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Nonobstructive coronary artery disease

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https://www.readbyqxmd.com/read/28610801/effect-of-myocardial-infarction-with-nonobstructive-coronary-arteries-on-physical-capacity-and-quality-of-life
#1
Maria Daniel, Stefan Agewall, Kenneth Caidahl, Olov Collste, Christina Ekenbäck, Mats Frick, Shams Y-Hassan, Logman Henareh, Tomas Jernberg, Karin Malmqvist, Karin Schenck-Gustafsson, Peder Sörensson, Örjan Sundin, Claes Hofman-Bang, Per Tornvall
Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA), including Takotsubo syndrome (TS), are considered to have a better survival compared with those with coronary heart disease (CHD). Studies of patients with MINOCA measuring physical and mental function including matched control groups are lacking. The aim of this study was to determine the physical capacity and quality of life in patients with MINOCA. One-hundred patients with MINOCA along with TS (25%) were investigated from 2007 to 2011...
May 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28607128/relationship-of-hypertension-to-coronary-atherosclerosis-and-cardiac-events-in-patients-with-coronary-computed-tomographic-angiography
#2
Rine Nakanishi, Lohendran Baskaran, Heidi Gransar, Matthew J Budoff, Stephan Achenbach, Mouaz Al-Mallah, Filippo Cademartiri, Tracy Q Callister, Hyuk-Jae Chang, Kavitha Chinnaiyan, Benjamin J W Chow, Augustin DeLago, Martin Hadamitzky, Joerg Hausleiter, Ricardo Cury, Gudrun Feuchtner, Yong-Jin Kim, Jonathon Leipsic, Philipp A Kaufmann, Erica Maffei, Gilbert Raff, Leslee J Shaw, Todd C Villines, Allison Dunning, Hugo Marques, Gianluca Pontone, Daniele Andreini, Ronen Rubinshtein, Jeroen Bax, Erica Jones, Niree Hindoyan, Millie Gomez, Fay Y Lin, James K Min, Daniel S Berman
Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease...
June 12, 2017: Hypertension
https://www.readbyqxmd.com/read/28605043/typical-angina-is-associated-with-greater-coronary-endothelial-dysfunction-but-not-abnormal-vasodilatory-reserve
#3
Ahmed AlBadri, Derek Leong, C Noel Bairey Merz, Janet Wei, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Michael D Nelson, Louise E Thomson, Daniel S Berman, Leslee J Shaw, Galen Cook-Wiens, Carl J Pepine
BACKGROUND: Typical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HYPOTHESIS: To further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28585034/myocardial-perfusion-imaging-in-women-for-the-evaluation-of-stable-ischemic-heart-disease-state-of-the-evidence-and-clinical-recommendations
#4
Viviany R Taqueti, Sharmila Dorbala, David Wolinsky, Brian Abbott, Gary V Heller, Timothy M Bateman, Jennifer H Mieres, Lawrence M Phillips, Nanette K Wenger, Leslee J Shaw
This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging (MPI), emphasizing new developments in single-photon emission tomography (SPECT) and positron emission tomography (PET) in the clinical evaluation of women presenting with symptoms of stable ischemic heart disease (SIHD). The clinical evaluation of symptomatic women is challenging due to their varying clinical presentation, clinical risk factor burden, high degree of comorbidity, and increased risk of major ischemic heart disease events...
June 5, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28540214/coronary-microvascular-dysfunction-in-women-with-nonobstructive-ischemic-heart-disease-as-assessed-by-positron-emission-tomography
#5
REVIEW
Roxana Campisi, Fernando D Marengo
Traditional approaches for risk assessment of ischemic heart disease (IHD) are based on the physiological consequences of an epicardial coronary stenosis. Of note, normal coronary arteries or nonobstructive coronary artery disease (CAD) is a common finding in women with signs and symptoms of ischemia. Therefore, assessment of risk based on a coronary stenosis approach may fail in women. Positron emission tomography (PET) quantifies absolute myocardial blood flow (MBF) which may help to elucidate other mechanisms involved such as endothelial dysfunction and alterations in the smooth muscle cell relaxation responsible for IHD in women...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28465992/stress-induced-worsening-of-left-ventricular-diastolic-function-as-a-marker-of-myocardial-ischemia
#6
Mohamad Jihad Mansour, Wael Aljaroudi, Ali Mroueh, Omar Hamoui, Walid Honeine, Nada Khoury, Jinane Abi Nassif, Elie Chammas
BACKGROUND: Echocardiography has been the subject of interest in diagnosing diastolic dysfunction and estimating left ventricular filling pressures (LVFPs). The present study is set to estimate the correlation between the worsening of diastolic parameters and the evidence of inducible ischemia during an exercise stress echocardiography (SE) in comparison with the results of coronary computed tomographic angiogram (CCTA). METHODS: A total of 191 consecutive patients from the executive screening program who underwent exercise SE followed by CCTA were evaluated...
April 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28389572/prognostic-value-of-noninvasive-cardiovascular-testing-in-patients-with-stable-chest-pain-insights-from-the-promise-trial
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
REVIEW
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
#14
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
#15
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...
May 2017: Academic Radiology
https://www.readbyqxmd.com/read/28139221/long-term-prognostic-value-of-lipoprotein-a-in-symptomatic-patients-with-nonobstructive-coronary-artery-disease
#16
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
#17
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
#18
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
#19
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
#20
RANDOMIZED CONTROLLED TRIAL
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
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