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Journal articles on the topic 'Lschaemia with no obstructive coronary artery disease'

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Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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1

Kereiakes, Dean J. "Chronic Obstructive Coronary Artery Disease." Reviews in Cardiovascular Medicine 10, S2 (February 20, 2009): 1–2. http://dx.doi.org/10.3909/ricm10s20001.

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2

Sechtem, Udo, David Brown, Shigeo Godo, Gaetano Antonio Lanza, Hiro Shimokawa, and Novalia Sidik. "Coronary microvascular dysfunction in stable ischaemic heart disease (non-obstructive coronary artery disease and obstructive coronary artery disease)." Cardiovascular Research 116, no. 4 (February 8, 2020): 771–86. http://dx.doi.org/10.1093/cvr/cvaa005.

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Abstract Diffuse and focal epicardial coronary disease and coronary microvascular abnormalities may exist side-by-side. Identifying the contributions of each of these three players in the coronary circulation is a difficult task. Yet identifying coronary microvascular dysfunction (CMD) as an additional player in patients with coronary artery disease (CAD) may provide explanations of why symptoms may persist frequently following and why global coronary flow reserve may be more prognostically important than fractional flow reserve measured in a single vessel before percutaneous coronary intervention. This review focuses on the challenges of identifying the presence of CMD in the context of diffuse non-obstructive CAD and obstructive CAD. Furthermore, it is going to discuss the pathophysiology in this complex situation, examine the clinical context in which the interaction of the three components of disease takes place and finally look at non-invasive diagnostic methods relevant for addressing this question.
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3

Dharampal, A. S., and P. J. de Feyter. "Coronary artery calcification: does it predict obstructive coronary artery disease?" Netherlands Heart Journal 21, no. 7-8 (July 2013): 344–46. http://dx.doi.org/10.1007/s12471-013-0436-5.

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4

Verghese, D., V. Manabolu, L. Alalawi, J. Aldana-Bitar, A. Kinninger, and M. Budoff. "505 Coronary Calcium And Obstructive Coronary Artery Disease." Journal of Cardiovascular Computed Tomography 16, no. 4 (July 2022): S49. http://dx.doi.org/10.1016/j.jcct.2022.06.116.

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5

Mandal, Swapna, and Brian D. Kent. "Obstructive sleep apnoea and coronary artery disease." Journal of Thoracic Disease 10, S34 (December 2018): S4212—S4220. http://dx.doi.org/10.21037/jtd.2018.12.75.

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6

Reynolds, Harmony R. "Myocardial infarction without obstructive coronary artery disease." Current Opinion in Cardiology 27, no. 6 (November 2012): 655–60. http://dx.doi.org/10.1097/hco.0b013e3283583247.

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7

Jyotsna, Maddury, Madhavapeddy Aditya, and Nemani Lalitha. "Obstructive Coronary Artery Disease in Young Females." Indian Journal of Cardiovascular Disease in Women WINCARS 01, no. 01 (March 2016): 004–7. http://dx.doi.org/10.1055/s-0038-1656468.

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AbstractBACKGROUND: To define myocardial infarction in “young”, many studies taken < 40 to 45 yrs. of age as cut off point. We have data in young males with obstructive coronary artery disease, but limited data in young females.OBJECTIVES: To see the disease pattern, risk factors, presentation, ventricular function and PCI efficiency of young females in comparison with young males with obstructive coronary artery disease who require PCI.MATERIAL AND METHODS We retrospectively analyzed the data of young patients (< 45 yrs. of age) who undergone PCI over past two years. We noted the clinical, investigative and treatment modalities of these patients.RESULTS: 200 young patients had undergone PCI for obstructive CAD with 42 females over two year period. Females had more frequently hypertension (69.1% vs. 43.7%) and Type 2 Diabetes (33.3% vs22.8%) which are statistically significant. Smoking was frequent in young males than young females. Males were presented as acute MI, whereas females with rest chest pain. Multi-vessel involvements, LV dysfunction, success of PCI and complication rates were similar in both groups. Females are more anemic (< 11 g/dl in females and < 13g/dl in males). Complexity of lesion (B2 or C type of lesions) is more in females which is statistically significant.CONCLUSION: Young females had more frequently hypertension, Diabetes, acute coronary syndrome without MI, mild anemia, complex lesions than young males, but with same success and complication rate of PCI.
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8

Lüthje, Lars, and Stefan Andreas. "Obstructive sleep apnea and coronary artery disease." Sleep Medicine Reviews 12, no. 1 (February 2008): 19–31. http://dx.doi.org/10.1016/j.smrv.2007.08.002.

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9

Hedner, Jan, Karl A. Franklin, and Yüksel Peker. "Obstructive Sleep Apnea and Coronary Artery Disease." Sleep Medicine Clinics 2, no. 4 (December 2007): 559–64. http://dx.doi.org/10.1016/j.jsmc.2007.07.008.

