Artery Lesions In Patients Research Articles

Impact of Chronic Renal Failure on Safety and Effectiveness of Paclitaxel-Eluting Stents for Femoropopliteal Artery Disease: Subgroup Analysis from Zilver PTX Post-Market Surveillance Study in Japan

PurposeFavorable long-term outcomes of the Zilver PTX drug-eluting stent (DES) in femoropopliteal lesions have been demonstrated. Chronic renal failure (CRF) has been shown to be a risk factor for restenosis and decreased limb salvage. The results of the DES in patients with CRF have not previously been reported. This study compares the results with the DES in patients with CRF and those without CRF.MethodsThis retrospective analysis from the Zilver PTX Japan Post-Market Surveillance Study included 321 patients with CRF and 584 patients without CRF. Outcomes included freedom from target lesion revascularization (TLR) and patency.ResultsOf the patients included in this subgroup analysis, 2-year data were available for 209 patients in the CRF group and 453 patients in the non-CRF group. The two groups were similar in terms of lesion length and the frequency of in-stent restenosis. Critical limb ischemia, severe calcification, and diabetes were more common in patients with CRF, whereas total occlusion was more common in patients without CRF. Freedom from TLR rates were 81.4 versus 84.9% (p = 0.24), and patency rates were 70.7 versus 70.3% (p = 0.95) in patients with and without CRF at 2 years, respectively.ConclusionThis is the first comparative study of the DES in femoropopliteal artery lesions in patients with and without CRF. These results indicate that the DES placed in femoropopliteal artery lesions of CRF patients is safe and effective with similar patency and TLR rates to patients without CRF.Level of EvidenceLevel 3, Post-Market Surveillance Study.

Expression of Fc < gamma > Rs on monocytes among Kawasaki disease patients with coronary artery lesions

ObjectiveTo study expression of Fc gamma receptors (Fc<gamma>Rs) on monocytes in Kawasaki disease (KD) patients with coronary artery lesions (CAL). Methods160 newly diagnosed KD patients and 80 health children were enrolled in this study. All patients were scheduled to receive both aspirin and intravenous immunoglobulin (IVIG). Serial blood samples were obtained before and 3days after completing IVIG therapy. The first two-dimensional echocardiographic examination was performed for all KD patients within 10days, and was repeated at 3weeks. CAL was defined by coronary artery Z-scores≥2.5 by echocardiography. Expression of inhibitory and activating Fc<gamma>Rs on CD14+ monocytes (MCs) was assessed by flow cytometry. Cytokine expression in MC was evaluated by PCR. ResultsOf the 160KD patients enrolled in this study, 36 had coronary artery lesions (KD-CAL+ group), while 124 did not (KD-CAL− group). There was no significant difference in Fc<gamma>RI expression on MCs from KD patients and that of Ctrls. Although Fc<gamma>RIII and Fc<gamma>RIIa levels were significantly higher in KD patients compared with those in Ctrls, there were no significant differences between the KD-CAL+ and KD-CAL− groups. Fc<gamma>RIIb expression in the KD patients was lower than that of Ctrls, meanwhile expression in the KD-CAL+ group was lower than that in the KD-CAL− group. After IVIG therapy, Fc<gamma>RIIb expression increased in KD-CAL+, but did not reach the normal range. A negative correlation was observed between the levels of IL-6, TNF-α and Fc<gamma>RIIb expression. ConclusionDecreased Fc<gamma>RIIb expression on MCs may contribute to the development of coronary artery lesions in patients with KD.

Association of Circulating IGFBP1 Level with the Severity of Coronary Artery Lesions in Patients with Unstable Angina.

