scholarly journals Correlation between Triglyceride/HDL Ratio with Severity of Coronary Artery Lesion in Non-Diabetic Stable Angina Pectoris Patients

2018 ◽  
Vol 4 (2) ◽  
pp. 95
Author(s):  
Pramon Aditya Sudjana ◽  
Chaerul Achmad ◽  
Achmad Fauzi Yahya ◽  
Januar W. Martha ◽  
M. Rizki Akbar

Background: Triglycerides (TG) as a risk factor for coronary artery disease (CAD) is still a matter of controversy but when used as a single ratio with high density lipoprotein (HDL) the predictive value for CAD is better. The TG/HDL ratio is also associated with the presence of small dense LDL (sdLDL) in the body. SdLDL is a more atherogenic LDL subfraction and has been proven to be associated with CAD progression.Aims: This study aims to find the correlation between the TG/HDL ratio and the degree of coronary lesion severity based on the Gensini score in stable non diabetic angina pectoris patients.Methods: This study was a cross sectional study conducted at Dr. Hasan Sadikin Hospital and Hasna Medika Palimanan Hospital. Subjects were non diabetic stable angina pectoris patients ≥18 years old who underwent elective coronary angiography. Blood collection for TG and HDL examination was performed after coronary angiography. Gensini scoring system was used to assess the severity of coronary lesions. The relationship between the TG/HDL ratio and the Gensini score was analyzed using multiple linear regression tests against confounding variables.Results: This study involved 60 patients with stable angina pectoris with a mean age of 60±8 years. The mean TG/HDL ratio is 2.56 ± 1.04. The average Gensini score was 51 ± 36. The TG/HDL ratio was significantly associated with the Gensini score (R = 0.637; p <0.001). Analysis of confounding variables showed age, hypertension, and metabolic syndrome had a weak correlation with Gensini score (r values of 0.321, 0.270, and 0.333, p <0.05, respectively), while those correlating with TG/HDL ratios were men, hypertension, and metabolic syndrome (r values of 0.290, 0.287, and 0.362, p <0.05, respectively).Conclusion: TG/HDL ratio was significantly positively correlated significantly with the severity of coronary lesions based on Gensini score in non diabetic stable angina pectoris patients.

