Relationship between body mass index, coronary disease extension and clinical outcomes in patients with acute coronary syndrome

Size: px
Start display at page:

Download "Relationship between body mass index, coronary disease extension and clinical outcomes in patients with acute coronary syndrome"

Transcription

1 Relationship between body mass index, coronary disease extension and clinical outcomes in patients with acute coronary syndrome Helder Dores, Luís Bronze Carvalho, Ingrid Rosário, Sílvio Leal, Maria João Correia, José Monge, José Azevedo, Isabel Arroja, Ana Aleixo, Miguel Mendes

2 Conflicts of interest: none

3 Introduction (1) Aim Methods Results Conclusions Obesity has reached epidemic proportions in the western countries: - Prevalence is trending upward - Risk factor for coronary disease and acute coronary syndrome (ACS) - Association with cardiovascular (CV) and non-cv mortality (general population)

4 Introduction (2) Aim Methods Results Conclusions Contradictory evidence in patients with established coronary artery disease (CAD) Obesity paradox? Conditions in which obesity has been associated with favourable prognosis First elective PCI n=9578 All-cause death 5-years

5 Aim Cardiology Department Introduction Methods Results Conclusions To assess the extension of coronary disease and the prognosis of patients with ACS according to the Body Mass Index (BMI)

6 Introduction Aim Methods (1) Results Conclusions Retrospective analysis Consecutive patients admitted with ACS in a Coronary Unit (Jan/03-Jan/04) Categorization of the patients according to the BMI * (kg/m 2 ) category (WHO * ): Underweight (<18.5 ) Normal weight ( ) Overweight ( ) Obesity ( 30.0) * WHO World Health Organization

7 Aim Methods (2) Introduction Results Conclusions Variables Demographic: Age and gender Clinical: CV risk factors (Hypertension, Diabetes Mellitus, Smoking, Dyslipidemia), past history [Acute Myocardial Infarction (AMI), Percutaneous Coronary Intervention (PCI), Coronary Artery Bypass Grafting (CABG), Stroke/Transient Ischemic Accident (TIA)] and clinical presentation (height, weight, blood pressure, heart rate, Killip class) Electrocardiographic: ST deviation, T wave inversion Echocardiographic: Left Ventricular Ejection Fraction (LVEF) Angiographic: Number of significant coronary artery stenosis (>50% lumen obstruction) Therapeutic: Reperfusion (PCI, Thrombolysis and CABG) and therapy at discharge

8 Introduction Aim Methods (3) Results Conclusions Comparison of the variables registered between the BMI categories Survival analysis and evaluation of the correlation between BMI and all-cause mortality at 30-days, 12 -months and 5-years of follow-up Statistical analysis (SPSS v18.0) Qualitative variables (numbers and percentages) compared by chi-square test continuous variables by t-student (m±sd) (Kolmogorov-Smirnov normality tested) Logistic regression (OR, 95% CI) comparing patients variables: BMI 24.9 vs 25.0 kg/m 2 Multivariate binary logistic regression - correlation between BMI and multivesel lesions Cox regression analysis to evaluate the association between BMI and all-cause mortality Survival analysis by the Kaplan-Meier method (Log-Rank test to evaluate differences) Statistical significance - p value <0.05

9 Aim Results (1) Introduction Methods Conclusions Baseline characteristics n = 270 patients Age (m±sd) = 64.8±12.2 years 67.8% (183) male NSTEMI % (104) STEMI % (98) UA % (68) BMI category (%)* BMI (m±sd) = 27.4±4.1 kg/m 2 * No patients underweight

10 Aim Results (2) Introduction Methods Conclusions Baseline characteristics Variables (%) BMI 24.9 (n=59) p value BMI (n=145) p value BMI 30.0 (n=66) Age (m±sd) 66.9± ± ±12.1 Age >75 years Male gender Hypertension Diabetes Mellitus Dyslipidemia Smoking Stroke/TIA Prior AMI Prior PCI Prior CABG

11 Introduction Aim Methods Results (3) Conclusions Baseline characteristics Variables (%) BMI 24.9 (n=59) p value BMI (n=145) p value BMI 30.0 (n=66) STEMI NSTEMI UA SBP (m±sd) 151.8± ± ±32.0 Heart rate (m±sd) 78.2± ± ±24.3 Killip class > I ECG ST-elevation ST-depression Isolated T wave inversion Normal LVEF (m±sd) 61.0± ± ±16.9 ECG Electrocardiogram; SAP Systolic Arterial Pressure; STEMI /NSTEMI ST Elevation/Non Myocardial Infarction; UA Unstable Angina.

12 Introduction Angiographic characteristics Aim Methods Results (4) Conclusions Variables (%) BMI 24.9 (n=59) p value BMI (n=145) p value BMI 30.0 (n=66) Angiography Left main ,1 Left anterior descending Left circunflex Right coronary Without significant lesions , One-vessel lesion , Multivessel lesions Logistic regression (predictors of multivessel lesions) Variables OR 95% CI p value Overweight 0.39 [ ] Diabetes Mellitus 2.58 [ ] Adjusted for gender, age > 75 years and cardiovascular risk factors (dyslipidemia, Diabetes Mellitus, Hypertension)

13 Introduction Aim Methods Results (5) Conclusions In-hospital management Variables (%) BMI 24.9 (n=59) p value BMI (n=145) p value BMI 30.0 (n=66) Thrombolysis * PCI In-hospital death Statins βb ACE-I/ARB Eligible patients; + Therapy at discharge ACE-I angiotensin-converting enzyme inhibitor; ARB angiotensin receptor blocker; β B Beta bloker.