Aims. Local IGFBP1 level was reported to affect the development of coronary artery plaque. This study investigated the association of circulating IGFBP1 level with the severity of coronary artery lesions in patients with unstable angina. Materials and Methods. In 112 consecutive patients with clinically diagnosed unstable angina, admitted from July 2014 to July 2015, we studied the correlations of circulating IGFBP1 and the severity of coronary artery disease (CAD). Results. All patients underwent scheduled coronary angiography, and 67 cases were diagnosed with critical and 45 with noncritical CAD. Of the 67 critical CAD patients, 41 (61.19%) presented with multivessel and 26 (38.81%) with single-vessel lesions. IGFBP1 levels were higher in patients with multivessel than those with single-vessel lesions. Moreover, the IGFBP1 level was positively correlated with the GRACE score. Among clinical variables, the IGFBP1 level was correlated with HDL-C. IGFBP1 alone (cutoff 20.86 ng/ml) demonstrated a sensitivity of 0.448 and specificity of 0.933 in predicting CAD. Combination of IGFBP1 and HDL-C had a sensitivity of 0.821 and specificity of 0.800 in predicting CAD. Conclusions. Circulating IGFBP1 level positively correlated with the severity of CAD. IGFBP1, when combined with HDL-C, might be useful in screening for high risk CAD patients.

Effect of blood glucose control level on coronary artery lesions in patients with coronary heart disease complicated with diabetes

Objective To analyze the effect of blood glucose control level on coronary artery lesions in patients with coronary heart disease complicated with diabetes. Methods One hundred patients with coronary heart disease complicated with type 2 diabetes mellitus treated at our hospital from March, 2013 to February, 2015 were selected as study objects and were divided into an observation group and a control group according to different blood glucose control levels (plasma glycosylated hemoglobin < 6.5% and fasting blood glucose ≤ 7.0 mmol/L indicate ideal blood glucose control), 50 cases for each group. The degree of coronary artery stenosis, the number of affected vessels, and the number of cases with diffuse lesions were compared between these two groups. The Gensini scores of coronary artery disease in the two groups were analyzed. The levels of von Willebrand factor (vWF) were compared between these two groups by enzyme linked immunosorbent assay (ELISA). Results There were no statistical differences in the degrees of coronary artery stenosis between the observation group (non-severe 46.00%, severe 34.00%) and the control group (non-severe 36.00%, severe 44.00%) (P>0.05). The numbers of affected vessels (single 4.00%, double vessels 60.00%, three vessels 36.00%) and diffuse lesions (16.00%) in the observation group were significantly lower than those in the control group (single 2.00%, double vessels 24.00%, three vessels 74.00%, diffuse lesions 42.00%) (P<0.05); HbA1c [(2.17±1.20)%], Gensini score [(49.27±1.14)] and vWF [(65.23±1.24)%] in the observation group were significantly lower than those in control group (P<0.05). Conclusion Diabetes aggravates the degree of coronary artery lesions. Therefore, coronary artery lesions can be reduced by controlling blood glucose levels and reducing vWF. Key words: Blood glucose; Control; Coronary heart disease; Diabetes; Coronary artery lesions; Effect; Analysis

Preoperative evaluation of coronary artery fistula using dual-source computed tomography

ObjectivesTo evaluate the efficacy of dual-source computed tomography (DSCT) in assessing the morphological features, quantitative features, and associated coronary artery lesions among patients with coronary artery fistula (CAF) before surgery. MethodsWe enrolled 34 patients with CAF that were morphologically and quantitatively analyzed by DSCT and compared the analyses with surgical results (reference standard). The associated coronary artery lesions were also assessed. ResultsBy DSCT, we identified 15 patients (44.1%) with left-sided CAF, 9 (26.5%) with right-sided CAF, and 10 (29.4%) with bilateral CAF; the left anterior descending coronary artery (50.0%) was most frequently involved. Drainage was most commonly in the main pulmonary artery (41.2%), and those with right-sided CAF had larger feeding coronary arteries and drainage sites than those with left-sided or bilateral CAF (p<0.05). All the morphological features presented by DSCT were confirmed at surgery. In the quantitative analysis of CAF, DSCT was as accurate as surgery (r=0.95–0.98, p<0.001), and it was able to evaluate associated lesions accurately, including arteriosclerotic plaques, coronary artery aneurysms, and myocardial bridges. The evaluation could be completed in a single scan, without requiring an increased radiation dose (mean ED=2.27±1.92mSv). ConclusionsDSCT is an alternative noninvasive imaging method that enables accurate assessment of morphological features, quantitative features, and associated coronary artery lesions in patients with CAF. It can be used to provide comprehensive information for determining surgical strategies.

