Biomechanical Determinants of Plaque Rupture

2010 ◽  
Author(s):  
Ali Cagdas Akyildiz ◽  
Lambert Speelman ◽  
Jolanda Wentzel ◽  
Anton van der Steen ◽  
Frank Gijsen
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Plaque Rupture ◽  
Myocardial Infarctions

Atherosclerosis is an important cardiovascular disease in which plaque build up occurs in a vessel. The rupture of the cap that covers the plaque of a coronary artery is the underlying cause of the majority of fatal acute myocardial infarctions and sudden coronary deaths [1].

Influence of Plaque Geometry on Peak Cap Stresses

2011 ◽  
Author(s):  
A. C. Akyildiz ◽  
L. Speelman ◽  
H. Nieuwstadt ◽  
J. Wentzel ◽  
A. van der Steen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Vulnerable Plaque ◽  
Necrotic Core ◽  
Myocardial Infarctions ◽  
Vulnerable Plaques

Atherosclerosis is an important cardiovascular disease in which plaque build up occurs in vessels. Plaques with thin cap and thick necrotic core are defined as vulnerable plaques. Rupture of the cap of a vulnerable plaque in a coronary artery is the underlying cause of the majority of acute myocardial infarctions and sudden coronary deaths [1].

Scintigraphic Detection of Experimental Myocardial Infarction with 99mTc-2,3-Dimercaptosuccinic Acid

1984 ◽  
Vol 23 (06) ◽  
pp. 317-319
Author(s):  
J. Novák ◽  
Y. Mazurová ◽  
J. Kubíček ◽  
J. Yižd’a ◽  
P. Kafka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Intravenous Administration ◽  
Experimental Myocardial Infarction ◽  
Myocardial Infarctions ◽  
Clinical Use ◽  
Scintigraphic Imaging ◽  
Tissue Samples ◽  
Scintigraphic Finding

SummaryAcute myocardial infarctions were produced by ligature of the left frontal descending coronary artery in 9 dogs. The possibility of scintigraphic imaging with 99mTc-DMSA 4 hrs after intravenous administration was studied. The infarctions were 4, 24 and 48 hrs old. The in vivo scan was positive in only one dog with a 4-hr old infarction. The in vivo scans were confirmed by the analysis of the radioactivity in tissue samples. The accumulation of the radiopharmaceutical increased slightly in 48-hr old lesions; however, this increase was not sufficient for a positive scintigraphic finding. Thus, we do not recommend 99mTc-DMSA for clinical use in acute lesions.

Psychological status of patients after coronary artery bypass grafting: Data from a 5-year-follow-up study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
O Raykh ◽  
A Sumin ◽  
E Korok
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Type D Personality ◽  
Psychological Status ◽  
Myocardial Infarctions ◽  
Bypass Grafting ◽  
Type D ◽  
Repeat Procedures

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases” Negative psychological status is acknowledged as one of risk of development of cardiovascular pathology.  However, predictive value of type D personality (psychosocial distress) in different cultures and the countries are not fully understood. Purpose: Study aim was to investigate the association of type D personality and quality of life (QoL) with the development of cardiovascular complication in patients in five years after coronary artery bypass grafting (CABG). Materials and Methods: Evaluation of psychological status and combined risk of nonfatal (strokes, nonfatal myocardial infarctions, repeat procedures of revascularization and hospitalization due to relapse or progression of angina pectoris) and fatal (general and cardiovascular mortality) cases before and in five years after CABG. Patients with chronic ischemic heart disease (n = 602, 112 (18.5%) females and 490 (81.5%) males, mean age = 57.7 ± 7.3 years.) who had had CABG were included in the study. Who were formed in two groups: patients with the presence of type D (n= 134) and patients without type D (n = 468). The study of the psychological status was carried out using questionnaire DS-14.  Analysis of long-term results were assessed using the Kaplan–Meier method. Data was collected by a SF-36 questionnaire, comprising of 36 questions divided in 8 domains. The score was designated as 0 to 100; with the higher score being indicative of a better QoL.  Results: Frequency of fatal cases in both groups amounted 8.3% and 8.1% (p = 0.145), in turn nonfatal end-points in group with type D amounted 31.8%, and 15.9% in group without type D (p = 0.044) in during the 5 years. Presence of type D personality at initial examination increased 3.21 times combined risk of nonfatal and fatal cases (OR 3.21, 95%  CI 2.02-6.14, p = 0.002). In long term period there were no differences in survival between groups type D and without type D (95.5% vs. 96.8%), There were  differences in groups type D and without type D in nonfatal events (strokes, nonfatal myocardial infarctions, secondary endpoint: repeat procedures of revascularization and hospitalization due to relapse or progression of angina pectoris) (respectively, 97.1% vs 88.0%, (p = 0.341). Findings showed that 75% of subjects  reported well QoL, while the mean score regarding QoL in patients with type D personality, were higher than in patients without type D in all health related dimensions. Based on t-test difference, the of QoL in  in patients with type D and  in patients without type D for physical health (p < 0.015), mental limitation (p < 0.043), somatic pain (p < 0.022) and mental health (p < 0.041) was observed. Conclusion: Type D patients had a greater risk for nonfatal cardiac events and lower  QoL indicators, compared with non Type D patients.  Accumulated proofs indicate that in detection of patients at risk of development of stress induced cardiac complications after CABG  it is reasonable to use approach which involves consideration of personality type.