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10

Jyotsna, Maddury, and Madhavapeddy Aditya. "Obstructive Coronary Artery Disease in Young Females." American Journal of Cardiology 111, no. 7 (April 2013): 81B. http://dx.doi.org/10.1016/j.amjcard.2013.01.205.

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11

Roversi, Sara, Pietro Roversi, Giuseppe Spadafora, Rosario Rossi, and Leonardo M. Fabbri. "Coronary artery disease concomitant with chronic obstructive pulmonary disease." European Journal of Clinical Investigation 44, no. 1 (October 26, 2013): 93–102. http://dx.doi.org/10.1111/eci.12181.

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12

Pregenzer-Wenzler, Arianna, Kathleen Allen, and Stacy Clegg. "SEVERE MULTIVESSEL CORONARY VASOSPASM MASQUERADING AS OBSTRUCTIVE CORONARY ARTERY DISEASE." Journal of the American College of Cardiology 77, no. 18 (May 2021): 2573. http://dx.doi.org/10.1016/s0735-1097(21)03928-0.

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13

Sandhu, Amneet, and Thomas M. Maddox. "Is non-obstructive coronary artery disease clinically important?" Future Cardiology 10, no. 6 (November 2014): 673–75. http://dx.doi.org/10.2217/fca.14.69.

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14

Safonova, E. A., and I. A. Sukmanova. "Myocardial infarction without obstructive coronary artery disease (MINORCA)." Clinical Medicine (Russian Journal) 98, no. 2 (July 15, 2020): 89–97. http://dx.doi.org/10.30629/0023-2149-2020-98-2-89-97.

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«MINOCA» (myocardial infarction with nonobstructive coronary arteries) is a new term in cardiology, which combines a different group of pathological conditions, as a result of which myocardial infarction develops with non-obstructive coronary arteries. The article reveals the etiology and pathogenesis of MINOCA, which is divided into coronarogenic: non-obstructive atherosclerosis, coronary spasm, microvascular dysfunction, coronary artery dissection, muscle bridge and not coranorogenic: myocarditis, cardiomyopathy, thrombophilia, pulmonary embolism. The issues of diagnosis and differential diagnosis attract attention, which determines the further choice of management and treatment tactics. Currently, there are no recommendations for the management and treatment of patients with a diagnosis of MINOCA; accordingly, prevention methods have not been developed. The term «MINOCA» poses a number of questions for us, many of which remain open for further discussion and resolution.
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15

Khera, Amit, Kamakki Banks, and Monica Lo. "Angina in Women without Obstructive Coronary Artery Disease." Current Cardiology Reviews 999, no. 999 (December 11, 2009): 1–8. http://dx.doi.org/10.2174/1573210ccr06018403x.

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16

Lindahl, Bertil, Tomasz Baron, Mario Albertucci, and Francesco Prati. "Myocardial infarction with non-obstructive coronary artery disease." EuroIntervention 17, no. 11 (December 2021): e875-e887. http://dx.doi.org/10.4244/eij-d-21-00426.

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17

Bairey Merz, C. Noel, Carl J. Pepine, Mary Norine Walsh, Jerome L. Fleg, Paolo G. Camici, William M. Chilian, Janine Austin Clayton, et al. "Ischemia and No Obstructive Coronary Artery Disease (INOCA)." Circulation 135, no. 11 (March 14, 2017): 1075–92. http://dx.doi.org/10.1161/circulationaha.116.024534.

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18

Waheed, Nida, Suzette Elias-Smale, Waddah Malas, Angela H. Maas, Tara L. Sedlak, Jennifer Tremmel, and Puja K. Mehta. "Sex differences in non-obstructive coronary artery disease." Cardiovascular Research 116, no. 4 (January 20, 2020): 829–40. http://dx.doi.org/10.1093/cvr/cvaa001.

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Abstract Ischaemic heart disease is a leading cause of morbidity and mortality in both women and men. Compared with men, symptomatic women who are suspected of having myocardial ischaemia are more likely to have no obstructive coronary artery disease (CAD) on coronary angiography. Coronary vasomotor disorders and coronary microvascular dysfunction (CMD) have been increasingly recognized as important contributors to angina and adverse outcomes in patients with no obstructive CAD. CMD from functional and structural abnormalities in the microvasculature is associated with adverse cardiac events and mortality in both sexes. Women may be particularly susceptible to vasomotor disorders and CMD due to unique factors such as inflammation, mental stress, autonomic, and neuroendocrine dysfunction, which predispose to endothelial dysfunction and CMD. CMD can be detected with coronary reactivity testing and non-invasive imaging modalities; however, it remains underdiagnosed. This review focuses on sex differences in presentation, pathophysiologic risk factors, diagnostic testing, and prognosis of CMD.
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19

Zhang, F. E., B. Mao, M. Y. Zhou, and J. Q. Zhang. "Left ventricular rupture without obstructive coronary artery disease." European Journal of Cardio-Thoracic Surgery 44, no. 6 (May 16, 2013): 1148–49. http://dx.doi.org/10.1093/ejcts/ezt260.

