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Nonobstructive coronary artery disease

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https://www.readbyqxmd.com/read/28389572/prognostic-value-of-noninvasive-cardiovascular-testing-in-patients-with-stable-chest-pain-insights-from-the-promise-trial
#1
Udo Hoffmann, Maros Ferencik, James E Udelson, Michael H Picard, Quynh A Truong, Manesh R Patel, Megan Huang, Michael J Pencina, Daniel B Mark, John F Heitner, Christopher B Fordyce, Patricia A Pellikka, Jean-Claude Tardif, Matthew J Budoff, George Nahhas, Benjamin J Chow, Andrzej S Kosinski, Kerry L Lee, Pamela S Douglas
Background -Optimal management of patients with stable chest pain relies on the prognostic information provided by noninvasive cardiovascular testing, but there are limited data from randomized trials comparing anatomic with functional testing. Methods -In the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial, patients with stable chest pain and intermediate pre-test probability for obstructive coronary artery disease (CAD) were randomized to functional testing (exercise electrocardiography, nuclear stress, or stress echocardiography) or coronary computed tomography angiography (CTA)...
April 7, 2017: Circulation
https://www.readbyqxmd.com/read/28387960/optimal-secondary-prevention-medication-use-in-acute-myocardial-infarction-patients-with-nonobstructive-coronary-artery-disease-is-modified-by-management-strategy-insights-from-the-triumph-registry
#2
Reynaria Pitts, Stacie L Daugherty, Fengming Tang, Philip Jones, P Michael Ho, Thomas T Tsai, John Spertus, Thomas M Maddox
BACKGROUND: Patients with acute myocardial infarction (AMI) and nonobstructive coronary artery disease (nonobCAD) may be perceived to be at lower risk for cardiac events, relative to those with obstructive CAD (obCAD), and thus less likely to receive optimal preventive medications in the year following AMI. HYPOTHESIS: We aimed to determine if AMI patients with nonobCAD, compared to obCAD, received lower rates of prevention medications in the year following AMI...
April 7, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28384014/cardiac-medication-use-in-patients-with-acute-myocardial-infarction-and-nonobstructive-coronary-artery-disease
#3
Falisha Adatia, Shannon Galway, Maja Grubisic, May Lee, Patrick Daniele, Karin H Humphries, Tara L Sedlak
IMPORTANCE: Patients with acute myocardial infarction (MI) and nonobstructive coronary artery disease (CAD) have an elevated cardiac event rate, suggesting that these patients may benefit from cardiac medication. OBJECTIVE: We evaluated the rates of cardiac medication use 3 months before angiography and 3 months following clinically indicated angiography for MI in patients with no CAD, nonobstructive CAD, and obstructive CAD. We also examined the sex differences in cardiac medication use 3 months following angiography in patients by extent of angiographic CAD...
April 6, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28384013/sex-differences-in-cardiac-medication-use-post-catheterization-in-patients-undergoing-coronary-angiography-for-stable-angina-with-nonobstructive-coronary-artery-disease
#4
Shannon Galway, Falisha Adatia, Maja Grubisic, May Lee, Patrick Daniele, Karin H Humphries, Tara L Sedlak
BACKGROUND: Treatment of patients with stable angina and nonobstructive coronary artery disease (CAD) has not been well characterized. We comparatively evaluated medication use in males and females with stable angina with no CAD, nonobstructive CAD, and obstructive CAD. METHODS: We studied all patients ≥20 years old with stable angina undergoing coronary angiography in British Columbia (BC), Canada, from January 2008 to March 2010 (n = 7,535). No CAD, nonobstructive CAD, and obstructive CAD were defined as 0%, 1%-49%, and ≥50% luminal narrowing in any epicardial coronary artery, respectively...
