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Background: In the United Arab Emirates (UAE), cardiovascular diseases (CVDs) are the leading cause of mortality, and the incidence of premature coronary heart diseases (CHDs) is about 10-15 years earlier than that in people of western countries., Aim: The current cross-sectional study aims to describe the prevalence of CVD risk factors and estimate the 10-years risk for CHDs in the population of Abu Dhabi, UAE., Objective: The main objective was to report the 10-years risk for CHD in a sample of the UAE population., Methods: We have analyzed the dataset from the Abu Dhabi Screening Program for Cardiovascular Risk Markers (AD-SALAMA), a population-based cross-sectional survey conducted between 2009 and 2015 (a sample of 1002, 20 to 79 years old without CVDs or diabetes)., Results: 18.0% of our sample have had hypertension (HTN), 26.3% were current smokers, 33% have had total cholesterol ≥200 mg/dL, 55.0% have had non-high-density lipoprotein (non-HDL) levels ≥130 mg/dL, 33.1% have had low-density lipoprotein cholesterol (LDL-C) levels ≥130 mg/dL, calculated by β-quantification as 112.3 ± 47.1 mg/dL. 66.8% were overweight or obese, and 46.2% had a sedentary lifestyle. Nearly 85% of our sample has had one or more major cardiovascular risk factors. The estimated 10-year risk of cardiovascular disease according to different risk assessment tools was as follows: 7.1% according to the national cholesterol education program Framingham risk score (FRAM-ATP), 2.9% according to Pooled Cohort Risk Assessment Equation (PCRAE) , 1.4% according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and 1.1% according to Reynolds Risk Score. Despite the fact that our sample population have had exhibited major risk factors, the above-mentioned international scoring systems underestimate the 10-year risk of cardiovascular diseases, given the high prevalence at younger ages., Conclusion: The proportion of modifiable risk factors has been found to be high in the UAE population, and the majority of them have had one or more risk factors with a higher 10-years risk for CHDs., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background- Atherosclerotic vascular diseases, major global health burden which comprises cerebrovascular disease and coronary heart disease. For coronary artery disease and cerebrovascular disease, diabetes is considered as an independent risk factor. Since more than 80% of diabetes cases occurs in developing countries so they pose the highest economic burden. HDL levels are low in diabetics then non diabetics. This Low level of HDL is strongly associated with elevated increase risk for CAD in diabetics. Hence it is very important to study the clinical way of presentation of the disease and in which pattern coronary arteries are involved in both patients with diabetes and without -diabetes. Methodology: The present study is a cross-sectional study. This study was conducted on 335 patients with ACS who subsequently underwent coronary angiogram admitted in Department of Cardiology. Patients who matched the inclusion and exclusion criteria were selected randomly during period of approximately one year formed the study group. The severity of involvement of coronary artery is quantitatively assessed by GENSINI score [Angiographic severity score].So in this study we analysed the comparison of coronary artery disease and its influence by change in glycaemic status quantitively. Result- CAD severity was higher in patients with diabetes with mean gensini score of 40.9 followed by pre-diabetics 33.7and non diabetics with 23.8 (p value .001). The severity of CAD was higher in patients with diabetes for more than 6 years. There was Statistically significant correlation between duration of diabetes and severity of CAD in diabetes. Conclusions: The severity and extent of CAD in diabetics was more compared to non-diabetics. Involvement and occlusion of vessels were more commonly seen in diabetic patients. The incidence of triple vessel or multi-vessel disease was significantly higher in diabetics. Patients with poor glycemic control with elevated levels of HbA1c had diffuse pattern of atherosclerotic disease and high levels of HbA1c mildly correlated with gensini score. [ABSTRACT FROM AUTHOR]

(1) Background: The increase in cardiovascular risk related to air pollution has been a matter of interest in recent years. The role of particulate matter 2.5 (PM2.5) has been postulated as a possible factor for premature death, including cardiovascular death. The role of long-term exposure to PM10 is less known. The aim of the study was to assess the individual relationship between air pollution in habitation and the development of coronary artery disease. (2) Methods: Out of 227 patients who underwent coronary angiography, 63 (38 men and 25 women) with a mean age of 69 (63–74) years, with nonsignificant atherosclerotic changes at the initial examination, were included in the study. The baseline and repeated coronary angiography were compared to reveal patients with atherosclerotic progression and its relation to demographic and clinical factors and exposure to air pollution in the habitation place. (3) Results: In the performed analysis, we found a significant correlation between Syntax score in de novo lesions and BMI (Spearman's rho −0.334, p = 0.008). The significant and strong correlation between median annual PM10 values of 20 µg/m3 and at least 25 µg/m3 in air pollution and the risk of de novo coronary disease was noticed (Spearman's rho = 0.319, p = 0.011 and Spearman's rho = 0.809, p < 0.001, respectively). (4) Conclusions: There is a positive correlation between long-term exposure to PM10 air pollution and coronary artery disease progression, demonstrated by the increase in Syntax score. The presented analysis revealed increased morbidity at lower PM10 concentrations than generally recommended thresholds. Therefore, further investigations concerning air pollution's influence on cardiovascular risk should be accompanied by promoting lifestyle changes in the population and revisiting the needs for environmental guidelines. [ABSTRACT FROM AUTHOR]

This study was performed to evaluate Coronary Arteries imaging by Computer Tomography (CT) and its ability to diagnose ischemic conditions among emergency department patients presented. To measure the sensitivity of coronary CT in the diagnosis of cardiac conditions, the study also assessed the correlation between variables such as age, sex, troponin level, Electrocardiogram (ECG), and symptoms with results of CT coronary. The research was done in the Emergency Department of Prince Sultan Cardiac Center, Riyadh, Saudi Arabia from January to June 2022. It includes 50 patients (males to females' ratio was 70% to 30%). All patients were diagnosed to have CT coronary abnormality. The results showed that related to patient symptoms, asymptomatic 6%, atypical chest pain 28%, chest pain 24%, palpitation 8%, and multiple symptoms 34%. The correlation between findings on ECG was that only (8%) had abnormal troponin levels. Calcium CT 28% and CT coronary were found to be abnormal in 48% of the patients, abnormal CT findings were found to be (52%) of the patients The most commonly reported symptoms by the patients were asymptomatic chest pain. There was no statistically significant association was seen between patients' gender and symptoms or between symptoms reported and age. patients aged above 50 years had significantly higher CT findings (75%) than other age groups (p=0.004). However, there was no statistically significant association observed between CT findings and symptoms, ECGfindings, and troponin hormone levels. The study recommended that the CT coronary is the best way to diagnose ischemic coronary diseases. [ABSTRACT FROM AUTHOR]

