Factors affecting the extent and severity of coronary artery disease in patients enrolled in the coronary artery surgery study.

Vlietstra, Ronald E.; Kronmal, Richard A.; Frye, Robert L.; Seth, Ashok; Tristani, Felix E.; Killip, Thomas

doi:10.1161/01.atv.2.3.208

Cited by 95 publications

(38 citation statements)

References 2 publications

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“…Risk factors collected at the time of catheterization represent a single, static view of a constantly changing exposure of the coronary arteries to those factors and are poor predictors of CAD extent. 8 Duration of the exposure to risk factors is generally difficult to estimate. B-mode score may estimate the aggregate effect of a multitude of risk factors over time.…”

Section: Resultsmentioning

confidence: 99%

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Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Wofford

Kahl

Howard

et al. 1991

Arterioscler Thromb

281

142

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The extent of carotid artery atherosclerosis as measured by B-mode ultrasound has been shown to be strongly and independently correlated with the presence or absence of coronary atherosclerotic disease (CAD), but no studies to date have used carotid B-mode ultrasound to compare the extent of atherosclerotic disease in the two arterial circulations. We used data from a registry of patients undergoing cardiac catheterization and B-mode ultrasound of the carotid arteries to compare the extent of CAD (number of major coronary vessels with 50% or greater stenosis as judged by a consensus interpretation) with the extent of extracranial carotid atherosclerosis. Four hundred thirty-four patients (234 men, 200 women) greater than 40 years of age were stratified by gender and then divided into quartiles on the basis of a B-mode score that was derived by summing arterial wall thickness at nine sites in the left and nine sites in the right carotid arteries. Evaluation of extent of CAD for the four B-mode quartiles showed that men in the lowest B-mode quartile were over six times more likely to have normal coronary arteries than three-to four-vessel CAD, while men in the highest B-mode quartile were over 10 times more likely to have three-to four-vessel CAD than normal coronary arteries. The findings were similar for women but not as dramatic Gender-specific discriminant function models using traditional risk factors alone or in combination with B-mode score were developed to predict the extent of CAD. Discriminant models containing traditional risk factors alone performed only slightly better than a model that contained only the B-mode score. The addition of the B-mode score to models of traditional risk factors added little to the predictive ability for CAD extent (/Irteriosclerosis and Thrombosis 1991;11:1786-1794) E pidemiological studies have established certain factors (age, male gender, hypertension, dyslipidemia, diabetes, and smoking) as predictors of clinical manifestations of coronary artery disease (CAD).1 -3 These same risk factors have also

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Section: Resultsmentioning

confidence: 99%

“…13 No studies to date, however, have compared B-mode findings of the carotid arteries with the extent of CAD. Since the prognosis associated with CAD is known to be directly related to disease extent CAD may differ from those related to extent of CAD, 8 we evaluated B-mode ultrasound for its ability to predict the extent of CAD.…”

mentioning

confidence: 99%

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Wofford

Kahl

Howard

et al. 1991

Arterioscler Thromb

281

142

View full text Add to dashboard Cite

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“…Coronary risk factors do not allow for discrimination of severity of angiographic CAD 17 or adverse outcomes in individuals but are useful prognostic indicators in large patient populations. Detection of CAC by EBT has been demonstrated to be highly sensitive for the presence of significant CAD.…”

Section: Discussionmentioning

confidence: 99%

Continuous Probabilistic Prediction of Angiographically Significant Coronary Artery Disease Using Electron Beam Tomography

et al. 2002

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Background-We sought to incorporate electron beam tomography-derived calcium scores in a model for prediction of angiographically significant coronary artery disease (CAD). Such a model could greatly facilitate clinical triage in symptomatic patients with no known CAD. Methods and Results-We examined 1851 patients with suspected CAD who underwent coronary angiography for clinicalindications. An electron beam tomographic scan was performed in all patients. Total per-patient calcium scores and separate scores for the major coronary arteries were added to logistic regression models to calculate a posterior probability of the severity and extent of angiographic disease. These models were designed to be continuous, adjusted for age and sex, corrected for verification bias, and independently validated in terms of their incremental diagnostic accuracy. The overall sensitivity was 95%, and specificity was 66% for coronary calcium to predict obstructive disease on angiography. With calcium scores Ͼ20, Ͼ80, and Ͼ100, the sensitivity to predict stenosis decreased to 90%, 79%, and 76%, whereas the specificity increased to 58%, 72%, and 75%, respectively. The logistic regression model exhibited excellent discrimination (receiver operating characteristic curve area, 0.842Ϯ0.023) and calibration ( 2 goodness of fit, 8.95; Pϭ0.442). Conclusions-Electron beam tomographic calcium scanning provides incremental and independent power in predicting the severity and extent of angiographically significant CAD in symptomatic patients, in conjunction with pretest probability of disease. This algorithm is most useful when applied to an intermediate-risk population.