April 6, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28330658/nonobstructive-coronary-artery-disease-by-coronary-ct-angiography-improves%C3%A2-risk-stratification-and-allocation%C3%A2-of-statin%C3%A2-therapy
#5
Hamed Emami, Richard A P Takx, Thomas Mayrhofer, Sumbal Janjua, Jakob Park, Amit Pursnani, Ahmed Tawakol, Michael T Lu, Maros Ferencik, Udo Hoffmann
OBJECTIVES: This study sought to determine prognostic value of nonobstructive coronary artery disease (CAD) for atherosclerotic cardiovascular disease (ASCVD) events and to determine whether incorporation of this information into the pooled cohort equation reclassifies recommendations for statin therapy as defined by the 2013 guidelines for cholesterol management of the American College of Cardiology and American Heart Association (ACC/AHA). BACKGROUND: Detection of nonobstructive CAD by coronary computed tomography angiography may improve risk stratification and permit individualized and more appropriate allocation of statin therapy...
March 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28266736/cardiac-ct-angiography-in-the-emergency-room-apical-hypertrophic-cardiomyopathy-presenting-as-acute-coronary-syndrome
#6
Michael C Turner, Edmund K Kerut, James Mckinnie, Michael Davis, Christine Hinton
A 59-year-old male presented to the emergency room with symptoms of chest tightness and palpitations. Following conversion of atrial fibrillation to sinus rhythm, he had deep symmetrical T-wave changes on his electrocardiogram. Symptoms resolved almost immediately, and his initial troponin was negative. He underwent cardiac CT angiography utilizing an emergency room triage protocol which resulted in a diagnosis of nonobstructive coronary artery disease and apical hypertrophic cardiomyopathy. Following a hospital stay of less than 24 hours, he was discharged to outpatient follow-up on medical management and has remained asymptomatic over 6 months...
March 7, 2017: Echocardiography
https://www.readbyqxmd.com/read/28259226/prevalence-and-prognosis-of-nonobstructive-coronary-artery-disease-in-patients-undergoing-coronary-angiography-or-coronary-computed-tomography-angiography-a-meta-analysis
#7
Zhi Jian Wang, Lin Lin Zhang, Sammy Elmariah, Hong Ya Han, Yu Jie Zhou
OBJECTIVE: To evaluate the prevalence, clinical characteristics, and risk of cardiac events in patients with nonobstructive coronary artery disease (CAD). PATIENTS AND METHODS: We searched PubMed, EMBASE, and the Cochrane Library from January 1, 1990, to November 31, 2015. Studies were included if they reported prevalence or prognosis of patients with nonobstructive CAD (≤50% stenosis) among patients with known or suspected CAD. Patients with nonobstructive CAD were further grouped as those with no angiographic CAD (0% or ≤20%) and those with mild CAD (>0% or >20% to ≤50%)...
March 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28228453/impaired-health-status-psychological-distress-and-personality-in-women-and-men-with-nonobstructive-coronary-artery-disease-sex-and-gender-differences-the-twist-tweesteden-mild-stenosis-study
#8
Paula M C Mommersteeg, Lindy Arts, Wobbe Zijlstra, Jos W Widdershoven, Wilbert Aarnoudse, Johan Denollet
BACKGROUND: Patients with nonobstructive coronary artery disease (NOCAD; wall irregularities, stenosis <60%), and women with NOCAD in particular, remain underinvestigated. We examined sex and gender (S&G) differences in health status, psychological distress, and personality between patients with NOCAD and the general population, as well as S&G differences within the NOCAD population. METHODS AND RESULTS: In total, 523 patients with NOCAD (61±9 years, 52% women) were included via coronary angiography and computed tomography as part of the TWIST (Tweesteden Mild Stenosis) study...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28169140/influence-of-cardiovascular-risk-factors-on-the-prevalence-of-coronary-atherosclerosis-in-patients-with-angiographically-normal-coronary-arteries
#9
Daniel O Bittner, Lutz Klinghammer, Mohamed Marwan, Jasmin Schmid, Christian Layritz, Udo Hoffmann, Stephan Achenbach, Tobias Pflederer
RATIONALE AND OBJECTIVES: Cardiovascular (CV) disease is predominately influenced by CV risk factors and coronary computed tomography angiography (CTA) is capable of detecting early-stage coronary artery disease. We sought to determine the influence of CV risk factors on the prevalence of nonobstructive atherosclerosis in patients with normal-appearing coronary arteries in invasive coronary angiography (ICA). MATERIALS AND METHODS: In this retrospective analysis, we included 60 consecutive symptomatic patients, having undergone ICA and coronary CTA...
