Diagnosis Of Coronary Heart Disease Research Articles

Risk factors associated with the false positive of cardiopulmonary exercise test in the diagnosis of coronary heart disease.

Cardiopulmonary exercise test (CPET) is a common method for preliminary evaluating coronary heart disease (CHD), but it may experience false positive. The present study aimed to reveal the potential factors relating to the false positive of CPET, including blood glucose and lipids. This observational cohort study included 103 subjects with false positive of CPET and 65 subjects with true positive of CPET. The baseline characteristics, blood glucose, and blood lipids between the true and false positive groups were compared. After adjusting for the age and sex, logistic regression analysis was performed to reveal the potential risk factors of false positive. Receiver operating characteristic curve analysis was performed to evaluate the potential of related factors in distinguishing between true and false positive results. Males, smokers, and patients with diabetes were less likely to suffer from false positive of CPET. Compared with the true positive group, the false positive group exhibited significantly higher levels of high-density lipoprotein (HDL) and apolipoprotein A1 (Apo-A1), and lower levels of fasting blood glucose (FBG) and glycosylated hemoglobin (GHb). After adjustment, FBG and GHb were protective factors of the true positive of CPET, and they both had moderate ability to distinguish false positive from true positive in females. However, their combination did not improve the discriminative effect more obviously than FBG alone. Sex, smoking, diabetes, and blood glucose were associated with the false positive of CPET. FBG was valuable in predicting the risk of false positive of CPET in females with suspected CHD. The present study is registered in Chinese Clinical Trial Register (ChiCTR2400089239).

Coronary stent migration into the aorta during implantation in the orifice of the right coronary artery and its elimination: Review with a clinical case

The purpose of this study was to analyse a vivid clinical case of problematic stent extraction that migrated during coronary stenting. Materials and methods. The following clinical methods of research were used: general laboratory and instrumental, which were applied in interventional cardiology. Results and discussion. A patient born in 1950 with pronounced symptoms of cardiac pathology was admitted to the cardiology department. The diagnosis of coronary heart disease in the form of class III of angina pectoris was established. Coronary angiography was recommended to the patient, where 3 vascular lesions of the coronary arteries were detected, coronary artery bypass grafting was recommended, which the patient flatly refused. Coronary stenting was performed 2 days later, but a complication occurred during the intervention – stent dislocation and migration during implantation into the mouth of the right coronary artery, which occurred during endovascular interventions for myocardial revascularisation in coronary heart disease. The causes of such complications have been identified, and the endovascular methods used in their treatment have been described. Several attempts have been made to extract the migrated stent, but the first of them were unsuccessful. Only after 5 attempts to remove the migrated stent using the ONE SNARE endovascular trap was success achieved. Conclusions. The article provides a comprehensive analysis of the problem of stent migration in various vascular systems and organs, emphasizing the seriousness and complexity of this phenomenon. It demonstrates the importance of timely diagnosis and discusses treatment approaches that can reduce the risk of complications and improve patient outcomes.

Peer support interventions improve disease self-management after coronary heart disease diagnosis: a systematic review and meta-analysis