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20

Banks, Kamakki, Monica Lo, and Amit Khera. "Angina in Women without Obstructive Coronary Artery Disease." Current Cardiology Reviews 6, no. 1 (February 1, 2010): 71–81. http://dx.doi.org/10.2174/157340310790231608.

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21

Mahajan, Kunal, Prakash Chand Negi, and Monika Thakur. "Predictors of obstructive coronary artery disease in women." Indian Heart Journal 70, no. 1 (January 2018): 194–95. http://dx.doi.org/10.1016/j.ihj.2017.11.002.

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22

Lee, Sang Hoon, Yong Kook Hong, Sung Il Park, Hyang Mee Lee, and Kyu Ok Choe. "Correlation Between Obstructive Coronary Artery Disease and Electron Beam Tomography Coronary Artery CalciumScan." Journal of the Korean Radiological Society 39, no. 2 (1998): 293. http://dx.doi.org/10.3348/jkrs.1998.39.2.293.

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23

Lerner, J., S. Lakshmanan, V. Rezvanizadeh, A. Kinninger, I. Rudenko, J. Wu, M. Budoff, and S. Roy. "Coronary Artery Calcium Better Predicts Obstructive Coronary Artery Disease Than Nuclear Stress Testing." Journal of Cardiovascular Computed Tomography 14, no. 3 (July 2020): S17. http://dx.doi.org/10.1016/j.jcct.2020.06.008.

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24

Pakhtusov, N. N., A. O. Yusupova, K. A. Zhbanov, A. A. Shchedrygina, E. V. Privalova, and Yu N. Belenkov. "Evaluation of Fibrosis Markers as a Potential Method for Diagnosing Non-Obstructive Coronary Artery Disease in Patients with Stable Coronary Artery Disease." Rational Pharmacotherapy in Cardiology 18, no. 6 (January 6, 2023): 630–37. http://dx.doi.org/10.20996/1819-6446-2022-11-01.

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Aim. To study the levels of fibrosis markers in patients with stable coronary artery disease (CAD) and various types of coronary artery (CA) lesions (obstructive and non-obstructive), to identify possible differences for diagnosing the types of coronary obstruction.Material and methods. The observational study included three groups of patients: with non-obstructive (main group, coronary artery stenosis <50%; n=20) and obstructive (comparison group, hemodynamically significant coronary artery stenosis according to the results of coronary angiography; n=20) CAD and healthy volunteers (control group; n=40). Transforming growth factor beta 1 (TGF-β1) and matrix metalloproteinase 9 (MMP-9) levels were measured in plasma by enzyme immunoassay. According to the results of echocardiography, all patients included in the study were divided into four groups depending on the type of myocardial remodeling.Results. TGF-β1 levels were significantly higher in patients with obstructive CAD (p=0.008) than in patients with non-obstructive CAD and healthy volunteers (p <0.001). There were no significant differences between the main and control groups (p>0.05). There were no statistically significant differences in TGF-β1 levels depending on the type of left ventricular remodeling (p=0.139). The maximum level of MMP-9 was in the group with obstructive coronary disease and significantly differed from the main group (p <0.001) and the control group (p=0.04).Conclusio. The maximum levels of TGF-β1 and MMP-9 were found in the group with obstructive coronary artery disease. The levels of these biomarkers in the main group were statistically different from the values obtained in the control group. Thus, considering the pathogenesis of the development of non-obstructive CAD, the use of fibrosis markers TGF-β1 and MMP-9 may be promising for diagnosing the severity of CA obstruction.
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25

Ahmad, Munir, Muhammad Yasir, Muhammad Hamid Saeed, Muhammad Saeed Ali Khan, Qasim Rauf, and Naeem Hameed. "Frequency of obstructive coronary artery disease in patients undergoing valvular heart disease surgery." Professional Medical Journal 27, no. 06 (June 10, 2020): 1297–303. http://dx.doi.org/10.29309/tpmj/2020.27.06.4675.

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Objectives: To determine the frequency of obstructive coronary artery disease in patients undergoing valvular heart disease surgery. Study Design: Cross-sectional study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: Six months, from 02 February, 2017 to 01 August, 2017. Material & Methods: After taking approval from hospital ethical committee, patients coming through outpatient department who fulfilled the inclusion criteria were enrolled and informed consent was taken from them. History of smoking, diabetes mellitus, renal dysfunction, dyslipidemia, hypertension and family history of coronary artery disease was assessed. Coronary angiography was performed by senior consultant interventional cardiologist for assessing obstructive coronary artery disease as per operational definition. All the information was collected on prespecified Performa. Results: In this study, out of 140 cases of valvular heart disease (VHD), 47.14%(n=66) were between 30-50 years of age whereas 52.86%(n=74) were between 51-70 years of age, mean ±sd was calculated as 51.71+9.09 years, 57.14%(n=80) were male while 42.86%(n=60) were female, frequency of obstructive coronary artery disease in patients undergoing valvular heart surgery was recorded as 29.3% (n=41) whereas 70.7% (n=99) had no such finding. Conclusion: The frequency of obstructive coronary artery disease was (29.3%) in patients undergoing valvular heart disease surgery. However, coronary artery disease was less frequent in rheumatic as compared to degenerative heart valve disease.
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26