The assessment of non culprit coronary artery lesions in patients with ST segment elevated myocardial infarction and multivessel disease by control angiography with quantitative coronary angiography.

Conflicting data is present in the literature about patients who are treated with percutaneous coronary intervention (PCI) due to the exaggeration of the non culprit artery. The precise understanding of the non culprit artery in the setting of ST segment elevated myocardial infarct (STEMI) is important since the time and modality of the treatment is planned accordingly. The aim of this study is to evaluate the lesions in the non culprit coronary artery during primary PCI and control coronary angiography (CAG) using quantitative coronary angiography (QCA) in multivessel STEMI patients. In this study, multivessel disease STEMI patients whom underwent primary PCI between January 2010 and March 2011 were included. Critical stenosis degree was accepted as ≥70 % in the non culprit artery. All patients were evaluated with control CAG 1month after primary PCI. Assessment with CAG was performed by two blinded cardiologists. QCA program was used to evaluate reference artery diameter (RAD), minimum luminal diameter (MLD) and degree of stenosis. With regard to the degree of stenosis, significant reduction was accepted as ≥15 % while % 5-15 decrease was accepted as moderate. Of the 81 patients, 61 were males and 20 were females (mean age 58.1 ± 10). In the control CAG, the degree of non culprit artery stenosis was found to be decreased (p < 0.001) while RAD and MLD were increased (p < 0.001 and p < 0.001 respectively). Significant decrease in critical non culprit artery lesions was detected in 22 patients (20.9 %) meanwhile moderate reduction was observed in 26 patients (24.7 %). In 14 patients (13.3 %), non culprit artery lesions accepted as critical during primary PCI were found to be non critical during the control CAG. Planned intervention was cancelled and medical treatment was initiated in those 14 patients. Our data indicated using QCA, approximately the half of non culprit lesions were found less critical during control CAG when compared to primary PCI. Therefore, it is concluded that complete revascularization during primary PCI should be avoided in multivessel STEMI patients and critical non culprit artery lesions should be re-evaluated with later control CAG.

48. Can early 24 hours Holter monitoring predict obstructive coronary artery lesions in patients with low risk acute coronary syndrome?

Identification of patients at increased risk of death due to acute coronary syndrome (ACS) can add to risk stratification and guide the next step in the management of those patients. Altered HRV has been associated with adverse outcomes in heart disease, but this has not been established in patients with acute chest pain.This study aimed to create a non-invasive, economical and risk-free method in the clinical evaluation and diagnosis of significant CAD among patients with unstable angina.Twenty-four-hour Holter recordings of 100 patients with ACS were initiated within 24 hours of admission at the emergency department; stress ECG was done for all patients while coronary angiography was done only for patients with abnormal stress test. Time domain, frequency domain, and nonlinear HRV were examined.The mean SDNN was statistically significantly lower in patients with abnormal stress test, many time and frequency domain HRV parameters was statistically lower in patients with significant coronary arteries obstruction. HRV measured close to the ACS onset may assist in risk stratification. HRV parameters may provide additional, incremental prognostic information to established assessment guidelines and possible early intervention in those patients.

