scholarly journals Association between Polymorphisms of Antioxidant Gene (MnSOD, CAT, and GPx1) and Risk of Coronary Artery Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hseng-Long Yeh ◽  
Li-Tang Kuo ◽  
Fung-Chang Sung ◽  
Chih-Ching Yeh
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Manganese Superoxide Dismutase ◽  
Medical Center ◽  
Stress Test ◽  
Genetic Effect ◽  
Multivariate Logistic Regression Model ◽  
Increased Risk ◽  
Artery Disease ◽  
Cad Risk

Objective. Reactive oxygen species (ROS) been cited as one of the major causes of atherosclerosis and coronary artery disease which are possible agents inducing DNA damage. Manganese superoxide dismutase (MnSOD), catalase (CAT), and glutathione peroxidase-1 (GPx1) have evolved to address primary defense against free radical mediated damage in mitochondria. The aim of this study was to delineate the association ofMnSOD,CAT, andGPx1polymorphisms and risk of CAD in Taiwan.Methods. We conducted a case-control study with 657 participants recruited at a medical center. All subjects were evaluated by noninvasive stress test and then quantitative coronary angiography to confirm the diagnosis of CAD. 447 CAD cases were defined as >50% stenosis of coronary artery and 210 controls were stenosed below 50%. Polymorphisms ofMnSOD(Val16Ala),CAT(C-262T), andGPx1(Pro198Leu) genes were determined by polymerase chain reaction methods. Multivariate logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs).Results. TheMnSODVal/Ala+Ala/Ala genotype was significantly associated with an increased risk of CAD compared to the Val/Val genotype (OR = 1.86, 95% CI = 1.15-3.01). This polymorphism was also associated with the severity of CAD of single and two vessel diseases. The corresponding ORs were 2.31 (95% CI = 1.32-4.03) and 1.92 (95% CI = 1.02-3.61), respectively. Among cigarette smokers, the harmful genetic effect ofMnSODAla allele on CAD risk was much higher (OR = 2.23, 95% CI = 1.02-4.88). However, the interaction betweenMnSODgenotype and cigarette smoking on CAD risk was not significant. No significant association betweenCATandGPx1polymorphisms and CAD risk was observed.Conclusion. Our results suggest thatMnSODpolymorphism is an independent risk factor for susceptibility to CAD in the Chinese population.

scholarly journals Prevalence, Epidemiological Characteristics, and Pharmacotherapy of Coronary Artery Disease among Patients with Atrial Fibrillation: Data from Jo-Fib Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 605
Author(s):  
Hanna K. Al-Makhamreh ◽  
Mohammed Q. Al-Sabbagh ◽  
Ala’ E. Shaban ◽  
Abdelrahman F. Obiedat ◽  
Ayman J. Hammoudeh
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antiplatelet Agents ◽  
Retrospective Case ◽  
Increased Risk ◽  
Artery Disease ◽  
Epidemiological Characteristics ◽  
Cad Risk

Background and Objectives: Patients with AF are at increased risk for Coronary Artery Disease (CAD) owing to their shared etiologies and risk factors. This study aimed to assess the prevalence, cardiovascular risk factors, and used medications of CAD in AF patients. Materials and Methods: This retrospective, case-control study utilized data from the Jordanian Atrial Fibrillation (Jo-Fib) registry. Investigators collected clinical features, history of co-existing comorbidities, CHA2DS2-VASc, and HAS BLED scores for all AF patients aged >18 visiting 19 hospitals and 30 outpatient cardiology clinics. A multivariable binary logistic regression was used to asses for factors associated with higher odds of having CAD. Results: Out of 2000 patients with AF, 227 (11.35%) had CAD. Compared to the rest of the sample, those with CAD had significantly higher prevalence of hypertension (82.38%; p < 0.01), hypercholesterolemia (66.52%, p < 0.01), diabetes (56.83%, p < 0.01), and smoking (18.06%, p = 0.04). Patients with AF and CAD had higher use of anticoagulants/antiplatelet agents combination (p < 0.01) compared to the rest of the sample. Females had lower CAD risk than males (OR = 0.35, 95% CI: 0.24–0.50). AF Patients with dyslipidemia (OR = 2.5, 95% CI: 1.8–3.4), smoking (OR = 1.7, 95% CI: 1.1–2.6), higher CHA2DS2-VASc score (OR = 1.5, 95% CI: 1.4–1.7), and asymptomatic AF (OR = 1.9, 95% CI: 1.3–2.6) had higher risk for CAD. Conclusions: Owing to the increased prevalence of CAD in patients with AF, better control of cardiac risk factors is recommended for this special group. Future studies should investigate such interesting relationships to stratify CAD risk in AF patients. We believe that this study adds valuable information regarding the prevalence, epidemiological characteristics, and pharmacotherapy of CAD in patients with AF.