Siddharth, Sonkamble, Sangeeta Pednekar, R. H. Girde, Shilpa Patil, and S. T. Nabar. "Association between Chronic Obstructive Pulmonary Disease and Coronary Artery Disease." IOSR Journal of Dental and Medical Sciences 13, no. 5 (2014): 04–07. http://dx.doi.org/10.9790/0853-13560407.

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27

Al'Aref, Subhi, Alexander van Rosendael, Gabriel Maliakal, Gurpreet Singh, Xiaoyue Ma, Mohit Pandey, Jing Wang, et al. "TCT-55 Clinical Predictors of Obstructive Coronary Artery Disease in Individuals with Suspected Coronary Artery Disease." Journal of the American College of Cardiology 72, no. 13 (September 2018): B24—B25. http://dx.doi.org/10.1016/j.jacc.2018.08.1142.

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28

Carpio, Carlos, Rodolfo Álvarez-Sala, and Francisco García-Río. "Epidemiological and Pathogenic Relationship between Sleep Apnea and Ischemic Heart Disease." Pulmonary Medicine 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/405827.

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Obstructive sleep apnea is recognized as having high prevalence and causing remarkable cardiovascular risk. Coronary artery disease has been associated with obstructive sleep apnea in many reports. The pathophysiology of coronary artery disease in obstructive sleep apnea patients probably includes the activation of multiple mechanisms, as the sympathetic activity, endothelial dysfunction, atherosclerosis, and systemic hypertension. Moreover, chronic intermittent hypoxia and oxidative stress have an important role in the pathogenesis of coronary disease and are also fundamental to the development of atherosclerosis and other comorbidities present in coronary artery diseases such as lipid metabolic disorders. Interestingly, the prognosis of patients with coronary artery disease has been associated with obstructive sleep apnea and the severity of sleep disordered breathing may have a direct relationship with the morbidity and mortality of patients with coronary diseases. Nevertheless, treatment with CPAP may have important effects, and recent reports have described the benefits of obstructive sleep apnea treatment on the recurrence of acute heart ischaemic events in patients with coronary artery disease.
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29

Mutlu, Bulent, and Batur Gönenç Kanar. "Angina due to obstructive coronary artery disease in association with peripheral artery disease." European Heart Journal Supplements 21, Supplement_G (November 1, 2019): G35—G36. http://dx.doi.org/10.1093/eurheartj/suz210.

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30

Schamroth Pravda, Nili, Orith Karny-Rahkovich, Arthur Shiyovich, Miri Schamroth Pravda, Naomi Rapeport, Hana Vaknin-Assa, Alon Eisen, Ran Kornowski, and Avital Porter. "Coronary Artery Disease in Women: A Comprehensive Appraisal." Journal of Clinical Medicine 10, no. 20 (October 12, 2021): 4664. http://dx.doi.org/10.3390/jcm10204664.

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Coronary artery disease (CAD) is a significant cause of illness and death amongst women. The pathophysiology, manifestations, and outcomes of CVD and CAD differ between sexes. These sex differences remain under-recognized. The aim of this review is to highlight and raise awareness of the burden and unique aspects of CAD in women. It details the unique pathophysiology of CAD in women, cardiovascular risk factors in women (both traditional and sex-specific), the clinical presentation of CAD in women, and the range of disease in obstructive and non-obstructive CAD in women.
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31

Maurovich-Horvat, Pál, Brian Ghoshhajra, and Maros Ferencik. "Coronary CT Angiography for the Detection of Obstructive Coronary Artery Disease." Current Cardiovascular Imaging Reports 3, no. 6 (September 22, 2010): 355–65. http://dx.doi.org/10.1007/s12410-010-9045-5.

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32

Peerwani, Ghazal, Saba Aijaz, Sana Sheikh, and Asad Pathan. "PREDICTORS OF NON OBSTRUCTIVE CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING ELECTIVE CORONARY ANGIOGRAPHY FOR DIAGNOSIS OF CORONARY ARTERY DISEASE." Journal of the American College of Cardiology 77, no. 18 (May 2021): 3381. http://dx.doi.org/10.1016/s0735-1097(21)04735-5.

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33

Nakao, Yoko M., Yoshihiro Miyamoto, Masahiro Higashi, Teruo Noguchi, Mitsuru Ohishi, Isao Kubota, Hiroyuki Tsutsui, et al. "Sex differences in impact of coronary artery calcification to predict coronary artery disease." Heart 104, no. 13 (January 13, 2018): 1118–24. http://dx.doi.org/10.1136/heartjnl-2017-312151.

