Colleges Of Pharmacy Research Articles

Effect of Platelet-Rich Fibrin on Soft Tissue, Periodontal Pocket Healing, and Alveolar Bone Height after Third Molar Surgery: A Randomized Clinical Trial

Background: More and more studies were being conducted to improve healing after third molar surgery. The aim of this study was to evaluate the effect of PRF on soft tissue and periodontal pocket healing, alveolar bone resorption distal to the second molar after lower third molar surgical removal. Methods: A Randomized, controlled clinical trial and split-mouth design was performed on 26 healthy patients who had an indication of impacted lower third molars extraction on both sides with symmetrical orientation and the same difficult index. All patients had the same extraction protocol on both sides at the Department of Oral Surgery, Faculty of Odonto-stomatology, University of Medicine and Pharmacy, Ho Chi Minh City. PRF was applied on one side, whereas the other was left empty as the control group. Assessing the soft tissue healing, periodontal pocket depth and distal bone resorption of the study and control groups after third molar removal surgery. Data obtained were statistically analyzed. Results: There is a statistically significant difference in soft tissue healing on the 3rd and 7th postoperative days and distal bone resorption (p<0.05) on the 3rd and 6th postoperative months between two groups. Periodontal pocket depth of the study group showed more reduction than the control group but was not significantly different. Conclusion: Using PRF can help improve soft tissue healing and lower distal bone resorption after surgical extraction of impacted lower third molars. PRF appears to reduce periodontal pocket depth but still needs more research to conclude.

Economic Considerations and Cost-Saving Strategies for Nonsterile Compounding Education

ObjectiveTo determine the economic considerations, including cost-saving strategies, associated with nonsterile compounding education for students in schools and colleges of pharmacy across the United States. MethodsAn electronic survey was sent to the American Association of Colleges of Pharmacy Pharmaceutics Section and Laboratory Instructor's Special Interest Group members. Quantitative and qualitative data were collected about the institution, student cohorts, compounding courses, equipment, budgets, personnel, and cost-saving measures. Descriptive statistics were calculated using SPSS. Open-ended responses were used by respondents if the primary question could not adequately capture their institution-specific information. These answers were added to the study findings. ResultsOf 555 surveys sent, 46 were completed. Reported annual compounding budgets ranged from $3000 to $96,000. Reported annual equipment maintenance costs ranged from $400 to $18,000. Fifty percent of respondents reported students shared equipment, and 29.6% collected a lab fee from students to offset costs. Approximately half of respondents reported the use of cost-saving measures, including contract pricing, purchasing supplies in bulk, price comparisons, use of simulated drugs, re-use of personal protective equipment, and procurement of donations. Fifty percent of respondents employed laboratory assistants to support nonsterile compounding sessions, with paid positions ranging from $200 to $1000 per semester. ConclusionFindings from this study may assist pharmacy administrators and course directors in evaluating the costs associated with nonsterile compounding education across the Academy and, more importantly, determining ways to reduce such costs while maintaining the intent and quality of these courses.

Recommendations for Assessing the Quality of Clinical Faculty Members’ Journal Publications

Evaluation of clinical faculty involves an assessment of the quality of their publications in addition to quantity (number) of publications. In contrast to assessing quantity, assessing quality is difficult. The purpose of this paper is to discuss practical considerations and provide recommendations related to quality of publications that clinical faculty members should bear in mind as part of their overall scholarship activity. College and schools of pharmacy may not provide written criteria for assessing quality of publications, so it is important that clinical faculty members seek guidance from their department chair or direct supervisor, experienced colleagues, and formal or informal mentors or advisers. One criterion for assessing quality is whether a publication was evaluated through a peer-review process although there are other considerations including dissemination of the paper via search engines such as PubMed. Clinical faculty also need to consider authorship order on their papers and potential journals for submission.