Background: CORONARY ARTERY DISEASE (CAD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of myocardium; it typically occurs when there is an imbalance between myocardium oxygen supply and demand. Coronary artery disease (CAD) (atherosclerotic heart disease/ischemic heart disease (IHD) results from the accumulation of atheromatous plaques within the walls of the coronary arteries hampering the supply of oxygen and nutrients to the myocardium. Objectives and Aims: To compare pulmonary function test in coronary artery disease patients with healthy controls. To compare the following parameters in coronary artery disease patients with healthy controls by spirometry1. Forced expiratory volume-1 second (FEV1) (L) 2. Forced vital capacity (FVC) 3. FEV1/FVC (%) 4. Peak expiratory flow rate (PEFR) (L/s) Materials and Methods: The present study was an analytical epidemiological study with case control design with the sample size of 200 cases the present study was conducted at the department of Medicine, Swami Dayan and Hospital, Delhi. Study period was of 18 months, from March 2018 to august 2019. The patients were recruited from outpatient and inpatient department of general medicine at Swami Dayan and Hospital, Delhi. Age group 30-70 years. Presence of coronary artery disease which was proven by 2D Echocardiography. Any patient with a documented history of myocardial infarction or past history of acute coronary syndrome were recruited for the study, irrespective of whether angiogram was done. Observations and Results: Study subjects were 200 cases based on matched ages. The highest proportion of patients in the cases and the control groups were 55-64 years old (40% and 39% respectively). The lowest proportion of patients belonged to the <45 year age group in both cases and controls (8%). there was no statistically significant difference between the cases and controls in terms of the age groups (p=0.998). the present study. Statistically significantly higher levels were haemoglobin (p=0.007) and HDL cholesterol (p=0.00) levels among the cases while the total leucocyte counts (p=0.00), ALT (p=0.00), AST (p=0.001), and FBS (p=0.00) were statistically significantly higher in the cases group. Conclusion: In conclusion, the present study showed a higher proportion of Obstructive Airway Disease (OAD) in patients with Coronary Artery Disease (CAD) than in patients without CAD. All spirometric parameters like FEV1, FVC, FEV1/FVC, and PEFR, except FEF25-75were statistically significantly lower in patients with CAD than in patients without CAD. [ABSTRACT FROM AUTHOR]

Background: Experimental clinical and research studies demonstrated that the renin–angiotensin system (RAS) affects the pathogenesis of atherosclerosis and the prognosis of coronary heart disease (CHD). The results show that ACE2 (angiotensin I-converting enzyme 2) might act as a protective protein for cardiovascular diseases; however, only a few studies in human populations have been carried out. The aim of this study was to develop, optimize, and validate a direct T-ARMS-based PCR assay for the precise and rapid genotyping of ACE1-rs4646996 D>I and ACE2-rs4240157T>C and study their association with coronary artery disease susceptibility and progression. Methodology: This study included 149 consecutive coronary artery disease patients and 150 healthy controls. We utilized T-ARMS for the precise and rapid genotyping of ACE2-rs4240157; rs4646994. Results: Our results indicated that the ACE1-rs4646996 D>I genotypes observed between CAD cases and controls were statistically significant (p < 0.008) and, similarly, the ACE2-rs4240157T>C genotypes observed were significant (p < 0.0001). Moreover, the frequency of the D allele (ACE1-D>I) and C allele (ACE2-rs4240157T>C) was found to be higher among CAD patients than the HC. Our results indicated that in the codominant model, the ACE2-ID genotype was strongly associated with increased CAD susceptibility in a codominant model with an OR of 2.37, (95%) CI = (1.023–5.504), and p < 0.04. Similarly, the ACE2-DD genotype was strongly associated with an increased CAD susceptibility with an OR of 3.48, (95%) CI = (1.49 to 8.117), and p < 0.003. Similarly, in allelic comparison, the D allele was strongly associated with CAD susceptibility with an OR of 1.59, (95%) CI = (1.12–2.24), and p < 0.003. Our results revealed that there was a significant correlation between ACE2-I/D genotypes and hypertension, T2D, and obesity (p < 0.05). The results of ACE2 rs4240157 genotyping indicated a strong association in the codominant model with an increased CAD susceptibility with an OR of 3.62, (95%) CI = (2.027 to 6.481), and p < 0.0001. Similarly, in a dominant inheritance model, a strong association is observed between the ACE2 rs4240157 (CT+CC) genotype with an OR of 6.34, (95%) CI = (3.741 to 10.749), and p < 0.0001. In allelic comparison, the T allele was strongly associated with CAD susceptibility with an OR of 5.56, (95% CI = (3.56 to 7.17), and p < 0.0001. Similarly, our results revealed that there was a significant association of the ACE2-rs4240157T>C genotypes with Triglycerides (mg/dL), HDL-C (mg/dL), total Cholesterol (mg/dL), and C-reactive protein (mg/L) in CAD. Conclusion: It was indicated that the ARMS technique and MS-PCR assay proved to be fast, accurate, and reliable for ACE2-rs4240157T>C and ACE1-rs4646996 D>I, respectively, and can be used as a potential molecular tool in the diagnosis of genetic diseases in undeveloped and developing countries—where there might be a shortage of medical resources and supplies. ACE1-I>D genotypes were strongly associated with T2D, hypertension, and obesity (p < 0.002). Besides the ACE2-rs4240157 CT heterozygosity genotype, the T allele was strongly associated with CAD susceptibility. Future longitudinal studies in different ethnic populations with larger sample sizes are recommended to validate these findings [ABSTRACT FROM AUTHOR]

Heart disease is most common disease occurred in general population in these days according to the research work. Coronary Heart Disease is disease occurred in population as increase in the upcoming scenario due to junk food intake containing high consumption of highly lipid and bad cholesterol by the major percentage of the population. The main factors of the highly rising Coronary Artery Disease (CAD) are malnutrition, high salt intake, not having proper balance diet, consumption of alcohol, not exercising regularly, etc. The medical management’s ambition is to spread awareness to the public regarding CAD. The CAD various prevention are some as regularly exercising, yoga asana, eating healthy food. CAD is one of the most common reasons for death of people. For spreading knowledge and awareness regarding to CAD this article explores information of the CAD like different types of CAD, pathophysiology, prevention and treatment. [ABSTRACT FROM AUTHOR]

Heme oxygenase (HO)-1 is a rate-limiting enzyme for degrading heme into carbon monoxide. Longer (GT)n repeat of the HO-1 gene (HMOX1) promoter has a lower transcription rate. Subjects with longer GT repeats in the HMOX1 promoter are more likely to have coronary artery disease (CAD) and cardiovascular events. We retrospectively enrolled CAD subjects with an abnormal ejection fraction (EF) < 50% from our catheterization data (N = 670). Polymerase chain reactions were performed for amplifying the HMOX1 promoter GT repeating segment to determine the number of repeats. Two subgroups, reduced EF < 40% (N = 256), and mid-range EF 40–49% (N = 414), were compared. The distribution of genotypes of SS, SL and LL were significantly different in reduced EF (29%, 48%, 23%) vs. mid-range EF CAD (64%, 30%, 5%) (S allele: ≤ 30 repeats, L allele: > 30 repeats) (p < 0.001). The patients with reduced EF had a significantly longer average (GT)n (median 27.5 vs. 26.5, p = 0.004) than those with the mid-range EF. In multivariate analysis, the carrier of L allele (odds ratio 4.437, p < 0.001) was a significant predictor for the diagnosis of reduced vs. mid-range EF CAD. In conclusion, CAD patients with reduced EF had longer HMOX1 promoter (GT)n repeats than those with mid-range EF. [ABSTRACT FROM AUTHOR]