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M M Eldeib

Abstract Background conventional echocardiography at rest provides little information regarding the presence of CAD, Longitudinally orientated myocardial fibers are located subendocardially, the area most susceptible to ischaemia, that is why measurements of longitudinal motion and deformation may be the most sensitive markers of CAD using (2DSE) The aim of this study was to determine if 2DSE performed at rest can enhance the sensitivity of exercise test and if it can predict the presence of coronary artery disease in patients with stable angina pectoris. Methods our study included (120) subjects suspected to be stable angina pectoris patients presented for evaluation of chest pain at Al-Hussein University Hospital – Al-Azhar University – Cairo – Egypt between December 2013 and December 2015, The patients were classified according to coronary angiography results in to two groups: Group (A): 40 patients with normal coronary angiography as a control subjects,Group (B): 80 patients with significant coronary artery disease. Results There was statistically significant difference between the two groups as regard E wave, A wave, E/A ration, DT, Em and E/Em, there was statistically significant difference between the two groups as regard SLSS and GLS 17 and GLS 12, there was statistically significant difference between the two groups as regard SLSr and Sr17and Sr 12, there was statistically significant difference between the two groups as regard ST segment deviation during stress ECG, exercise capacity (METs) and Duke Score,;in this study we found that strain parameters at BA, BAS, MA, MIS, MAS, AI and AL segments were found to be significant predictor of LAD stenosis and BP and MP were found to be significant predictor of LCX stenosis and BI was found to be predictor of RCA stenosis, also we found that strain rate parameters at BA, MA, MAS, AI, AL and apex segments were found to be significant predictor of LAD stenosis, and BL, BP and ML were found to be significant predictor of LCX stenosis and BI and MI were found to be predictor of RCA stenosis, the diagnostic performance of the exercise test was significantly improved by GLS17 in terms of a significant increased AUC for the exercise test in combination with GLS17 Conclusion: In patients with suspected SAP, GLS assessed by 2DSE at rest is a predictor of significant CAD and significantly improves the diagnostic performance of exercise test, and capable of identifying which coronary artery is stenotic.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
MM Svenningsson ◽  
I Dhar ◽  
GFT Svingen ◽  
EKR Pedersen ◽  
D Nilsen ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background/Aim Increased plasma trimetyllysine (TML), a methylated amino acid, has recently been linked to higher risk of acute myocardial infarction (AMI). TML is also a precursor of trimethylamine-N oxide (TMAO), which has been linked to increased cardiovascular risk, including that of  atrial fibrillation (AF). We investigated the association between TML and new-onset AF in two large Norwegian cohorts. Methods The primary cohort consisted of 6396 participants in the community-based Hordaland Health Study (HUSK). The validation cohort consited of 2027 patients who underwent coronary angiography due to suspected stable angina pectoris in the Western Norway Coronary Angiography Cohort (WECAC). Information on new-onset AF was obtained by linking patient data to Norwegian public health registries. Risk associations were explored by Cox regression. Results During median (25th-75th percentile) follow-up of 10.9 (10.6-11.3) and 7.0 (6.3-8.6) years, 560 (8.8%) patients in the HUSK and 210 (10.4%) in the WECAC was diagnosed with AF. In the HUSK, the age and gender adjusted HR (95 % CI) for the 4th vs. 1st plasma TML quartiles 1.84 (1.37-2.48) p &lt; 0.001. In multivariable models the association was only slightly attenuated. Correspondingsly, the age and gender adjusted HR (95% CI) for the 4th vs. 1st TML quartiles in the WECAC was 1.48 (0.96-2.27) p = 0.07. Testing for collinearity between TMAO and TML revealed variance inflation factors between 1.0-1.1 in HUSK and WECAC, thus ruling out collinearity. Conclusion Plasma TML was associated with new-onset AF among subjects from the general population, and the relationship was independent from established AF risk factors. A similar trend was also seen in patients with suspected stable angina pectoris, strengthening our findings, which motivate further studies to explore potential pathophysiological relationships between one-carbon metabolism and cardiac arrhythmias


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Koga ◽  
S Ikeda ◽  
R Akashi ◽  
Y Yamagata ◽  
T Yonekura ◽  
...  

Abstract Background Klotho, which was originally identified as an aging suppressor, is a key regulator of bone and mineral metabolism. Transmembrane and soluble forms of Klotho protein have been identified. The transmembrane form serves as an obligate co-receptor for fibroblast growth factor 23 (FGF23). However, the physiological importance of soluble form of Klotho has not been determined. Purpose The present study aimed to test the hypothesis that circulating soluble Klotho levels can predict the presence or extent of coronary artery calcification (CAC) in patients with coronary artery disease. Methods We analyzed CAC of culprit lesions in patients with 75 stable angina pectoris who were not on dialysis and were scheduled for percutaneous coronary intervention (PCI) following intravascular ultrasound (IVUS). Arc and length of each calcium within the culprit lesion was measured by IVUS. The main outcome measure was the calcium index; a volumetric IVUS-derived measure which was calculated as total calcium length/lesion length × maximal calcium arc/360°. Low calcium index was defined as calcium index <0.042 of the first quartile value. Serum Klotho and FGF23 were measured before PCI. Patients were divided into two groups according to median serum Klotho value: low-Klotho (n=37, ≤460 pg/mL) and high-Klotho group (n=38, >460 pg/mL). Results Compared with patients with low-Klotho, those with high-Klotho had higher estimated glomerular filtration rate (eGFR) (69±20 vs. 55±16 mL/min/1.73 m2, p<0.001), lower FGF23 levels (51±24 vs. 67±41 pg/mL, p=0.010). Patients with high-Klotho had significantly lower calcium index than those with low-Klotho (0.17±0.21 vs. 0.24±0.23, p=0.043). Serum Klotho levels correlated significantly and inversely with calcium index (r=−0.31, p=0.006). The correlation between Klotho and calcium index was pronounced at analysis in patients with eGFR <60 mL/min/1.73 m2 (r=−0.52, p<0.001). Logistic regression analysis showed that high-Klotho is a sole significant independent factor associated with low calcium index (odds ratio 7.17, p=0.004). Presence of high-Klotho had high sensitivity and negative predictive value for identifying low calcium index (83% and 92%, respectively). Conclusions Serum Klotho values were independently and inversely associated with the degree of CAC assessed by IVUS. These findings have important clinical implications for serum Klotho as a biomarker that reflects the extent of CAC.