14 Introduction Aim Methods Results (6) Conclusions Logistic regression: BMI 24.9 vs BMI 25.0 Kg/m 2 Unadjusted model Variables OR * 95% CI p value Hypertension 3.08 [ ] Isolated T-wave inversion 3.97 [ ] Multivessel lesions 0.5 [ ] OR for IMC > 25.0 Kg/m 2

15 Aim Results (7) Introduction Methods Conclusions Correlation between BMI and all-cause mortality (Cox regression) Unadjusted model (univariate) BMI HR 95% CI p value 30-days 0.9 [ ] months 0.9 [ ] years 0.9 [ ] 0.10 Adjusted model (multivariate) * BMI HR 95% CI p value 30-days months 0.9 [ ] years 0.9 [ ] 0.24 * Adjustment for age, gender and confounders [cardiovascular risk factors, clinical presentation, LVEF and angiographic findings]

16 Aim Results (8) Introduction Methods Conclusions Independent predictors of all-cause mortality (Cox regression * ) Variables (%) HR 95% CI p value 30-days months LVEF 0.91 [ ] years LVEF 0.96 [ ] * Adjustment for age, gender and confounders [cardiovascular risk factors, clinical presentation, LVEF and angiographic findings]

17 Introduction Aim Methods Results (9) Conclusions Survival analysis (Kaplan-Meier curves) BMI categories Normal Overweight Obesity BMI 25.0 <25.0 Time (days) 25.0 Kg/m 2 Log-Rank test (p) Time BMI categories BMI 24.9 vs Events (%/n) 30-days /11 12-months /13 5-years /22

18 Aim Results Conclusions (1) Introduction Methods 1) In the studied population, patients with normal BMI had more extensive CAD Paradoxically, overweight seems to have exerted a protective effect 2) Obese patients were more likely to underwent coronary angiography and PCI 3) These differences were not reflected in the prognosis (short, medium or long-term) 4) BMI was not an independent predictor for all-cause mortality

19 Aim Results Conclusions (2) Introduction Methods The question of which measure of obesity better predicts survival in patients with coronary artery disease remains controversial It is crucial to improve the understanding of the relationship between excess weight and cardiovascular outcomes

20 Aim Results Conclusions (3) Introduction Methods Limitations - Retrospective analysis - Small dimension of the sample - Duration of obesity, body-fat distribution and percentage were not quantified - Temporal weight changes during the follow-up were not valued (BMI reflects global adiposity)

21 Relationship between body mass index, coronary disease extension and clinical outcomes in patients with acute coronary syndrome Helder Dores, Luís Bronze Carvalho, Ingrid Rosário, Sílvio Leal, Maria João Correia, José Monge, José Azevedo, Isabel Arroja, Ana Aleixo, Miguel Mendes Thanks

22 Introduction Aim Methods Results Conclusions Severity of angiographic coronary stenosis and BMI n=46663 (PCI) Relation between obesity and severity of coronary artery disease in patients undergoing coronary angiography. Rubinshtein R, Halon DA, Jaffe R, Shahla J, Lewis BS. n=928 Advancing age, male gender, diabetes mellitus and hyperlipidemia were independent predictors of high-risk anatomy, whereas obesity remained a significant negative independent predictor. n=9146 (PCI)

23 Introduction Aim Methods Results Conclusions n=770 (ACS)

Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes

Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Seung-Jae Joo and other KAMIR-NIH investigators Department of Cardiology, Jeju National

More information

Cardiology Department Coimbra Hospital and Medical School Portugal

Cardiology Department Coimbra Hospital and Medical School Portugal Quantitative troponin elevation provide incremental prognostic value beyond comprehensive risk stratification in patients with acute coronary syndromes. Rui Baptista, Elisabete Jorge, Hélia Martins, Fátima

More information

Patient characteristics Intervention Comparison Length of followup

Patient characteristics Intervention Comparison Length of followup ISCHAEMIA TESTING CHAPTER TESTING FOR MYCOCARDIAL ISCHAEMIA VERSUS NOT TESTING FOR MYOCARDIAL ISCHAEMIA Ref ID: 4154 Reference Wienbergen H, Kai GA, Schiele R et al. Actual clinical practice exercise ing

More information

Asian AMI Registry Session The 17 th Joint Meeting of Coronary Revascularization (JCR 2017) Busan, Korea Dec 8 th 2017

Asian AMI Registry Session The 17 th Joint Meeting of Coronary Revascularization (JCR 2017) Busan, Korea Dec 8 th 2017 Asian AMI Registry Session The 17 th Joint Meeting of Coronary Revascularization (JCR 2017) Busan, Korea Dec 8 th 2017 Trends of acute myocardial infarction in Korea from the experience of Korea Acute

More information

Alex versus Xience Registry Preliminary report

Alex versus Xience Registry Preliminary report Interventional Cardiology Network Alex versus Xience Preliminary report Mariusz Gąsior 1,2, Marek Gierlotka 1, Lech Poloński 1,2 1 3rd Department of Cardiology, Medical University of Silesia Centre tor

More information

Supplementary Material to Mayer et al. A comparative cohort study on personalised

