Frequency Of Coronary Artery Disease Research Articles

Evaluating Dyslipidemia and Atherogenic Indices as Predictors of Coronary Artery Disease Risk: A Retrospective Cross-Sectional Study.

The frequency of coronary artery disease (CAD) has alarmingly increased in India accounting for the majority of all fatalities. The primary risk factor for CAD, acute myocardial infarction, and stroke is dyslipidemia. CAD risk can be ascertained by the lipid profile as well as atherogenic risk indices. Due to the current scenario of increased CAD prevalence and the established role of dyslipidemia as a risk factor for CAD, this study aimed at identifying the prevalent lipid abnormalities in a tertiary care hospital in Telangana and studying the predictive value of atherogenic indices for assessing CAD risk. This is a retrospective cross-sectional study. Data pertaining to the subjects from January 2021 to December 2021 was retrieved from the hospital records. Serum triglycerides (TG) were in the higher range for 47 % (n= 235) of total subjects and isolated Low-density lipoprotein (LDL) was higher in 12.6% (n = 63). The overall burden of dyslipidemia was 72.20% (n=361) with 57.6 % (n=208) in males and 42.4% (n=153) in females). The most common dyslipidemia found was Familial Combined Hyperlipidemia in 42.8% (n=214) of individuals. The second most common pattern of dyslipidemia was Primary Familial Hypercholesterolemia which was observed in 25% (n=125) of subjects. Dysbetalipoproteinemia was seen in 24.2% (n=121) of the study subjects. ROC analysis found the Atherogenic Coefficient (AC) to be the most sensitive and specific cardiovascular risk index. 57.8% of the subjects had AC >2.44 and were at the highest risk for developing CAD. The overall burden of dyslipidemia was 72.2%. AC was found to be the most sensitive and specific cardiovascular risk index by ROC curve analysis. Around 57.8% of the subjects had AC >2.44 and were at the highest risk for developing CAD. This study emphasizes the importance of atherogenic indices in the primary prevention and management of CAD, a growing non-communicable disease.

Quality of life in patients with heart failure and implantable cardioverter defibrillator. Results from 42 heart failure clinics in norway

Abstract Background Patients with heart failure (HF) have an increased risk of sudden cardiac death, and treatment with an implantable cardioverter defibrillator (ICD) has become standard treatment for selected patient groups. HF is associated with impaired QoL, but there is no consensus regarding the implication of having an ICD. Knowledge regarding QoL in patients with HF and ICD attending follow-up in outpatient HF-clinics is sparse. Purpose The aim of this study was to determine QoL in patients with HF and ICD. Further, to compare QoL in patients with HF with and without ICD, using data from the first and follow-up visits in outpatient HF clinics. Methods Longitudinal data from the National Norwegian Heart Failure Registry (NNHFR), including 9 274 patients, of which 1 206 with an ICD, were studied. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Data was collected at the first and follow-up visits in outpatient HF clinics approximately six months after optimal treatment was achieved. Results Patients with an ICD were younger, more often men, and had higher frequency of coronary artery disease (all p<0.001). At the first visit, there was no significant difference in QoL between patients with and without ICD, with both groups reporting moderate QoL. Both groups had a significant improvement in QoL from the first visit to the follow-up visit (p<0.001). However, patients with ICD reported significantly less improvement in QoL (p<0.001) at follow-up. This disparity was evident regarding both the physical (p<0.001) and the emotional (p<0.001) dimension. Conclusion QoL in patients with HF and ICD improves after follow-up in outpatient HF clinics, although not to the same extent as in patients without ICD. Thus, tailored interventions in outpatient HF clinics may be necessary to improve outcomes in this subgroup of patients with both HF and ICD.

Frequency of Coronary Artery Disease in Patients Undergoing Valvular Heart Surgery: A Retrospective Observational Study