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ObjectiveTo assess sex-specific differences regarding use of conventional risks and coronary artery calcification (CAC) to detect coronary artery disease (CAD) using coronary CT angiography (CCTA).MethodsThe Nationwide Gender-specific Atherosclerosis Determinants Estimation and Ischemic Cardiovascular Disease Prospective Cohort study is a prospective, multicentre, nationwide cohort study. Candidates with suspected CAD aged 50–74 years enrolled from 2008 to 2012. The outcome was obstructive CAD defined as any stenosis ≥50% by CCTA. We constructed logistic regression models for obstructive CAD adjusted for conventional risks (clinical model) and CAC score. Improvement in discrimination beyond risks was assessed by C-statistic; net reclassification index (NRI) for CAD probability of low (<30%), intermediate (30%–60%) and high (≥60%); and risk stratification capacity.ResultsAmong 991 patients (456 women, 535 men; 65.2 vs 64.4 years old), women had lower CAC scores (median, 4 vs 60) and lower CAD prevalence (21.7% vs 37.0%) than men. CAC significantly improved model discrimination compared with clinical model in both sexes (0.66–0.79 in women vs 0.61–0.83 in men). The NRI for women was 0.33, which was much lower than that for men (0.71). Adding CAC to clinical model had a larger benefit in terms of moving an additional 43.3% of men to the most determinant categories (high or low risk) compared with −1.4% of women.ConclusionsThe addition of CAC to a prediction model based on conventional variables significantly improved the classification of risk in suspected patients with CAD, with sex differences influencing the predictive ability.Trial registration numberUMIN-CTR Clinical Trial: UMIN000001577.
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34

Kozlov, S. G., O. V. Chernova, V. N. Shitov, T. N. Veselova, M. A. Saidova, and S. K. Ternovoy. "Stress echocardiography vs coronary oomputed tomography angiography for the detection of obstructive coronary artery disease in patients aged >70 years with suspected stable coronary artery disease." Cardiovascular Therapy and Prevention 19, no. 5 (November 14, 2020): 2374. http://dx.doi.org/10.15829/1728-8800-2020-2374.

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Aim. To compare stress echocardiography and coronary computed tomography angiography (CCTA) in the diagnosis of stable coronary artery disease (CAD) in patients aged >70 years.Materials and methods. The study included 390 patients aged >70 years with suspected stable CAD, which underwent elective coronary artery angiography (CAG). Initially, patients for whom stress echocardiography and CCTA is appropriate was determined. After that diagnostic accuracy of both methods in the detection of obstructive CAD was evaluated in patients with atypical angina and non-anginal chest pain.Results. Among 111 patients with atypical angina and non-anginal pain which underwent stress echocardiography and had unequivocal results, 69 (62 %) patients had obstructive CAD. Stress echocardiography has sensitivity of 89%, specificity of 95%, positive likelihood ratio (LR+) of 17,8, and negative likelihood ratio (LR-) of 0,1. Positive result increased probability of obstructive CAD from 62% to 95%, while negative result reduced probability to 16%. Among 82 patients with atypical angina and non-anginal pain which underwent CCTA, 48 (59 %) patients had obstructive CAD. CCTA has sensitivity of 100 %, specificity of 88%, LR+ of 8,3, and LR- of 0,3. Positive result increased post-test probability of obstructive CAD from 59% to 86%, while negative result reduced post-test probability to 0%.Conclusion. Stress echocardiography and CCTA has comparable diagnostic accuracy in the detection of obstructive CAD in patients aged >70 years with atypical angina and non-anginal pain. Stress echocardiography has a greater diagnostic value of positive result; CCTA has a greater diagnostic value of negative result.
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35

Deb, Tripti, Jyotsna Maddury, and Prasant Kr Sahoo. "Coronary Artery Perforation." Indian Journal of Cardiovascular Disease in Women WINCARS 04, no. 02 (May 2019): 110–20. http://dx.doi.org/10.1055/s-0039-1697079.

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AbstractPercutaneous coronary intervention (PCI) is considered as the standard treatment of obstructive coronary artery disease in indicated patients. Even though PCI gives symptomatic angina improvement, but associated with serious complications like coronary artery perforation (CAP), the incidence is quite low. With the more complex lesions for successful angioplasty, different devices are required, which in turn increase the incidence of CAP in these patients. Here we review the classification, incidence, pathogenesis, clinical sequela, risk factors, predictors, and management of CAP in the current era due to PCI.
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36

Anthonisen, Nick R. "Chronic Obstructive Pulmonary Disease and Coronary Artery Bypass Grafting." Canadian Respiratory Journal 14, no. 1 (2007): 13–14. http://dx.doi.org/10.1155/2007/646153.

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37

Williams, Michael J. A., Peter R. Barr, Mildred Lee, Katrina K. Poppe, and Andrew J. Kerr. "Outcome after myocardial infarction without obstructive coronary artery disease." Heart 105, no. 7 (September 29, 2018): 524–30. http://dx.doi.org/10.1136/heartjnl-2018-313665.