Study of the features of coronary artery atheromatous plaque using intravascular ultrasound in patients with impaired glucose tolerance

ObjectiveWe used intravascular ultrasound (IVUS) to analyze the features of coronary artery atheromatous plaque in patients with impaired glucose tolerance and mild-to-moderate angiographic coronary stenosis. The aim was to determine the clinical significance of plaque characteristics as well as the relationship between hemoglobin A1c (HbA1c) levels and coronary artery lesions. MethodsHbA1c levels were evaluated in 85 patients (96 lesions), of whom 46 had impaired glucose tolerance (IGT Group) and 39 had normal blood glucose (NBG Group). IVUS was used to analyze the lesion vessel of both groups qualitatively and quantitatively. The external elastic membrane area (EEMA), minimal lumen area (MLA), plaque area (PA), and plaque burden (PB) were measured for both the target lesion and the reference segments (reference external elastic membrane area (REEMA), reference minimal lumen area (RMLA), reference plaque area (RPA), and reference plaque burden (RPB), respectively). ResultsHbA1c levels were significantly higher in the IGT Group than in the NBG Group (P < 0.05). In the IGT Group there was more soft plaque, eccentric plaque, and positive remodeling, and less calcification, while in the NBG Group there was much harder plaque and calcification, no reconstruction, and negative remodeling (P < 0.05). MLA was smaller in the IGT Group than in the NBG Group, while EEMA, PA, and PB were clearly greater (P < 0.05). In the meantime, RMLA was clearly smaller in the IGT Group than in the NBG Group, while RPA and RPB were greater (P < 0.05). HbA1c levels were positively correlated with PA and PB, and negatively correlated with MLA. ConclusionIVUS is very valuable for the evaluation of mild-to-moderate coronary lesions. The coronary artery lesions in patients with IGT are more serious and widespread than those in patients with NBG. HbA1c levels might be of some value in assessing the severity of coronary artery lesions.

CORONARY ARTERY LESIONS IN PATIENTS OVER 50 YEAR OLD WITH VALVULAR HEART DISEASES INDICATED FOR VALVE SURGERY

Objectives: To investigate the features of coronary artery lesions in patients over 50 with heart valve diseases and to find out the relationship between the levels of coronary artery lesions and heart valve diseases. Results: In patients over 50 year old with heart valve diseases, the rate of significant coronary artery lesions is 55.5%. In which, significant lesions in the group of both mitral and aorta valve diseases is 44.19%, only mitral valve diseases is of 70%, only aortic valve diseases is of 51.85%. There is a relationship between the severity of mitral valve diseases and right coronary artery lesions (OR 3.74: 1.64 to 8.5, p = 0.0017) and circumflex coronary artery lesions (OR 2.59: 1.16 to 5.75, p = 0.0192). The severity of heart valve lesions in significant coronary artery lesions group is higher than insignificant coronary artery lesions group or normal group. Conclusion: Coronary artery lesions is common in patients &gt; 50 years old with heart valve diseases, there is a relationship between the severity of mitral valve diseases and and right coronary artery lesions and circumflex coronary artery lesions. Key words: coronary artery lesions, mitral valvediseases

Effects of antioxidant system on coronary artery lesions in patients with abnormal glucose metabolism.

To evaluate the effects of catalase (CAT), superoxide dismutase (SOD), and glutathione (GSH) system on the range and severity of coronary artery lesions in patients with abnormal glucose metabolism. This study included 766 patients with abnormal glucose metabolism. Levels of fasting blood lipids, blood glucose, CAT, SOD, GSH, glutathione reductase (GR), and glutathione peroxidase (GSH-Px) were measured in all the patients. Coronarography was performed, and the degree of the lesions in each coronary artery was quantitatively analyzed using the Gensini scoring system. In patients with impaired glucose regulation and diabetes, the number of coronary artery branches with stenosis and the Gensini scores were inversely correlated with the plasma levels of CAT, SOD, GSH, GH, and GSH-Px (P<0.001). Patients were grouped according to the Gensini scores. As the scores increased, the levels of CAT, SOD, GSH, GSH-Px, and GR gradually decreased. Logistic gradual regression analysis showed that GSH-Px and CAT were independent risk factors associated with the coronary artery lesions in three or more branches. Decreased plasma levels of CAT, SOD, GSH, GR, and GSH-Px were inversely correlated, at least to some extent, with the extent of coronary artery lesions. Particularly, GSH-Px and CAT were independent risk factors associated with coronary artery lesions involving three or more branches. This suggests that long-term hyperglycemia leads to enhancement of oxidative stress.

