardial ischemia and to assess the relationship between MDCT myocardial perfusion abnormalities and coronary artery stenosis. Methods: Forty seven patients underwent stress/rest 99mTc sestamibi SPECT and RS-MDCT, using a 16-row detector scanner (Philips Brilliance-16). Myocardial segments were classified by SPECT as normal, ischemic or scarred. SPECT results were then compared with MDCT regional myocardial contrast enhancement. The results of MDCT coronary angiography were also analyzed in 20 patients who underwent invasive catheterization. Results: The presence of a reduction in contrast enhancement at rest by MDCT identified scar by SPECT with 96% sensitivity and 98% specificity. A stress-induced reduction in contrast enhancement by MDCT identified ischemia by SPECT with 77% sensitivity and 99% specificity. The segment-based sensitivity and specificity for the detection of significant stenosis by MDCT were 92% and 98%, respectively. Conclusion: Our results showed that a rest-dipyridamole stress MDCT protocol can identify the presence of myocardial ischemia as well as the severity of coronary artery stenosis in patients with suspected coronary artery disease.

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