Abstract 12291: Contribution of Rare Mutations in Mendelian Hypercholesterolemia Genes to Risk for Premature Coronary Artery Disease in the Population

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hong-Hee Won ◽  
Ron Do ◽  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Null Allele ◽  
Coronary Revascularization ◽  
Null Alleles ◽  
Premature Coronary Artery Disease ◽  
Rare Mutations ◽  
Increased Risk ◽  
Artery Disease ◽  
Cad Risk

Introduction: Low-density lipoprotein cholesterol (LDL-C) is a causal risk factor for coronary artery disease (CAD). Rare mutations in at least 6 genes lead to Mendelian forms of high or reduced LDL-C; three ( APOB, LDLR, PCSK9 ) act in a dominant pattern whereas three ( ABCG5, ABCG8, LDLRAP1 ) in a recessive pattern. We address to what extent rare mutations in Mendelian LDL-C genes contribute to early CAD risk in the population. Methods: We sequenced the exons of the 6 genes in 9,329 early CAD cases (myocardial infarction, angiographic CAD, or coronary revascularization in men≤50 and women≤60) and 10,245 controls from 9 studies using targeted and whole exome next-generation sequencing. We tested 3 sets: ‘Null alleles’ (nonsense, splice-site, or frameshift); ‘Deleterious (7/7)’ (null and missense annotated as damaging by 7 algorithms); and ‘Deleterious (6/7)’ (null and missense annotated as damaging by at least 6 algorithms). Given the rarity of deleterious mutations, we aggregated these mutations in each gene and tested for an excess or deficit in cases vs . controls. Results: Counts of mutations are provided in Table. Null mutations in LDLR , carried by 1:500 participants, confered a 8-fold increase in CAD risk (P=8х10 -7 ) whereas heterozygosity for a null mutation in ABCG5 (1:650 frequency) was associated with a 3-fold increased risk (P=5х10 -3 ). ‘Deleterious (7/7)’ mutations in LDLR , carried by 1:100 participants, confered a 4-fold increased risk (P=8х10 -17 ) whereas heterozygosity for a ‘Deleterious (7/7)’ mutation in ABCG5 (1:250 frequency) was associated with a 2-fold increased risk (P=2х10 -3 ). Heterozygous null allele carriers at LDLR and ABCG5 had increased LDL-C (P<0.001). Conclusions: Of early CAD cases, 2-3% carry a rare, deleterious mutation at LDLR or ABCG5 associated with increased risk. Although previously reported to cause recessive sitosterolemia, we find that heterozygosity for a null allele at ABCG5 is associated with markedly higher early CAD risk.

scholarly journals Genetic susceptibility of five tagSNPs in the endothelin-1 (EDN1) gene to coronary artery disease in a Chinese Han population

2018 ◽  
Vol 38 (5) ◽  
Author(s):  
Li-li Liang ◽  
Lin Chen ◽  
Meng-yuan Zhou ◽  
Meng-yun Cai ◽  
Jie Cheng ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chinese Han Population ◽  
Chinese Han ◽  
Han Population ◽  
Endothelin 1 ◽  
Increased Risk ◽  
Artery Disease ◽  
Cad Risk