The results of already published studies regarding relationship between interleukin-10 (IL-10), interleukin-18 (IL-18) polymorphisms and predisposition to coronary artery disease (CAD) were still controversial. So the authors designed this meta-analysis to more precisely estimate relationship between IL-10, IL-18 polymorphisms and CAD by pooling the results of already published studies. The authors searched Pubmed, Embase, Web of Science and CNKI for already published studies. The authors used Review Manager to pool the results of already published studies. Thirty-four studies were pooled analyzed in this meta-analysis. The pooled meta-analyses results showed that IL-18 rs187238, IL-18 rs1946518 and IL-18 rs1946519 polymorphisms were all significantly associated with predisposition to CAD in the general population. We also detected similar significant results for IL-10 rs1800871, IL-10 rs1800896, IL-18 rs187238 and IL-18 rs1946518 polymorphisms in East Asians in further subgroup analyses. In conclusion, this meta-analysis suggested that IL-10 rs1800871, IL-10 rs1800896, IL-18 rs187238 and IL-18 rs1946518 polymorphisms might influence predisposition to CAD in East Asians. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) is one of the major causes of mortality worldwide. Knowledge about risk factors that increase the probability of developing CAD can help to understand the disease better and assist in its treatment. Recently, modern computer‐aided approaches have been used for the prediction and diagnosis of diseases. Swarm intelligence algorithms like particle swarm optimization (PSO) have demonstrated great performance in solving different optimization problems. As rule discovery can be modelled as an optimization problem, it can be mapped to an optimization problem and solved by means of an evolutionary algorithm like PSO. An approach for discovering classification rules of CAD is proposed. The work is based on the real‐world CAD data set and aims at the detection of this disease by producing the accurate and effective rules. The proposed algorithm is a hybrid binary‐real PSO, which includes the combination of categorical and numerical encoding of a particle and a different approach for calculating the velocity of particles. The rules were developed from randomly generated particles, which take random values in the range of each attribute in the rule. Two different feature selection methods based on multi‐objective evolutionary search and PSO were applied on the data set, and the most relevant features were selected by the algorithms. The accuracy of two different rule sets were evaluated. The rule set with 11 features obtained more accurate results than the rule set with 13 features. Our results show that the proposed approach has the ability to produce effective rules with highest accuracy for the detection of CAD. [ABSTRACT FROM AUTHOR]

Despite extensive clinical research and management protocols applied in the field of coronary artery diseases (CAD), it still holds the number 1 position in mortality worldwide. This indicates that we need to work on precision medicine to discover the diagnostic, therapeutic, and prognostic targets to improve the outcome of CAD. In precision medicine, epigenetic changes play a vital role in disease onset and progression. Epigenetics is the study of heritable changes that do not affect the alterations of DNA sequence in the genome. It comprises various covalent modifications that occur in DNA or histone proteins affecting the spatial arrangement of the DNA and histones. These multiple modifications include DNA/histone methylation, acetylation, phosphorylation, and SUMOylation. Besides these covalent modifications, non-coding RNAs—viz. miRNA, lncRNA, and circRNA are also involved in epigenetics. Smoking, alcohol, diet, environmental pollutants, obesity, and lifestyle are some of the prime factors affecting epigenetic alterations. Novel molecular techniques such as next-generation sequencing, chromatin immunoprecipitation, and mass spectrometry have been developed to identify important cross points in the epigenetic web in relation to various diseases. The studies regarding exploration of epigenetics, have led researchers to identify multiple diagnostic markers and therapeutic targets that are being used in different disease diagnosis and management. Here in this review, we will discuss various ground-breaking contributions of past and recent studies in the epigenetic field in concert with coronary artery diseases. Future prospects of epigenetics and its implication in CAD personalized medicine will also be discussed in brief. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of our study was to determine the frequency of left main stem disease on coronary angiography in patients with non-ST segment elevation myocardial infarction (NSTEMI). By studying the exact frequency of the left main stem (LMS) disease in NSTEMI patients in our population, we will be able to better risk stratify and plan further management for this group of patients. Methodology: This cross-sectional study was conducted at the Department of Cardiology, Chaudhry Pervez Elahi Institute of Cardiology (CPEIC), Multan from 14-June-2017 to 13-Dec-2017. Total 248 patients with NSTEMI were included in the study. Coronary angiography was done in all selected patients. Diagnosis of LMS disease was made when stenosis in the LMS artery was more than half of the diameter of the left main coronary artery. Results: There were 80.6% male and 19.4% female patients with a mean age 49.39±7.23 years. In this study, 37.1% patients were found with left main stem disease. Among LMS disease patients, there was 82.6% male and 17.4% female patients. 55.4% of patients were aged 50 years and above. 40.2% were smokers and 33.7% were diabetic. No significant association of LMS was found with the age group (p=0.66), gender (p=0.54), smoking status (p=0.54) and diabetes mellitus (p=0.95). Conclusion: In this study, we found a high frequency of LMS disease in our population. This subset of patients with NSTEMI requires early revascularization. This also signifies a need to re-evaluate our screening programs and management protocols related to coronary artery disease. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) is one of the leading causes of death worldwide; therefore, identifying new risk factors to predict the severity of the disease is thought to be associated with mortality reduction. In an effort to investigate whether platelet parameters are related to the extent of CAD and can be considered as risk factors, we designed experiments to evaluate platelet parameters in these patients. In a crosssectional study, sixty-nine patients with CAD (including fifty-two patients with acute coronary syndrome and seventeen patients with stable angina) and sixty-four healthy volunteers were evaluated for platelet count, mean platelet volume (MPV), and platelet distribution width (PDW). Echocardiography, electrocardiogram (ECG), and coronary angiography were conducted as well. Results showed significantly higher values for MPV and PDW in patients with acute coronary syndrome as compared to patients with stable angina and healthy volunteers (P<0.001 and P=0.009, respectively). There was no significant difference in platelet count between patients and healthy volunteers (P=0.379). Our results also revealed a significant difference in the ejection fraction (EF) percentage between the three groups (P=0.008). Investigating the correlation between platelet parameters and EF percentage, ECG changes, and the results of coronary angiography did not show any significant association. The present study showed that the elevated levels of MPV and PDW in patients with CAD are not related to the extent of coronary artery disease, which was estimated by echocardiography, ECG changes, and coronary angiography. Thus, these parameters cannot be considered as risk factors for coronary artery disease. [ABSTRACT FROM AUTHOR]

Mortality rates from acute myocardial infarctions have been declining in the past 4 decades since percutaneous coronary interventions (PCIs) became a valid therapeutical option. PCI is a non-surgical revascularization procedure in which blood flow in an occluded or narrowed epicardial coronary artery is re-established by inflating an angioplasty balloon in order to remove the blockage, followed by the insertion of a stent in order to maintain the patency of the artery. Since the late '70s when the first bare metal stents (BMS) became available, progress has been made in developing new types of stents in order to lower the incidence of two important and feared complications: thrombosis and restenosis. While thrombosis is manageable and preventable with antithrombotic therapy, restenosis is a more complex issue of which many clinicians may not be aware or underestimate. The review would like to summarize the current knowledge from the literature on stent restenosis and present to clinicians some tools for recognizing, or at least suspecting, restenosis in their patients. [ABSTRACT FROM AUTHOR]

Atherosclerotic cardiovascular disease (ASCVD), the buildup of plaque within the arterial walls, contributes to acute coronary syndrome, angina, stroke, transient ischemic attack, and peripheral arterial disease. This second article in a series about the most commonly billed diagnoses in primary care describes the pathophysiologic processes of ASCVD as well as how the clinical manifestations and treatments are linked to the pathogenesis of the disease. [ABSTRACT FROM AUTHOR]