Supplementary Material to Mayer et al. A comparative cohort study on personalised Suppl. Table : Baseline characteristics of the patients. Characteristic Modified cohort Non-modified cohort P value (n=00) Age years 68. ±. 69.5 ±. 0. Female sex no. (%) 60 (0.0) 88 (.7) 0.0 Body Mass

More information

PROMUS Element Experience In AMC

PROMUS Element Experience In AMC Promus Element Luncheon Symposium: PROMUS Element Experience In AMC Jung-Min Ahn, MD. University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea PROMUS Element Clinical

More information

Supplement materials:

Supplement materials: Supplement materials: Table S1: ICD-9 codes used to define prevalent comorbid conditions and incident conditions Comorbid condition ICD-9 code Hypertension 401-405 Diabetes mellitus 250.x Myocardial infarction

More information

GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS

GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS Table of Contents List of authors pag 2 Supplemental figure I pag 3 Supplemental figure II pag 4 Supplemental

More information

Impact of coronary atherosclerotic burden on clinical presentation and prognosis of patients with coronary artery disease

Impact of coronary atherosclerotic burden on clinical presentation and prognosis of patients with coronary artery disease Impact of coronary atherosclerotic burden on clinical presentation and prognosis of patients with coronary artery disease Gjin Ndrepepa, Tomohisa Tada, Massimiliano Fusaro, Lamin King, Martin Hadamitzky,

More information

Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing

Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing Evidence and Uncertainties Robert O. Bonow, MD, MS, MACC Northwestern University Feinberg School of Medicine

More information

SUPPLEMENTAL MATERIAL. Supplemental Methods. Duke CAD Index

SUPPLEMENTAL MATERIAL. Supplemental Methods. Duke CAD Index SUPPLEMENTAL MATERIAL Supplemental Methods Duke CAD Index The Duke CAD index, originally developed by David F. Kong, is an angiographic score that hierarchically assigns prognostic weights (0-100) based

More information

Early discharge in selected patients after an acute coronary syndrome can it be safe?

Early discharge in selected patients after an acute coronary syndrome can it be safe? Early discharge in selected patients after an acute coronary syndrome can it be safe? Glória Abreu, Pedro Azevedo, Carina Arantes, Catarina Quina-Rodrigues, Sara Fonseca, Juliana Martins, Catarina Vieira,

More information

4. Which survey program does your facility use to get your program designated by the state?

4. Which survey program does your facility use to get your program designated by the state? STEMI SURVEY Please complete one survey for each TCD designation you have in your facility. There would be a maximum of three surveys completed if your facility was designated as a trauma, stroke and STEMI

More information

Cronicon CARDIOLOGY. N Laredj*, HM Ali Lahmar and L Hammou. Abstract

Cronicon CARDIOLOGY. N Laredj*, HM Ali Lahmar and L Hammou. Abstract Cronicon OPEN ACCESS CARDIOLOGY Research Article Persistent Ischemia in Recovery Predicts Mortality after Myocardial Infarction in Patients Undergoing Dobutamine N Laredj*, HM Ali Lahmar and L Hammou Department

More information

Abstract Background: Methods: Results: Conclusions:

Abstract Background: Methods: Results: Conclusions: Two-Year Clinical and Angiographic Outcomes of Overlapping Sirolimusversus Paclitaxel- Eluting Stents in the Treatment of Diffuse Long Coronary Lesions Kang-Yin Chen 1,2, Seung-Woon Rha 1, Yong-Jian Li

More information

Quality Payment Program: Cardiology Specialty Measure Set

Quality Payment Program: Cardiology Specialty Measure Set Quality Payment Program: Cardiology Specialty Set Title Number CMS Reporting Method(s) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for

More information

Transient Atrial Fibrillation and Risk of Stroke after Acute Myocardial Infarction

Transient Atrial Fibrillation and Risk of Stroke after Acute Myocardial Infarction Transient Atrial Fibrillation and Risk of Stroke after Acute Myocardial Infarction Doron Aronson MD, Gregory Telman MD, Fadel BahouthMD, Jonathan Lessick MD, DSc and Rema Bishara MD Department of Cardiology

More information

Statistical analysis plan

Statistical analysis plan Statistical analysis plan Prepared and approved for the BIOMArCS 2 glucose trial by Prof. Dr. Eric Boersma Dr. Victor Umans Dr. Jan Hein Cornel Maarten de Mulder Statistical analysis plan - BIOMArCS 2

More information

INTRODUCTION. Key Words:

INTRODUCTION. Key Words: Original Article Acta Cardiol Sin 2017;33:377 383 doi: 10.6515/ACS20170126A Percutaneous Coronary Intervention Predictors of Mortality in Elderly Patients with Non-ST Elevation Acute Coronary Syndrome

More information

Quality Payment Program: Cardiology Specialty Measure Set

Quality Payment Program: Cardiology Specialty Measure Set Measure Title * Reportable via PINNACLE α Reportable via Diabetes Collaborative CQMC v1.0 Measure High Priority Measure Cross Cutting Measure Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor

More information

Lessons learned From The National PCI Registry

Lessons learned From The National PCI Registry Lessons learned From The National PCI Registry w a v e On Behalf of The Publication Committee of the National PCI Registry Objectives & Anticipated Achievements To determine the epidemiology of patients

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bucholz EM, Butala NM, Ma S, Normand S-LT, Krumholz HM. Life