Objectives: Valvular heart disease (VHD) significantly impacts patients' lives and often necessitates cardiac surgery. This study aimed to assess the frequency of ischemic heart disease in patients undergoing valvular heart surgery. Methodology: This observational study analyzed the records of 204 consecutive patients presenting to the Peshawar Institute of Cardiology between January 2021 and December 2022. All patients underwent screening angiography before surgery according to the American College of Cardiology (ACC) criteria. Results: Among the 204 patients studied, 57.4% were male, with a mean age of 53.16 ± 12.708 years. Hypertension was the most common comorbid condition (38.2%). Mitral valve pathology was the predominant indication for valvular surgery, while isolated aortic stenosis was the most common valvular lesion observed (25%). Out of the 204 patients who underwent screening angiography, 23% had significant coronary artery disease (CAD), defined as luminal narrowing >50%. Patients younger than 40 years had a lower prevalence of significant CAD (9.8%) compared to older patients (p = 0.003). Angiographic findings revealed single-vessel disease as the most common coronary lesion (16.7%), followed by double-vessel disease (12.7%), with triple-vessel disease observed in 5.4% of cases. Conclusion: The frequency of coronary artery disease was lower in patients younger than 40 years compared to older patients. Noninvasive investigations such as CT coronary angiography may serve as an alternative to invasive coronary angiography as a screening tool prior to cardiac surgery in older patients, if needed.

Elevated Troponin I as a Marker for Unfavorable Outcomes in Acute Ischemic Stroke.

To assess if elevated cardiac troponin I (cTnI) serves as a sign of unfavorable functional outcomes in ischemic stroke. In this single-center prospective cohort study, 100 consecutive patients admitted with acute ischemic stroke (normal troponin I group n = 52, raised troponin I group n = 48) were included. Hospital mortality was documented in both groups; the remaining patients were followed up to 90 days. Then two groups were compared in terms of unfavorable short-term outcomes (Modified Rankin Scale > 3) and mortality. Multivariate logistic regression was conducted to determine the predictive value of elevated cTnI. The Kaplan-Meier curve was drawn and compared to determine the difference in survival between the two groups. To find out the most probable cut-off level for an unfavorable outcome, a receiver operating characteristic (ROC) analysis was conducted. A higher frequency of coronary artery disease (p=0.030), higher National Institutes of Health Stroke Scale (NIHSS) (p=0.008) score, and lower Glasgow Coma Scale (GCS) (p=0.002) was observed in raised troponin I group. Even after the exclusion of confounding elevated troponin I was found to be an independent predictor of unfavorable outcomes (adjusted odds ratio, OR 8.25 {95% confidence interval, CI: 2.65-25.75}; p<0.001). The patients with raised troponin I had a significantly lower rate of survival after 90 days (p=0.022). The elevated troponin I was observed to have a significantly high accuracy (p<0.001; area under curve, AUC: 0.768 {moderate accuracy}, 95% CI: 0 .676 to 0.861)in predicting unfavorable outcomes. Elevated cTnI is independently associated with unfavorable short-term outcomes. It is also associated with a lower rate of survival.

Abstract 15108: Systematic Review to Explore Differential Frequencies of Coronary Artery Disease in Survivors of Different Cancers

Introduction: The leading non-neoplastic cause of morbidity and mortality in cancer survivors is cardiovascular disease, of which coronary artery disease (CAD) is emerging as a significant burden. Inherent in screening is an understanding of pre-test risk, and the association of CAD with particular cancers is not well-defined. Hypothesis: To develop a systematic review to explore differential frequencies of CAD in survivors of different cancers. Methods: We searched MEDLINE and EMBASE (2006-2021) for studies of CAD in survivors. For studies without a control population, we utilized a community prevalence for CAD from the 2021 US. National Centre of Health Statistics; 0.5% for 18-44 years, 4.7% for 45-64 years, 11% for 65-74 years and 19.5% for &gt;75 years. A random-effects model was used to compare CAD prevalence in survivors and controls. Results: Twenty studies (736,956 survivors) involved 17 types of cancer (bladder, breast, colorectal, hematologic, head and neck, kidney, liver, lung, melanoma, ovarian, pancreatic, prostate, renal, stomach, testicular, thyroid, uterus). Survivors overall were associated with an increased risk of CAD compared to controls (risk difference = 0.11, 95% CI: 0.07-0.15, p=0.0, I2=99.93%). Eight cancer types (breast, hematologic, head and neck, kidney, liver, pancreatic, stomach, and testicular) resulted in a significantly higher CAD compared to other cancer types (Figure). Conclusions: Cancer survivors are at an increased risk of CAD compared to general population, but certain cancer types associate with a significantly higher CAD risk.

Correlation analysis of lipid accumulation index, triglyceride-glucose index and H-type hypertension and coronary artery disease.