Impact of age and sex on subclinical coronary atherosclerosis in a healthy asian population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Wong ◽  
J Yap ◽  
KK Yeo
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Atherosclerosis ◽  
Ldl Cholesterol ◽  
Multivariable Analysis ◽  
Asian Population ◽  
Atherosclerotic Cardiovascular Disease ◽  
Age And Gender ◽  
And Gender

Abstract Funding Acknowledgements Type of funding sources: None. Background and Aims The influence of age and gender on clinical atherosclerotic cardiovascular disease is well reported, but literature remains sparse on whether these extend to the disease in its preclinical stage. We aim to report the prevalence, risk-factors and impact of age and gender on the burden of subclinical coronary atherosclerosis in a healthy Asian population. Methods Healthy subjects aged 30-69 years old, with no history of cardiovascular disease or diabetes were recruited from the general population. Subclinical coronary atherosclerosis was quantified via the Coronary Artery Calcium Score (CACS) with CACS of 0 indicating the absence of calcified plaque, 1 to 10 minimal plaque, 11 to 100 mild plaque, and >100 moderate to severe plaque. Results A total of 663 individuals (mean age 49.4 ± 9.2 years, 44.8% male) were included. The prevalence of any CAC was 29.3% with 9% having CAC > 100.  The prevalence was significantly higher in males than females (43.1 vs 18.0%, p < 0.001). These gender differences became increasingly pronounced with increasing age, especially in those with moderate-severe CAC. Multivariable analysis revealed significant associations between increasing age, male, higher blood pressure, increased glucose levels and higher LDL cholesterol levels with the presence of any CAC. LDL cholesterol was more significantly associated with CAC in females compared to males (Pinteraction = 0.022). Conclusions The prevalence of preclinical atherosclerosis increased with age, and was higher in males than females, with gender-specific differences in associated risk factors. These results will better inform individualised future risk management strategies to prevent the development and progression of coronary artery disease within healthy individuals.

scholarly journals Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

2021 ◽  
Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Long Term Outcomes ◽  
Vital Status ◽  
Increased Risk ◽  
Artery Disease ◽  
The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

The utility of coronary artery calcium in non-gated high resolution CT thorax scans in predicting cardiac events as compared to the Framingham risk score: a retrospective study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Saluja ◽  
H Contractor ◽  
M Daniells ◽  
J Sobolewska ◽  
K Khan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Retrospective Study ◽  
Coronary Artery ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Cardiac Events ◽  
End Point ◽  
Framingham Risk ◽  
Good Concordance

Abstract Background There is existing evidence to suggest a correlation between coronary artery calcification (CAC) measured using ECG-triggered chest computed tomography and cardiovascular disease. Further evidence has emerged to suggest a correlation between CAC measured using non-gated CT scans and cardiovascular disease. Herein, we sought to ascertain the utility of incidental findings of CAC on non-triggered high resolution CT (HRCT) thorax used for patients undergoing lung cancer screening or follow-up for interstitial lung disease and Framingham risk score (FRS) in predicting cardiovascular events. Methods The Computerised Radiology Information Service (CRIS) database was manually searched to determine all HRCT scans performed in a single trust from 05/2015 to 05/2016. The reports issued by Radiologists and images of selected studies were reviewed. For patients with CAC, we calculated the calcium score for patients using the Agatston method. Clinical events were determined from the electronic medical record without knowledge of patients' CAC findings. For these patients, the Framingham Risk Score (FRS) was also calculated. The primary end point of the study was composite of all-cause mortality and cardiac events (non-fatal myocardial infarction, coronary revascularization, new atrial fibrillation or heart failure episode requiring hospitalization). Results We selected 300 scans from a total of approximately 2000 scans performed over this time. Data at follow up was available for 100% of the patients, with a median duration of follow up of 1.6 years. Moderate to severe CAC was found in 35% of people. Multivariable analysis showed good concordance between CAC and FRS in predicting composite clinical end point. The Odds Ratio for cardiac events in patients with moderate to severe CAC was 5.3 (p&lt;0.01) and for composite clinical end point was 3.4 (p&lt;0.01). This is similar to the OR predicted by the FRS: 4.8; p&lt;0.01 and 3.1; p&lt;0.01 respectively. Only 6.2% of patients with moderate to severe CAC were currently statin treated. Conclusion In this retrospective study of patients with respiratory disease attending for HRCT scanning, co-incidentally detected CAC predicts cardiac events, with good concordance with the FRS. The incidental finding of CAC on non-gated CT scanning should be reported with Agatston score calculation allowing consideration of intervention to mitigate cardiovascular risk and optimize. Further multi-centre prospective studies of this strategy, with a larger patient cohort should be conducted to clarify the utility of CAC as a prediction tool to modify cardiac risk. Funding Acknowledgement Type of funding source: None

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