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ObjectiveThe medium-term outcome and cause of death in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) is not well characterised. The aim of this study was to compare mortality and rates of recurrent events in post myocardial infarction (MI) patients with obstructive coronary artery disease (CAD) and in patients with MINOCA compared with an age and sex-matched cohort without cardiovascular disease (CVD).MethodsWe performed a national cohort study of consecutive patients undergoing coronary angiography for MI during 2 years between 2013 and 2015 from the All New Zealand Acute Coronary Syndrome—Quality Improvement (ANZACS QI) registry. MI patient registry data were linked anonymously to national hospitalisation and mortality records. Age and sex matched patients without known CVD formed the comparison group.ResultsOf the 8305 patients with MI, 897 (10.8%) were classified as MINOCA. Compared with those without known CVD, the adjusted HRs for the primary outcome (all-cause death or recurrent non-fatal MI) were 7.81 (95% CI 6.64 to 9.19, p<0.0001) in those with obstructive CAD and 4.64 (95% CI 3.54 to 6.10, p<0.0001) in those with MINOCA. Kaplan-Meier all-cause mortality at 2 years was 7.9% for those with obstructive CAD, with nearly half being CVD deaths (3.6% CVD deaths and 4.5% non-CVD deaths, respectively). In contrast, MINOCA all-cause mortality was 4.9% with non-CVD death (4.5%) predominating.ConclusionsMINOCA is common and has an adverse outcome rate approximately half than that of those with obstructive CAD. The predominant contributor to mortality is non-CVD death. The rate of events in MINOCA is significantly greater than the population without CVD.
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38

Toth, P. P. "Statin Use in Outpatients With Obstructive Coronary Artery Disease." Yearbook of Endocrinology 2012 (January 2012): 59–62. http://dx.doi.org/10.1016/j.yend.2012.05.051.

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39

Pepine, Carl J. "Multiple Causes for Ischemia Without Obstructive Coronary Artery Disease." Circulation 131, no. 12 (March 24, 2015): 1044–46. http://dx.doi.org/10.1161/circulationaha.115.015553.

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40

Reynolds, Harmony R. "Mechanisms of myocardial infarction without obstructive coronary artery disease." Trends in Cardiovascular Medicine 24, no. 4 (May 2014): 170–76. http://dx.doi.org/10.1016/j.tcm.2013.12.002.

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41

Jyotsna, Maddury, and Janaswamy Vibhav Sri Narayana. "CRT-74 Obstructive Coronary Artery Disease In Young Females." JACC: Cardiovascular Interventions 6, no. 2 (February 2013): S24—S25. http://dx.doi.org/10.1016/j.jcin.2012.12.092.

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42

Arnold, Suzanne V., John A. Spertus, Fengming Tang, Harlan M. Krumholz, William B. Borden, Steven A. Farmer, Henry H. Ting, and Paul S. Chan. "Statin Use in Outpatients With Obstructive Coronary Artery Disease." Circulation 124, no. 22 (November 29, 2011): 2405–10. http://dx.doi.org/10.1161/circulationaha.111.038265.

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43

Phan, Anita. "Persistent Chest Pain and No Obstructive Coronary Artery Disease." JAMA 301, no. 14 (April 8, 2009): 1468. http://dx.doi.org/10.1001/jama.2009.425.

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44

Yang, Sushan, Nirmanmoh Bhatia, Meng Xu, and John A. McPherson. "Incidence and Predictors of Obstructive Coronary Artery Disease and the Role of Cardiac Troponin Assays in Patients with Unstable Angina." Texas Heart Institute Journal 46, no. 3 (June 1, 2019): 161–66. http://dx.doi.org/10.14503/thij-17-6329.

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In a time when cardiac troponin assays are widely used to detect myocardial injury, data remain scarce concerning the incidence and predictors of substantial obstructive coronary artery disease that causes unstable angina. This retrospective single-center study included consecutive patients hospitalized for unstable angina from January 2015 through January 2016. Patients with troponin I levels above the upper reference limit and those who did not undergo angiography were excluded. Multivariate logistic regression analysis was used to identify predictors of obstructive coronary artery disease that warranted revascularization and of major adverse cardiac events up to 6 months after discharge from the hospital. Of the 114 patients who met the inclusion criteria, 46 (40%) had obstructive coronary artery disease. In the univariate analysis, male sex, white race, history of coronary artery disease, prior revascularization, hyperlipidemia, chronic kidney disease, aspirin use, long-acting nitrate use, and Thrombolysis in Myocardial Infarction score ≥3 were associated with obstructive coronary artery disease. History of coronary artery disease, prior revascularization, hyperlipidemia, and long-acting nitrate use were associated with major adverse cardiac events. Male sex was an independent predictor of obstructive coronary artery disease (adjusted odds ratio=4.82; 95% CI, 1.79–13; P=0.002) in the multivariate analysis. Our results showed that coronary artery disease warranting revascularization is present in a considerable proportion of patients who have unstable angina. The association that we found between male sex and obstructive coronary artery disease suggests that the risk stratification of patients presenting with unstable angina may need to be refined to improve outcomes.
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45

