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Nonobstructive coronary artery disease

Ramzi Y Khamis
No abstract text is available yet for this article.
September 15, 2016: Trends in Cardiovascular Medicine
Se Hun Kang, Gyung-Min Park, Seung-Whan Lee, Sung-Cheol Yun, Young-Hak Kim, Young-Rak Cho, Hyun Woo Park, Jon Suh, Dong Hyun Yang, Joon-Won Kang, Tae-Hwan Lim, Chang Hee Jung, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Ki-Up Lee, Joong-Yeol Park
OBJECTIVES: This study sought to evaluate the long-term prognostic value of coronary computed tomography angiography (CTA) in asymptomatic patients with type 2 diabetes mellitus. BACKGROUND: There are limited data on the long-term prognostic impact of coronary CTA in asymptomatic patients with type 2 diabetes mellitus. METHODS: This study analyzed clinical outcomes of 591 consecutive asymptomatic patients with type 2 diabetes mellitus who underwent coronary CTA (mean age 62...
September 9, 2016: JACC. Cardiovascular Imaging
Yong Fan, Yong Li, Yan Chen, Yi-Jing Zhao, Li-Wei Liu, Jin Li, Shi-Lei Wang, Raphael N Alolga, Yin Yin, Xiang-Ming Wang, Dong-Sheng Zhao, Jian-Hua Shen, Fan-Qi Meng, Xin Zhou, Hao Xu, Guo-Ping He, Mao-De Lai, Ping Li, Wei Zhu, Lian-Wen Qi
BACKGROUND: Pathogenesis and diagnostic biomarkers for diseases can be discovered by metabolomic profiling of human fluids. If the various types of coronary artery disease (CAD) can be accurately characterized by metabolomics, effective treatment may be targeted without using unnecessary therapies and resources. OBJECTIVES: The authors studied disturbed metabolic pathways to assess the diagnostic value of metabolomics-based biomarkers in different types of CAD. METHODS: A cohort of 2,324 patients from 4 independent centers was studied...
September 20, 2016: Journal of the American College of Cardiology
Tracy K Paul, Kaartiga Sivanesan, Joshua Schulman-Marcus
The existence of sex differences in the epidemiology, presentation, diagnosis, and management of coronary artery disease (CAD) has been a subject of growing inquiry for the past several decades. The prevailing paradigm is that the prevalence of anatomically obstructive disease of the epicardial coronary arteries is less common in women than similarly aged men, while nonobstructive and microvascular ischemic disease is more prevalent in women. Although both "patterns" of coronary atherosclerosis are associated with angina and cardiovascular events, the dominant diagnostic and therapeutic tools used in cardiology have focused on the male-predominant pattern of anatomically obstructive epicardial CAD...
August 11, 2016: Trends in Cardiovascular Medicine
Alberto García-Lledó, José L Moya-Mur, Virginia Ponz-Mir, Susana Novo-Aparicio, Azucena Sanz-Barrio, Concepción Álvarez-Sanz, Ana de Santiago-Nocito
BACKGROUND: Risk score systems (RSS) were designed to estimate the risk of cardiac events. Their ability to predict coronary atherosclerosis (CA) has not been established. HYPOTHESIS: Risk score systems can predict presence of CA in patients without typical symptoms or ischemia. Because design of each RSS is different, their predictive value could also differ. METHODS: A retrospective analysis was done on patients from a low-risk region referred for cardiac multislice computed tomography (MSCT)...
September 6, 2016: Clinical Cardiology
Mark R Burge, R Philip Eaton, David S Schade
The coronary artery calcium (CAC) scan has recently emerged as a reproducible noninvasive test to detect asymptomatic atherosclerotic coronary artery disease. It has several advantages over the traditional cardiac stress testing modalities, including lower cost, greater sensitivity for nonobstructing coronary artery lesions, and excellent prognostic value when combined with the Framingham risk parameters. Its chief disadvantage is that it does not identify obstructing coronary artery lesions or noncalcified coronary artery plaque...
September 2016: Diabetes Technology & Therapeutics
Philipp Blanke, Christopher Naoum, Amir Ahmadi, Chaitu Cheruvu, Jeanette Soon, Chesnal Arepalli, Heidi Gransar, Stephan Achenbach, Daniel S Berman, Matthew J Budoff, Tracy Q Callister, Mouaz H Al-Mallah, Filippo Cademartiri, Kavitha Chinnaiyan, Ronen Rubinshtein, Hugo Marquez, Augustin DeLago, Todd C Villines, Martin Hadamitzky, Joerg Hausleiter, Leslee J Shaw, Philipp A Kaufmann, Ricardo C Cury, Gudrun Feuchtner, Yong-Jin Kim, Erica Maffei, Gilbert Raff, Gianluca Pontone, Daniele Andreini, Hyuk-Jae Chang, Benjamin W Chow, James Min, Jonathon Leipsic
OBJECTIVES: The goal of this study was to determine the long-term prognostic value of coronary computed tomography angiography (CTA) among patients with diabetes mellitus (DM) compared with nondiabetic subjects. BACKGROUND: The long-term prognostic value of coronary CTA in patients with DM is not well established. METHODS: Patients enrolled in the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry with 5-year follow-up data were identified...