Impact of an educational program on community pharmacist’s preparedness to conduct pharmacist-led diabetes clinic in Saudi Arabia

BackgroundDemand for diabetes care and prevention has increased due to Saudi Arabia’s high prevalence of diabetes mellitus and its insufficient treatment. This raised awareness of the significance of community pharmacists in Saudi Arabia, who may significantly improve diabetes treatment by setting up pharmacist-led diabetic clinics. Thus, to assess community pharmacists’ readiness to lead diabetes clinics in Saudi Arabia, this study evaluated the usefulness of an educational session on diabetes care.MethodThe preparation of community pharmacists for diabetes treatment and management was assessed using a validated diabetes-specific questionnaire. An engaging and thorough diabetes education class was presented by two licensed diabetes educators. One-way ANOVA, chi-square, and the Mann–Whitney U-test were used to statistically assess the pre- and post-knowledge and attitude scores of community pharmacists.ResultsFollowing a learning session, the community pharmacists had a significant increase in understanding oral hypoglycemic medicines, monitoring the disease’s course, and dosing of insulin for diabetics (p = 0.01). Additionally, the community pharmacist’s perspective and attitude score on managing diabetes increased from 49.74 to 52.74 (p = 0.01).ConclusionThe study’s findings demonstrated a marked improvement in community pharmacist’s knowledge of and attitude toward running pharmacist-led diabetic clinics following a session on diabetes education in collaboration with the Pharmacy College. The study’s findings also emphasized the significance of developing a structured programme for diabetes education in Saudi Arabia to address the demands of community pharmacists in terms of professional development.

Non-Approved Uses of Celecoxib and Indomethacin: Pharmacy Students’ Knowledge and Opinions

A survey was conducted among first-year pharmacy students at Howard University College of Pharmacy to measure their level of knowledge and gauge their opinion regarding the off-label uses of two non-steroidal anti-inflammatory drugs (NSAIDs), indomethacin and celecoxib. The average level of knowledge on indomethacin and celecoxib was 36.2% and 31.2%, respectively. Among the five knowledge-based questions on each of these drugs, the highest correct response rate was obtained on indomethacin dosing at 72.9%, and 64.7% on the class of drugs celecoxib belongs to. In the responses to questions on indomethacin, the highest correct response of 72.9% was significantly higher (p<0.05) than responses to other knowledge-based questions, except for the knowledge level on the class of drugs (59.5%; p=0.3257). In the same manner, the correct response rate of 64.7% for the class of drugs that celecoxib belongs to was significantly higher than the response rates for the other questions (p<0.05), except when compared to the response to the question whether hyperplastic polyps and serrated polyps can develop into cancer (41.2%, p=0.0883). The opinions of the students varied, with a majority (55.9%) agreeing that serious diseases should be treated with non-approved medications. In the case of indomethacin, 35.5% of the respondents believed that because of toxicity issues, it should not be used outside the approved indications, while 27.8% believed that the safety has been established and can be used outside the approved use. Most respondents (55.9%) on celecoxib thought colorectal cancer is a serious disease and can be treated with non-approved drugs.

Prevalence of Consanguineous Marriages in UAE Nationals and the Risk of Genetic Diseases

Introduction: The occurrence of consanguineous marriages has been common in the Arab populations due to socio-cultural factors. Genetic diseases are rare in the overall population, but their frequency unusually increases as the prevalence of consanguineous marriages increases. The aim of our pilot study was to investigate the extent of consanguinity and its effects on non-communicable genetic diseases, in Emirati population. Methodology: This research was based on a socio-economic survey (SES) conducted by a group of students of Dubai Pharmacy College for Girls in the year 2018. Subjects for this preliminary study were selected by using convenience sampling method from urban regions of United Arab Emirates local households. A questionnaire was designed for this purpose and data was collected during household visits. Results: Our study showed that the incidence of consanguinity is relatively high with a rate of about 65% approximately and 33% of all these consanguineous marriages are of the first cousin and closer marriage type. Our results states that consanguineous marriages have a negative effect on reproductive health factors and in turn posing a risk for occurrence of noncommunicable genetic diseases, congenital malformations, and various chronic and complex multifactorial diseases in Emirati Arab population. Discussion: Genetic counselling and premarital counselling must be accentuated to reduce the risk of genetic syndromes in the population. J MEDICINE 2023; 24(2): 82-88

THE ACADEMIC STAFF’S PERCEPTIONS TOWARDS ONLINE EDUCATION DURING THE COVID-19 PANDEMIC

The outbreak of the COVID-19 pandemic has prompted the closure of educational institutions worldwide. As a result, most educational institutions shifted to online learning platforms to keep up with instructional activities. This study aims to determine how teachers perceive the online teaching and learning context at the George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş (UMPhST), Romania. An online questionnaire was created in Google Forms and sent to the academic staff at the university to evaluate the efficacy, drawbacks, and benefits of online education. A total of 139 faculty members from different departments completed the questionnaire thoroughly. According to the findings, more than half of those questioned agreed that online teaching is essential during pandemic times, but it is not a long-term solution. The difficulty of engaging students in practical activities, the lack of feedback, and the difficulty in fulfilling online assignments are just some of the challenges that were brought about. Furthermore, the survey identifies the traits of online courses the respondents preferred and additional challenges they encountered throughout this demanding time.