February 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28139221/long-term-prognostic-value-of-lipoprotein-a-in-symptomatic-patients-with-nonobstructive-coronary-artery-disease
#10
Hao Xie, Liming Chen, Hang Liu, Yuqi Cui, Zhun Zhang, Lianqun Cui
Our study aimed to evaluate the association of lipoprotein(a) [Lp(a)] and prognosis in patients with nonobstructive coronary artery disease (CAD). A total of 4,254 symptomatic patients with suspected CAD referred for coronary angiography were analyzed and 451 patients (250 women, average age 58 ± 9 years) with nonobstructive CAD (defined as no angiographic stenosis ≥50% in any major epicardial artery) were finally included in our cohort. Subjects were categorized into tertile groups according to Lp(a) levels on admission...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28122619/obesity-metabolic-syndrome-and-cardiovascular-prognosis-from-the-partners-coronary-computed-tomography-angiography-registry
#11
Edward A Hulten, Marcio Sommer Bittencourt, Ryan Preston, Avinainder Singh, Carla Romagnolli, Brian Ghoshhajra, Ravi Shah, Siddique Abbasi, Suhny Abbara, Khurram Nasir, Michael Blaha, Udo Hoffmann, Marcelo F Di Carli, Ron Blankstein
OBJECTIVE: To investigate the relationship among body mass index (BMI), cardiometabolic risk and coronary artery disease (CAD) among patients undergoing coronary computed tomography angiography (CTA). METHODS: Retrospective cohort study of 1118 patients, who underwent coronary CTA at two centers from September 2004 to October 2011. Coronary CTA were categorized as normal, nonobstructive CAD (<50%), or obstructive CAD (≥50%) in addition to segment involvement (SIS) and stenosis scores...
January 25, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28030655/percutaneous-coronary-intervention-with-bioresorbable-scaffolds-in-a-young-child
#12
Tamim M Nazif, Sanjog Kalra, Ziad A Ali, Dimitrios Karmpaliotis, Mariel E Turner, Thomas J Starc, Yang Cao, Charles C Marboe, Michael B Collins, Martin B Leon, Ajay J Kirtane
Importance: Although much less frequent than in adults, coronary artery disease requiring revascularization may develop in children because of homozygous familial hypercholesterolemia or other underlying conditions. Percutaneous coronary intervention (PCI) with a bioresorbable scaffold (BRS) may have advantages over metallic coronary stents in this population. Objective: To present a case of the successful treatment of unstable, multivessel coronary artery disease in a child with PCI with BRS implantation...
April 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/27986756/nonobstructive-versus-obstructive-coronary-artery-disease-in-acute-coronary-syndrome-a-meta-analysis
#13
REVIEW
Carmine Pizzi, Borejda Xhyheri, Grazia Maria Costa, Massimiliano Faustino, Maria Elena Flacco, Maria Rosaria Gualano, Giorgia Fragassi, Francesco Grigioni, Lamberto Manzoli
BACKGROUND: Differences in prognosis and baseline clinical presentation have been documented among patient with acute coronary syndrome and coronary artery disease with obstructive (ObCAD) or nonobstructive arteries (NObCAD), but the rates of events largely varied across single studies. We carried out a meta-analysis to compare the clinical presentation and prognosis of NObCAD versus ObCAD acute coronary syndrome patients, as well as of the subjects with zero versus mild occlusion. METHODS AND RESULTS: Searches were made in MedLine, EMBASE, Cochrane databases, and proceedings of international meetings up to June 30, 2015...