0282 : Hyperglycemia on admission predicts severity of coronary artery lesions in patients admitted for acute myocardial infarction

High blood glucose (HBG) on admission is a major common metabolic disorder in patients with acute myocardial infarction (MI). However, only few data have examined its predictive performance over established risk score. The aim of our study was to determine if hyperglycemia on admission correlates to severity of coronary artery lesions evaluated by the Synthax score. We evaluated 128 patients admitted for MI. The population was divided into: hyperglycemia (glycemia on admission >1.10g/l) and non-hyperglycemia (<1.10g/l) regardless of previous diabetic status. 63.4% of our patients presented with hyperglycemia on admission. Patients aged over 65 years old represented 89% of the population studied. There were significant differences in baseline clinical status established by calculating CHADSVASC score (2,60±1,54 vs 1,5±1,05; p =0.01). Biological status differed significantly between the two groups especially troponine Ic, LDL cholesterol and triglyceride which were higher in HBG patients (32,20±63,93 vs 17,64±31,16 p=0.014; 0,94± 0,33 vs 0,87±0,27 p=0.015; 1,45± 0,67 vs 1,16±,42 p=0.04 respectively). Synthax score was higher in the hyperglycemia group 11,21±8,377 vs 7,50±8,782 p=0.03. A multivariate linear regression analysis showed that hyperglycemia on admission was an independent predictor of severity of coronary artery lesions. In patients with MI, hyperglycemia on admission predicts severity of coronary artery lesions so we should be more careful with this population. The author hereby declares no conflict of interest

Association between insulin dosage and insulin usage time, and coronary artery lesions in patients with type 2 diabetes and coronary heart disease.

Insulin is used in the treatment of type 2 diabetes, with its usage reaching 30–50% in Western countries. The aim of the present study was to determine the association between insulin dosage (ID)/insulin usage time (IT) and coronary artery lesions in patients of type 2 diabetes with coronary heart disease. Based on the insulin using dosage, 353 type 2 diabetes patients were divided into the high-dose (≥0.5 IU/kg) and low-dose (<0.5 IU/kg) group. Selected coronary angiography was performed and the Gensini score was used to determine the degree of the coronary artery lesions. The homeostasis model assessment-insulin sensitivity (HOMA-IS) index was assessed by HOMA2. Data including age, gender, smoking, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG), glucose (Glu), hemoglobin A1c (HbA1c), C-peptide, ID, IT, diabetes duration time (DT), and IT/DT were collected. The association between insulin usage (both dose and time) and the coronary artery lesions in these patients was then determined. Statistical differences for the two groups for factors including C-peptide, HbA1c, ID, IT, DT, IT/DT and the Gensini score values (P<0.05) were identified. By contrast, no significant differences for factors such as gender, smoking history, age, BMI, TC, TG, LDL, HDL, fasting insulin, Glu, SBP and DBP were observed. The coronary artery damage Gensini score in insulin-insensitive individuals was significantly greater than that in the insulin-sensitive individuals. The Spearman analysis revealed that ID and IT, DT and IT/DT were positively correlated with the coronary artery damage Gensini score. The multivariate regression, the interquartile range method and receiver operating characteristic analyses showed that ID, ID/DT, IT had a greater effect on coronary vascular damage compared with DT. In conclusion, the degree of coronary artery lesions were correlated with ID, IT, DT, IT/DT. High doses of insulin or a high IT/DT ratio may aggravate coronary artery damage.