Endothelin-1 (ET-1) plays important roles in endothelial dysfunction, vascular physiology, inflammation, and atherosclerosis. Nonetheless, the role of ET-1 (EDN1) gene variants on coronary artery disease (CAD) risk remains poorly understood. The aim of the present study was to evaluate the role of EDN1 gene polymorphisms on individual susceptibility to CAD. We genotyped five tagSNPs (single-nucleotide polymorphisms) (rs6458155, rs4145451, rs9369217, rs3087459, and rs2070699) within EDN1 gene in 525 CAD patients and 675 control subjects. In a multivariate logistic regression analysis, we detected an association of rs6458155 in EDN1 gene with the CAD risk; compared with the TT homozygotes, the CT heterozygotes (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.02–2.29, P=0.040) and the CC homozygotes (OR = 1.55, 95% CI = 1.01–2.36, P=0.043) were statistically significantly associated with the increased risk for CAD. A similar trend of the association was found in dominant model (OR = 1.53, 95% CI = 1.05–2.25, P=0.029). Consistently, the haplotype rs6458155C-rs4145451C containing rs6458155 C allele exhibited the increased CAD risk (OR = 1.22, 95% CI = 1.03–1.43, and P=0.018). In addition, CT genotype of rs6458155 conferred the increased plasma ET-1 levels compared with TT genotype (P<0.05). No association of the other four tagSNPs in EDN1 gene with CAD risk was observed. In conclusion, our study provides the first evidence that EDN1 tagSNP rs6458155 is associated with CAD risk in the Chinese Han population, which is probably due to the influence of the circulating ET-1 levels.

scholarly journals Implementation and evaluation of depression screening in patients with recently diagnosed coronary artery disease

2020 ◽  
Vol 10 (1) ◽  
pp. 12-17
Author(s):  
Lindsay M. Mailloux ◽  
Matthew T. Haas ◽  
Steven P. Kennedy ◽  
Beth M. DeJongh
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medical Center ◽  
Depression Screening ◽  
Additional Patient ◽  
Quality Improvement Initiative ◽  
Comorbid Depression ◽  
Increased Risk ◽  
Artery Disease ◽  
Service Referral

Abstract Introduction Patients with coronary artery disease (CAD) are at an increased risk for depression. Additionally, comorbid depression in patients with CAD is associated with increased mortality and worse cardiac outcomes. Screening this patient population for depression is recommended but is not routinely done in practice. The purpose of this quality improvement initiative was to implement a protocol to screen patients with CAD for depression using the Patient Health Questionnaire (PHQ-9). Primary objectives were to determine the frequency of positive depression screens and the frequency of acceptance of mental health (MH) service referral. Methods Patients with CAD were screened for depression using the PHQ-9 during a hospital admission to the inpatient cardiology unit at the Clement J. Zablocki Veterans Affairs Medical Center. All patients were rescreened for depression at 4 and 8 weeks after discharge. Patients with positive screens for depression were offered referral for MH services, and reasons for decline were documented. Results Of the 36 patients screened for depression, 14 (39%) screened positive for depression, including 10 patients at baseline (28%), 3 additional patients (8%) at week 4 after discharge, and 1 additional patient (3%) at week 8 after discharge. Of the 14 patients who screened positive for depression, 3 patients (21%) accepted MH service referral. The most commonly reported reason for declining referral was no perceived benefit. Discussion The results of this initiative support the utility of using the PHQ-9 for depression screening in patients with recently diagnosed CAD and offering MH service referral for treatment of comorbid depression.

scholarly journals Cis-epistasis at the LPA locus and risk of coronary artery disease

2019 ◽  
Author(s):  
Lingyao Zeng ◽  
Nazanin Mirza-Schreiber ◽  
Claudia Lamina ◽  
Stefan Coassin ◽  
Christopher P. Nelson ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Association Studies ◽  
Arterial Disease ◽  
Genome Wide Association Studies ◽  
Interaction Patterns ◽  
Cardiovascular Risks ◽  
Increased Risk ◽  
Artery Disease ◽  
Cad Risk