Abstract Background Patients with coronary heart disease (CHD) diagnoses often experience impacts on patient-reported outcomes (quality of life, depression, disease self-management and self-efficacy) at a time when secondary prevention is required. Peer support has proven benefits for these issues in many chronic conditions but synthesis of the evidence in CHD populations has not been undertaken. Purpose In this systematic review and meta-analysis, we aimed to explore the impact of peer support interventions on health-related quality of life, depression, anxiety, self-management and self-efficacy in CHD. Methods Electronic databases were searched from inception to November 2023 (MEDLINE, Embase, PsycINFO, CINAHL, Scopus, PubMed [non-MEDLINE], Web of Science, and the Cochrane Central Register of Controlled Trials). Randomised controlled trials (RCTs) evaluating peer support interventions (that enable experience sharing and/or support by others with the same condition) in populations with diagnosed CHD were eligible for inclusion. Risk of bias was assessed using the Cochrane risk of bias tool. Meta-analyses were undertaken in RevMan Version: 7.4.0 using the inverse variance method and a random effects model. Results In total, 16 papers reporting 14 unique RCTs were included. The total sample (n=1793) was 65% male with a mean age of 54.5±13.0 years. The diagnosis of the samples varied between studies, including coronary artery bypass graft(s), first time or newly diagnosed myocardial infarction and percutaneous coronary intervention. By 6-months follow-up, peer support interventions demonstrated no statistically significant improvements in health-related quality of life (SMD -0.38, 95% CI -1.84, 1.08), depression (SMD -0.09, 95% CI -0.26, 0.08) and anxiety (SMD -0.85, 95% CI -1.83, 0.14). Whereas, improvements occurred in disease self-management (SMD 1.49, 95% CI 0.66, 2.32) and self-efficacy in both short term (by 6-months, SMD 0.57, 95% CI 0.37, 0.77) and longer term (6-12 months, SMD 0.67, 95% CI 0.29, 1.05). Peer support interventions varied widely in format and several studies were of poor quality. Conclusion Peer support interventions benefit patient-reported outcomes of disease self-management and self-efficacy up to 6 and 12 months, but not for other patient reported outcomes after CHD diagnosis. More exploration is needed of content, delivery and focus of peer support interventions to maximise effectiveness for CHD secondary prevention.

Real-world effectiveness of primary care psychological therapy for depression and anxiety in patients with coronary heart disease

Abstract Background Depression and anxiety are often inadequately treated in patients with coronary heart disease (CHD), despite mental health issues being associated with poorer quality of life, higher cardiovascular morbidity, and higher mortality. Talking therapies, such as cognitive behavioural therapy, are the recommended first-line treatment for depression and anxiety symptoms in CHD patients. However, the evidence for their effectiveness was considered low in a recent Cochrane review, and trial participants may not represent patients treated in routine clinical settings. Purpose To assess the effectiveness of routinely-delivered talking therapies in patients with CHD from nationwide primary care talking therapy services in England, and to compare their treatment outcomes to patients without a CHD diagnosis. Methods Healthcare records from 1.9 million patients who completed a course of treatment (≥2 treatment sessions) via NHS Talking Therapies for anxiety and depression (NHS TTad) between 2012-2019 were linked to Hospital Episode Statistics, the Mental Health Services Data Set, and death records. Standard NHS TTad outcome indicators (recovery, reliable improvement, and reliable deterioration) were examined in three groups, with (1) any CHD (n=41,317; ICD-10=I20-I25), (2) acute coronary syndromes (ACS, n=29,991; I21, I22, I20.0), and (3) chronic CHD (n=40,524; I20.1-I20.9, I23-I25) at baseline. Effect sizes for pre-post treatment changes in depression and anxiety symptom measures (PHQ-9 and GAD-7) were calculated using the adapted Cohen’s d for within-subjects design (dav). Outcomes were also compared to those of propensity-score matched control groups without the relevant diagnoses, using logistic regression. Results After completing a course of talking therapy, 49.8% (95%CI=49.3;50.3) of patients with CHD recovered from depression or anxiety, 69.4% (95%CI=69.0;69.9) saw reliable improvement in symptoms, and 7.3% (95%CI=7.0;7.5) experienced reliable deterioration in symptoms. There were large reductions in both depression (dav=-1.02) and anxiety symptoms (dav=-1.03) on average. Compared to a control sample of patients with no diagnosis of CHD, those with a CHD diagnosis were less likely to recover (OR=0.87[95%CI=0.84;0.89]) or reliably improve (OR=0.84[95%CI=0.81;0.87]) and more likely to reliably deteriorate (OR=1.28[95%CI=1.21;1.36]), when matched on age, sex, ethnicity, deprivation, baseline depression and anxiety symptom scores, self-reported long-term health condition, and waiting times between referral, assessment, and treatment. The findings were consistent for patients with ACS and those with chronic CHD. Conclusions Nearly half of CHD patients who received primary care talking therapy recovered, in line with the UK Government target of 50% recovery for the services. Nevertheless, compared to otherwise similar patients without CHD, those with CHD at baseline had worse psychological treatment outcomes.