Relationship between endothelial nitric oxide synthase (eNOS) polymorphisms and predisposition to coronary artery disease (CAD) are still controversial and ambiguous. So we performed this meta-analysis to more precisely estimate relationship between eNOS polymorphisms and CAD by pooling the results of already published studies. We searched Pubmed, Embase, Web of Science and CNKI for eligible studies. We used Review Manager to pool the results of eligible studies. One hundred and fifty-five studies were included in this meta-analysis. We found that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms were all significantly associated with CAD in the general population. We also detected similar significant results for eNOS rs1799983, rs2070744 and rs869109213 polymorphisms in both Caucasians and Asians in further subgroup analyses. This meta-analysis demonstrated that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms might influence predisposition to CAD in both Caucasians and Asians. • This is a comprehensive meta-analysis regarding eNOS gene polymorphisms and CAD. • We found that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms may serve as genetic biomarkers of CAD. • Our findings indicated that eNOS may involve in the development of CAD. [ABSTRACT FROM AUTHOR]

Background: Coronary arteries disease (CAD) has been recognized as one of the most common causes of death worldwide, with an estimated seven million deaths annually. Methods: Two hundred blood samples from Iranian CAD patients and normal healthy controls were collected. CAD and the 9p21 locus variants rs1333049 and rs10757278 were analyzed for potential associations. Results: No significant differences in rs10757278 and rs1333049 polymorphisms were found between patients and controls, but a significant relationship was found between rs10757278 and rs1333049 in CAD patients at the genotype level (p= 0.0323). At the haplotype level and on the basis of diplotype analysis, a significant relationship was found between patients and controls (OR= 5.16, p= 0.047, 95% CI: 1.02-26.0). In CAD patients, rs10757278 and rs1333049 were associated at locus 9p21. Conclusions: The inconsistency between the results of this and other studies on different CAD populations may be due to high population, different ethnicities, low prevalence of some alleles in populations, and interactions of different genes. [ABSTRACT FROM AUTHOR]

The aim of the study is to investigate the association of fasting plasma glucose (FPG) with the prevalence and severity of coronary artery disease (CAD) in different ethnic groups without diabetes history in Xinjiang. Patients without diabetes history, who had undergone coronary angiography, were obtained. The levels of FPG in different ethnics were analyzed. The Gensini score was explored to evaluate the degree of coronary artery stenosis, and the logistic regression analysis was adopted to explore the risk factors of the prevalence of CAD. A total of 1500 cases (men 71.2%; mean age 57.6±10.6 years; 1095 cases of CAD) were included. The incidence rates of CAD were 76.8% in Han, 72.5% in Uyghur and 68.1% in Kazakh group, respectively (P = .009), while the Gensini scores in Kazahk group (36.63±33.88) were lower than the other ethnic populations (P = .003). The FPG levels in patients with CAD were significant higher than that without in all the ethnic groups (P < .01). Furthermore, it was indicated that the FPG levels (OR = 1.22, 95%CI 1.07-1.39, P = .003), as well as the age, sex, smoking or hypertension history, were associated with the CAD risk. FPG level was an independent risk factor of the prevalence and severity of CAD in population in Xinjiang. [ABSTRACT FROM AUTHOR]

Introduction: There are numerous shared risk factors in the etiopathogenesis of coronary artery disease (CAD) and cancer both at epidemiologic and molecular level. Additionally, different modalities of treatment of cancer such as radiation, chemotherapy, immunotherapy, and hormonal therapies further increase the risk of CAD and acute coronary syndrome. Most large database analysis and single-center experiences have shown that cancer patients undergoing PCI are at an increased risk of in-hospital mortality, bleeding, repeat revascularization.Areas covered: In this review article the authors discuss the associations between CAD and cancer, challenges for PCI in cancer patients and outcome data.Expert opinion: Interventionists performing PCI on cancer patients should be cognizant of the heightened risk of bleeding, thrombosis, possible need for interruption of dual-antiplatelet therapy, and the increased risk of target lesion revascularization in this cohort. These risks may be partially mitigated by utilization of best practices such as the use of radial artery access, intravascular imaging for lesion assessment and stent optimization and avoidance of complex stenting strategies. Finally, it is of paramount importance to have a multidisciplinary approach consisting of the treating cardiologist, medical and/or surgical oncologist, and palliative medicine, and involve the patient and their family in making informed decisions. [ABSTRACT FROM AUTHOR]

Whether adiponectin (ADIPOQ) polymorphisms affect individual susceptibility to coronary artery disease (CAD) remains controversial. Therefore, we performed this meta-analysis to better analyse associations between ADIPOQ polymorphisms and CAD. PubMed, Web of Science, Embase and CNKI were searched for eligible studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Totally, 51 studies were eligible for analyses. In overall analyses, significant associations with the susceptibility to CAD were detected for rs266729 (overdominant model: p= 0.03, OR = 1.11, 95% CI 1.01–1.22), rs822395 (recessive model: p= 0.007, OR = 1.21, 95% CI 1.05–1.40) and rs2241766 (dominant model: p= 0.0009, OR = 0.82, 95% CI 0.73–0.92; recessive model: p= 0.04, OR = 1.29, 95% CI 1.02–1.64; allele model: p< 0.0001, OR = 0.80, 95% CI 0.73–0.88) polymorphisms. Further subgroup analyses by ethnicity revealed that rs1501299 polymorphism was significantly associated with the susceptibility to CAD in East Asians, while rs2241766 polymorphism was significantly associated with the susceptibility to CAD in Caucasians, East Asians and South Asians. In summary, our findings indicated that rs266729, rs822395, rs1501299 and rs2241766 polymorphisms were all significantly associated with the susceptibility to CAD in certain populations. [ABSTRACT FROM AUTHOR]

Matrix Gla protein (MGP) is an important regulatory protein for inhibition of calcification in the vessel wall and cartilage. The MGP gene polymorphisms are suspected to increase the risk of extracellular calcification through altering the related gene expression and serum MGP levels. The goal of this study was to examine the correlation between rs4236 (Thr83-Ala), rs12304 (Glu60-X) and rs1800802 (T138-C) polymorphisms of the MGP gene and coronary artery calcification. Serum MGP levels of 168 subjects who had undergone coronary angiography were analyzed along with genotyping of MGP gene polymorphisms. The results indicated that serum MGP levels were significantly associated with rs4236 and rs1800802 polymorphisms of the MGP gene with the occurrence of coronary artery diseases (CAD). Allelic distributions of MGP gene polymorphisms and serum MGP levels, respectively, were not significantly interconnected with the presence of CAD. Our results revealed that serum MGP levels of CAD patients show association with rs4236 and rs1800802 polymorphisms, but serum MGP levels alone do not directly reflect the risk of CAD. The role of MGP genetic variants on formation and progression of arterial calcification should be regarded in cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: The association between uric acid (UA) and coronary artery disease (CAD) was controversial. It was still unclear how the UA level changes with age and gender. Aims: To confirm the relationship between the change of UA with age and gender and CAD, especially in elderly people. Methods: 8285 individuals were investigated. The changes of UA and hyperuricemia in female and male with age were analyzed. The associations of UA, and hyperuricemia with CAD in different age and sex were assessed. Results: Individuals were stratified into four groups according to their age: ≤ 39 years; 40–59 years; 60–79 years, and ≥ 80 years. The level of UA and the proportion of hyperuricemia increased significantly with age in female (P < 0.001), but showed a downward trend in male (P < 0.001). After adjusting for confounding factors, hyperuricemia remained an independent risk factor for the incident of CAD in all women (P = 0.029). In ≥ 80 year groups of female, UA and hyperuricemia became independent risk factors for the incident of CAD in the univariate and multivariate logistic regression analyses (all P ≤ 0.001). Discussion: The level of UA showed significantly different changes with age in different gender. The relationship between UA and CAD showed differences in different age and sex. Conclusions: There were significant correlations between UA, hyperuricemia, and CAD only in female, particularly in the ≥ 80 year elderly women, but not in men. [ABSTRACT FROM AUTHOR]