More information

Patient referral for elective coronary angiography: challenging the current strategy

Patient referral for elective coronary angiography: challenging the current strategy Patient referral for elective coronary angiography: challenging the current strategy M. Santos, A. Ferreira, A. P. Sousa, J. Brito, R. Calé, L. Raposo, P. Gonçalves, R. Teles, M. Almeida, M. Mendes Cardiology

More information

Exercise treadmill testing is frequently used in clinical practice to

Exercise treadmill testing is frequently used in clinical practice to Preventive Cardiology FEATURE Case Report 55 Commentary 59 Exercise capacity on treadmill predicts future cardiac events Pamela N. Peterson, MD, MSPH 1-3 David J. Magid, MD, MPH 3 P. Michael Ho, MD, PhD

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Weintraub WS, Grau-Sepulveda MV, Weiss JM, et al. Comparative

More information

Supplementary Online Content

Supplementary Online Content 1 Supplementary Online Content Friedman DJ, Piccini JP, Wang T, et al. Association between left atrial appendage occlusion and readmission for thromboembolism among patients with atrial fibrillation undergoing

More information

Importance of the third arterial graft in multiple arterial grafting strategies

Importance of the third arterial graft in multiple arterial grafting strategies Research Highlight Importance of the third arterial graft in multiple arterial grafting strategies David Glineur Department of Cardiovascular Surgery, Cliniques St Luc, Bouge and the Department of Cardiovascular

More information

What oral antiplatelet therapy would you choose? a) ASA alone b) ASA + Clopidogrel c) ASA + Prasugrel d) ASA + Ticagrelor

What oral antiplatelet therapy would you choose? a) ASA alone b) ASA + Clopidogrel c) ASA + Prasugrel d) ASA + Ticagrelor 76 year old female Prior Hypertension, Hyperlipidemia, Smoking On Hydrochlorothiazide, Atorvastatin New onset chest discomfort; 2 episodes in past 24 hours Heart rate 122/min; BP 170/92 mm Hg, Killip Class

More information

10-Year Mortality of Older Acute Myocardial Infarction Patients Treated in U.S. Community Practice

10-Year Mortality of Older Acute Myocardial Infarction Patients Treated in U.S. Community Practice 10-Year Mortality of Older Acute Myocardial Infarction Patients Treated in U.S. Community Practice Ajar Kochar, MD on behalf of: Anita Y. Chen, Puza P. Sharma, Neha J. Pagidipati, Gregg C. Fonarow, Patricia

More information

The prognostic role of serum uric acid level in patients with acute ST elevation myocardial infarction

The prognostic role of serum uric acid level in patients with acute ST elevation myocardial infarction The prognostic role of serum uric acid level in patients with acute ST elevation myocardial infarction Bita Omidvar a, Fazlolah Ayatollahi a, Mohammad Alasti b, a Department of Internal Medicine, Golestan

More information

SUPPLEMENTAL MATERIAL

SUPPLEMENTAL MATERIAL SUPPLEMENTAL MATERIAL Table S1: Number and percentage of patients by age category Distribution of age Age

More information

What is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation?

What is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation? What is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation? Keun-Ho Park, Myung Ho Jeong, Min Goo Lee, Jum Suk Ko,

More information

The MAIN-COMPARE Study

The MAIN-COMPARE Study Long-Term Outcomes of Coronary Stent Implantation versus Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Disease Revascularization for Unprotected Left MAIN Coronary Artery Stenosis:

More information

Journal of the American College of Cardiology Vol. 35, No. 4, by the American College of Cardiology ISSN /00/$20.

Journal of the American College of Cardiology Vol. 35, No. 4, by the American College of Cardiology ISSN /00/$20. Journal of the American College of Cardiology Vol. 35, No. 4, 2000 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00 Published by Elsevier Science Inc. PII S0735-1097(99)00643-9 Early

More information

Stable Angina: Indication for revascularization and best medical therapy

Stable Angina: Indication for revascularization and best medical therapy Stable Angina: Indication for revascularization and best medical therapy Cardiology Basics and Updated Guideline 2018 Chang-Hwan Yoon, MD/PhD Cardiovascular Center, Department of Internal Medicine Bundang

More information

Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft in Acute Coronary Syndrome patients with Renal Dysfunction

Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft in Acute Coronary Syndrome patients with Renal Dysfunction www.nature.com/scientificreports Received: 26 June 2017 Accepted: 22 January 2018 Published: xx xx xxxx OPEN Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft in Acute Coronary Syndrome

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Valle JA, Tamez H, Abbott JD, et al. Contemporary use and trends in unprotected left main coronary artery percutaneous coronary intervention in the United States: an analysis

More information

Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial

Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Myeong-Ki Hong, MD. PhD on behalf of the IVUS-XPL trial investigators

More information

Journal of the American College of Cardiology Vol. 35, No. 5, by the American College of Cardiology ISSN /00/$20.