The current research was designed to explore the relationship between the lipid accumulation index (LAP), coronary artery disease (CAD), and the triglyceride-glucose (TyG) index in patient with H-type hypertension. From June 2021 to January 2022, our hospital's information management system collected data on 186 patients with essential hypertension. The participants were categorized into two groups (H-type hypertension (n = 113) and non-H-type hypertension (n = 73)) based on their homocysteine levels. Both groups' general condition, lipid accumulation index, triglyceride-glucose index, and Gensini score were compared to determine the factors influencing the severity of CAD in H-type hypertension patients. There were statistically significant differences (P < 0.05) in homocysteine (Hcy, GLP-1 and SAA) level, LAP, and TyG indexes, but not in body mass index (BMI), smoking, sex, age, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), diastolic blood pressure, and systolic blood pressure. Additionally, there were substantial variations between the two groups regarding the number of lesion branches, degree of stenosis, and Gensini score (P > 0.05). patient with grade III to IV lesions had substantially higher LAP and TyG indices than those with stage I to II (P < 0.05). TyG (OR = 2.687) and TyG-LAP (OR = 4.512) were the factors determining the incidence of coronary artery disease in H-type hypertension, according to multivariate logistic regression analysis. The lesion number, stenosis degree, and Gensini score (P < 0.05) varied among both groups. LAP and TyG indexes were substantially greater in patients with double and triple vessel lesions than in those without lesions or with single vessel lesions (P < 0.05); similarly, these two indexes were considerably higher in individuals with grade III to IV lesions than in patients with grade I to II lesions (P < 0.05). As per the Pearson correlation analysis, the LAP, TyG indices and SAAlevel were adversely connected to the Gensini score (r = 0.254, 0.262, 0.299, P < 0.05), the GLP-1 level was negatively correlated to the Gensini score (r = -0.291, P < 0.05). TyG (OR = 2.687) and TyG-LAP (OR = 4.512) were the factors determining the frequency of coronary artery disease in H-type hypertension, according to multivariate logistic regression analysis. In conclusion, the LAP and TyG indexes were observed to be closely related to the degree of CAD in H-type individuals with hypertension, which can better understand the pathogenesis of coronary artery disease in patients with H-type hypertension and is of great significance for guiding clinical doctors to carry out personalized treatment and management.

Primer hiperparatiroidizmle ilişkili hiperkalsemide yaştan bağımsız olarak hipertansiyon ve koroner arter hastalığı sıklığında artış

Aims: There are conflicting data in the literature regarding whether there is an increased frequency of coronary artery disease (CAD) in patients with primary hyperparathyroidism (PHP). In this study, we planned to investigate the frequency of CAD and hypertension (HT) in patients with PHP.&#x0D; Methods: Patients with PHP aged 18 years and older who were admitted to the endocrinology clinic between September 2020 and February 2023 were included as the patient group, and age- and gender-matched individuals who presented with thyroid nodules between the same dates were included as the control group. A total of 217 patients, 114 with PHP and 103 as control group, were eligible for the study. The study was conducted as a retrospective data analysis and laboratory and demographic information of the patients and the control group were obtained from their files.&#x0D; Results: Age and gender distribution of the patient group and the control group were similar (respectively; age: 55.6+12.9 years, 53.0+7.2 years, p=0.058, female/male distribution: 93/21, 80/23 p=0.48). The prevalence of HT and CAD was higher in the patient group (respectively; HT: 65.1%, 31.0%, p

Factors associated with coronary artery disease among people living with human immunodeficiency virus: Results from the Colombian HIV/AIDS registry

BackgroundPeople living with HIV (PLWHIV) are at a higher risk of developing coronary artery disease (CAD). We aimed to assess the factors associated with CAD among PLWHIV in Colombia. MethodsWe conducted a retrospective cohort study based on adults newly diagnosed with HIV, reported to the Colombian HIV/AIDS registry from 2018 to 2021. Baseline demographic and clinical characteristics were compared by age (<50 and ≥ 50 years). Our main outcome was the presence of CAD. Logistic regression models were used to assess the association between traditional and HIV-related factors with CAD. These associations were also evaluated in stratified models by age. Effect measures were odds ratios (OR) and their 95% confidence intervals. ResultsAmong 36,483 PLWHIV, the frequency of CAD was 0.53% (n = 196). There was a high prevalence of impaired fasting glucose/diabetes mellitus (12.62%), overweight/obesity (27.79%), elevated LDL-c (86.69%), and hypertriglyceridemia (72.76%). Factors associated with CAD included male gender (OR: 2.01, 95% CI: 1.12–3.58), age ≥50 years (OR: 4.96, 95% CI: 3.29–7.45), lipoatrophy or lipodystrophy (OR 5.12, 95% CI: 1.12–23.33), AIDS-defining conditions (OR: 1.83, 95% CI: 1.07–3.12), obesity (OR: 2.95, 95% CI: 1.69–5.10), diabetes mellitus (OR: 2.50, 95% CI: 1.25–4.97), and renal impairment (OR: 3.15, 95% CI: 1.83–5.42). ConclusionsTraditional CAD risk factors are common in PLWHIV. There were traditional and disease-specific factors associated with increased odds of CAD. These findings may aid clinicians and decision-makers in reducing the impact of CAD in PLWHIV.

Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed Coronary Artery Disease.

Chronic obstructive pulmonary disease (COPD) worsens prognosis in patients with coronary artery disease (CAD). However, the cardiovascular prognosis in patients with stable or mildly symptomatic COPD remains unclear. Here, we sought to determine the long-term cardiovascular events in patients with subclinical or early-stage COPD with concomitant CAD. This was a longitudinal analytical study involving 117 patients with suspected or established CAD who underwent assessment of pulmonary function by spirometry and who were followed up for six years (March 2015-January 2021). The patients were divided into two groups, one comprising COPD (n=44) and the other non-COPD (n=73) patients. Cox regression was used to evaluate the association between COPD and cardiovascular events, with adjustment for the established CAD risk factors, and the effect size was measured by the Cohen test. COPD patients were older (p=0.028), had a greater frequency of diabetes (p=0.026), were more likely to be smokers (p<0.001), and had higher modified Medical Research Council scores (p<0.001). There was no difference between the groups regarding gender, body mass index, hypertension, dyslipidemia, family history of CAD, and type of angina. CAD frequency and the proportion of patients with severe and multivessel CAD were significantly higher among COPD than among non-COPD patients (all p<0.001). At six-year follow-up, patients with COPD were more likely to have experienced adverse cardiovascular events than those without COPD (p<0.001; effect size, 0.720). After adjusting for established CAD risk factors, COPD occurrence remained an independent predictor for long-term adverse cardiovascular events (OR: 5.13; 95% CI: 2.29-11.50; p<0.0001). COPD was associated with increased severity of coronary lesions and a greater number of adverse cardiovascular events in patients with suspected or confirmed CAD. COPD remained a predictor of long-term cardiovascular events in stable patients with subclinical or early-stage of COPD, independently of the established CAD risk factors.

Coronary Arterial Disease in Patients of Aortic Stenosis and Associated In-Hospital Complications after Surgical Management

Objectives: This study aimed to determine the frequency of coronary artery disease (CAD) and its complications following surgical management in patients with aortic stenosis (AS). Methodology: This descriptive case series included 113 patients, both male and female, aged between 40 and 80 years, diagnosed with severe AS. All patients underwent coronary angiography prior to surgical management to assess the presence of CAD. Postoperatively, patients were monitored during their hospital stay for up to 72 hours, and complications such as major bleeding, acute kidney injury (AKI), stroke, and mortality were recorded. Results: The study included 113 patients with a mean age of 55.4±12.4 years, of whom 63 (55.8%) were male. Positive family history of CAD was found in 24 (21.2%) patients. CAD was observed in 65 (56.6%) patients. In-hospital complications were as follows: major bleeding occurred in 7 (6.2%) patients, AKI in 13 (11.5%), stroke in 10 (8.8%), and mortality in 3 (2.7%) patients. Mortality rates were 4.7% vs. 0% (p=0.125), stroke rates were 14.1% vs. 2% (p=0.026), and AKI rates were 17.2% vs. 4.1% (p=0.023) for patients with and without CAD, respectively. Conclusion: The prevalence of CAD was found to be high in more than half of the patients with severe AS. The presence of CAD was associated with an increased risk of mortality and complications such as stroke and AKI. It is crucial to identify the underlying risk factors for CAD in this patient population in order to effectively address the burden of the disease and optimize management strategies accordingly.