Triglyceride-glucose index predicts the prognosis of patients with ischemic cardiomyopathy

Abstract Objective A large number of studies have provided strong statistical evidence that the Triglyceride-glucose (TYG) index is associated with the development and prognosis of cardiovascular disease. However, little is known about the predictive value of TYG index for ischemic cardiomyopathy (ICM). This study aimed to investigate the predictive value of TYG index in patients with ICM. Methods Hospitalized patients ICM in our Hospital from April 2014 to December 2017 were included in this study. Inclusion criteria: previous definite diagnosis of coronary atherosclerotic heart disease (coronary angiography found one or more vessels stenosis > 50%) and echocardiography showed LVEF < 45 percent. In addition, the TYG index was calculated as follows :LN[fasting triglycerides (mg /dl)× fasting blood glucose (mg /dl)x1/2]. The endpoint of the study was MACE events, including all-cause death, myocardial infarction, ischemia-induced revascularization and heart failure (HF) rehospitalization. Results A total of 688 patients were included in this study and followed up for 1 year. In the multivariate Cox proportional hazards model, TYG index (adjusted HR 2.33 [95% CI: 1.30-4.20], P<0.01) were associated with an increased risk of MACE events, and the area under the ROC curve (AUC) was 0.604 (95%CI: 0.528-0.680, p <0.05). A total of 197 ICM patients with previously diagnosed diabetes were screened for analysis. We found that TYG index (adjusted HR 6.63 [95% CI: 2.15-20.47], P<0.01), and the AUC was 0.691 (95%CI: 0.562-0.820, p<0.05). Conclusion TYG index can predict the poor prognosis of ICM patients, and the predictive value of TyG index for ICM patients with diabetes is more significant.

Circulating Factors as Potential Biomarkers of Cardiovascular Damage Progression Associated with Type 2 Diabetes.

Background: Diabetes, particularly type 2 diabetes (T2D), is linked with an increased risk of developing coronary heart disease (CHD). The present study aimed to evaluate potential circulating biomarkers of CHD by adopting a targeted proteomic approach based on proximity extension assays (PEA). Methods: The study was based on 30 patients with both T2D and CHD (group DC), 30 patients with T2D without CHD (group DN) and 29 patients without diabetes but with a diagnosis of CHD (group NC). Plasma samples were analyzed using PEA, with an Olink Target 96 cardiometabolic panel expressed as normalized protein expression (NPX) units. Results: Lysosomal Pro-X carboxypeptidase (PRCP), Liver carboxylesterase 1 (CES1), Complement C2 (C2), and Intercellular adhesion molecule 3 (ICAM3) were lower in the DC and NC groups compared with the DN groups. Lithostathine-1-alpha (REG1A) and Immunoglobulin lambda constant 2 (IGLC2) were found higher in the DC group compared to DN and NC groups. ROC analysis suggested a significant ability of the six proteins to distinguish among the three groups (whole model test p < 0.0001, AUC 0.83-0.88), with a satisfactory discriminating performance in terms of sensitivity (77-90%) and specificity (70-90%). A possible role of IGLC2, PRCP, and REG1A in indicating kidney impairment was found, with a sensitivity of 92% and specificity of 83%. Conclusions: The identified panel of six plasma proteins, using a targeted proteomic approach, provided evidence that these parameters could be considered in the chronic evolution of T2D and its complications.