Journal of the American College of Cardiology Vol. 35, No. 5, by the American College of Cardiology ISSN /00/$20. Journal of the American College of Cardiology Vol. 35, No. 5, 2000 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)00546-5 CLINICAL

More information

Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease

Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Impact of Angiographic Complete Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Young-Hak Kim, Duk-Woo Park, Jong-Young Lee, Won-Jang

More information

Coronary artery disease (CAD) risk factors

Coronary artery disease (CAD) risk factors Background Coronary artery disease (CAD) risk factors CAD Risk factors Hypertension Insulin resistance /diabetes Dyslipidemia Smoking /Obesity Male gender/ Old age Atherosclerosis Arterial stiffness precedes

More information

APPENDIX F: CASE REPORT FORM

APPENDIX F: CASE REPORT FORM APPENDIX F: CASE REPORT FORM Instruction: Complete this form to notify all ACS admissions at your centre to National Cardiovascular Disease Registry. Where check boxes are provided, check ( ) one or more

More information

Epicardial fat volume as a predictor of coronary vulnerable plaques using cardiac computed tomography in the patients with zero calcium score

Epicardial fat volume as a predictor of coronary vulnerable plaques using cardiac computed tomography in the patients with zero calcium score ESC Congress 2011 Epicardial fat volume as a predictor of coronary vulnerable plaques using cardiac computed tomography in the patients with zero calcium score K. Harada, N. Terada, A. Okada, M. Shigekiyo,

More information

Rita Calé, Miguel Mendes, António Ferreira, João Brito, Pedro Sousa, Pedro Carmo, Francisco Costa, Pedro Adragão, João Calqueiro, José Aniceto Silva.

Rita Calé, Miguel Mendes, António Ferreira, João Brito, Pedro Sousa, Pedro Carmo, Francisco Costa, Pedro Adragão, João Calqueiro, José Aniceto Silva. Peak Circulatory Power : a new parameter of cardiopulmonary exercise testing to predict arrhythmic events in patients with implantable cardioverter defibrillator for primary prevention Rita Calé, Miguel

More information

Acute Myocardial Infarction. Willis E. Godin D.O., FACC

Acute Myocardial Infarction. Willis E. Godin D.O., FACC Acute Myocardial Infarction Willis E. Godin D.O., FACC Acute Myocardial Infarction Definition: Decreased delivery of oxygen and nutrients to the myocardium Myocardial tissue necrosis causing irreparable

More information

egfr > 50 (n = 13,916)

egfr > 50 (n = 13,916) Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according

More information

FFR-guided Complete vs. Culprit Only Revascularization in AMI Patients Ki Hong Choi, MD On Behalf of FRAME-AMI Investigators

FFR-guided Complete vs. Culprit Only Revascularization in AMI Patients Ki Hong Choi, MD On Behalf of FRAME-AMI Investigators FFR-guided Complete vs. Culprit Only Revascularization in AMI Patients Ki Hong Choi, MD On Behalf of FRAME-AMI Investigators Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of

More information

Effect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary PCI

Effect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary PCI Effect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary PCI Dr Sasha Koul, MD Dept of Cardiology, Lund University Hospital, Lund, Sweden

More information

Statin pretreatment and presentation patterns in patients with acute coronary syndromes

Statin pretreatment and presentation patterns in patients with acute coronary syndromes Brief Report Page 1 of 5 Statin pretreatment and presentation patterns in patients with acute coronary syndromes Marcelo Trivi, Ruth Henquin, Juan Costabel, Diego Conde Cardiovascular Institute of Buenos

More information

Can Angiographic Complete Revascularization Improve Outcomes for Patients with Decreased LV Function? NO!

Can Angiographic Complete Revascularization Improve Outcomes for Patients with Decreased LV Function? NO! Can Angiographic Complete Revascularization Improve Outcomes for Patients with Decreased LV Function? NO! Young-Hak Kim, MD, PhD Heart Institute, University of Ulsan College of Medicine Asan Medical Center,

More information

DIFFERENTIATING THE PATIENT WITH UNDIFFERENTIATED CHEST PAIN

DIFFERENTIATING THE PATIENT WITH UNDIFFERENTIATED CHEST PAIN DIFFERENTIATING THE PATIENT WITH UNDIFFERENTIATED CHEST PAIN Objectives Gain competence in evaluating chest pain Recognize features of moderate risk unstable angina Review initial management of UA and

More information

ESC CONGRESS Munich, Germany, August. Compliance to a Cardiac Rehabilitation Program: what are the benefits and impact on prognosis?

ESC CONGRESS Munich, Germany, August. Compliance to a Cardiac Rehabilitation Program: what are the benefits and impact on prognosis? ESC CONGRESS 2012 Munich, Germany, 25-29 August Compliance to a Cardiac Rehabilitation Program: what are the benefits and impact on prognosis? Inês Rangel (1), Afonso Rocha (2), Carla de Sousa, (1) Alexandra

More information

The MAIN-COMPARE Registry

The MAIN-COMPARE Registry Long-Term Outcomes of Coronary Stent Implantation versus Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Disease Revascularization for Unprotected Left MAIN Coronary Artery Stenosis:

More information

Program Metrics. New Unique ID. Old Unique ID. Metric Set Metric Name Description. Old Metric Name

Program Metrics. New Unique ID. Old Unique ID. Metric Set Metric Name Description. Old Metric Name Program Metrics The list below includes the metrics that will be calculated by the PINNACLE Registry for the outpatient office setting. These include metrics for, Atrial Fibrillation, Hypertension and.

More information

Acute Myocardial Infarction

Acute Myocardial Infarction Acute Myocardial Infarction Hafeza Shaikh, DO, FACC, RPVI Lourdes Cardiology Services Asst.Program Director, Cardiology Fellowship Associate Professor, ROWAN-SOM Acute Myocardial Infarction Definition:

More information

Acute Myocardial Infarction Treatment of Young versus Elderly patients: Insights from the Leiden MISSION! program.