Zaffar, Muhammad Zubair, Ammar Akhtar, Syed Naseem Iqbal Bukhari, and Rashid Minhas. "CORONARY ARTERY DISEASE ON CT-CORONARY ANGIOGRAM – COMPARISON BETWEEN DIABETIC AND NON-DIABETIC POPULATION." Pakistan Heart Journal 54, no. 1 (May 26, 2021): 85–89. http://dx.doi.org/10.47144/phj.v54i1.2070.

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Objective: To evaluate the CT coronary angiograms of patients presenting with symptoms of coronary artery disease (CAD) as well as to compare the results between the diabetics and non-diabetics. Methodology: This descriptive cross-sectional study was carried out in Cardiology department of Chaudhary Pervaiz Elahi Institute of Cardiology, Multan. One hundred and fifty nine patients with history of symptoms of CAD and no previous history of myocardial infarction or revascularization were included in study. The conventional risk factors were noted and 64 slice multi detector CT coronary angiogram was done on all patients. Total calcium score and number of segments with disease, obstructive disease and non-obstructive disease were noted. Results were compared among diabetic and non-diabetic patients. Results: Mean age of the patients was 50.54±7.90 years. Out of 159 patients 118(74.2%) were males and 41 (25.8%) were females. Diabetic patients were 101(63.5%), 64 (40.3%) were hypertensive, 39(24.5%) were smokers, 24.5% (n=39) had positive family history, 18.2% (n=29) were obese and 13.8% (n=22) had dyslipidemia. There was no coronary artery disease in 40 (25.2%) patients while 91 (57.2%) patients had obstructive and 28 (17.6%) patients had non-obstructive disease. 83. 1% diabetics had obstructive CAD and 12.0% of non diabetic patients had obstructive CAD. Mean number of obstructive segments in diabetic patients are 2.36±1.23. Conclusion: CAD was more prevalent in diabetic patients and CAD is easily predicted by non-invasive technique of CT coronary angiography.
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46

Kitamura, Soichiro, and Etsuko Tsuda. "Significance of Coronary Revascularization for Coronary-Artery Obstructive Lesions Due to Kawasaki Disease." Children 6, no. 2 (January 29, 2019): 16. http://dx.doi.org/10.3390/children6020016.

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As an acquired ischemic heart disease in childhood, coronary-artery disease caused by Kawasaki disease (KD) has been known worldwide since the mid-1970s. KD patients who develop coronary-artery obstructive disease often need revascularization some time in their life. Coronary-artery revascularization for KD coronary lesions can be done with the surgical coronary-artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures. However, the characteristics of coronary-arterial lesions caused by KD significantly differ from atherosclerotic coronary disease in adults. Therefore, it is much more difficult to determine the optimal time and selection of a coronary-artery revascularization procedure for KD sequelae. CABG using the internal thoracic artery has been accepted as a very useful and beneficial procedure since the mid-1980s, even in small children. Although the use of PCI in the late period can be effective in some adolescent and adult patients, the small vessel size and severe coronary-artery calcification are often limiting factors for its use in children. Therefore, CABG is a better approach for severe leftanterior descending artery and multiple-vessel disease in children and adolescents with KD coronary sequelae. Good coronary revascularization can improve the long-term outcomes of patients with severe KD complications.
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47

Košuta, Daniel, Borut Jug, and Zlatko Fras. "Prognostic Impact of Nonobstructive Coronary Artery Disease Detected by Coronary Computed Tomographic Angiography." Angiology 72, no. 8 (March 19, 2021): 749–53. http://dx.doi.org/10.1177/0003319721999494.

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Coronary computed tomographic angiography (CCTA) is a promising technique for ruling out coronary artery disease (CAD) in patients with chest pain. We aimed to investigate the prognostic impact of nonobstructive CAD on CCTA. We retrospectively reviewed patients who underwent CCTA between 2010 and 2016 at our institution. We divided them into 3 groups: (1) patients with no CAD, (2) patients with nonobstructive CAD, and (3) patients with obstructive CAD. We investigated the incidence of the primary outcome (combination of death, nonfatal myocardial infarction, unstable angina, and late revascularization). A total of 989 patients were included: 540 patients had CAD, which was obstructive (≥50% stenosis) in 256 cases. During the follow-up period, 99 events occurred (32 [7%] in patients without CAD, 26 [9%] in patients with nonobstructive CAD, and 41 [16%] in patients with obstructive CAD; P < .001). The presence of nonobstructive and obstructive CAD was an independent predictor of events (HR: 2.33 [1.15-4.69], P < .001; and 4.02 [1.98-8.13], P = .019, respectively) compared with no CAD. Nonobstructive CAD on CCTA is associated with a 2-fold increase in risk of coronary events compared with patients with no CAD.
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48

Rodríguez-Capitán, Jorge, Andrés Sánchez-Pérez, Sara Ballesteros-Pradas, Mercedes Millán-Gómez, Rosa Cardenal-Piris, Manuel Oneto-Fernández, Lola Gutiérrez-Alonso, et al. "Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings." Journal of Clinical Medicine 10, no. 9 (April 25, 2021): 1863. http://dx.doi.org/10.3390/jcm10091863.