Telehealth Integration into Pharmacy Practice Curricula: An Exploratory Survey of Faculty Perception.

(1) Background: The use of telehealth in the United States during the coronavirus disease 2019 pandemic was accelerated and there was a lack of telehealth training programs available to clinicians of all levels. At the onset of the pandemic, the American Association of Colleges of Pharmacy (AACP) had no educational outcomes or professional activity standards for the inclusion of telehealth in the didactic Doctor of Pharmacy curriculum. Yet, in November 2022, the AACP encouraged colleges of pharmacy to include digital health and telehealth. The purpose of this study was to assess faculty perceptions in preparation for a nation-wide survey regarding telehealth integration into pharmacy practice curricula. (2) Methods: An exploratory questionnaire was developed to describe faculty perceptions and opinions of telehealth integration into the pharmacy practice curriculum at a single college of pharmacy. The questionnaire was emailed to 76 faculty members over six weeks in Summer 2022. Data were summarized descriptively. (3) Results: A total of 18 faculty members completed the survey (24% response rate). The responding faculty were typically very aware (median = 4) of telehealth, its benefits, and barriers, and were very comfortable (median = 4) discussing telehealth communication, benefits of telehealth, and barriers of telehealth. Yet, they were less comfortable discussing telehealth applications (median = 2.5). The faculty had a positive perception of telehealth in general (mean = 8.1 ± 1.5), telehealth services (mean = 8.6 ± 1.6), and the incorporation of telehealth instruction into the pharmacy practice curriculum (mean = 7.7 ± 2.7). Most respondents (67%) could discuss telehealth in their course. Lack of time to teach (50%) was the most reported reason by those who did not have plans to incorporate telehealth instruction into their course. (5) Conclusions: This exploratory survey of faculty at one college of pharmacy indicated positive perceptions and opinions of telehealth integration into the Doctor of Pharmacy curriculum. Further efforts to incorporate telehealth into the curriculum at other pharmacy schools is warranted.

Teaching of subject Biostatistics Its Applications and Research Methodology to Undergraduate Pharmacy Students in Central Region of Saudi Arabia

Background: Biostatistics means statistical tools have been used in the study of medical/biomedical sciences. It is also called Medical Biostatistics/Medical Statistics. It is an important subject in medical, nursing, pharmacy, Bioallied Health Sciences, and other biology related specialties. In this article, I briefly explained my teaching and research experiences related to Biostatistics to the College of Pharmacy (COP) students. Materials and Methods: In this paper I have discussed and explored all the steps related to teaching Biostatistics, its applications, and research methods and its implications to the College of Pharmacy students in Saudi Arabia. Online classes was conducted at the time of Covid-19 pandemic time of the year 2020 – 2021 and 2021 – 2022. Results: I trained COP students in all aspects of Biostatistical tools, their applications, research methods, and other research steps fully. That’s why the Statistical thinking is a crucial part of the studies in pharmacy/medical and biomedical areas. COP students followed my instructions and advice in a good way, and they benefited from my teaching and research methods and its steps throughout their graduation study. Conclusion: I have concluded that teaching of the subject biostatistics and its applications are essential and important to all science and medical specialty students all over the world. Saudi Government must take a necessary step to implement/initiate Biostatistics departments/unit in all colleges separately. It will be very useful to their pharmacist/pharmacy to educate the patients, safe and high-quality care, to control the drugs effect/adherence among patients successfully and to achieve the best high-quality results of patients’ health. Key Words: biostatistics, teaching, research methodology, college of pharmacy, Saudi Arabia

STUDENTS’ PERSPECTIVES AND CHALLENGES OF ONLINE LEARNING AT DANANG UNIVERSITY OF MEDICAL TECHNOLOGY AND PHARMACY

Like many other countries, educational institutions in Vietnam were forced to shift their courses from a face-to-face approach to online classes during the Covid-19 pandemic to try to stop the spread of the coronavirus. The objectives of this study were to investigate students’ perceptions of online learning as well as to identify challenges of online learning they confronted. The study took a quantitative approach, using an online questionnaire on Google Forms to collect data from 631 undergraduate students at Danang University of Medical Technology and Pharmacy in Danang, Vietnam. The data were analyzed using descriptive statistics. The results revealed that the participants perceived online learning as being useful and time-saving. However, the study revealed some challenges the students encountered, such as unreliable internet connections, poor e-learning platforms and services, a lack of information and communication technology skills, and distractions. Based on the findings, some implications on online learning have been put forward.