Acute Myocardial Infarction Treatment of Young versus Elderly patients: Insights from the Leiden MISSION! program. Chapter 7 Acute Myocardial Infarction Treatment of Young versus Elderly patients: Insights from the Leiden MISSION! program. Jael Z. Atary, a M. Louisa Antoni, a Su San Liem, a Bas L. van der Hoeven, a

More information

Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)?

Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)? Cronicon OPEN ACCESS CARDIOLOGY Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)? Valentin Hristov* Department of Cardiology, Specialized

More information

Online Appendix (JACC )

Online Appendix (JACC ) Beta blockers in Heart Failure Collaborative Group Online Appendix (JACC013117-0413) Heart rate, heart rhythm and prognostic effect of beta-blockers in heart failure: individual-patient data meta-analysis

More information

Cafri C; Zahger D; Rosenshtein G, Kleshian I; Ilia R

Cafri C; Zahger D; Rosenshtein G, Kleshian I; Ilia R Primary Percutaneous Coronary Intervention and Large Thrombus Burden Lesio: A Questionable Impact of Mesh Covered Stent on the Frequency of No Reflow Cafri C; Zahger D; Rosehtein G, Kleshian I; Ilia R

More information

Impaired Chronotropic Response to Exercise Stress Testing in Patients with Diabetes Predicts Future Cardiovascular Events

Impaired Chronotropic Response to Exercise Stress Testing in Patients with Diabetes Predicts Future Cardiovascular Events Diabetes Care Publish Ahead of Print, published online May 28, 2008 Chronotropic response in patients with diabetes Impaired Chronotropic Response to Exercise Stress Testing in Patients with Diabetes Predicts

More information

DUKECATHR Dataset Dictionary

DUKECATHR Dataset Dictionary DUKECATHR Dataset Dictionary Version of DUKECATH dataset for educational use that has been modified to be unsuitable for clinical research or publication (Created Date and Time: 28OCT16 14:35) Table of

More information

A Prior Myocardial Infarction: How Does it Affect Management and Outcomes in Recurrent Acute Coronary Syndromes?

A Prior Myocardial Infarction: How Does it Affect Management and Outcomes in Recurrent Acute Coronary Syndromes? A Prior Myocardial Infarction: How Does it Affect Management and Outcomes in Recurrent Acute Coronary Syndromes? Address for correspondence: Kim A. Eagle, MD University of Michigan Cardiovascular Center

More information

Downloaded from:

Downloaded from: Annemans, L; Danchin, N; Van de Werf, F; Pocock, S; Licour, M; Medina, J; Bueno, H (2016) Prehospital and in-hospital use of healthcare resources in patients surviving acute coronary syndromes: an analysis

More information

CLINICAL COURSE, MANAGEMENT AND IN-HOSPITAL OUTCOMES

CLINICAL COURSE, MANAGEMENT AND IN-HOSPITAL OUTCOMES Open Access Research Journal, www.pieb.cz Medical and Health Science Journal, MHSJ ISSN: 1804-1884 (Print) 1805-5014 (Online) Volume 5, 2011, pp. 10-15 CLINICAL COURSE, MANAGEMENT AND IN-HOSPITAL OUTCOMES

More information

Consensus Core Set: Cardiovascular Measures Version 1.0

Consensus Core Set: Cardiovascular Measures Version 1.0 Consensus Core Set: Cardiovascular s NQF 0330 Hospital 30-day, all-cause, riskstandardized readmission rate (RSRR) following heart failure hospitalization 0229 Hospital 30-day, all-cause, riskstandardized

More information

Characteristics of Transient ST-Elevation versus ST-Elevation and Non-ST-Elevation Myocardial Infarction

Characteristics of Transient ST-Elevation versus ST-Elevation and Non-ST-Elevation Myocardial Infarction Characteristics of Transient ST-Elevation versus ST-Elevation and Non-ST-Elevation Myocardial Infarction Blondheim DS, Shochat M, Asif A, Kazatsker M, Frimerman A, Vassilenko L, Abu Fane R, Neiman E, Barel

More information

Impact of Body Mass Index on In-Hospital Outcomes after Percutaneous Coronary Intervention

Impact of Body Mass Index on In-Hospital Outcomes after Percutaneous Coronary Intervention PERCUTANEOUS CORONARY INTERVENTION ORIGINAL RESEARCH Impact of Body Mass Index on In-Hospital Outcomes after Percutaneous Coronary Intervention Bahram Sohrabi MD 1, Afshin Habibzadeh MD 1, Samad Ghaffari

More information

Compliance of pharmacological treatment for non-st-elevation acute coronary syndromes with contemporary guidelines: influence on outcomes

Compliance of pharmacological treatment for non-st-elevation acute coronary syndromes with contemporary guidelines: influence on outcomes Original Article Compliance of pharmacological treatment for non-st-elevation acute coronary syndromes with contemporary guidelines: influence on outcomes Hélder Dores 1, Carlos Aguiar 1, Jorge Ferreira

More information

Ticagrelor compared with clopidogrel in patients with acute coronary syndromes the PLATO trial

Ticagrelor compared with clopidogrel in patients with acute coronary syndromes the PLATO trial compared with clopidogrel in patients with acute coronary syndromes the PLATO trial August 30, 2009 at 08.00 CET PLATO background In NSTE-ACS and STEMI, current guidelines recommend 12 months aspirin and