Abstract WP136: Clinical, Laboratory, and Imaging Characteristics Oof Transient Ischemic Attack Caused by Large Artery Lesion: A Comparison Between Carotid and Intracranial Artery

Background: The purpose of this study was to determine the differences in clinical characteristics and the risk of ischemic stroke between patients with transient ischemic attack (TIA) attributable to extracranial carotid and intracranial artery occlusive lesions. Methods: Among 445 patients admitted to our stroke care unit within 48 hours of TIA onset between April 2008 and December 2013, 85 patients (63 men, 69.4 years) with large artery occlusive lesions relevant to symptoms were included in this study. The primary endpoints were ischemic stroke at 2 days and 90 days after TIA onset. Results: Twenty-eight patients had carotid artery occlusive lesions (extracranial group), and 57 patients had intracranial artery occlusive lesions (intracranial group). Patients in the intracranial group were significantly younger, had lower levels of fibrinogen, and were less likely to have occlusion when compared to those in the extracranial group. Eleven patients in the extracranial group and no patient in the intracranial group underwent revascularization procedures within 90 days of TIA onset. The 2-day risk (14.2% vs. 0%, p = 0.044) and 90-day risk (17.1% vs. 0%, p = 0.020) of ischemic stroke after TIA onset were significantly higher in the intracranial group than in the extracranial group. Conclusions: Patients with intracranial artery occlusive lesions were more frequent and were at higher risk of early ischemic stroke than those with extracranial carotid artery occlusive lesions among our patients with TIA caused by large artery disease. These data highlight the importance of prompt assessment of intracranial artery lesions in patients with TIA.

0156: Hyperglycemia on admission predicts severity of coronary artery lesions in patients admitted for acute myocardial infarction

High blood glucose (HBG) on admission is a major common metabolic disorder in patients with acute myocardial infarction (MI). However, only few data have examined its predictive performance over established risk score. The aim of our study was to determine if hyperglycemia on admission correlates to severity of coronary artery lesions evaluated by the Synthax score. We evaluated 93 patients admitted for MI. The population was divided into: hyperglycemia (glycemia on admission >1.10g/l) and non-hyper-glycemia (<1.10g/l) regardless of previous diabetic status. 63.4% of our patients presented with hyperglycemia on admission. Patients aged over 65 years old represented 89% of the population studied. There were significant differences in baseline clinical status established by calculating CHADSVASC score (2,60±1,54 vs 1,5±1,05; p=0.01). Biological status differed significantly between the two groups especially troponine Ic, LDL cholesterol and triglyceride which were higher in HBG patients (32,20±63,93 vs 17,64±31,16 p=0.014; 0,94±0,33 vs 0,87±0,27 p=0.015; 1,45±0,67 vs 1,16±,42 p=0.04 respectively). Synthax score was higher in the hyperglycemia group 11,21±8,377 vs 7,50±8,782 p=0.03. A multivariate linear regression analysis showed that hyperglycemia on admission was an independent predictor of severity of coronary artery lesions. In patients with MI, hyperglycemia on admission predicts severity of coronary artery lesions so we should be more careful with this population.

Concentration of plasma vascular endothelial growth factor and related factors in patients with unstable angina pectoris