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“…The atherosclerotic coronary artery disease prevalence levels of the patients were calculated using CASS 20 scoring system. 4 The patients were divided into 3 groups, being those with CASS scores equal to 0 (patients detected to have normal coronary arteries), those with CASS scores equal to 1 to 3 (patients with low atherosclerosis prevalence), and those with CASS scores over 3 (patients with high atherosclerosis prevalence). The effects of the parameters to be studied on the formation of atherosclerosis and prevalence of coronary artery disease were evaluated on the basis of the serum samples collected.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Serum IL-12 and TGF-β1 Levels on the Prevalence of Atherosclerosis

Bolayır

2016

Cumhuriyet Med J

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SUMMARYObjective: It was observed that inflammation plays an important role in the progress of atherosclerotic vascular disease. This study is intended to indicate that, in oxidative and inflammatory medium, the course of the atherosclerotic process can be determined by the imbalance between Interleukin-12 (IL-12) and Transforming Growth Factor-beta1 (TGF-β1) with a view to evaluate the effects of proinflammatory and anti-inflammatory cytokines on the course of the atherosclerotic coronary artery disease. Method: 80 patients, who applied to cardiology outpatient clinic for typical chest pain, to whom coronary angiography was applied upon the detection of ischemia as a result of the effort test or myocardial perfusion scintigraphy conducted, and each of whom is exposed to at least one traditional risk factor for atherosclerotic coronary artery disease, were included to the study. Findings: The patients were split into three groups as those, in whom atherosclerosis was not detected, those, for whom atherosclerosis prevalence is low, and those, for whom atherosclerosis level is high, according to the CASS 20 scores. It was observed that, as the atherosclerosis prevalence increased; average serum IL-12 levels (3,33±0,15 / 9,70±0,22 / 23,60±0,46 pg/ml) increased while average serum TGF-β1 levels, (32,1±0,59 / 18±0,28 / 6,74±0,42 ng/ml), decreased. Conclusion: It was indicated that, in oxidative and inflammatory medium, the course of the atherosclerotic coronary artery disease was determined by the dominant cytokine on the intima of the related vascular segment. Keywords: IL-12, TGF-β1, atherosclerosis ÖZET Amaç: Ateroskelrotik vasküler hastalığın ilerleyişinde inflamasyonun önemli bir rol oynadığı izlenmiştir. Bu çalışma, oksidatif ve inflamatuar ortamda aterosklerotik coroner hastalığı gidişatında proinflamatuar ve antiinflamatuar sitokinlerin etkilerini değerlendirme noktasında interlökin 12 (IL-12) ve transforming growth faktör beta 1 (TGF-β1) arasındaki dengesizliğin belirlenebilmesini işaret etmeyi amaçlamaktadır.Yöntem: Tipik göğüs ağrısıyla kardiyoloji polikliniğine başvuran 80 hastaya, efor testi ya da myocardial perfüzyon sintigrafisinin sonucu iskemi tespitine dayanarak coroner anjiografi uygulandı. Aterosklerotik coroner arter hastalığı için geleneksel olarak en az bir risk faktörüne sahip hastalar çalışmaya dahil edildi.Bulgular: Hastalar CASS 20 skorlarına göre aterosklerozu olmayan, düşük ve yüksek olmak üzere üç gruba ayrıldı. Ortalama serum IL-12 düzeyi arttıkça (3,33±0,15 / 9,70±0,22 / 23,60±0,46 pg/ml) aterosklerozun arttığı, TGF-β1'in (32,1±0,59 / 18±0,28 / 6,74±0,42 ng/ml) ise azaldığı gözlendi. 196 CMJ Cumhuriyet Medical JournalSonuç: Oksidatif ve inflamatuar ortamda aterosklerotik koroner arter hastalığının gidişatının, ilişkili vasküler segmentin intimasındaki dominant sitokin tarafından tayin edildiği belirlenmiştir.

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Factors affecting the extent and severity of coronary artery disease in patients enrolled in the coronary artery surgery study.

Cited by 95 publications

References 2 publications

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis.

Continuous Probabilistic Prediction of Angiographically Significant Coronary Artery Disease Using Electron Beam Tomography

The Effect of Serum IL-12 and TGF-β1 Levels on the Prevalence of Atherosclerosis

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