More information

Impact of Body Mass Index on Long-Term All-Cause Mortality after Percutaneous Coronary Intervention in African-Americans

Impact of Body Mass Index on Long-Term All-Cause Mortality after Percutaneous Coronary Intervention in African-Americans Original Contribution Impact of Body Mass Index on Long-Term All-Cause Mortality after Percutaneous Coronary Intervention in African-Americans Shyam Poludasu, MD, Erdal Cavusoglu, MD, Waqas Khan, MD, Jonathan

More information

Impact of Chronic Kidney Disease on Long-Term Outcome in Coronary Bypass Candidates Treated with Percutaneous Coronary Intervention

Impact of Chronic Kidney Disease on Long-Term Outcome in Coronary Bypass Candidates Treated with Percutaneous Coronary Intervention Original Article Print ISSN 1738-5520 On-line ISSN 1738-5555 Korean Circulation Journal Impact of Chronic Kidney Disease on Long-Term Outcome in Coronary Bypass Candidates Treated with Percutaneous Coronary

More information

The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters

The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Trends in Clinical, Demographic, and Biochemical Characteristics of Patients with Acute Myocardial Infarction from 2003 to 2008: A Report from the American Heart Association Get with the Guidelines Coronary

More information

Particularities of Coronary Artery Disease in Hypertensive Patients with Left Bundle Branch Block Larisa ANGHEL a ; Catalina ARSENESCU GEORGESCU a,b

Particularities of Coronary Artery Disease in Hypertensive Patients with Left Bundle Branch Block Larisa ANGHEL a ; Catalina ARSENESCU GEORGESCU a,b MAEDICA a Journal of Clinical Medicine 2014; 9(4): 333-337 Mædica - a Journal of Clinical Medicine ORIGINAL PAPERS Particularities of Coronary Artery Disease in Patients with Left Bundle Branch Block Larisa

More information

Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion

Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion Hyeon-Cheol Gwon Cardiac and Vascular Center Samsung Medical Center Sungkyunkwan University School of Medicine Dr. Hyeon-Cheol

More information

The Author(s) This article is published with open access by ASEAN Federation of Cardiology

The Author(s) This article is published with open access by ASEAN Federation of Cardiology DOI 10.7603/s40602-014-0011-3 ASEAN Heart Journal http://www.aseanheartjournal.org/ Vol. 22, no. 1, 60 65 (2014) ISSN: 2315-4551 Erratum Erratum to: Impact Of Sex On Clinical Characteristics And In-Hospital

More information

Ischemic Heart Disease Interventional Treatment

Ischemic Heart Disease Interventional Treatment Ischemic Heart Disease Interventional Treatment Cardiac Catheterization Laboratory Procedures (N = 89) is a regional and national referral center for percutaneous coronary intervention (PCI). A total of

More information

Safety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD

Safety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD Safety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD Mun K. Hong, MD Associate Professor of Medicine Director, Cardiovascular Intervention and Research Weill Cornell

More information

HEART RATE IN PATIENTS WITH CORONARY ARTERY DISEASE IN LATVIA

HEART RATE IN PATIENTS WITH CORONARY ARTERY DISEASE IN LATVIA Inga Balode HEART RATE IN PATIENTS WITH CORONARY ARTERY DISEASE IN LATVIA Summary of the Doctoral Thesis for obtaining the degree of a Doctor of Medicine Speciality Internal Medicine Riga, 2014 Doctoral

More information

Journal of the American College of Cardiology Vol. 46, No. 8, by the American College of Cardiology Foundation ISSN /05/$30.

Journal of the American College of Cardiology Vol. 46, No. 8, by the American College of Cardiology Foundation ISSN /05/$30. Journal of the American College of Cardiology Vol. 46, No. 8, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.06.070

More information

Hyeon-Cheol Gwon, On the behalf of SMART-DATE trial investigators ACC LBCT 2018

Hyeon-Cheol Gwon, On the behalf of SMART-DATE trial investigators ACC LBCT 2018 Six-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndromes (SMART-DATE): a randomized, openlabel, multicenter trial

More information

Lack of Effect of Beta-blocker Therapy in Patients with ST-elevation Acute Myocardial Infarction in PCI Era

Lack of Effect of Beta-blocker Therapy in Patients with ST-elevation Acute Myocardial Infarction in PCI Era Lack of Effect of Beta-blocker Therapy in Patients with ST-elevation Acute Myocardial Infarction in PCI Era B. Bao 1, N. Ozasa 1, T. Morimoto 2, Y. Furukawa 3, M. Shirotani 4, H. Ogawa 5, C. Tei 6, H.