To observe plasma vascular endothelial growth factor(VEGF) levels and related factors in patients with unstable angina pectoris(UAP). A total of 108 consecutive patients with chest pain hospitalized in our department from October to December 2014 were included. They were divided into UAP (n=78) and non-CHD group (n=30) by the result of coronary angiography(CAG). Coronary artery lesion was assessed according to the Gensini score, serum lipids, homocysteine(Hcy) levels and other biochemical indicators were also determined. The peripheral arterial tonometry was evaluated by reactive hyperemia index(RHI) measured by Endo-PAT2000 Noninvasive Diagnostic System.The level of plasma VEGF was detected in patients with unstable angina pectoris. Multiple linear regression analysis was used to analyze the correlations between VEGF and various related factors. Percent of male gender, triglyceride (TG) and Hcy levels were significantly higher in UAP group than in no-CHD group(all P<0.05). VEGF values was significantly higher ((102.1 ± 55.7)ng/L vs.(80.9 ± 38.1)ng/L, P<0.05), while RHI was significantly lower (1.53 ± 0.27 vs.1.65 ± 0.32, P<0.05) in UAP group than in no-CHD group. Multiple linear regression analysis showed that VEGF value was significantly correlated with degree of coronary artery stenosis, Gensini score and RHI (β=38.03, P<0.01; β=0.51, P<0.01; β=-69.30, P=0.03; respectively). VEGF levels are significantly increased in patients with unstable angina pectoris, and VEGF level is significantly associated with the degree of coronary artery stenosis, Gensini score and RHI. V EGF level might serve as a new biochemical indicator for coronary artery lesion in patients with UAP.

Abstract 14637: Effects of Dietary Patterns in the Severity of Coronary Artery Disease

Introduction: The impact of diet on atherosclerosis progression is well established. However, the independent predictive value of unhealthy diet in the prognosis and severity of coronary artery disease (CAD) has not been definitely confirmed and clinicians often ignore how to incorporate it in clinical practice. Hypothesis: Dietary patterns may impact CAD severity. Methods: In this cohort study we included 188 consecutive symptomatic stable CAD patients. The diagnosis of CAD was based on coronary angiography and patients were categorized as having severe CAD and non-severe CAD. The diagnosis of severe CAD was based on the presence of either left main coronary artery disease (stenosis≥50%), or three-vessel coronary artery disease, or two-vessel coronary artery disease marked by stenosis of the proximal left anterior descending artery ≥70%. Among several demographics and clinical characteristics all subjects were tested with a validated semi quantitative food frequency questionnaire. Results: Concerning baseline demographic characteristics there was no difference between subjects with severe CAD and non-severe CAD while, the prevalence of severe CAD was higher in current smokers compared to non-smokers. Principal component analysis revealed 8 distinct dietary patterns. The first component-western dietary pattern (increased intake of fat, red meat and carbohydrates and minimal consumption of fruits vegetables and green leafy)- was predictive of severe CAD (AUC:0.73, 95% CIs:0.64-0.83, p&lt;0.001) and more interestingly, can increase the discriminative ability of a multivariate model based on all major risk factors. Conclusion: The unhealthy western type of diet is associated with the severity and extent of coronary artery lesions in patients with stable CAD. These findings highlight the importance of accessing dietary patterns when calculating cardiovascular risk and to take into consideration dietary habits in the management of cardiovascular patients.

Clinical, Laboratory, and Imaging Characteristics of Transient Ischemic Attack Caused by Large Artery Lesions: A Comparison between Carotid and Intracranial Arteries

Background/Aims: The aims of this study were to determine the differences in clinical characteristics and the risk of ischemic stroke between patients with transient ischemic attack (TIA) attributable to extracranial carotid and intracranial artery occlusive lesions. Methods: Among 445 patients admitted to our stroke care unit within 48 h of TIA onset between April 2008 and December 2013, 85 patients (63 men, mean age 69.4 years) with large artery occlusive lesions relevant to symptoms were included in this study. The primary endpoints were ischemic stroke at 2 and 90 days after TIA onset. Results: Twenty-eight patients had carotid artery occlusive lesions (extracranial group), and 57 patients had intracranial artery occlusive lesions (intracranial group). Patients in the intracranial group were significantly younger, had lower levels of fibrinogen, and were less likely to have occlusion when compared with those in the extracranial group. Eleven patients in the extracranial group and none in the intracranial group underwent revascularization procedures within 90 days of TIA onset. The 2-day risk (14.2 vs. 0%, p = 0.044) and the 90-day risk (17.1 vs. 0%, p = 0.020) of ischemic stroke after TIA onset were significantly higher in the intracranial group than in the extracranial group. Conclusions: Among our patients with TIA caused by large artery disease, patients with intracranial artery occlusive lesions were more frequent and were at higher risk of early ischemic stroke than those with extracranial carotid artery occlusive lesions. These data highlight the importance of prompt assessment of intracranial artery lesions in patients with TIA.