To focus on the prevalence and role of different risk factors contributing in pathophysiology of coronary artery disease (CAD). Relevant articles published between 2006 and 2018 were studied with the help of various data bases including Google scholar, PubMed, Medline, Springer link, and Science direct. Articles published only in indexed journals were taken in account to ensure the credibility of data. Coronary artery disease (CAD) is a silently progressive chronic disorder which generally establishes overtime to an advance stage till the symptoms appear. In high income countries, the mortality rate has declined since 1980 whereas, middle and low income countries bear three quarters of the global CAD burden. South Asians are at a greater risk and the prevalence is 50% to 300% higher than the rest of the world. It is a multifactorial disorder and arises from an interaction between environmental and genetic factors. The conventional CAD risk factors (CRFs) include age, gender, blood lipids, smoking, blood pressure and diabetes. Most of the CAD risk factors are modifiable by targeting lifestyle changes, drug intervention and prior identification of those who are at high risk of developing disease. The variability in disease susceptibility in individuals exposed to similar environmental factors and having almost same CRFs can be attributed to the genetic variations. Genetic testing may improve discrimination over and above the CRFs. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) and osteoporosis, the two most frequently occurring chronic diseases of aging populations, share many risk factors including lack of estrogen, smoking, and low physical activity. CAD and low bone mineral density (BMD) are strongly associated. Statins, (3-hydroxy-3-methylglutaryl coenzyme A [HMG-CoA] reductase inhibitors), are used to prevent and treat CAD and have been associated with high BMD. This cross-sectional study examined associations of BMD with statin use and nonuse in elderly women with or without CAD. Multivariate regression analyses were conducted on 185 women aged ≥60 years who were referred between October 2010 and March 2015 to a geriatric osteoporosis clinic in Houston, Texas, for compromised skeletal health. Compared to the control group (without CAD and without statin use), patients with CAD and no statin use were more likely to have lower femoral neck BMD (β: −0.46, 95% confidence interval: −0.75 to −0.18). The BMD of patients taking statins, regardless of presence of CAD, was similar to that of the control group. Statins may be protective in preventing bone loss in elderly women suffering from CAD. Prospective trials are warranted to determine if continued use of statins in them would help prevent both CAD and bone loss. [ABSTRACT FROM AUTHOR]

C-reactive protein (CRP) in the form of high sensitivity CRP (hs-CRP) is one of the better extensively used risk marker for the coronary artery disease (CAD) in clinical practice. Increased value of hs-CRP has been related with increased threat for the development of blood pressure, stroke, peripheral arterial disease, temporary ischemic attack and sudden coronary deceased condition. If hs-CRP involves a fundamental role in atherothrombosis, then hs-CRP is the better biomarker proposed to be necessary for improving to detect the risk of coronary events of arterial disease. In this study, the HCV seropositive patients (by Anti HCV-IgG Indirect Elisa) more than 2 years old, hepatic and leukaemia were investigated for extra hepatic manifestation. The Lab request forms with questionnaire were together including CRP, HS-CRP, serum cholesterol and liver function tests were scrutinized. Total of 170 cases (around the Chennai) was taken for the study. In which, 45.3% of cases were observed as hepatitis patients with ALL cases. The other 8% of cases were having liver cirrhosis and rest of the cases was not having cirrhosis. Finally, the study explores the relationship between the HCV seropositive of leukaemia cases, HCV RNA and CRP, hs CRP with cirrhosis. These evaluations point out that HCV infection may amend the chronic inflammatory condition in leukaemia patients. Additionally, the results recommended that screening for hs-CRP should be considered previous to evaluation of cardiovascular risk in HCV patients, because the results may affect the risk scoring of coronary artery disease. [ABSTRACT FROM AUTHOR]

Coronary artery disease (CAD) is the most common type of cardiovascular disease and becomes a leading cause of death worldwide. Aiming to uncover the underlying molecular features for different types of CAD, we classified 352 CAD cases into three subgroups based on gene expression profiles, which were retrieved from the Gene Expression Omnibus database. Also, these subgroups present different expression patterns and clinical characteristics. To uncover the transcriptomic differences between the subgroups, weighted gene co‐expression analysis (WGCNA) was used and identified six subgroup‐specific WGCNA modules. Characterization of the WCGNA modules revealed that lipid metabolism pathways, specifically upregulated in subgroup I, might be an indicator of increased severity. Moreover, subgroup II was considered as an early‐stage of CAD because of normal‐like gene expression patterns. In contrast, the mammalian target of rapamycin signaling pathway was significantly upregulated in subgroup III. Although subgroups II and III did not have a significant prognostic difference, their intrinsic biological characteristics were highly different, suggesting that the transcriptome classification may represent risk factors of both age and the intrinsic biological characteristics. In conclusion, the transcriptome classification of CAD cases revealed that cases from different subgroups may have their unique gene expression patterns, indicating that patients in each subgroup should receive more personalized treatment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of nutritional counseling on weight loss in overweight/obese patients with established coronary artery disease (CAD). Methodology: This was an interventional study conducted in Preventive section, Cardiology Department, Lady Reading Hospital, Peshawar. The study was conducted from January to September 2018.Data was collected from 200 CAD patients with BMI 25 and above. Out of these, subjects fulfilling inclusion criteria were selected. Baseline data from all subjects including demographic and anthropometric data was recorded. The caloric intake was calculated and a heart healthy diet plan with more vegetables, fruits and whole grains and reduced fats was recommended to subjects. The subjects were advised to follow the diet plan for 3 months. There were 2 follow up visits spaced at 6-week intervals. At the end of 3 months each subject was weighed again and waist circumference was measured. BMI was recalculated and difference in before and after nutritional counseling was noted. Data was analyzed by statistical program for social sciences SPSS version 16. Results: Out of 200 CAD patients, a sample of 50 subjects was included in analyses. Mean age of subjects was 52.12±10.37 years. Males were 42%. Among the subjects 22% were educated,88% had poor SES,86% pursued sedentary life style. Diabetes was documented in 50% and hypertension recorded in 76% subjects. Mean BMI and before and after nutritional counseling was 31.33±3.92 kg/m2 and 27.97±3.28 kg/m2 (p<0.001)..Waist 2 2 circumference reduced from 41.41 ± 3.47cm to 37.62± 2.7cm (p<0.001). Weight reduced in 80% subjects. Conclusion: Nutritional counseling was effective in weight loss in overweight/obese patients with coronary artery disease in a majority of patients with significant reduction in weight and BMI. [ABSTRACT FROM AUTHOR]