Satisfaction on educational training quality amongst college pharmacist alumni in Vietnam

Abstract Objectives This study aimed to determine the factors affecting the satisfaction of 3-year-programme college pharmacy alumni on training/educational quality at a pharmacy college in Vietnam. Methods A cross-sectional research using a purposive sampling method was conducted on the alumni who had recently graduated in 2020 of a pharmacy college in Hai Duong, Vietnam. Data collection was conducted in two phases from November 2021 to January 2022, with the first phase being an online survey through Google Forms and the second phase being phone interviews and the use of the Zalo application. The quality of educational training was evaluated using 21 items, with an additional item designated for overall satisfaction. Exploratory factor analysis identified the four factors from the 21 items assessing training quality, whereas multivariate regression analysis determined the relationship between satisfaction factors and the overall satisfaction. Results A total of 282 complete records were obtained. The college pharmacist alumni’s satisfaction with the training qualities is influenced by four main factors, with internal consistency assessed using Cronbach’s alpha (α): the training staff (α = 0.93), the facilities and environment qualities (α = 0.91), the training programmes (α = 0.88) and the administrative formalities and support activities (α = 0.84). All factors had a positive impact on alumni satisfaction, the training staff factor (β = 0.460, P < 0.001) had the greatest impact on the alumni satisfaction. Conclusions This study identified four factors affecting the satisfaction of college pharmacy alumni on training quality, including (1) the training staff, (2) the facilities and environmental qualities, (3) the training programmes and (4) the administrative formalities and support activities. To enhance training quality and alumni satisfaction, educational institutions should focus on innovating the teaching methods of the faculty, shifting from traditional teaching methods to active teaching methods that make lectures dynamic and help students develop necessary skills, as well as organizing training sessions and practical visits to improve specialized knowledge and practical experience for the faculty.

Quality of Life and Related Factors Among Final Year Nursing Students During the COVID-19 Pandemic

Background: COVID-19 has significantly influenced to the healthcare educational programs. Final year nursing students did not except, even maybe became the vulnerable respondents in the pandemic. Therefore, their quality of life has considerably reduced. Objectives: To describe the physical quality of life and explore the relationships between demographic information, fear of COVID-19, and physical quality of life among final year nursing students. Methods: This was a cross-sectional descriptive study of 113 final year nursing students at Da Nang University of Medical Technology and Pharmacy, Vietnam, from March to April 2022. All participants completed a questionnaire which consisted of 3 parts including the demographic information, fear of COVID-19, and the World Health Organization Quality of Life Brief (WHOQOL-BREF). Data were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, and Spearman rank correlation. Results: The physical quality of life of participants was at medium level (mean [SD], 87.86 [9.14]). There were statistically significant relationships between gender and fear of COVID-19 to quality of life (P < .05), whereas age, living with, and monthly income were not correlated with quality of life (P > .05). Conclusions: During the COVID-19 pandemic, final year nursing students had medium quality of life. Physical domain and fear of COVID-19 should be improved to increase quality of life.

Assessment of pharmacy students' knowledge about breast cancer and colon cancer in Northern Cyprus universities.