AbstractIdentification of epistasis affecting complex human traits has been challenging. Focusing on known coronary artery disease (CAD) risk loci, we explore pairwise statistical interactions between 8,068 SNPs from ten CAD genome-wide association studies (n=30,180). We discovered rs1800769 and rs9458001 in the vicinity of the LPA locus to interact in modulating CAD risk (P=1.75×10−13). Specific genotypes (e.g., rs1800769 CT) displayed either significantly decreased or increased risk for CAD in the context of genotypes of the respective other SNP (e.g., rs9458001 GG vs. AA). In the UK Biobank (n=450,112) significant interaction of this SNP pair was replicated for CAD (P=3.09×10−22), and was also found for aortic valve stenosis (P=6.95×10−7) and peripheral arterial disease (P=2.32×10−4). Identical interaction patterns affected circulating lipoprotein(a) (n=5,953; P=8.7×10−32) and hepatic apolipoprotein(a) (apo(a)) expression (n=522, P=2.6×10−11). We further interrogated potential biological implications of the variants and propose a mechanism explaining epistasis that ultimately may translate to substantial cardiovascular risks.

Abstract 18043: Factors That Influence the Decision for Ischemic Work-up in Hypertensive Emergency

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Obiora Maludum ◽  
Kenechukwu Mezue ◽  
Sylvia Biso ◽  
Mary Rodriguez-Ziccardi ◽  
Talal Alnabelsi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Troponin I ◽  
Medical Center ◽  
Stress Test ◽  
Significant Coronary Artery Disease ◽  
Artery Disease ◽  
Work Up ◽  
To Receive

Background: Hypertensive emergencies (HE) account for 3% of emergency room hospitalizations and it is estimated that 1-2% of America’s 50 million hypertensive patients will have at least one occurrence of HE in their lifetime. Recent studies have shown that cardiac troponin-I is elevated in a third of patients with HE, however the pathophysiology and significance of this elevation is still being explored. We tried to look at different factors that influence the decision to do ischemic work up in patients with HE. Method: Patients admitted to Albert Einstein Medical Center from 01/01/2005 to 08/30/2014 with a diagnosis of HE were included in this retrospective study. Patients were divided into two groups: those who had either cardiac catheterization or stress test, and those who had no ischemic work up. Demographic and clinical variables were collected. A cumulative risk score for coronary artery disease was calculated by assigning 1 point for each risk factor. Results: There were total of 187 patients with HE of which only 37 had ischemic work up. 20 out of the 37 patients who had ischemic work up had chest pain. Of the 20 patients only 3 were found to have significant coronary artery disease. Comparisons between the demographics and clinical predictors in both groups are shown in the table. Multivariate analysis shows chest pain to independently predict which patients were more likely to receive an ischemic work up (OR=4.7; 95% CI 1.6 to 7.6; p=0.001). Conclusion: In the setting of HE, our study shows that chest pain was the only single factor that independently predicts which HE patients are more likely to receive an ischemic work up. Elevated troponins or EKG changes alone were not found to independently predict the decision to perform an ischemic work up. This may reflect the pattern of clinical practice at our center. Large multi-center studies might be needed to explore this further and also assess the clinical outcomes of this decision making process.

scholarly journals Associations between LPL gene polymorphisms and coronary artery disease: evidence based on an updated and cumulative meta-analysis

2018 ◽  
Vol 38 (2) ◽  
Author(s):  
Wen-Qi Ma ◽  
Ying Wang ◽  
Xi-Qiong Han ◽  
Yi Zhu ◽  
Nai-Feng Liu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Gene Polymorphisms ◽  
Genetic Model ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Increased Risk ◽  
Lpl Gene ◽  
Artery Disease ◽  
Cad Risk