More information

Revascularization In HFrEF: Are We Close To The Truth. Ali Almasood

Revascularization In HFrEF: Are We Close To The Truth. Ali Almasood Revascularization In HFrEF: Are We Close To The Truth Ali Almasood HF epidemic 1-2% of the population have HF At least one-half have heart failure with reduced ejection fraction (HF- REF) The most common

More information

Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Japan

Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Japan Association between continuously elevated C-reactive protein and restenosis after percutaneous coronary intervention using drug-eluting stent in angina patients Division of Cardiovascular Medicine, Jichi

More information

Kavitha Yaddanapudi Stony brook University New York

Kavitha Yaddanapudi Stony brook University New York Kavitha Yaddanapudi Stony brook University New York 8 million ER visits a year for chest pain 2-10% have Acute coronary syndrome (ACS) Coronary CTA(CCTA) -safe alternative to standard of care (SOC) and

More information

Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors

Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors Carmine Pizzi 1 ; Lamberto Manzoli 2, Stefano Mancini 3 ; Gigliola Bedetti

More information

Clinical Study Age Differences in Long Term Outcomes of Coronary Patients Treated with Drug Eluting Stents at a Tertiary Medical Center

Clinical Study Age Differences in Long Term Outcomes of Coronary Patients Treated with Drug Eluting Stents at a Tertiary Medical Center Aging Research Volume 2013, Article ID 471026, 4 pages http://dx.doi.org/10.1155/2013/471026 Clinical Study Age Differences in Long Term Outcomes of Coronary Patients Treated with Drug Eluting Stents at

More information

Predicting Outcomes Over Time in Patients With Heart Failure, Left Ventricular Systolic Dysfunction, or Both Following Acute Myocardial Infarction

Predicting Outcomes Over Time in Patients With Heart Failure, Left Ventricular Systolic Dysfunction, or Both Following Acute Myocardial Infarction Predicting Outcomes Over Time in Patients With Heart Failure, Left Ventricular Systolic Dysfunction, or Both Following Acute Myocardial Infarction Renato D. Lopes, MD, PhD, MHS; Karen S. Pieper, MS; Susanna

More information

Central pressures and prediction of cardiovascular events in erectile dysfunction patients

Central pressures and prediction of cardiovascular events in erectile dysfunction patients Central pressures and prediction of cardiovascular events in erectile dysfunction patients N. Ioakeimidis, K. Rokkas, A. Angelis, Z. Kratiras, M. Abdelrasoul, C. Georgakopoulos, D. Terentes-Printzios,

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Schulz Schüpke S, Helde S, Gewalt S; et al. Comparison of vascular closure devices vs manual compression after femoral artery puncture: the ISAR-CLOSURE randomized clinical

More information

DECLARATION OF CONFLICT OF INTEREST

DECLARATION OF CONFLICT OF INTEREST DECLARATION OF CONFLICT OF INTEREST Is there a mortality risk associated with aspirin use in heart failure? Results from a large community based cohort Margaret Bermingham, Mary-Kate Shanahan, Saki Miwa,

More information

The ESC Registry on Chronic Ischemic Coronary Disease

The ESC Registry on Chronic Ischemic Coronary Disease EURObservational Research Programme The ESC Registry on Chronic Ischemic Coronary Disease Prof. Fausto J. Pinto, FESC, FACC, FASE, FSCAI Immediate Past-President, ESC University Hospital Sta Maria University

More information

Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome

Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Hiroyuki Okura*, MD; Nobuya Matsushita**,MD Kenji Shimeno**, MD; Hiroyuki Yamaghishi**, MD Iku Toda**,

More information

Supplementary Table S1: Proportion of missing values presents in the original dataset

Supplementary Table S1: Proportion of missing values presents in the original dataset Supplementary Table S1: Proportion of missing values presents in the original dataset Variable Included (%) Missing (%) Age 89067 (100.0) 0 (0.0) Gender 89067 (100.0) 0 (0.0) Smoking status 80706 (90.6)

More information

Background- Methods and Results- Conclusion-

Background- Methods and Results- Conclusion- Patterns of Use of Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers Among Patients With Acute Myocardial Infarction in China From 2001 to 2011: China PEACE Retrospective AMI Study

More information

Journal of the American College of Cardiology Vol. 50, No. 11, by the American College of Cardiology Foundation ISSN /07/$32.

Journal of the American College of Cardiology Vol. 50, No. 11, by the American College of Cardiology Foundation ISSN /07/$32. Journal of the American College of Cardiology Vol. 50, No. 11, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2007.05.035

More information

Rehospitalization Prognostic Factors in Patients with Heart Failure: a Prospective Follow-up Study

Rehospitalization Prognostic Factors in Patients with Heart Failure: a Prospective Follow-up Study ARC Journal of Cardiology Volume2, Issue 2, 2016, PP 13-18 ISSN No. (Online) 2455-5991 http://dx.doi.org/10.20431/2455-5991.0202002 www.arcjournals.org Rehospitalization Prognostic Factors in Patients

More information

Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents

Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents Received: July 15, 2016 Accepted: October 18, 2016 Published online: December 9, 2016 Original Paper Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the

More information

Development of a risk score to identify patients with type 2 diabetes mellitus and multivessel coronary artery disease who can defer bypass surgery

Development of a risk score to identify patients with type 2 diabetes mellitus and multivessel coronary artery disease who can defer bypass surgery Perry et al. Diagnostic and Prognostic Research (2019) 3:3 https://doi.org/10.1186/s41512-019-0048-7 Diagnostic and Prognostic Research RESEARCH Open Access Development of a risk score to identify patients

More information

Journal of the American College of Cardiology Vol. 37, No. 2, by the American College of Cardiology ISSN /01/$20.

Journal of the American College of Cardiology Vol. 37, No. 2, by the American College of Cardiology ISSN /01/$20. Journal of the American College of Cardiology Vol. 37, No. 2, 2001 2001 by the American College of Cardiology ISSN 0735-1097/01/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)01133-5 Coronary

More information