Comparative analysis of the structure of the heart and blood vessels surgeries, taking into account the clinical and functional status of patients with coronary heart disease in 2015 and 2020

Relevance. In a very short period of time, surgical treatment methods have become widespread due to the expansion of indicators for performing heart surgery in patients with severe complicated forms of coronary heart disease and the use of combined surgical operations.Aim: To study changes in the clinical and functional status of patients depending on the type of surgical intervention for coronary artery disease in different time periods in the gender aspect.Material and Methods. The study was conducted retrospectively. For comparative analysis, patients with an established diagnosis of coronary heart disease who underwent surgical treatment at the Federal Center for Cardiovascular Surgery of the of the Ministry of Healthcare of the Russian Federation (Chelyabinsk) in 2015 (n = 1017) and 2020 (n = 967) were included. Of the total number of patients in 2015, there were 771 (75.8%) men and 246 (24.2%) women, in 2020 718 (74.3%) and 249(25.7%), respectively.Results. In the structure of interventions performed, there is a decrease in the number of almost all types of surgical interventions for complications of myocardial infarction, most pronounced in relation to resection of the left ventricular aneurysm, reconstruction of the left ventricle and operations in combination with mitral valve replacement. In a large percentage of cases, patients with a history of risk factors for cardiovascular diseases are referred for coronary artery bypass surgery, regardless of gender. The majority of patients had angina pectoris of the 3rd–4th functional class. However, there is a trend towards a decrease in the proportion of people with post-infarction cardiosclerosis when referred for surgery.Conclusion. Despite the significant volume and availability of practical information, the number of patients with major cardiovascular risk factors is not decreasing.

Clinical Diagnostic Significance of Combined Measurement of Lipoprotein(a) and Neck Circumference in Patients with Coronary Heart Disease.

The study aimed to explore the clinical diagnostic significance of lipoprotein(a) [Lp(a)] and neck circumference (NC) in patients with coronary heart disease (CHD). This cross-sectional study was conducted at Chengde Central Hospital from September 2021 to June 2023, enrolling 791 patients with suspected CHD who underwent selective coronary angiography (CAG). Patients were categorized into CHD and non-CHD groups based on the severity of arterial narrowing. Subsequently, the diagnostic value of Lp(a) combined with NC in patients with CHD was assessed using receiver operating characteristic (ROC) curves. Based on the results of multivariate logistic regression, a nomogram was constructed, and its clinical applicability was validated using decision curve analysis (DCA) and clinical impact curve (CIC). Multivariate logistic regression proved that high Lp(a) and high NC are risk factors for CHD, with OR of 1.836 (95% CI: 1.282-2.630) and 1.383 (1.0.978-1.955), respectively. Patients in the high NC or Lp(a) group exhibited a higher prevalence of multi-vessel disease. The area under the ROC curve (AUC) of the predictive model combining high Lp(a) and high NC was 0.710 (95% CI: 0.670-0.751) and also demonstrated good calibration (Hosmer-Lemeshow goodness-of-fit test P value=0.494). The DCA and CIC confirmed the clinical utility of the nomogram developed to predict CHD based on the combination of high Lp(a) and high NC. The levels of Lp(a) and NC exhibit a significant correlation with the presence of CHD, and their combined assessment holds specific clinical value in the diagnosis of CHD.

The Association between Depression, Self-efficacy, and Health-related Quality of Life Among Chinese Patients Undergoing Their First Percutaneous Coronary Intervention