Circulation ◽  
1987 ◽  
Vol 76 (1) ◽  
pp. 15-20 ◽  
Author(s):  
C Rainer ◽  
D T Kawanishi ◽  
P A Chandraratna ◽  
R M Bauersachs ◽  
C L Reid ◽  
...  

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tetsumin Lee ◽  
Tadashi Murai ◽  
Yoshihisa Kanaji ◽  
Eisuke Usui ◽  
Makoto Araki ◽  
...  

Backgrounds: The aim of the present study is to investigate the relationship between physiological coronary artery stenosis severity and lesion instability by Optical Coherence Tomography (OCT) in patients with stable angina pectoris (SAP). Methods and Results: We investigated 198 culprit lesions of 180 SAP patients who underwent OCT imaging and fractional flow reserve (FFR) measurement before PCI procedure. Physiological coronary stenosis severity was assessed by FFR analysis, and lesions were divided into two groups on the basis of FFR values; severe stenosis group (group S): FFR <0.75 (n=78, 39%), moderate stenosis group (group M): FFR ≥0.75 (n=120, 61%) according to the previous study. Thin-capped fibroatheroma (TCFA) was defined as lipid-rich plaque (lipid arc ≥90°) with fibrous cap thickness <70μm. The median FFR values in total lesions, group S, and group M were 0.77 (interquartile range [IQR]: 0.69—0.83), 0.65 (0.57—0.72), and 0.81 (0.78—0.87), respectively. There were no significant differences in patient characteristics expect for the frequency of previous myocardial infarction (S: 15%, M: 38%, P <0.01) and previous PCI (S: 29%, M: 60%, P <0.01). In angiographic analysis, there were significant differences in the frequency of culprit lesion location in LAD (S: 72%, M: 49%, P <0.01), minimum lumen diameter (S: 1.07±0.36 mm, M: 1.35±0.32 mm, P <0.01), % diameter stenosis (S: 58.9 % [53.1—70.8], M: 52.8 % [47.7—57.5], P <0.01), and lesion length (S: 13.7 mm [10.6—17.5], M: 11.5 mm [9.2—14.5], P = 0.02) between the two groups. In OCT analysis, there were significant differences in the lipid arc (S: 200° [160—232], M: 168° [143—211], P <0.01), CT (S: 110 μm [63—157], M: 140 μm [93—197], P <0.01), and frequency of TCFA (S: 27%, M: 9%, P <0.01) between the two groups. Subgroup analysis of LAD lesions showed similar results between the two groups. Conclusions: Lesions of physiologically severe coronary stenosis in SAP were associated with lesion instability assessed by OCT. These findings may challenge the concept that lesions responsible for acute coronary syndromes are mild in most cases provided that plaque rupture of TCFA evenly results in coronary events in the wide range of stenosis severity in patients with SAP.


1991 ◽  
Vol 17 (5) ◽  
pp. 1058-1062 ◽  
Author(s):  
Juan Carlos Kaski ◽  
Dimitris Tousoulis ◽  
Stavros Gavrielides ◽  
Eugene McFadden ◽  
Alfredo R. Galassi ◽  
...  

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