Objectives: To validate the application of ETT screening and to assess the extent of CAD in serving soldiers. Study Design: Comparative cross-sectional. Place and Duration of Study: Study was conducted in AFIC/NIHD, from Oct 2018 to Jun 2019. Methodology: Conducted in AFIC/NIHD for the duration of 9 months. Cases with abnormal ETT at screening were further worked up with Computed Tomographic (MSCT) Angiography. Those having critical disease underwent Coronary angiogram. All cases with severe or more disease, were worked for revascularization. Chi-square test was used to find association between ETT and its diagnostic yield and management modalities. A p-value <0.05 was taken as significant. Results: A total of 256 cases with abnormal ETT were studied with 57.8% (148) cases from age group of 35-45 years. Majority of the cases 203 (76.6%) had normal CT angiography and 26 (10.2%) cases had any pattern of critical disease and 9 (3.5%) cases had calcium. Out of 256 cases 36 (14.06%) were proceeded with further work up with coronary angiogram. 31 out of these 36 cases revealed any pattern of critical CAD with 19 (7.4%) proceeded to Percutaneous Coronary Intervention (PCI) and 14 (5.5%) were offered Coronary Artery Bypass Grafting (CABG). Results show statistically significant association between diagnostic techniques and treatment modality. Conclusion: The application of ETT screening for diagnosis of occult CAD is helpful. [ABSTRACT FROM AUTHOR]

Introduction: Value-based contracts (VBCs) that link drug payments to disease-related performance metrics aim to increase the value and lower the cost of medications by aligning incentives and sharing risk between payers and pharmaceutical manufacturers. This study sought to identify outcome measures that are meaningful to key stakeholders to inform VBCs for coronary artery disease (CAD) medications. Methods: We administered a modified Delphi survey to gather expert opinion from a diverse panel of patients (n = 9), cardiologists (n = 4), primary care physicians (n = 5), payers (n = 2), pharmacy benefits managers (n = 3), and pharmaceutical company representatives (n = 2). A list of 16 CAD-associated clinical indicators was generated from the literature and expert consultation. Delphi participants rated the importance of each outcome on a five-point Likert scale, and selected the three most meaningful outcomes. We defined consensus as ≥ 75% agreement on the importance of an outcome (Likert scores 4 or 5 or selection of an outcome as most meaningful). Results: Eleven of 13 outcomes reached consensus for importance on the Likert scale. "Preventing heart attacks" was selected as the most meaningful outcome (80%) while "preventing death" ranked second (76%). Conclusions: Our study results verify the utility of a widely used clinical CAD outcome measure, myocardial infarction events, for the purpose of pharmaceutical value-based contracting. [ABSTRACT FROM AUTHOR]

Sudden cardiac death (SCD) is a sudden, unexpected death that is caused by the loss of heart function. While SCD affects many patients suffering from coronary artery diseases (CAD) and heart failure (HF), a considerable number of SCD events occur in asymptomatic individuals. Certain risk factors for SCD have been identified and incorporated in different clinical scores, however, risk stratification using such algorithms is only useful for health management rather than for early detection and prediction of future SCD events in high-risk individuals. In this review, we discuss different molecular biomarkers that are used for early detection of SCD. This includes genetic biomarkers, where the majority of them are genomic variants for genes that encode for ion channels. Meanwhile, protein biomarkers often denote proteins that play roles in pathophysiological processes that lead to CAD and HF, notably (i) atherosclerosis that involves oxidative stress and inflammation, as well as (ii) cardiac tissue damage that involves neurohormonal and hemodynamic regulation and myocardial stress. Finally, we outline existing challenges and future directions including the use of OMICS strategy for biomarker discovery and the multimarker panels. [ABSTRACT FROM AUTHOR]

Background: The incidence of severe coronary artery disease (CAD) in patients with end-stage renal disease (ESRD) on dialysis is high. Coronary artery bypass grafting (CABG) is the preferred treatment in those with severe CAD. Bilateral internal thoracic artery (BITA) vs single internal thoracic artery (SITA) grafting has been shown to improve late survival in other high-risk populations. In ESRD, comparative studies are limited by sample size to detect outcome differences. We sought to determine the late survival and early outcomes of BITA compared with SITA in patients with ESRD.Methods: MEDLINE and EMBASE were searched from inception to 2017 for studies directly comparing BITA to SITA in patients with ESRD undergoing CABG. The primary outcome was late survival; secondary outcomes were in-hospital/30-day mortality, stroke, and deep sternal wound infection (DSWI). Kaplan-Meier curve reconstruction for late mortality was performed.Results: Five studies (three adjusted [n = 197] and two unadjusted observational studies [n = 231]) were included in the analysis. Reported ITA skeletonization ranged from 83% to 100% (median: 100%). There was no difference in in-hospital mortality (risk risk [RR], 0.84; 95% confidence interval [95%CI], 0.36,1.98; P = 0.70), perioperative stroke (RR, 1.97; 95%CI, 0.58,6.66; P = 0.28), and DSWI (RR, 1.56; 95%CI, 0.60,4.07; P = 0.36) between BITA and SITA. All studies reported adjusted late mortality, which was similar between BITA and SITA (incident rate ratio, 0.81; 95%CI, 0.59,1.11) at mean 3.7-year follow-up.Conclusions: BITA grafting is safe in patients with ESRD although there was no survival benefit at 3.7 years. Additional studies with longer follow-up are required to determine the potential late benefits of BITA grafting in patients with ESRD. [ABSTRACT FROM AUTHOR]

Positron emission tomography (PET) has been successfully applied to an increasing number of cardiovascular conditions. This review will highlight the status of cardiovascular PET, including the present state of the art and the expanding pool of clinical evidence guiding its use. Additionally, we highlight upcoming developments in the field, including the development of new tracers and applications of PET to novel indications within cardiovascular medicine. [ABSTRACT FROM AUTHOR]

Apolipoprotein A5 (APOA5) regulates the metabolisms of triglyceride and HDL. APOA5 variants have been linked to coronary artery disease (CAD), but their causal roles are not well studied yet. This study aims to identify the causal effects of APOA5 variants on premature CAD. Sequencing analysis of APOA5 in 128 premature, familiar CAD patients from GeneQuest identified 11 genomic variants, including p.S19W (rs3135506). SKAT analysis showed that all sequenced variants, in aggregate, significantly increased the risk of premature CAD (P‐skat = 0.037). Individually, the p.S19W variant was significantly associated with risk of premature CAD (OR = 2.30, P = 0.008) in an independent set of 342 premature CAD patients and 537 controls after adjusting for covariates of sex, age, hypertension, body mass index, triglycerides (TGs), and total, LDL‐, and HDL‐cholesterol levels. Meanwhile, p.S19W significantly correlated with HDL‐C levels (P = 0.048) and TG levels (P = 0.025). Mediation analysis yielded a mediation effect of p.S19W on risk of premature CAD through HDL‐C (OR = 0.98, P = 0.040) and TG (OR = 0.98, P = 0.042), suggesting a causal relationship between p.S19W and premature CAD partially through its effects on HDL‐C and TG levels. These results suggest that APOA5 variation regulates TG and HDL levels, thus displaying a causal role in the development of CAD. [ABSTRACT FROM AUTHOR]