Colon and breast cancer are the most common types of cancer in cancer patients worldwide. Therefore, health students, especially pharmacy students, should be well-educated about colon and breast cancer. Adequate education and knowledge provide significant benefits from early diagnosis to treatment. This study was conducted as a cross-sectional study for 3 months between 1 November 2022, and 31 January 2023, in Northern Cyprus. The aim of this study was to assess pharmacy students' knowledge of breast cancer and colon cancer in North Cyprus Universities. A total of 494 pharmacy students participated in this study. Twenty-three incompletely filled questionnaires were excluded from the study. Regarding Near East University and Cyprus International University pharmacy students' knowledge of colon cancer, 298 out of 494 had good knowledge and 196 out of 494 had poor knowledge. Regarding Near East University and Cyprus International University pharmacy students' knowledge of breast cancer, 317 out of 494 had good knowledge and 177 out of 494 had poor knowledge. The total score of knowledge of Near East University and Cyprus International University pharmacy students about breast cancer was 10 ± 3.43 and 11.40 ± 3.67, respectively. The total score of knowledge of Near East University and Cyprus International University pharmacy students about colon cancer was 7.54 ± 3.67 and 9.19 ± 4.08, respectively. The findings of the study indicate that most of the pharmacy students have good knowledge about the risk factors and symptoms of breast and colon cancer, but are not at the ideal knowledge level expected in the fight against cancer after graduation.

The PharmD Students’ Beliefs, Perceptions, and Challenges Regarding their First Year in the PharmD Program: A Qualitative Study

Background: The beliefs of pharmacy students in their curriculum may be critical to the success of medical education and the development of global health competences. Objective: To assess the beliefs, attitudes, and obstacles of PharmD students at the College of Pharmacy, University of Baghdad, during their first year in the newly adopted PharmD program. Method: In-depth qualitative interviews were conducted using flexible probing approaches. A sample of fourth-year PharmD students from the University of Baghdad's College of Pharmacy was selected using a purposive sampling method. The gathered data was analyzed using a thematic content analysis approach. Results: 40% of participants applied for the program because they believed it would improve their chances of finding work in the future. The majority of participants complained about the difficulties of the first course, citing the numerous themes as their greatest issue. Two individuals (13%) said the benefits were minor, while 40% said the subjects' difficulty allowed them to adapt and study faster and more efficiently. Six of the fifteen participants thought the information they were given was inadequate. Furthermore, more than half of the participants said the practical aspect was insufficient. Moreover, half of those polled advised decreasing organic chemistry because they thought it was superfluous. Sixty percent are hopeful about the future of PharmD in Iraq and believe that if it is well organized, it will be successful. Conclusion: Despite some challenges during the first year of the program, most participants are hopeful about the future of PharmD in Iraq and believe that it will be successful if it is well organized.

Correlations between CT-assessed vascular inflammation at different levels of the coronary circulation and the risk of atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This work was supported by the George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Research Grant number 510/5/17.01.2022 This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Background Atrial fibrillation (AF) may occur any time in the evolution of various cardiovascular diseases, most of them having an inflammatory substrate. Perivascular inflammation may be assessed nowadays using coronary computed tomography angiography (CCTA) imaging. The new pericoronary fat attenuation index (FAI HU) and the FAI Score (an individualized quantification of coronary artery inflammation adjusted for age and gender) have prognostic value for predicting future cardiovascular events. Purpose The aim of our study was to investigate the correlation between pericoronary fat inflammation and the presence of atrial fibrillation among patients with coronary artery disease. We also compared the CA-Ri Heart Risk derived from the FAI Score values, the plaque burden and other clinical risk factors in patients with AF versus those in sinus rhythm. Methods In total, 81 patients (mean age 64.75 ± 7.84 years) who performed 128- slice CCTA were included in the study and divided them in two groups: group 1: 36 patients with documented AF, and group 2: 45 patients without known history of atrial fibrillation. For each patient demographyc characteristics, comorbidities and cardiovascular risk factors, echocardiography findings and lab tests were recorded and the FAI and FAI score were calculated. Results The CaRI Heart Risk was not significantly different between the two groups (18.14±14.09 vs. 18.09±13.59, p = ns). There were no significant differences in the absolute value of fat attenuation between the study groups (p>0.05). However, mean FAI Score was significantly higher in patients with AF (15.53 ± 10,29 vs. 11.09±6,70, p<0.05). Regional analysis of coronary inflammation indicated higher levels of inflammation especially at the level of the left anterior descending artery (13.17 ± 7,91 in group 1 vs 8.80 ± 4,75 in group 2, p = 0.008). Conclusions Patients with AF present a higher level of inflammation in the epicardial fat surrounding coronary arteries especially at the level of the left coronary circulation. A high inflammation at this level seems to be associated with a higher risk of atrial fibrillation development.