Introduction: The demand for percutaneous coronary intervention (PCI) has been steadily increasing along with the number of patients with coronary heart disease (CHD) in China. However, there is a lack of studies investigating health-related quality of life (HRQoL), self-efficacy, and depression among Chinese patients undergoing their first PCI. The aim of this study was to explore the association between depression, self-efficacy, and HRQoL among Chinese patients with CHD undergoing their first PCI. Methods: In this cross-sectional study, 212 Chinese patients with CHD who underwent their first PCI were recruited through convenience sampling from October 2019 to March 2020. HRQoL, self-efficacy, and depression were assessed using the Seattle Angina Questionnaire, Cardiac Self-Efficacy Scale, and Short-Form Cardiac Depression Scale, respectively, along with the collection of patients’ sociodemographic and clinical information. Results: Among the 212 participants, the average age was 59.82 years, and 145 (68.4%) were male. The average scores for self-efficacy, depression, and HRQoL were 33.49 (±10.28), 16.14 (±6.12), and 328.33 (±62.55), respectively. Among the 212 patients who underwent PCI, 134 (63.21%) were found to have depression symptoms according to the cutoff score of 14. A higher body mass index, a diagnosis of acute coronary syndrome, fewer years of CHD diagnosis, the absence of symptoms of depression and greater self-efficacy were significantly positively associated with HRQoL. In total, these variables explained 37.2% of the variance in HRQoL. Conclusion: This study revealed that the HRQoL of patients in this group needs to receive more attention. A comprehensive secondary prevention intervention for CHD patients undergoing their first PCI should emphasize mitigating depression and positively influencing their self-efficacy.

Quality of Life Indices in Patients with Coronary Heart Disease with Stable Angina Pectoris Accompanied by Non-alcoholic Steatohepatitis after Complex Treatment Supplemented with Ezetimibe and Ursodeoxycholic Acid

Introduction. Coronary heart disease (CHD) is often complicated by the presence of concomitant diseases, especially non-alcoholic fatty liver disease (NAFLD). According to the data from numerous studies, it is known that the number of cardiovascular complications in patients with NAFLD is increasing. This negatively affects the clinical course of both diseases, worsens the quality of life of patients and increases the percentage of cardiovascular mortality among the population. The aim of the study. To evaluate the quality of life indicators in patients with coronary heart disease with stable angina pectoris in combination with nonalcoholic steatohepatitis after complex therapy including ezetimibe and ursodeoxycholic acid. Materials and methods. The study involved 145 patients with a verified diagnosis of coronary heart disease, stable angina pectoris II functional class combined with nonalcoholic steatohepatitis (NASH) and 100 patients with coronary heart disease without NASH. There were 140 men (57.0 %), and 105 women (43.0 %). The average age of patients is 55.3 ± 6.3 years. Results. A decrease in the number of angina attacks and the need to use nitroglycerin per week was registered in patients with coronary artery disease in combination with NASH under the influence of the treatment, which was more pronounced in the group with the addition of ezetimibe and ursodeoxycholic acid (UDCA). According to the Medical Outcomes Study 36-Item Short-Form Health Status (SF-36) questionnaire after treatment, a tendency to improve most of its indicators was revealed, which was more clearly observed in patients in the group with the addition of ezetimibe and UDCA. Also, according to the EuroQoL-5D (EQ-5D) questionnaire, significant positive dynamics of the quality of life were found for all indicators, which were more reliably increased in the group with the addition of ezetimibe and UDCA. According to the Seattle Angina Questionnaire (SAQ), after treatment, reliable positive changes on 4 scales were observed in patients in the group with the addition of ezetimibe and UDCA. Conclusion. The inclusion of ezetimibe and ursodeoxycholic acid in the basic therapy has a positive effect on the clinical course of coronary heart disease in combination with non-alcoholic steatohepatitis, the quality of life of patients and the patient's attitude to his disease.

