Achilles tendon thickness is associated with coronary lesion severity in acute coronary syndrome patients without familial hypercholesterolemia

Fujiwara, Ryosuke; Yahiro, Ryosuke; Horio, Takeshi; Miyauchi, Masafumi; Yoshimura, Ryuichi; Matsuoka, Yuichiro; Yokouchi, Go; Sakamoto, Yuya; Matsumoto, Naoki; Fukuda, Kohei; Izumiya, Yasuhiro; Yoshiyama, Minoru; Fujimoto, Kohei; Kasayuki, Noriaki

doi:10.1016/j.jjcc.2021.09.021

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…[20][21][22][23][24] Data initially obtained from a population of patients with FH, concerning the ability of ATT to be used to make a representative measurement of the severity of coronary atherosclerosis, has been replicated in the past few years in populations of patients without FH and other vascular beds. [3][4][5] The main findings of the study being presented here are as follows: 1) patients with asymptomatic PAD possessed statistically significant higher values of ATT (p = .049), ATT/BSA (p = .002), ATW/BSA (p < .01), AT CSA/BSA (p = .003) in comparison with the control group and 2) according to the results of ROC-analysis, the diagnostic performance of AT sizes, after their normalization to BSA, increased significantly (in AUC and the Youden index). The ATT/BSA (Du Bois) had the highest diagnostic value; an increase of >0.29 cm/m 2 allowed for the prediction of the presence of asymptomatic PAD with a sensitivity of 61.1% and a specificity of 77.9%.…”

Section: Discussionmentioning

confidence: 99%

“…10,12,13 For the first time, using the data in our study has clearly demonstrated that ATT, ATW and AT CSA normalized to BSA either possess greater diagnostic value (for ATT) or acquire such a value (for ATW and AT CSA) compared to This fact also strongly suggests that the diagnostic value of ATT can be considered outside the context of FH and the appearance of tendon xanthomas. 4 There are several potential applications of ATT/BSA measurement in clinical practice. First, it can be used as part of the screening of patients with severe hypercholesterolaemia.…”

Section: Discussionmentioning

confidence: 99%

“…This fact also strongly suggests that the diagnostic value of ATT can be considered outside the context of FH and the appearance of tendon xanthomas. 4…”

Section: Discussionmentioning

confidence: 99%

“…3 However, a growing body of evidence suggests that ATT has diagnostic and prognostic value not only in patients with FH and tendon xanthomas but also in the general population. Fujiwara et al 4 found that regardless of potential confounding factors among patients with acute coronary syndrome without FH, mean and maximal ATT are significantly associated with SYNTAX score. We have previously demonstrated that ATT directly correlates with the degree of carotid artery stenosis and the burden of carotid atherosclerosis, and also allows for the prediction of the presence of carotid plaque with a sensitivity of 68.3% and a specificity of 62.5%.…”

Section: Introductionmentioning

confidence: 99%

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Achilles tendon thickness normalized to body surface area as a marker of asymptomatic peripheral arterial disease

et al. 2022

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Objectives The normalisation of Achilles tendon thickness (ATT) to anthropometric parameters may increase the diagnostic efficiency of the assessment of ATT. The aim of this study was to compare the diagnostic value of AT dimensions depending on their normalization to body surface area (BSA) in patients with asymptomatic peripheral arterial disease (PAD). Methods All patients underwent duplex scanning of the carotid arteries and the lower limb arteries. Asymptomatic PAD was defined as the presence of ≥50% stenosis in the carotid and/or lower limb arteries. ATT was measured using a longitudinal scan, width (ATW) and cross-sectional area (AT CSA), which was determined during a cross-sectional scan. Results The study included 369 patients, among whom asymptomatic PAD was detected in 18 (4.88%) patients. Only the ATT demonstrated diagnostic value for asymptomatic PAD. After normalizing the size of the AT to the BSA, the diagnostic performance of ATT, ATW and AT CSA became statistically significant. Among the studied parameters, only an increase in ATT/BSA >0.29 cm/m2 was associated with a significant increase in the odds ratio (OR) of asymptomatic PAD by 4.11 times (95% CI 1.08–15.7; p = .038) after adjustments. Conclusion An increase in ATT/BSA >0.29 cm/m2 predicted the presence of asymptomatic PAD with a sensitivity of 61.1% and a specificity of 77.9%. ATT/BSA values of less than 0.29 cm/m2 made it possible to exclude asymptomatic PAD with a probability of 97.5%. An increase in ATT/BSA >0.29 cm/m2 was associated with a 4.11-fold increase in the OR of asymptomatic PAD (95% CI 1.08–15.7).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…This fact also strongly suggests that the diagnostic value of ATT can be considered outside the context of FH and the appearance of tendon xanthomas. 4…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Achilles tendon thickness normalized to body surface area as a marker of asymptomatic peripheral arterial disease

et al. 2022

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“…In fact, it has been shown that Achilles tendon thickening is associated with CAD as well as the severity of the lesion. 30, 31 Accordingly, Achilles tendon thickening can be regarded as a surrogate marker of atherosclerosis in patients with FH. Ogura et al also demonstrated an inverse relationship between CEC and the presence of cardiovascular disease, as well as Achilles tendon thickening and carotid intima-media thickness in heterozygous FH.…”

Section: Advance Publicationmentioning

confidence: 99%

Impact of High-Density Lipoprotein Function, Rather Than High-Density Lipoprotein Cholesterol Level, on Cardiovascular Disease Among Patients With Familial Hypercholesterolemia

Tada

Okada

Nohara

et al. 2023

Circ J

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tors, their residual risks for CAD remain very high. 5- 7 We and others have clarified that other classical coronary risk factors, including hypertension, diabetes, and smoking, appear to be the residual risk factors for CAD in patients with FH. 8-11 In contrast, recent studies have shown that cholesterol efflux capacity (CEC), which reflects the initial step of the reverse cholesterol transport mediated by highdensity lipoprotein (HDL), is associated with probability of CAD independently of HDL cholesterol (HDL-C) levels. 12 However, there are few data regarding this issue F amilial hypercholesterolemia (FH) is among the most common causes of coronary artery disease (CAD) worldwide, with an estimated frequency of 1 in 300 among the general population, and 1 in 31 among patients with CAD. 1,2 Patients with FH have an extremely elevated risk for CAD due to a very high level of lowdensity lipoprotein cholesterol (LDL-C). 3,4 Although there are many approaches to reduce LDL-C levels in patients with FH, including the use of statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibi-

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Prognostic impact of Achilles tendon thickness in elderly patients after percutaneous coronary intervention: A 5-year follow-up

Isawa¹,

Horie²,

Toyoda³

et al. 2023

Journal of Cardiology

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Achilles tendon thickness is associated with coronary lesion severity in acute coronary syndrome patients without familial hypercholesterolemia

Cited by 7 publications

References 18 publications

Achilles tendon thickness normalized to body surface area as a marker of asymptomatic peripheral arterial disease

Achilles tendon thickness normalized to body surface area as a marker of asymptomatic peripheral arterial disease

Impact of High-Density Lipoprotein Function, Rather Than High-Density Lipoprotein Cholesterol Level, on Cardiovascular Disease Among Patients With Familial Hypercholesterolemia

Prognostic impact of Achilles tendon thickness in elderly patients after percutaneous coronary intervention: A 5-year follow-up

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