CORONARY ARTERY DISEASE IN PATIENTS OF PERIPHERAL ARTERIAL DISEASE: AN OBSERVATIONAL STUDY

This study assessed the frequency of coronary artery disease in patients with peripheral arterial disease undergoing angiography. The study was carried out between January 2019 and June 2019, at the Department of Cardiology, MTI-KTH, Peshawar, on 149 patients who met the operational characteristics of PAD as stated were enrolled in the study through the outpatient and accident and emergency departments before being admitted to the cardiology ward for additional assessment. The patients were informed of the study's goals and advantages, and written informed consent was taken. Patients underwent coronary angiography in the same setting through the femoral or radial artery approach electively. The mean and SDs for age were 51 ±10.92, whereas the disease duration was 4±1.58. The mean and SDs for BMI were 29.4±1.07. 114 (76.51%) patients were found to be hypertensive, whereas 35 (23.48%) patients had normal blood pressure. 133 (89.26%) patients had diabetes, while 17 (10.73%) patients were non-diabetic. 91 (61.07%) patients were found to be smokers, whereas 58 (38.92%) patients were nonsmokers. 80 (53.69%) patients were recorded with coronary artery disease (CAD). It is concluded that scrutiny must be concentrated on the concomitant likelihood of coronary artery disease in patients with diagnosed severe peripheral arterial disease. Moreover, non-invasive coupled with invasive investigation must also be carried out to lessen the burden of this condition regarding morbidity and mortality.

Clinical Status of Patients with Coronary Artery Disease Treated in a Tertiary Care Hospital, Dhaka, Bangladesh

Background: Coronary artery disease (CAD) is the most common form of heart disease. It is the result of atheromatous changes in the vessels supplying the heart. CAD is used to describe a range of clinical disorders from asymptomatic atherosclerosis and stable angina to acute coronary syndrome (unstable angina, NSTEMI, STEMI). Objective: To assess the clinical status of patients with coronary artery disease (CAD). Methods: This prospective observational study was conducted in the Department of Cardiology, Dhaka Medical College Hospital, Dhaka, Bangladesh from July, 2017 to Dec, 2017. Total 110 confirmed coronary artery disease (CAD) patients were included as the study subjects for this study. A predesigned questionnaire was used in data collection. All data were collected, processed and analyzed by using MS Office and SPSS version 23 programs as per need. Results: In this study, among total 110 participants, 67.3% were male and the rest 32.7% were female. The mean (±SD) age and BMI of the participants were 47.28±11.87 years and 23.68± 2.44 Kg/m2 respective. The waist and hip circumferences of the participants were found 89.81±10.32 cm and 106.82±18.56 cm respectively. The mean (±SD) total cholesterol (mg/dl), S creatinine (mg/dl) and ESR (mm in 1st hour) of the participants were found as 177.69±31.55, 1.6±0.04 and 26.55±5.17 respectively. Conclusion: The frequency of coronary artery disease among male population is found as alarming. The abnormalities in waist or hip circumferences, total cholesterol (mg/dl), S creatinine (mg/dl) and ESR (mm in 1st hour) of patients may be considered as some potential indicator for coronary artery diseases.

The prognostic implications of a fragmented QRS pattern in patients diagnosed with heart failure

Objectives: The purpose of this study was to investigate the potential association between the presence of a fragmented QRS (fQRS) pattern on electrocardiogram (ECG) and prognostic outcomes in patients with heart failure (HF). Methods: In the study, 238 patients with a left ventricular ejection fraction of less than 35% were included. The presence of fQRS pattern on ECG was analyzed in all patients. Patients were divided into two groups based on the presence or absence of fQRS on ECG. The primary clinical end points were all-cause mortality and rehospitalization. Results: Baseline demographic characteristics were comparable between the groups. Patients with fQRS had a higher frequency of coronary artery disease and atrial fibrillation (72 (76%) vs 90 (62%), (p = 0.023; 27 (29%) vs 25 (17%), (p = 0.038, respectively). Additionally, patients with fQRS had a higher rate of mortality and rehospitalization during the 5-year follow-up period compared to patients without fQRS. (30 (32%) / 28 (19%), (p = 0.028; 56 (60%) / 50 (35%), p &amp;lt; 0.001, respectively). Multivariable logistic regression analysis revealed that the presence of fQRS was independently associated with mortality and rehospitalization ((p = 0.02 and p &amp;lt; 0.001, respectively). Conclusions: The results of this study suggest that the presence of fQRS on ECG in patients with HF is independently related to a higher risk of mortality and hospitalization. Therefore, the presence of fQRS may be a useful indicator of poor prognosis in these patients.