Troponin and NT-proBNP in the prediction of impaired myocardial deformation after STEMI

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): University of Medicine and Pharmacy “Iuliu Hațieganu” Cluj- Napoca. Introduction One adverse consequence that may follow an ST-elevation myocardial infarction (STEMI) is left ventricular (LV) remodeling. The majority of evidence indicates speckle-tracking echocardiography and global longitudinal strain may identify early changes in deformation after MI, while circumferential strain (GCS) is less extensively studied. However, since strain is thought to be afterload-dependent, the global work index (GWI), a novel afterload-incorporating parameter recently evolved. Objective The aim of this study was to determine whether the levels of high-sensitive troponin and NT-proBNP, two variables known to be of prognostic significance in STEMI, might indicate whether GCS and GWI are more impaired after STEMI. Material and methods 60 patients with STEMI and preserved LVEF who underwent PCI were included in the study. Using a Vivid E95 scanner, early echocardiography (2–4 days) was performed, and the EchoPac BT13 software (GE Vingmed ultrasound) was used for analysis. Both conventional and deformation parameters were assessed. GWI was determined by using pressure-strain loops (strain and estimated LV pressure from the peak arterial brahial cuff pressure). ROC curves were used to determine the optimal cut-off values of Troponin and NT-proBNP to predict the values below the median for each of the studied parameters (GCS and GWI). Results The mean age of the patients was of 68±13 years and 55% were male. The majority of the patients presented with anterior MI (n=29, 48.3%), followed by inferior MI (n=25, 42%). Patients frequently reported hypertension (n=45,75%), while others had dyslipidemia (n=15, 25%), diabetes (n=8, 13.3%), and smoking (n=23, 38.3%) as cardiovascular risk factors. The median values of NT-proBNP were 600 [280–1930] pg/mL and 0.52 mg/dL [0.16–1.6] for troponin, respectively. Mean values of GCS were −11.6 ± 5.1% and of GWI were 927 ± 403 mmHg%. We analysed the ROC curves of troponin and NT-proBNP to predict values below the median of −10% for GCS and of 937mmHg% for GWI (Fig.1). We found that troponin values > 0.612 mg/dL (AUC 0.674, 95% CI 0.541 to 0.790, p = 0.014, Se 66%, Sp 71%) and NT-proBNP values > 715 pg/mL (AUC 0.678, 95 %CI 0.545 to 0.793, p = 0.0117, Se 59%, Sp 74%) were able to predict more impaired GWI. Interestingly, only troponin values > 0.315 mg/dL, a threshold that was lower than in the case of GWI, were able to predict more impaired GCS (AUC 0.755, 95% CI 0.627 to 0.857, p<0.0001, Se 91%, Sp 58%). Conclusion High sensitive troponin and NT-proBNP may indicate more impaired myocardial mechanics after STEMI. Both GCS and GWI, a parameter integrating strain and afterload, may provide additional information In the early stages of remodeling following MI.

Association between coronary inflammation measured by FAT attenuation index and CT features of atheromatous plaque vulnerability

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Background Coronary computed tomography angiography (CCTA) is a rapidly evolving tool for the assessment of coronary artery disease (CAD), being able to characterise not only the degree of coronary artery stenosis but also the presence and severity of coronary plaque vulnerability. Fat attenuation index (FAI) is a recently developed marker of coronary inflammation, based on the gradient of CT density at the level of pericoronary fat. Purpose The aim of our study is to investigate the correlation between (1) coronary inflammation as assessed by FAI score, and (2) vulnerability degree of atheromatous coronary plaques, as assesses by presence and severity of CT features of vulnerability at the level of coronary plaques. Methods A total of 54 patients who underwent 128-slice CCTA for chest pain, and having at least one vulnerable coronary plaque, were enrolled in the study. Vulnerable plaques were defined as plaques showing at least one of the following on CT scan: low attenuation plaque, napkin-ring sign, spotty calcifications, or positive remodeling. In total, 114 vulnerable plaques were identified and analyzed using the advanced via Syngo.via Frontier software. FAI score was determined using the FAI technology patented by Caristo. Results The FAI score of coronary inflamamtion was significantly correlated with the total plaque volume at the level of left anterior descendent artery (LAD) (p = 0,01), respectively with the calcified plaque volume at the level of the circumflex artery (p = 0,02). Receiver operating characteristic (ROC) analysis for the correlation between the FAI score and the presence of the Napkin Ring Sign (NRS) showed a significant correlation for plaques located on LAD (AUC 0,729; 95%CI 0,585 – 0,845; p = 0,01), and lefty circumflex artery (AUC 0,745; 95%CI 0,601–0,859; p = 0,032), but not for the right coronary artery (AUC 0,636; 95%CI 0,487–0,767; p = 0,25). Furthermore, the ROC analysis identified a good correlation between the FAI score and the presence of spotty calcification or positive coronary remodeling (AUC 0,777, p = 0,0004, respectively AUC 0,717, p = 0,0081). Conclusion Coronary inflammation measured by FAT attenuation index is significantly correlated with the presence of CT vulnerability features in the coronary tree.