August 20, 2016: JACC. Cardiovascular Imaging
Nirav Patel, Abhishek Shenoy, George Dous, Haroon Kamran, Nabil El-Sherif
Background. Takotsubo cardiomyopathy (TCM) is sudden and reversible myocardial dysfunction often attributable to physical or emotional triggers. Case Report. We describe a 51-year-old man presented to emergency department with sepsis from urinary tract infection (UTI). He was placed on cefepime for UTI and non-ST-elevation myocardial infarction protocol given elevated troponins with chest pain. Subsequently, patient was pulseless with torsades de pointes (TdP) and then converted to sinus rhythm with cardioversion...
2016: Case Reports in Cardiology
Seong-Mi Park, C Noel Bairey Merz
Cardiovascular disease is one of the most frequent causes of death in both males and females throughout the world. However, women exhibit a greater symptom burden, more functional disability, and a higher prevalence of nonobstructive coronary artery disease (CAD) compared to men when evaluated for signs and symptoms of myocardial ischemia. This paradoxical sex difference appears to be linked to a sex-specific pathophysiology of myocardial ischemia including coronary microvascular dysfunction, a component of the 'Yentl Syndrome'...
July 2016: Korean Circulation Journal
Rina Mauricio, Monvadi B Srichai, Leon Axel, Judith S Hochman, Harmony R Reynolds
BACKGROUND: In a prospective study, cardiac MRI (CMR) and intravascular ultrasound were performed in women with myocardial infarction (MI) and nonobstructive coronary artery disease (MINOCA). Forty participants underwent adenosine-stress CMR (sCMR). HYPOTHESIS: Abnormal perfusion may co-localize with ischemic late gadolinium enhancement (LGE) and T2-weighted signal hyperintensity (T2+), suggesting microvascular dysfunction contributed to MI. METHODS: Qualitative perfusion analysis was performed by 2 independent readers...
July 26, 2016: Clinical Cardiology
Tara L Sedlak, Meijiao Guan, May Lee, Karin H Humphries, B Delia Johnson, Carl J Pepine, C Noel Bairey Merz
No abstract text is available yet for this article.
July 1, 2016: JAMA Cardiology
Christoph Sinning, Elvin Zengin, Christoph Waldeyer, Moritz Seiffert, Renate B Schnabel, Edith Lubos, Tanja Zeller, Christoph Bickel, Stefan Blankenberg, Peter M Clemmensen, Dirk Westermann
BACKGROUND: The complexity of coronary artery disease (CAD) is a predictor of cardiovascular events in patients with >50 % diameter stenosis as determined by SYNTAX score. Here, we compare the Gensini score to SYNTAX in patients with CAD as well as apply the Gensini score in patients with nonobstructive CAD (NOB-CAD), defined by ≤50 % diameter stenosis, were the SYNTAX score cannot be utilized to define future risk. METHODS: The AtheroGene study enrolled 2316 patients [861/37...
June 30, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Homayoun R Ahmadian, Dustin M Thomas, David J Shaw, Megan L Barnwell, Ronald L Jones, Ryan J McDonough, Ryan L Prentice, Charles K Lin, Ahmad M Slim
Introduction. The purpose of this study is to investigate chest pain evaluations after initial coronary computed tomography angiography (CCTA) based upon coronary artery disease (CAD) burden. Methods. CCTA results of 1,518 patients were grouped based on the CCTA results into no CAD, nonobstructive CAD (<50% maximal diameter stenosis), or obstructive CAD (≥50% stenosis). Chest pain evaluation after initial CCTA and rates of major adverse cardiovascular events (MACE) defined as the incidence of all-cause mortality, nonfatal MI, ischemic stroke, and late revascularization (>90 days following CCTA) were evaluated...
2014: International Scholarly Research Notices
Csilla Celeng, Pál Maurovich-Horvat, Brian B Ghoshhajra, Béla Merkely, Tim Leiner, Richard A P Takx
OBJECTIVE: The usefulness of coronary computed tomography angiography (CTA) for the evaluation of coronary artery disease (CAD) in patients with diabetes is ambiguous. We therefore performed a meta-analysis of studies reporting event rates and hazard ratios (HR) to determine the prognostic value of CTA in this patient population. RESEARCH DESIGN AND METHODS: We searched PubMed and Embase up to November 2015. Study subjects' characteristics, events (all-cause mortality or cardiac death, nonfatal myocardial infarction, unstable angina pectoris, stroke, revascularization), and events excluding revascularization were collected...