Myocardial Perfusion Scintigraphy in Diagnosic of Coronary Heart Disease

&amp;lt;i&amp;gt;Introduction: &amp;lt;/i&amp;gt;Atherosclerosis plays a key role in the etiopathogenesis of cardiovascular diseases. Atherosclerosis is a generalized chronic inflammatory disease of the vascular wall, which results in anatomical and histological changes that, together with functional changes, lead to endothelial dysfunction, narrowing of the arterial lumen, and insufficient blood supply to the tissues. The shift in the incidence of cardiovascular diseases to younger age groups is alarming. The presence of microvascular changes in the myocardium is significant. The high incidence of cardiovascular diseases, especially ischemic heart disease, requires early diagnosis and modern treatment. &amp;lt;i&amp;gt;Aim: &amp;lt;/i&amp;gt;The aim of the paper is to analyse and point out early diagnosis of coronary heart disease using nuclear medicine methods. &amp;lt;i&amp;gt;Set of examined patients and methodology: &amp;lt;/i&amp;gt;Using nuclear medicine methods, we try to detect these changes in time and thus prevent the occurrence of acute coronary events. In nuclear cardiology, instead of a large-area scintillation detector, a new type of cardio-gamma camera &amp;quot;Discovery CZT 530c&amp;quot; based on the principle of semiconductor detectors began to be used. The abbreviation CZT stands for semiconductor composition (Cadmium-Zinc-Tellur). The set of respondents consisted of 4270 people examined in the years 2014-2016 by myocardial perfusion scintigraphy. There were 950 diabetic patients in the analysed group of the 4270 examined. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; In the analysed group of 4270 respondents, 61% had negative findings and 39% had positive findings in terms of the presence of ischemic heart disease. In the group of diabetic patients, there was a negative finding in 28% of respondents and a positive finding in 72% of the respondents in the sense of positive ischemic heart disease. Using myocardial perfusion scintigraphy in the diagnosis of functional changes, we confirmed a great benefit in detecting early changes in coronary heart disease, including in the diagnosis of microvascular angina. &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; Nuclear medicine methods are of great benefit for the diagnosis of small vessel disease, diabetic cardiomyopathy and cardiac autonomic neuropathy in patients with diabetes mellitus. The new type of cardio gamma camera &amp;quot;Discovery CZT 530c&amp;quot; allows more accurate assessment of myocardial perfusion abnormalities and at the same time the reduction of the radiopharmaceutical dose reduces the patient&amp;apos;s radiation load by 50%.

ZNF429 Participates in the Progression of Coronary Heart Disease through Regulating Inflammatory and Adhesive Factors

Background: Coronary heart disease (CHD) is an intricate and multifaceted cardiovascular disorder that contributes significantly to global morbidity and mortality. Early and accurate identification and diagnosis of CHD are paramount to ensuring patients receive optimal therapeutic interventions and satisfactory outcomes. Methods: Data on CHD gene expression were obtained from the Gene Expression Omnibus (GEO) repository and potential hub genes were screened through gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), weighted gene co-expression network analysis (WGCNA), and least absolute shrinkage and selection operator (LASSO) analyses. Functional validation of these hub genes was conducted by interfering with them in human umbilical vein endothelial cells (HUVECs). Cell proliferation and apoptosis were assessed through cell counting kit-8 (CCK-8) and flow cytometry assays, respectively, while enzyme-linked immunosorbent assay (ELISA), quantitative polymerase chain reaction (qPCR), Western blot, and immunofluorescence were used to measure the expression of key indicators. Results: We identified 700 upregulated differentially expressed genes (DEGs) and 638 downregulated DEGs in CHD, and utilized LASSO analyses to screen disease potential biomarkers, such as zinc finger protein 429 (ZNF429). Interference with ZNF429 in HUVECs mitigated the CHD-induced decrease in cell proliferation and increase in apoptosis. Moreover, the expression of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), cluster of differentiation 62E (CD62E), and cluster of differentiation 62P (CD62P) was reduced, leading to decreased cellular inflammation and adhesion. Conclusions: CHD-associated biomarker ZNF429 was identified through bioinformatics analysis to potentially regulate the expression of inflammatory factors IL-6, IL-1β, and TNF-α, along with adhesion molecules ICAM-1, VCAM-1, CD62E, and CD62P. This modulation influence was subsequently found to impact the progression of CHD. These findings offered valuable insights into potential targets for further investigation and therapeutic interventions for CHD management.