Time to Triple Therapy in Patients With de Novo Heart Failure With Reduced Ejection Fraction: a Population-Based Study

Quadruple therapy is recommended for the management of patients with heart failure (HF) and reduced ejection fraction (HFrEF). In order to provide background and identify barriers to quadruple therapy, in this study, the aim was to explore the time to initiation of triple therapy in a population-based cohort of patients with de novo HF. Adult patients with de novo hospital or emergency department (ED) diagnosis of HF between April 1, 2008, and March 31, 2018, in Alberta, Canada, were included and were linked to echocardiography data to identify patients with HFrEF (EF ≤ 40%). Any treatment with angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers/ angiotensin receptor neprilysin inhibitors, beta-blockers, and mineralocorticoid receptor antagonists was captured if prescribed for ≥ 28 days and filled at least once during the 12 months after the index episode. Among 14,092 patients with de novo HF and available echocardiography data, 54.9% had HFrEF. By 1 year after diagnosis, of those in the HFrEF cohort, 9.5% had received no therapy, 27.5% monotherapy, 41.6% dual therapy, and 21.4% triple therapy. The median (interquartile range) of time to mono-, dual- and triple therapy in patients with HFrEF were 1 (0, 26), 8 (0, 44), and 14 (0, 52) days, respectively. Patients who received triple therapy were younger, more likely to be male and to have higher frequencies of coronary artery disease, higher glomerular filtration rates and lower left ventricular ejection fraction levels compared to their counterparts. Patients with triple therapy had lower rates of clinical outcomes compared to those on no, mono or dual therapy (adjusted hazard ratio 0.15, 95% confidence interval 0.13, 0.17 for the composite outcome of death, hospitalization due to HF, or ED visit due to HF). Despite guideline recommendations, triple therapy is underused and is slowly deployed in patients with HFrEF, even after hospitalization and ED presentation.

TIME TO GUIDELINE-DETERMINED MEDICAL THERAPY IN PATIENTS WITH DE NOVO HEART FAILURE: A RETROSPECTIVE POPULATION-BASED STUDY FROM ALBERTA, CANADA

TIME TO GUIDELINE-DETERMINED MEDICAL THERAPY IN PATIENTS WITH DE NOVO HEART FAILURE: A RETROSPECTIVE POPULATION-BASED STUDY FROM ALBERTA, CANADA

Evaluation of relationship between epicardial adipose tissue and vascular calcification in patients with severe aortic stenosis

Background and Aims : Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart that covers 80% of the cardiac surfaces and accounts for approximately 20% of total heart weight. EAT produces atherogenic adipokines and accelerates atherogenic process. We aimed to evaluate relationship between EAT and vascular calcification in patients who underwent TAVR.Methods: All of the patients who underwent CT for TAVR planning between 2013 and 2020 were screened. EAT volume and parameters regarding vascular calcification were measured from CT images. Patients were divided into 3 groups according to EAT volumes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Conclusions: EAT is an important opportunistic cardiovascular risk factor that can be easily detected via echocardiography or cardiac CT. Despite coronary artery disease frequency did not increase in conjunction with EAT volume in our study, renal artery stenosis is more frequent in patients with higher EAT volumes. Background and Aims : Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart that covers 80% of the cardiac surfaces and accounts for approximately 20% of total heart weight. EAT produces atherogenic adipokines and accelerates atherogenic process. We aimed to evaluate relationship between EAT and vascular calcification in patients who underwent TAVR. Methods: All of the patients who underwent CT for TAVR planning between 2013 and 2020 were screened. EAT volume and parameters regarding vascular calcification were measured from CT images. Patients were divided into 3 groups according to EAT volumes. Conclusions: EAT is an important opportunistic cardiovascular risk factor that can be easily detected via echocardiography or cardiac CT. Despite coronary artery disease frequency did not increase in conjunction with EAT volume in our study, renal artery stenosis is more frequent in patients with higher EAT volumes.

Familial hypercholesterolemia in China requires greater efforts

Familial hypercholesterolemia in China requires greater efforts

Influence of coronary artery disease and percutaneous coronary intervention on mid-term outcomes in patients with aortic valve stenosis treated with transcatheter aortic valve implantation.