Increased risk of coronary plaque vulnerabilization following COVID-19 infection, identified by elevated FAI index of pericoronary inflammation at coronary CT

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Background Inflammation plays an essential role in all stages of atherosclerosis, with stable plaques characterized by chronic inflammation and vulnerable or ruptured plaques exhibiting "active" inflammation. COVID infection may significantly increase systemic inflammation, but the role of SARS COV-2 infection on local plaque vulnerability is still not elucidated. Mapping the PCAT - FAI on routine CCTA can detect coronary artery inflammation non-invasively by measuring changes in the composition of pericoronary fat. Purpose The aim of this study was to assess the impact of COVID-19 infection on CAD in patients who underwent CCTA examinations for chest pain in the early stages after infection, using the new AI - powered CaRi-Heart® solution. Methods In our study, we included 158 patients (mean age was 61.63 ± 10.14 years) with chest pain and low to intermediate clinical likelihood of CAD, who underwent 128-slice CCTA for assessment of coronary anatomy, atherosclerosis, and determination of FAI – Score. The study population was divided into two main groups: Group 1 (n = 75) – patients who had a COVID-19 infection a few months prior to their CCTA examination, and Group 2 (n = 83) – patients adjusted for age and gender, who did not have a COVID-19 infection. Results The FAI - Score was consistently higher in the non COVID-19 group: LAD (11.61 ± 7.60 vs. 9.32 ± 6.00, p = 0.05), LCX (12.43 ± 6.65 vs. 10.48 ± 6.24, p = 0.05), RCA (15.40 ± 11.36 vs. 14.54 ± 12.17, p = ns), the average FAI - Score (12.81 ± 8.28 vs. 10.47 ± 7.19, p = 0.001). For the FAI-Score Centile, the overall pattern shifts significantly, as the values for all three coronary arteries are higher for the subjects in the COVID-19 positive group, as follows: LAD (0.66 ± 0.29 vs. 0.58 ± 0.28, p = 0.05), LCX (0.79 ± 0.16 vs. 0.68 ± 0.26, p = 0.03), RCA (0.83 ± 0.20 vs. 0.68 ± 0.29, p = 0.05). In both cases, the CaRi Heart® Risk (p < 0.0001) and the Duke Score (p < 0.0001) had significantly higher values for the patients in the COVID-negative group. Conclusion Lesions with higher pericoronary FAI - Score Centile values were more commonly found in patients who had previously been infected with COVID-19. The higher levels of inflammation in the pericoronary adipose tissue suggests that COVID-19 infection is linked to an increased risk of coronary plaque destabilization.

Regional distribution of pericoronary inflammation in post COVID-19 patients - an angio-CT study of epicardial fat attenuation