Improved Cascade-RCNN for automatic detection of coronary artery plaque in multi-angle fusion CPR images

Coronary heart disease is a disease that seriously endangers human health and life which is caused by plaque formation due to coronary artery atherosclerosis or spasm. The detection of coronary plaques through medical imaging is a non-destructive and fast diagnostic method, which holds significant medical and clinical value for the diagnosis of coronary heart disease. In this paper, We proposed an automatic detecting method for coronary artery vulnerable plaque based on CTA image sequence. We collected CTA image sequences from 132 patients and obtained the coronary artery tree by performing three-dimensional (3D) segmentation. The coronary artery centerline was extracted using the skeleton thinning method. To address the issue of insufficient features in a single CPR image, we constructed Curved Planar Reconstructed (CPR) images from multiple directions perpendicular to the coronary artery, following the centerline. In total, we established 8797 images in the training dataset and 1553 images in the test dataset. We proposed an attentive detection method that fused a new Cascade RCNN ResNet50-FPN neural network model with a convolutional attention module (CBAM). This method achieved automatic recognition and detection of plaques on the two-dimensional multi-angle fused CPR images. The proposed ResNet50-FPN network performed feature extraction, and CBAM was added after the first and last convolutional layers to enhance the network’s attention to plaque features. Our experimental results demonstrate that deep learning neural networks can provide a feasible approach to automatically detecting coronary artery plaques. Our method achieved a plaque detection accuracy of 94.6%, outperforming the RCNN method proposed by Zriek.

Diagnostic and prognostic value of serum Cys-C, retinol-binding protein, and ischemia-modified albumin in patients with coronary heart disease: A diagnostic accuracy study.

The use of 3 biomarkers - cystatin-C (Cys-C), retinol-binding protein (RBP), and ischemia-modified albumin (IMA) - for the clinical classification and outcome of coronary heart disease (CHD) has not been adequately evaluated. We explored the serum levels of these 3 markers and evaluated their diagnostic and prognostic values in patients with CHD. This retrospective case-control study, conducted between June 2017 and June 2018, included 201 patients with CHD hospitalized at the Henan Provincial People's Hospital and 127 healthy individuals from Henan Provincial People's Hospital as controls. Cys-C, RBP, IMA levels, and other laboratory parameters in the 2 groups were determined, and patient outcomes were analyzed. Cys-C, RBP, and IMA levels were higher in the case group than in the control group (P < .05). Logistic regression analysis confirmed that these 3 biomarkers were independent risk factors for CHD. Each indicator has clinical significance in the diagnosis and prognosis of CHD, with RBP being the most significant. The AUC value for CHD detection using a combination of the 3 indicators was 0.783, and the sensitivity and specificity values were 78% and 74.6%, respectively. Simultaneous detection of Cys-C, RBP, and IMA could be an optimal method for early diagnosis and prognosis of CHD.

Light-Activated Virtual Sensor Array with Machine Learning for Non-Invasive Diagnosis of Coronary Heart Disease

HighlightsPhotoresponsive black phosphorus (BP)/Ti3C2Tx composites were synthesized by a self-assembly strategy.Enhanced gas sensitive property was achieved by visible light modulation.Light activated virtual sensor array was fabricated based on BP/Ti3C2Tx composite.Diagnosis of coronary heart disease was achieved with the help of machine learning.