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The clinical significance of non-obstructive coronary artery disease is the subject of debate. Our objective was to evaluate the long-term cardiovascular prognosis associated with non-obstructive coronary artery disease in patients undergoing coronary angiography, and to conduct a stratification by sex, diabetes, and clinical indication. We designed a multi-centre retrospective longitudinal observational study of 3265 patients that were classified into three groups: normal coronary arteries (lesion <20%, 1426 patients), non-obstructive coronary artery disease (20–50%, 643 patients), and obstructive coronary artery disease (>70%, 1196 patients). During a mean follow-up of 43 months, we evaluated a combined cardiovascular event: acute myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Multivariable-adjusted Cox proportional hazard models showed a worse prognosis in patients with non-obstructive coronary artery disease, in comparison with patients of normal coronary arteries group, in the total population (hazard ratio 1.72, 95% confidence interval 1.23–2.39; p for trend <0.001), in non-diabetics (hazard ratio 2.12, 95% confidence interval: 1.40–3.22), in women (hazard ratio 1.75, 95% confidence interval 1.10–2.77), and after acute coronary syndrome (hazard ratio 2.07, 95% confidence interval 1.25–3.44). In conclusion, non-obstructive coronary artery disease is associated with an impaired long-term cardiovascular prognosis. This association held for non-diabetics, women, and after acute coronary syndrome.
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49

Erdol, Mehmet Akif, Ahmet Goktug Ertem, Koray Demirtas, Sefa Unal, Mustafa Karanfil, Ahmet Akdi, Cagri Yayla, et al. "Association Between Chronic Obstructive Pulmonary Disease and Coronary Artery Disease Severity." Angiology 71, no. 4 (December 9, 2019): 380. http://dx.doi.org/10.1177/0003319719893559.

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50

Yakhontov, D. A., and Yu O. Ostanina. "Clinical phenotypes of coronary artery disease patients with intermediate coronary artery stenosis." Journal of Siberian Medical Sciences 6, no. 3 (2022): 129–42. http://dx.doi.org/10.31549/2542-1174-2022-6-3-129-142.

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Introduction. Patients with stable coronary artery disease (CAD) and intermediate coronary artery stenosis are of great interest because, despite the absence of obstructive coronary artery lesion, the risk of cardiovascular complications is very high and is conditioned by a number of concomitant factors. Aim. Study of cardiovascular risk factors and assessment of clinical and angiographic picture in stable CAD patients with intermediate coronary artery stenosis of various clinical phenotypes. Materials and methods. 236 stable angina pectoris class I–III patients (190 men, 46 women, age 49–59 years) with intermediate (40–70%) coronary artery stenosis were examined. All patients underwent general clinical examination, ultrasound of the heart and coronary angiography. Based on the cardio-ankle vascular index (CAVI) values, the chronological age/biological age coefficient was determined. The study design is a comparative non-randomized descriptive study of four parallel groups. Results. The prevailing phenotypes in CAD patients with intermediate (40–70%) coronary artery stenosis in a random sample turned out to be those with: CAD without a previous myocardial infarction (MI); CAD with MI > 6 months ago; CAD with metabolically unhealthy obesity (MUO) phenotype without diabetes mellitus (DM) and, finally, CAD with type 2 DM. In CAD patients with MUO and type 2 DM, the frequency of previous MI did not significantly differ. In addition, patients with CAD and MUO, who had previously had MI, differed in the earliest age of its onset. Despite the 100% presence of arterial hypertension (AH) in different phenotypes groups, CAD and type 2 DM patients had the highest values of the left ventricular mass index. They also had the most frequently recorded multivessel lesion during coronary angiography. Despite the ongoing outpatient year-long treatment, the values of lipid and inflammatory parameters (low-density lipoprotein cholesterol (LDL-C), triglycerides, C-reactive protein) were high, so, only in few patients the target values of LDL-C were reached; besides a large number of patients with insufficient blood pressure control were revealed. In more than half of the surveyed, the biological age prevailed over the chronological age. Conclusion. Stable angina patients with intermediate coronary artery stenosis represent a rather serious group in terms of prognosis. Despite the absence of vascular obstructive lesions, the risk of cardiovascular complications is conditioned by almost 100% presence of hypertension, high body mass index values, a significant frequency of obesity, dyslipidemia, carbohydrate metabolism disorders, and high biological age.
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