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This work was supported by the George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Research Grant number 164/20/10.01.2023. Background Epicardial fat (EF) and pericoronary adipose tissue (PCAT) have been extensively studied in the last decade as markers and promotors of local coronary inflammation. Quantification of EF and PCAT via CCTA, can predict the risk of acute events across various cardiovascular disorders, and has been linked to markers of local or systemic inflammation. Mapping the fat attenuation index (FAI) on routine CCTA can detect coronary artery inflammation at different levels of the coronary tree. Objectives This study aimed to evaluate the regional differences between left and right coronary inflammation in patients who had CCTA examinations for chest pain in the early stages after COVID-19 infection COVID-19 infection, using the AI-powered CaRi-Heart® medical software. Methods In this study, we included 172 patients (mean age: 62.43 ± 11.62 years) with chest pain and low to intermediate clinical likelihood of CAD, who underwent 128-slice CCTA to assess coronary anatomy, atherosclerosis, and FAI – Score determination. The study population was divided into two groups: Group 1 (n = 80) – with COVID-19 infection 2–3 months prior to their CCTA examination, Group 2 (n = 92) – adjusted for age and gender, without COVID-19 infection. For each patient, we recorded and analyzed demographic and clinical characteristics, cardiovascular risk factors, and the onset of signs and symptoms before the CCTA examination. Results The FAI - Score was considerably higher in the non COVID-19 group: LAD (11.87 ± 8.23 vs. 9.12 ± 6.20, p = 0.05), LCX (13.02 ± 6.76 vs. 10.77 ± 6.13, p = 0.05), RCA (15.88 ± 10.36 vs. 14.74 ± 12.24, p = ns), the average FAI - Score (13.23 ± 8.92 vs. 10.34 ± 7.22, p = 0.001). Comparing the FAI - Score between the left and right coronary artery, we found that for the entire study population, the FAI score was significantly higher at the RCA level (15.23 ± 11.97 vs. 11.21 ± 6.98, p = 0.02), and this difference was also maintained in the COVID-19 positive group (14.54 ± 12.17 vs. 9.77 ± 5.94, p = 0.0002), but not in the non-COVID-19 group (14.20 ± 10.78 vs. 12.88 ± 7.41, p = ns). In both groups, the CaRi Heart® Risk (p < 0.0001) and Duke Score (p < 0.0001) were significantly higher for the COVID-negative patients. Conclusions COVID-19 infection is associated with a higher risk of coronary plaque destabilization, as shown by increased inflammation in the PCAT. For the entire study population, the FAI - Score was significantly higher at the RCA level, the difference being driven by the increased RCA inflammation in the post-COVID group. This indicates a potential role of local hemorheological factors in the complex process of inflammation-mediated plaque vulnerabilization.

Correlations between coronary calcium score, FAI index of epicardial fat inflammation and regional distribution of pericoronary inflammation - insights from the IntelFAT study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): This research has been funded by the research grant Intel-FAT, proposal registration code PN-III-P4-ID-PCE-2020-2861, contract number PCE 206/2021, Project funded by the European Union and the Government of Romania through the Ministry of European Funds, and the Doctoral School of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Introduction Coronary calcium score (CCS) is a well-established coronary CT angiography (CCTA) feature associated with the future risk of cardiovascular events. At the same time, coronary inflammation, which can be measured by the recently developed FAI technology at the level of epicardial fat using CCTA, has been proved to be associated with increased plaque-associated risk. However, the correlation between these 2 CT features, both associated with cardiovascular risk, has not been established so far. The aim of the study was to assess the correlation between CCS, as a measure of coronary calcification, and FAI index of coronary inflammation, as a measure of associated inflammation in the coronary tree. Methods In total, 169 patients who underwent CCTA were enrolled in the study and divided into two groups according to their calculated CCS: group 1: 54 patients with CCS < 130, and group 2: 115 patients with CCS > 130. In all patients, FAI index of coronary inflammation and associated FAI score centiles were calculated for each coronary artery. The global CT-derived cardiovascular risk was calculated according to both Duke score and CariHeart score, a risk score derived from the FAI index of coronary inflammation and CT phenotype of the coronary plaques. Results Patients with high CCS had a higher FAI score (mean FAI score 12.37 +/- 8.33 in group 2 vs 11.65 +/- 7.84 in group 1, p = 0.7). The presence of a high CCS was not significantly associated with the CT-derived Duke score of lesion severity (3.02 +/- 1.38 in group 2 vs 3.09 +/- 1.29 in group 1, p = ns), however the CaRI Heart Risk was significantly higher in the group with high Calcium score (22.88 +/- 19.05 vs 15.95 +/- 11.87, p = 0.0004). At the same time, mapping of inflammation scores along the coronary tree identified that in the group with high CCS, lesions located in the right coronary artery (RCA) had a significantly higher score of inflammation than those in the left coronary artery (Mean FAI score 17.95 +/- 14.56 for RCA versus 11.47 +/- 7.03 for LCA, p = 0.002), while this difference was not significant in patients with lower CCS (p>0.05). Conclusions A high level of coronary calcification, as expressed by a high CCS, is associated with an increased level of inflammation at the level of pericoronary fat. At the same time, patients with high CCS present regional differences in distribution of coronary inflammation, showing increased inflammatory reactions especially at the level of the right coronary circulation. This suggests the potential role of geometric and hemorheologic alterations in the complex process of plaque progression.