July 2016: Diabetes Care
Quinn R Pack, Brian D Lahr, Ray W Squires, Francisco Lopez-Jimenez, Kevin L Greason, Hector I Michelena, Kashish Goel, Randal J Thomas
We sought to measure the impact of cardiac rehabilitation (CR) on mortality in patients with mitral or aortic heart valve surgery (HVS) and nonobstructive coronary artery disease. We surveyed all patients (or a close family member if the patient was deceased) who had HVS without coronary artery bypass in 2006 through 2010 at the Mayo Clinic to assess if they attended CR after their HVS. We performed a propensity-adjusted landmark analysis to test the association between CR attendance and long-term all-cause mortality conditional on surviving the first year after HVS...
June 15, 2016: American Journal of Cardiology
Márton Kolossváry, Bálint Szilveszter, István Ferenc Édes, Sándor Nardai, Viktor Voros, István Hartyánszky, Béla Merkely, Szilard Voros, Pál Maurovich-Horvat
Numerous clinical studies using coronary computed tomography angiography (CTA) and conventional invasive coronary angiography (ICA) confirmed the strong relation between atherosclerotic disease burden and risk of adverse events. Few studies have compared coronary CTA and ICA regarding semiquantitative plaque burden measurements, reproducibility, and cardiovascular risk assessment. We enrolled 71 consecutive patients (mean age 62 ± 9 years, 37% women) from the Genetic Loci and the Burden of Atherosclerotic Lesions study (NCT01738828), who underwent 256-slice multidetector row coronary CTA and ICA at a single site...
June 15, 2016: American Journal of Cardiology
Wesam Ostwani, Holly Fleming, Carlos A Roldan
The patient is a 70-year-old male with no other atherogenic risk factors who presented with an acute coronary syndrome (ACS) of unstable angina subsequently complicated by a non-ST elevation myocardial infarction (NSTEMI). The patient's presentation posed 3 unique features: (1) cardiac catheterization demonstrated nonobstructive 3-vessel multi-aneurysmal coronary artery disease with sluggish antegrade coronary flow; (2) a nonobstructive aneurysmal dissection flap based on contrast staining of the mid left anterior descending artery, which may have led to in situ nonocclusive thrombosis and distal microvascular embolization; and (3) successful conservative medical therapy of coronary artery aneurysmal disease (CAAD) complicated with ACS...
January 2016: Journal of Investigative Medicine High Impact Case Reports
Mariana Garcia, Sharon L Mulvagh, C Noel Bairey Merz, Julie E Buring, JoAnn E Manson
Cardiovascular disease continues to be the leading cause of death among women in the United States, accounting for ≈1 of every 3 female deaths. Sex-specific data focused on cardiovascular disease have been increasing steadily, yet is not routinely collected nor translated into practice. This comprehensive review focuses on novel and unique aspects of cardiovascular health in women and sex differences as they relate to clinical practice in the prevention, diagnosis, and treatment of cardiovascular disease...
April 15, 2016: Circulation Research
Joshua Schulman-Marcus, Bríain ó Hartaigh, Heidi Gransar, Fay Lin, Valentina Valenti, Iksung Cho, Daniel Berman, Tracy Callister, Augustin DeLago, Martin Hadamitzky, Joerg Hausleiter, Mouaz Al-Mallah, Matthew Budoff, Philipp Kaufmann, Stephan Achenbach, Gilbert Raff, Kavitha Chinnaiyan, Filippo Cademartiri, Erica Maffei, Todd Villines, Yong-Jin Kim, Jonathon Leipsic, Gudrun Feuchtner, Ronen Rubinshtein, Gianluca Pontone, Daniele Andreini, Hugo Marques, Leslee Shaw, James K Min
OBJECTIVES: The purpose of this study was to examine sex-specific associations, if any, between per-vessel coronary artery disease (CAD) extent and the risk of major adverse cardiovascular events (MACE) over a 5-year study duration. BACKGROUND: The presence and extent of CAD diagnosed by coronary computed tomography angiography (CTA) is associated with increased short-term mortality and MACE. Nevertheless, some uncertainty remains regarding the influence of sex on these findings...
April 2016: JACC. Cardiovascular Imaging
Marko Banovic, Voin Brkovic, Ivana Nedeljkovic, Milan Nedeljkovic, Dejana Popovic, Ana Djordjevic-Dikic, Arsen Ristic, Srdjan Nikolic, Branko Beleslin
BACKGROUND AND AIM: Coronary flow reserve is impaired in asymptomatic patients with aortic stenosis and has a prognostic value. We investigated whether the type II diabetes mellitus additionally impairs microvascular circulation assessed by coronary flow reserve in patients with asymptomatic severe aortic stenosis, normal left ventricular ejection fraction and nonobstructed coronary arteries. METHODS: A total of 128 patients, mean age of 66.35 ± 10.51 (58.6% males), with severe aortic stenosis and normal left ventricular ejection fraction were enrolled in this study...
May 2016: Diabetes & Vascular Disease Research
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