Understanding the disconnect between lifestyle advice and patient engagement: a discourse analysis of how expert knowledge is constructed by patients with CHD

Objective Adherence to healthy lifestyle advice is effective in prevention of non-communicable diseases like coronary heart disease (CHD). Yet patient disengagement is the norm. We take a novel discursive approach to explore patients’ negotiation of lifestyle advice and behaviour change. Method A discourse analysis was performed on 35 longitudinal interviews with 22 heterosexual British people in a long-term relationship, where one had a diagnosis of CHD. The analysis examined the relationships between patients’ constructions of expert knowledge and the implications of these accounts for patients’ dis/engagement with lifestyle advice. Results Expert knowledge was constructed in four ways: (1) Expert advice was valued, but adherence created new risks that undermined it; (2) expert knowledge was problematised as multiple, contradictory, and contested and therefore difficult to follow; (3) expert advice was problematised as too generalised to meet patients’ specific needs; and (4) expert advice was understood as limited and only one form of valued knowledge. Conclusion Patients and partners simultaneously valued and problematised expert knowledge, drawing on elaborate lay epistemologies relating to their illness which produced complex patterns of (dis)engagement with expert lifestyle advice. Recognition of the multiple and fluid forms of knowledge mobilised by CHD patients could inform more effective interventions.

The use of genetic algorithm and particle swarm optimization on tiered feature selection method in machine learning-based coronary heart disease diagnosis system

Coronary heart disease (CHD) is a leading global cause of death. Early detection is the right step to reduce mortality rates and treatment costs. Early detection can be developed using machine learning by utilizing patient medical record datasets. Unfortunately, this dataset has excessive features which can reduce machine learning performance. For this reason, it is necessary to reduce the number of redundant features and irrelevant data to improve machine learning performance. Therefore, this research proposes a tiered of feature selection model with genetic algorithm (GA) and particle swarm optimization (PSO) to improve the performance of the diagnosis model. The feature selection model is evaluated using parameters derived from the confusion matrix and using the CatBoost machine learning algorithm. Model testing uses z-Alizadeh Sani, Cleveland, Statlog, and Hungarian datasets. The best results for this model were obtained on the z-Alizadeh Sani dataset with 6 selected features from 54 features and the resulting performance for accuracy parameters was 99.32%, specificity 98.57%, sensitivity 100.00%, area under the curve (AUC) 99.28%, and F1-Score 99.37%. The proposed feature selection model is able to provide machine learning performance in the very good category. The diagnostic model proposed is of excellent standard.

Peer Support Interventions Improve Disease Self-Management After Coronary Heart Disease Diagnosis: A Systematic Review and Meta-Analysis

Peer Support Interventions Improve Disease Self-Management After Coronary Heart Disease Diagnosis: A Systematic Review and Meta-Analysis

Immature Surfactant Protein Type B and Surfactant Protein Type D Correlate with Coronary Heart Disease in Patients with Type 2 Diabetes.

Different specific surfactant proteins (SPs) have been associated with various pathological conditions, not only of the respiratory system, but also more recently with cardiovascular diseases, such as heart failure. The aim of the present study was to evaluate the role of SP-A, SP-D, and the precursor protein of SP-B (proSP-B) in the pathogenesis of cardiovascular damage in patients affected by type 2 diabetes (T2D). The study considered 31 patients with T2D (DN group), 34 patients with both T2D and coronary heart disease (CHD) (DC group), and 30 patients without diabetes but with a diagnosis of CHD (NC group). SP-A, SP-D, and proSP-B concentrations were determined in plasma samples, and were statistically compared using parametric and multivariate methods. Higher plasma concentrations of SP-D and proSP-B were found in patients affected by both T2D and CHD (DC group), and in patients with CHD without diabetes (NC group), in comparison to T2D patients (DN group). A significant correlation, both with linear regression (r = 0.3565, p = 0.001) and Principal Component Analysis (PCA), was found between the plasma levels of SP-D and proSP-B in the overall cohort of patients. No differences in SP-A were observed among the three groups of subjects. The present study extends the knowledge on the role of plasma SPs' levels as possible indicators of the risk of CHD being linked to T2D disease progression.

Progress And Challenges of Coronary Angiography in The Diagnosis and Treatment of Coronary Heart Disease

Progress And Challenges of Coronary Angiography in The Diagnosis and Treatment of Coronary Heart Disease