Lipoprotein lipase (LPL) is widely linked to lipid and lipoprotein metabolism, but its effects on coronary artery disease (CAD) are not clearly elucidated. The aim of the present study was to clarify the association between LPL gene polymorphisms and CAD susceptibility. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the strength of the relationship between LPL gene polymorphisms and CAD risk. Comprehensive electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library, were systematically searched. A total of 45 records containing 80 eligible studies were analyzed. The results indicated an increased risk between the LPL D9N polymorphism and susceptibility to CAD in the dominant genetic model (AA + GA vs. GG: OR = 1.46, 95% CI = 1.14–1.87), whereas the LPL HindIII polymorphism showed a protective effect against CAD under all tested models (GG + GT vs. TT: OR = 0.85, 95% CI = 0.75–0.97; GG vs. TT + TG: OR = 0.62, 95% CI = 0.47–0.83; G vs. T: OR = 0.81, 95% CI = 0.71–0.92). No significant association was identified for the LPL N291S and PvuII polymorphisms. Stratification analysis by ethnicity suggested a significant correlation between the LPL S447X polymorphism and CAD susceptibility in Caucasians under the dominant and allele genetic models. In summary, our meta-analysis indicated that the LPL D9N polymorphism was associated with an increased risk of CAD, whereas the S447X and HindIII polymorphisms showed protective effects. There was no association observed between the N291S and PvuII polymorphisms and CAD risk.

scholarly journals Osteoprotegerin SNP associations with coronary artery disease and ischemic stroke risk: a meta-analysis

2020 ◽  
Vol 40 (10) ◽  
Author(s):  
Jine Wu ◽  
Xiyang Li ◽  
Fan Gao ◽  
Shanshan Gao ◽  
Jun Lyu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Nucleotide Polymorphisms ◽  
Increased Risk ◽  
Ischemic Stroke Risk ◽  
Artery Disease ◽  
Cad Risk

Abstract Osteoprotegerin (OPG) is involved in the development of atherosclerosis and cardio-cerebrovascular disease. The goal of this meta-analysis was to evaluate the association of OPG single nucleotide polymorphisms (SNPs) with coronary artery disease (CAD) and ischemic stroke. A total of 15 eligible studies were extracted from electronic databases. Odds ratios (ORs) were presented, with 95% confidence intervals (CIs), to assess the associations. Meta-analysis was conducted using MetaGenyo, STATA, and Comprehensive Meta-Analysis. Meta-analysis of our data showed that the OPG SNP T950C was significantly associated with increased CAD risk among Asians via recessive (OR 1.55, 95% CI 1.18–2.04, P=0.002), CC vs TT (OR 1.57, 95% CI 1.16–2.11, P=0.003) and allelic (OR 1.21, 95% CI 1.05–1.38, P=0.007) models. No strong associations were observed for the OPG SNP G1181C, T245G and G209A with CAD risk. When evaluating the OPG SNP T245G and T950C associations with ischemic stroke, we found the OPG SNP T245G to be significantly associated with increased risk of ischemic stroke among Chinese via recessive (OR 1.53, 95% CI 1.02–2.29, P=0.039) and CC vs AA (OR 1.61, 95% CI 1.07–2.42, P=0.021) models. Our results suggested that the OPG SNP T950C was associated with increased risk of CAD among Asians, and the OPG SNP T245G was associated with enhanced ischemic stroke risk among Chinese.

Abstract 13601: Risk of Coronary Artery Disease Associated With Familial Hypercholesterolemia Genetic Variants is Independent of Historical Low-density Lipoprotein Cholesterol Exposure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shoa L Clarke ◽  
Catherine Tcheandjieu ◽  
Austin Hilliard ◽  
Kyung Min Lee ◽  
julie lynch ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Familial Hypercholesterolemia ◽  
Index Date ◽  
Coronary Revascularization ◽  
African Ancestry ◽  
Increased Risk ◽  
Artery Disease ◽  
Incident Cases ◽  
Cad Risk

