scholarly journals Coronary Artery Calcium as an Independent Surrogate Marker in the Risk Assessment of Patients With Atrial Fibrillation and an Intermediate Pretest Likelihood for Coronary Artery Disease Admitted to a German Chest Pain Unit

2016 ◽  
Vol 39 (3) ◽  
pp. 157-164 ◽  
Author(s):  
Frank Breuckmann ◽  
Jan Olligs ◽  
Liane Hinrichs ◽  
Matthias Koopmann ◽  
Michael Lichtenberg ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Assessment ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Surrogate Marker ◽  
Chest Pain Unit ◽  
Pretest Likelihood ◽  
Artery Disease

Abstract 224: Obesity Paradox in Coronary Artery Disease in Patients With Acute Chest Pain

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Kongkiat Chaikriangkrai ◽  
Mahwash Kassi ◽  
Sayf Khaleel bala ◽  
Su Min Chang
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Acute Chest Pain ◽  
P Value ◽  
Artery Disease ◽  
Severe Calcification

Introduction Obesity has been inconsistently linked with coronary artery calcium score (CACS) as a surrogate of coronary artery disease (CAD) in asymptomatic subjects. Our aim was to examine whether there is relationship between obesity defined by BMI≥30kg/m 2 and presence and severity of CAD defined by CACS in patients with acute chest pain. Methods In this cross-sectional study, 1030 consecutive patients without reported history of coronary artery disease who presented with acute chest pain were included. CACS by non-contrast CT scan and BMI were collected. Patients were categorized by CACS classifications and BMI. Results The population with mean age of 54±13 years, 33% (338 of 1030) of patients being overweight and 46% (477 of 1030) being obese consisted of 60.6% (624 of 1030) patients with zero CACS, 21.7% (223 of 1030) with mild calcification (0<CACS<100) and 17.8% (183 of 1030) with moderate-to-severe calcification (CACS≥100). Compared to non-overweight/non-obese group, obese group had less patients with moderate-to-severe calcification (69 of 477; 14.5% VS 50 of 215; 22.6% p-value=0.016) despite more patients with hypertension (311 of 477; 65.2% VS 98 of 215; 45.6% p-value<0.001), diabetes (98 of 477; 20.5% VS 11 of 215; 5.1% p-value<0.001) and hyperlipidemia(174 of 477; 36.5% VS 57 of 215; 26.5% p-value=0.010). Obesity is INVERSELY associated with presence of CACS and moderate-to-severe calcification in multivariable logistic regression analysis (table 1). Conclusion Obesity defined by body mass index ≥ 30kg/m 2 is INVERSELY associated with presence and severity of coronary artery disease defined by coronary artery calcium score in patients with acute chest pain.

scholarly journals Coronary artery calcium in patients with atrial fibrillation undergoing catheter ablation – an opportunity to personalize cardiovascular and thromboembolic risk management

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Fernandes ◽  
R Ladeiras-Lopes ◽  
R Faria ◽  
W Ferreira ◽  
M Carvalho ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Catheter Ablation ◽  
Risk Stratification ◽  
Statin Therapy ◽  
Coronary Artery Calcium ◽  
Thromboembolic Risk ◽  
History Of ◽  
Artery Disease

Abstract Introduction There is a well-established association between atrial fibrillation (AF) and coronary artery disease (CAD). Coronary artery calcium score (CACS) is a helpful tool to refine cardiovascular risk stratification and guide strategies of cardiovascular (CV) primary prevention. Purpose To evaluate the prevalence and clinical implications of CACS in terms of CV and thromboembolic risk stratification and preventive therapies, in patients with AF and atrial flutter (AFL) undergoing catheter ablation. Methods Cross-sectional study including patients with AF/AFL undergoing multidetector computed tomography (MDCT) for ablation procedure planning from 2017 to 2019. Baseline clinical and demographical data were collected. CV and thromboembolic risks were evaluated based on the SCORE (Systematic Coronary Risk Evaluation) system and CHA2DS2-VASc score. CACS was assessed in patients without history of coronary artery disease using the Agatston method. Results A total of 474 patients were included (441 with AF and 33 with AFL, mean age of 58±10 years, 62% male). Excluding those over 70 years of age (n=50, 11%), most patients had low (n=69, 22%) or moderate (n=188, 60%) CV risk and 277 (64%) patients had a CHA2DS2-VASc score ≥1 (male) or ≥2 (female). Overall, 265 patients (65%) were under chronic anticoagulation and 157 (39%) were under statin therapy. CAC was present in 254 (54%) patients and showed a multivessel distribution in 62% of the cases. The left main stem was affected in 81 (17%) patients and the left anterior descending artery in 211 (45%). Incorporating CACS&gt;100 as a variable in CHA2DS2-VASc score (vascular disease parameter in patients without history of vascular disease) would have resulted in a significant score reclassification (n=87, 20%) and identification of new potential candidates for anticoagulation (n=12, 3%). Additional, anticoagulation would be indicated as a class IA recommendation in more 26 (6%) patients. Twenty three percent of patients with zero calcium were taking statins, and only 7% of patients with a CACS &gt;300 were on high-intensity statin therapy. According to the recommendations and based on their CACS and current therapy, 103 (25%) patients would be candidates for statin therapy and 69 (17%) patients would be candidates for changes in the current statin therapy intensity (Table 1). Conclusion In our study, more than half of the patients undergoing MDCT before AF/AFL catheter ablation had coronary calcium above zero. Our findings suggest that an opportunistic evaluation of CACS can be clinically valuable in thromboembolic risk stratification and management of preventive pharmacological strategies such as anticoagulation and statins. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Feasibility and Safety of Evaluating Patients with Prior Coronary Artery Disease Using an Accelerated Diagnostic Algorithm in a Chest Pain Unit

PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0163501
Author(s):  
Roy Beigel ◽  
Alexander Fardman ◽  
Ronen Goldkorn ◽  
Orly Goitein ◽  
Sagit Ben-Zekery ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Algorithm ◽  
Chest Pain Unit ◽  
Artery Disease

Positive non-invasive tests in the chest pain unit: importance of the clinical profile for estimating the probability of coronary artery disease

2008 ◽  
Vol 10 (4) ◽  
pp. 205-208 ◽  
Author(s):  
Manuel Martínez-Sellés ◽  
Héctor Bueno ◽  
Álvaro Estévez ◽  
José De Miguel ◽  
Javier Muñoz ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Clinical Profile ◽  
Chest Pain Unit ◽  
Non Invasive ◽  
Artery Disease
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