Usefulness of Neutrophil to Lymphocyte Ratio in Prediction of Coronary Artery Lesions in Patients with Kawasaki Disease.

Kawasaki disease is an inflammatory condition. Neutrophil to lymphocyte ratio is a marker reflecting inflammation. The aim of the study is to evaluate usefulness of neutrophil to lymphocyte ratio in diagnosis of Kawasaki disease and in prediction of coronary artery lesions. Retrospective cross-sectional study. Seventy-five children with Kawasaki disease and 66 controls were retrospectively enrolled. Their leukocyte, neutrophil, and lymphocyte counts were recorded. Abnormally distributed data were shown as median (interquartile range). Cases having coronary artery diameter two standard deviation above mean were diagnosed to have coronary artery lesions. Median age of Kawasaki disease patients was 34 months. Twentyfive of those (33.33%) had incomplete Kawasaki disease and twenty-six (34.66%) had coronary artery lesions. Leukocyte [12.61 (6.09)×10(3)/µL vs. 8.48 (5.58)×10(3)/µL], neutrophil [6.73 (4.10) ×10(3)/µL vs. 4.62 (5.47)×10(3)/µL], and lymphocyte [4.04 (2.91)×10(3)/µL vs. 3.02 (2.57) ×10(3)/µL] counts were significantly higher in Kawasaki disease patients compared to controls (all p values <0.01). However, there was not significant difference between patients and controls regarding neutrophil to lymphocyte ratio [1.72 (1.22) vs. 1.71 (1.88)]. Findings of Kawasaki disease and incomplete Kawasaki disease cases did not differ, while comparison of patients with and without coronary artery lesions revealed significantly higher neutrophil to lymphocyte ratio values in former group [2.02 (1.63) vs. 1.50 (1.28), p=0.01]. The cut-off neutrophil to lymphocyte ratio value for prediction of coronary artery lesions was determined as 1.32. Neutrophil to lymphocyte ratio values in Kawasaki patients with coronary lesions were significantly higher than the ones without and values greater than 1.32 were useful in prediction of coronary lesions.

Characteristics of coronary artery lesion in patients with and without diabetes mellitus.

The goal of this study was to compare the coronary atherosclerotic burden in patients with and without type-2 diabetes by using CT coronary angiography (CTCA). A total of 206 diabetic (mean age 67±11years; male: 136) and 523 non-diabetic patients (mean age 62±13years; male: 323) without history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined, and each diseased segment was classified as showing obstructive lesion (luminal narrowing>50%) or not. Coronary angiography was then performed to confirm diagnosis. Diabetics showed a higher rate of abnormal CAD (76 vs. 53% of patients; p<0.0001) and fewer normal coronary arteries (24 vs. 47%; p<0.0001) compared with non-diabetics. Multi-vessel disease was seen more frequently in patients with diabetes than in patients without diabetes [15% (n=22) vs. 7% (n=62), respectively; p=0.0004]. The per-patient number of segments with plaque (4.5 vs. 2.0, respectively; p<0.0001) and the number of segments with obstructive disease (0.9 vs. 0.5, respectively; p=0.0001) were higher for diabetic patients than for non-diabetic patients. Diabetes was associated with higher coronary plaque burden.

GW26-e1836 Correlation between insulin dosage∖insulin usage time and the coronary artery lesions in patients of type 2 diabetes with coronary heart disease in Chongqing China

GW26-e1836 Correlation between insulin dosage∖insulin usage time and the coronary artery lesions in patients of type 2 diabetes with coronary heart disease in Chongqing China