Objective: Coronary artery disease (CAD) causes more than 1 million deaths in China annually. The incidence of coronary artery disease tends to increase in the middle age and elderly people. Pulse pressure is associated with increased risk of CAD in middle-aged and older subjects, whereas soluble receptor for advanced glycation end products (sRAGE) and S100A12 are involved in pathology of atherosclerosis. In this study, we examine the associations of the expression level of sRAGE, S100A12 and PP value in both CAD and non-CAD groups; thus, providing more comprehensive strategies on preventing CAD. Method: Selected were divided into two main groups based on their angiograph results: CAD group (patients with at least one coronary artery of more than 50% occlusion) and Non-CAD Group (patients with less than 50% occlusion or without coronary artery occlusion). Soluble RAGE (sRAGE) and S100A12 concentration in blood samples were collected before CAG procedure were measured using ELISA. Pulse Pressure was measure from the difference between SBP and DBP Results: Significant decrease in concentration of serum sRAGE (p<0.05) and S100A12 (p<0.01) was observed, while PP value (p<0.01) had significantly higher level in patients with CAD. The value of PP (r = 0.35, p < 0.01), expression level of both sRAGE (r = -0.21, p < 0.01) and S100A12 (r = -0.24, p < 0.01) had association with prevalence of CAD. Conclusion: Low level of sRAGE expression and higher pulse pressure in CAD group are associated to coronary artery disease within middle age and elderly people of the Chinese population. Therefore providing alternative novel therapeutic strategies may prevent CAD before entering the middle age. [ABSTRACT FROM AUTHOR]

The purpose of this nationwide cohort study was to investigate the incidence and risk of coronary artery disease (CAD) in patients with acetaminophen (APAP) poisoning. We identified the patients with APAP poisoning and randomly selected comparison patients according to a 1:4 ratio, matching them by age, sex, and the index year using data from the National Health Insurance Research Database from 2000 to 2010. We traced both cohorts until a diagnosis of CAD, loss to follow-up, or the end of 2011. In total, 2723 patients with APAP poisoning and 10,892 comparison patients have followed. The incidence rate of CAD was higher in the APAP poisoning cohort than in the non-APAP poisoning cohort (1.53 vs 0.87 per 1000 patient-years). The APAP poisoning cohort exhibited a 1.85-fold higher risk of CAD than did the non-APAP poisoning cohort (adjusted hazard ratio [aHR] 1.85; 95% confidence interval [CI] 1.16-2.94). Male sex, advanced age, and hypertension were independently associated with CAD risk. The risk of CAD was considerably higher within 3 years following APAP poisoning (aHR 2.73; 95% CI 1.31-5.69). This study indicated that APAP poisoning may increase risk of CAD development. [ABSTRACT FROM AUTHOR]

Purpose To compare the diagnostic value of monochromatic and material decomposition (MD) dual- energy computed tomography (DECT) imaging for the evaluation of ischemia. Methods Patients with suspected coronary artery disease underwent rest-stress DECT and SPECT perfusion imaging. DECT images were reconstructed between 40 and 140 keV and through MD of iodine/muscle. Results MD and monochromatic imaging had a sensitivity, specificity, negative predictive, positive predictive value, and accuracy of 89%, 40%, 67%, 73% and 71%; and 91%, 67%, 67%, 91% and 86%, respectively ( p = 0.05). Conclusion DECT using monochromatic energy displayed a non-significantly higher diagnostic accuracy for myocardial ischemia as compared with DECT MD. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension (PH) is an uncommon cause for chest pain in patients without significant coronary artery disease (CAD). Therefore, we studied the association between chest pain, right ventricular dimensions (RVDs), and PA size on coronary coronary tomographic angiography (CCTA). Materials and methods: It was a prospective study done from the February 1, 2015 to August 31, 2015. Total of 98 patients were identified, 67 in the chest pain and 31 in the non-chest pain group. Results: Patients with chest pain without CAD showed markedly dilated right atrial and ventricular chambers compared with standard parameters. PAD was measured as 24.81± 0.47 mm in the chest pain group and 21.91 ± 0.41 mm in the control group (P < 0.05). Odds ratio between chest pain and a significantly higher PAD was 10.11 (2.76-41.91, P < .05), 10.33 (2.15-61.41, P < .05) after adjusting for age, sex, BMI, history of HTN, HLP, CHF, COPD, OSA, and smoking. The chest pain group had an RAD1 of 47.19± 0.61 mm, RAD2 of 43.83 ± 1.79 mm, RVD1 of 37.91± 0.75 mm, RVD2 of 30.87± 0.73 mm, and RVD3 of 60.31± 1.1 mm. Based on the existing echocardiographic reference ranges, these measures fall within the upper limits of normal range. When comparing chest pain vs non-chest pain group, respectively, the mean RAD2 measured 39.98 ± 0.73 mm vs 33.78± 1.13 mm (P = .005), and the mean RVD2 measured 30.87± 0.73 mm vs 26.71± 1.73 (P = .03). Conclusion: In patients presenting with chest pain without CAD on CCTA, there is a strong association between the presence of chest pain and enlarged PAD. [ABSTRACT FROM AUTHOR]

Background: Ventricular Tachycardia (VT) constitutes an important manifestation of coronary artery disease (CAD). VT can occur in the immediate acute myocardial infarction (MI) period, further complicating the management. VT also occurs after long duration of acute coronary syndrome (ACS) in the healed MI. Aim: The aim of our study was to evaluate the epidemiology, clinical presentation, hemodynamic status, treatment received and finally the outcome of CAD patients manifesting as sustained VT. Materials and methods: This prospective study was conducted at Sher I Kashmir Institute of Medical Sciences (SKIMS), a tertiary care center in Srinagar, Jammu and Kashmir, India, between August 2013 to May 2016. All the cases of definite sustained VT already admitted in the hospital or presenting in the emergency department including those who developed VT during the course of acute MI were evaluated. Results: In our study, a total of 35 patients of CAD manifesting as sustained VT were observed. Majority of these patients were males. The most common presenting symptom was chest pain seen in a total of 14 patients. A total of 23 patients (66%) were hemodynamically stable at the time of VT. A decreased Left Ventricular Ejection Fraction (LVEF <50%) was seen in 18 patients (51%). Monomorphic VT was seen in a total of 28 patients (80%) and the rest of 7 patients showed polymorphic VT. Mortality was seen in 8 patients (23%). Conclusion: Polymorphic pattern of sustained VT, hemodynamic instability at the time of VT and a decreased LVEF are associated with increased mortality in patients of CAD manifesting as VT. [ABSTRACT FROM AUTHOR]