December 16, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27956407/coronary-plaque-morphology-and-the-anti-inflammatory-impact-of-atorvastatin-a-multicenter-18f-fluorodeoxyglucose-positron-emission-tomographic-computed-tomographic-study
#14
Parmanand Singh, Hamed Emami, Sharath Subramanian, Pal Maurovich-Horvat, Gergana Marincheva-Savcheva, Hector M Medina, Amr Abdelbaky, Achilles Alon, Sudha S Shankar, James H F Rudd, Zahi A Fayad, Udo Hoffmann, Ahmed Tawakol
BACKGROUND: Nonobstructive coronary plaques manifesting high-risk morphology (HRM) associate with an increased risk of adverse clinical cardiovascular events. We sought to test the hypothesis that statins have a greater anti-inflammatory effect within coronary plaques containing HRM. METHODS AND RESULTS: In this prospective multicenter study, 55 subjects with or at high risk for atherosclerosis underwent (18)F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and after 12 weeks of treatment with atorvastatin...
December 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27881570/excess-cardiovascular-risk-in-women-relative-to-men-referred-for-coronary-angiography-is-associated-with-severely-impaired-coronary-flow-reserve-not-obstructive-disease
#15
Viviany R Taqueti, Leslee J Shaw, Nancy R Cook, Venkatesh L Murthy, Nishant R Shah, Courtney R Foster, Jon Hainer, Ron Blankstein, Sharmila Dorbala, Marcelo F Di Carli
BACKGROUND: Cardiovascular disease (CVD) fatality rates are higher for women than for men, yet obstructive coronary artery disease (CAD) is less prevalent in women. Coronary flow reserve (CFR), an integrated measure of large- and small-vessel CAD and myocardial ischemia, identifies patients at risk for CVD death, but is not routinely measured in clinical practice. We sought to investigate the impact of sex, CFR, and angiographic CAD severity on adverse cardiovascular events. METHODS: Consecutive patients (n=329, 43% women) referred for invasive coronary angiography after stress testing with myocardial perfusion positron emission tomography and with left ventricular ejection fraction >40% were followed (median, 3...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/27867292/new-impella-cardiac-power-device-used-in-patient-with-cardiogenic-shock-due-to-nonischemic-cardiomyopathy
#16
Marek Cena, Frances Karam, Rajesh Ramineni, Wissam Khalife, Alejandro Barbagelata
The new percutaneous Impella CP (Cardiac Power; Abiomed, Inc., Danvers, MA) was designed to provide a higher level of support than Impella 2.5 (Abiomed, Inc.). We present the first documented case of a patient that was transitioned from the Impella 2.5 to Impella CP. A 48-year-old male patient with no medical history was transferred to our institution with a one day history of worsening shortness of breath. The patient was unstable and found to have monomorphic ventricular tachycardia at 220 beats/min that was cardioverted to normal sinus rhythm...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27751734/editorial-commentary-dissecting-the-gender-differences-in-nonobstructive-coronary-artery-disease-how-do-we-bridge-the-gap
#17
EDITORIAL
Ramzi Y Khamis
No abstract text is available yet for this article.
September 15, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27639757/long-term-prognostic-value-of-coronary%C3%A2-ct-angiography-in-asymptomatic-type-2-diabetes-mellitus
#18
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
https://www.readbyqxmd.com/read/27634119/comprehensive-metabolomic-characterization-of-coronary-artery%C3%A2-diseases
#19
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
https://www.readbyqxmd.com/read/27617797/sex-differences-in-nonobstructive-coronary-artery-disease-recent-insights-and-substantial-knowledge-gaps
#20
REVIEW
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
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