BackgroundA high frequency of coronary artery disease (CAD) is reported in patients with severe aortic valve stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the optimal management of CAD in these patients remains unknown.HypothesisWe hypothesis that AS patients with TAVI complicated by CAD have poor prognosis. His study evaluates the prognoses of patients with CAD and severe AS after TAVI.MethodsWe divided 186 patients with severe AS undergoing TAVI into three groups: those with CAD involving the left main coronary (LM) or proximal left anterior descending artery (LAD) lesion (the CAD[LADp] group), those with CAD not involving the LM or a LAD proximal lesion (the CAD[non‐LADp] group), and those without CAD (Non‐CAD group). Clinical outcomes were compared among the three groups.ResultsThe CAD[LADp] group showed a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) and all‐cause mortality than the other two groups (log‐rank p = .001 and p = .008, respectively). Even after adjustment for STS score and percutaneous coronary intervention (PCI) before TAVI, CAD[LADp] remained associated with MACCE and all‐cause mortality. However, PCI for an LM or LAD proximal lesion pre‐TAVI did not reduce the risk of these outcomes.ConclusionsCAD with an LM or LAD proximal lesion is a strong independent predictor of mid‐term MACCEs and all‐cause mortality in patients with severe AS treated with TAVI. PCI before TAVI did not influence the outcomes.

Cardiovascular risk assessment by coronary artery calcium score in subjects with maturity-onset diabetes of the young caused by glucokinase mutations

AimsMaturity-Onset Diabetes of the Young (MODY) caused by glucokinase (GCK) mutations is characterized by lifelong mild non-progressive hyperglycemia, with low frequency of coronary artery disease (CAD) compared to other types of diabetes. The aim of this study is to estimate cardiovascular risk by coronary artery calcification (CAC) score in this group. Materials and methodsTwenty-nine GCK-MODY cases, 26 normoglycemic controls (recruited among non-affected relatives/spouses of GCK mutation carriers), and 24 unrelated individuals with type 2 diabetes were studied. Patients underwent CAC score evaluation by computed tomography and were classified by Agatston score ≥ or < 10. Framingham Risk scores of CAD in 10 years were calculated. ResultsMedian [interquartile range] CAC score in GCK-MODY was 0 [0,0], similar to controls (0 [0,0], P = 0.49), but lower than type 2 diabetes (39 [0, 126], P = 2.6 × 10-5). A CAC score ≥ 10 was seen in 6.9% of the GCK group, 7.7% of Controls (P = 1.0), and 54.2% of individuals with type 2 diabetes (P = 0.0006). Median Framingham risk score was lower in GCK than type 2 diabetes (3% vs. 13%, P = 4 × 10-6), but similar to controls (3% vs. 4%, P = 0.66). ConclusionsCAC score in GCK-MODY is similar to control individuals from the same family and/or household and is significantly lower than type 2 diabetes. Besides demonstrating low risk of CAD in GCK-MODY, these findings may contribute to understanding the specific effect of hyperglycemia in CAD.

INFLUENCE OF CORONARY ARTERY DISEASE AND PERCUTANEOUS CORONARY INTERVENTION ON MID-TERM OUTCOMES IN PATIENTS WITH AORTIC VALVE STENOSIS TREATED WITH TRANSCATHETER AORTIC VALVE IMPLANTATION

Background A high frequency of coronary artery disease (CAD) is reported in patients with severe aortic valve stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the optimal management of CAD in these patients remains unknown. Hypothesis We hypothesis that AS patients with TAVI complicated by CAD have poor prognosis. His study evaluates the prognoses of patients with CAD and severe AS after TAVI. Methods We divided 186 patients with severe AS undergoing TAVI into three groups: those with CAD involving the left main coronary (LM) or proximal left anterior descending artery (LAD) lesion (the CAD[LADp] group), those with CAD not involving the LM or a LAD proximal lesion (the CAD[non-LADp] group), and those without CAD (Non-CAD group). Clinical outcomes were compared among the three groups. Results The CAD[LADp] group showed a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) and all-cause mortality than the other two groups (log-rank p = .001 and p = .008, respectively). Even after adjustment for STS score and percutaneous coronary intervention (PCI) before TAVI, CAD[LADp] remained associated with MACCE and all-cause mortality. However, PCI for an LM or LAD proximal lesion pre-TAVI did not reduce the risk of these outcomes. Conclusions CAD with an LM or LAD proximal lesion is a strong independent predictor of mid-term MACCEs and all-cause mortality in patients with severe AS treated with TAVI. PCI before TAVI did not influence the outcomes.