Introduction: Familial Hypercholesterolemia (FH) variants confer risk for coronary artery disease (CAD) even after adjusting for a single baseline LDL measure. Hypothesis: We hypothesized that a model incorporating serial LDL measures over many years may account for the risk associated with FH variants. Methods: We analyzed 418,790 participants in the Million Veteran Program with electronic health records (EHR) spanning up to 15 years prior to and 7 years after enrollment. FH variants were defined using ClinVar and standard bioinformatic approaches. Carriers were identified by custom genotype array. CAD cases were identified by chart codes for acute MI and coronary revascularization. We used a nested case-control design conditional on survival to enrollment. Controls were matched on year of first LDL, time between first LDL and the case index date, age, sex, and ancestry. Logistic regression was used to estimate CAD risk among FH carriers while adjusting for CAD risk factors and the first, maximum (max), or mean LDL prior to the index date. Results: We found 53 LDLR , 2 APOB , and 2 PCSK9 variants, and FH prevalence was 1:303. We identified 23,091 cases with ≥1 LDL measure prior to the diagnosis of CAD and matched 10 controls per case. Cases had a median of 6 LDL measures over a median of 49 months prior to the index date. Carriers had an increased risk for CAD compared to non-carriers. Adjusting for the first, max, and mean LDL progressively attenuated risk of CAD associated with FH, but residual FH risk remained substantial ( Figure ). This pattern did not change in the subset of subjects with the most extensive LDL data nor in the subset of incident cases. We additionally found evidence of modifying effects of sex and ancestry, with higher within-group risk for females and subjects of African ancestry ( Figure ). Conclusion: The risk associated with FH variants cannot be fully captured by the LDL data available in the EHR, even when considering multiple LDL measurements spanning several years.

scholarly journals Coronary angiography finding of exercise tread mill test positive patients in a tertiary care center

2017 ◽  
Vol 7 (2) ◽  
pp. 1-6
Author(s):  
Amit Shrestha ◽  
Sanjeev Thapa ◽  
Shilendra Shakya ◽  
Ravi Shahi
Keyword(s):  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Myocardial Perfusion Imaging ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Stress Test ◽  
Vessel Disease ◽  
Artery Disease ◽  
Cad Risk

Background: The diagnosis rate of coronary artery disease (CAD) has been dramatically increased with the development of interventional technique. Coronary angiography (CAG) is the “gold standard” tool for CAD diagnosis. Due to its invasive property, CAG has been limited. Treadmill test (TMT) is still broadly used as an economic and simple method to screen and assist the diagnosis of CAD. However, correct interpretation of such data is essential in determining diagnostic and treatment strategies. Methods: All the patients attending outpatient department of Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC) and having positive findings in tread mill stress test (TMT) using Bruce protocol underwent selective coronary angiography (CAG), in MCVTC Cath Lab using standard technique and were analyzed in multiple views with significant coronary stenosis defined as of ≥70 % lesion, 50-60% as borderline and 20-30% as minor coronary artery disease. Results: A total of 303 patients (mean age 52.8 ±9.7 yrs) were included during a study period of approximately 1½ yrs (Oct 2015 to Dec 2016), among whom male were of average 53.6 ±10.5 yrs and female were of 51.7±8.6 yrs. Risk factor estimation among patients showed that 49.3 % were hypertensive, 29.9% were overweight, 15.2% were diabetic and 5.7% were smoker. Coronary angiography of patients revealed normal coronaries in 114(54.0%), borderline lesion in 29(13.7%) and significant lesion in 68 (32.2%). Among those with diagnosed coronary artery disease (CAD), 48(22.7%) had single vessel disease, 29(13.7%) had double vessel disease and 14(6.6%) had triple vessel disease. The sub group analysis based on of risk factor and coronary artery disease showed coronary artery diseases was highest among diabetics (57.7%) followed by smokers (55%) compared. The risk of Coronary artery disease found to be significantly higher among patient with ≥2 CAD risk factor. Males with stress test positive had significantly higher chances of having CAD than females (53% vs 35% respectively). Conclusion: Coronary artery disease (CAD) among patients with TMT positive status is higher in patients with diabetics and smokers, especially those with two or more CAD risk factors. Results of this study showed that the pretest probability of treadmill stress-test is higher in males with two or more CAD risk factor especially diabetes and smoking compared to the female counterparts with similar factors, so should be supplemented by other non-invasive techniques (such as stress echocardiography, myocardial perfusion imaging) for further confirmation of diagnosis. (such as Astress echocardiography, myocardial perfusion imaging) for further confirmation of diagnosis.

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