Aims: Cardiovascular disease is the leading cause of death in Jamaica. The aim of this study was to recognize the independent predictors of coronary artery disease (CAD) detected by stress myocardial perfusion imaging (MPI), and identify the predictive ability of MPI in detecting significant CAD in a Caribbean population who were referred to a cardiology clinic in Jamaica. Methods: Retrospective analysis of a cohort of 202 patients who had a stress MPI from 2015-2016. Ninety-one patients underwent symptom-limited treadmill stress MPI, one hundred and nine patients had dobutamine stress MPI and two patients had adenosine stress test. Results: Exercise stress testing showed a significantly higher hemodynamic response compared to dobutamine stress test (p 0.00034), though there was no significant correlation between the type of stress and test results (p 0.077). Logistic regression model demonstrated that age (odds ratio 1.043; p=0.08), male gender (odds ratio, 0.34; P = .006) and history of hypertension (odds ratio, 0.046 p value 0.0001) were significant independent predictors of a positive MPI. Twenty one patients with abnormal MPI had invasive coronary angiography. The predictive ability of abnormal vascular territory perfusion to correlate with assigned coronary artery was 64.3%, while the predictive ability of abnormal MPI to detect CAD was 95.2%. Conclusion: The prevalence of abnormal myocardial perfusion findings is relatively greater in elderly, male and hypertensive Caribbean patients with high probability of significant CAD. Therefore, MPI scan may be advocated in assessment workup of patients with presumed greater probability of CAD. [ABSTRACT FROM AUTHOR]

Background: Digit ratio (2D:4D) is fixed in utero and affected by fetal sex steroids. It has been proposed as a putative biomarker of certain hormone- related adult life traits and diseases. Several evidence suggest that 2D:4D ratio may correlate with cardiovascular disease risk (e.g., coronary artery disease).Aims: To investigate whether there is a possible relationship between digit ratio (especially 2D:4D ratio) and coronary artery disease (CAD), and age at CAD in north Chinese women.Methods: Photographs of the two hands of 303 females (controls: 194; patients: 109) were collected. Left hand, right hand and right minus left hand (Dr-l) digit ratio were analyzed and compared.Results: The mean values of digit ratio in patients with CAD were lower than controls for each hand. Significant differences of 2D:4D (left and right hand: P<0.01), 2D:5D (left hand: P<0.01; right hand: P<0.05) and 3D:4D (left hand: P<0.01) were found between two groups. There were no associations between 2D:4D ratio and age at CAD on both hands.Conclusion: Decreased digit ratio (especially 2D:4D ratio) may suggest a higher prenatal testosterone (lower prenatal oestrogen) exposure in north Chinese women with coronary artery disease. [ABSTRACT FROM AUTHOR]

Objective: Coronary artery disease is increasing and accounts for a high proportion among others diseases. In Iraq various studies have been reported that the polymorphism of vitamin D receptor VDRFok I gene like rs 2228570 are associated with CAD patients. Aim: This study was aimed to investigate the association between the SNP of VDR Fok I (rs2228570) gene with various anthropometric and biochemical parameters as a risk for CAD in Iraqi population. Methods and Materials: The current case - control study consisted of 300 samples, 150 of them were obtained from CAD patients who underwent the angiography department - heart centre - Al- Hussein Teaching Hospital, Al-Hussein Medical City/Holy Kerbala - Iraq and another 150 healthy control samples. Phenotypic data included body mass index (BMI), levels of fasting blood sugar (FBS), lipid profile, and blood urea, serum creatinine. Genotyping of rs2228570 polymorphism was carried out by PCR-RFLP method. DNA was extracted from genomic whole blood and genotyping was achieved with specific primers to amplify fragments for digestion with restriction enzymes. The enzyme Fok I was used for the digestion of VDR gene product followed by electrophoresis on agarose gel. Various statistical analyses were applied to analyse the data. Result: Digestion of VDR - Fok I gene product (PCR-product) exhibited an amplicon size of 273 bp, when this amplicon digested with Fok I enzyme, it gives three genotypes indicated one (273bp), two (75 bp + 198 bp) and three (75 bp + 198 bp + 273 bp) bands for those with wild type (TT), homozygous (CC) and heterozygous (TC) genotypes respectively. Genotype frequencies of rs2228570 polymorphism were found to be consistent with Hardy-Weinberg equilibrium with allele frequencies of TT wild genotype (33.3%), TC heterozygous genotype (46.7%), and CC homozygous genotype (20%) in cases of CAD group while 66.7%, 30% and 3.3% for wild, heterozygous, and homozygous in the control group respectively. The homozygous genotype (CC) was significantly (OR= 7.25, CI 2.74-19.20, P<0.001) increased the risk of CAD seven and quarter folds with respect to those of the wild type (TT) after adjustment for age, sex and BMI, while the TC genotype significantly (OR = 2.04, CI 95%; 1.27- 3.28, P<0.001) raised the risk of CAD by two folds. Co-dominant genotypes of rs2228570 polymorphism exhibited significant association with anthropometric and biochemical parameters such as BMI, and lipid profile among patients groups as compared with control groups. Conclusion: The obtained results improved that the gene polymorphism of VDR-Fok I was associated with high risk for development and progression of CAD and exhibited a significant association with increased BMI and lipid profile of coronary artery diseases of Iraqi population. [ABSTRACT FROM AUTHOR]

Background: This study is to compare the effects of Liraglutide and Metformin alone or combined treatment on the cardiac function in T2DM patients complicated with CAD. Methods: 120 T2DM patients were included at Endocrinology Department of Tianjin First Center Hospital (Tianjin, China) from April 2012 to September 2013. The study contained two sections. Section 1: 30 patients in group 1 was treated with Liraglutide (Novo Nordisk) (1.2 mg/d), and 30 patients in group 2 with Metformin (Shiguibao) (1500 mg/d) for 24 weeks. Section 2: 30 patients in group1 was treated with Liraglutide (1.8 mg/d) and 30 in group 2 with Liraglutide (1.2mg/d) plus Metformin (1500 mg/d) for 24 weeks. Fasting blood glucose (FBG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), body mass index (BMI), blood pressure (BP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), C reactive protein (CRP), left ventricular end-diastolic diameter (LVEDD), ejection fraction (EF) and the ratio of early (E) to late (A) ventricular filling velocities (E/A ratio) were measured before and after the 24-week treatment. Results: After 24-week treatment, when blood glucose level was controlled in 4 groups, Liraglutide alone treatment showed better improvements than on all measuring except TG in Section 1, however, combined treatment of Liraglutide and Metformin showed better improvements on all measuring except BMI, TG and BP in Section 2. Conclusions: With similar glycemic control, the Liraglutide (1.2 mg/d) monotherapy showed the better effects than either Metformin alone, or combination of Liraglutide and Metformin on lipid metabolism and cardiovascular function. [ABSTRACT FROM AUTHOR]

Introduction: Ischemic heart disease (IHD) is one of the leading causes of death. Short sleep duration may increase the risk of coronary artery disease (CAD). The study was designed to evaluate the association between CAD and sleep duration. Objectives: To determine the frequency of patients who have short sleep duration may suffer from CAD. Study design: Case series. Setting: Punjab Institute of Cardiology (PIC), Lahore. Period: It was carried out in six months. Methods: 400 patients admitted who presented with IHD. Sleep duration was categorized into three categories like <6 hours, 6-8 hours and >8 hours. Angiography was performed for patients who have CAD. Results: Sleep duration was <6 hours, 6-8 hours, and >8 hours in 172 (43%), 124 (31%) and 104 (26%) patients respectively. Significant CAD was presented among 84 (21%) patients of sleep duration <6 hours, 16 (4%) patients of sleep duration 6-8 hours and 32 (8%) patients of >8 hours sleep duration. Conclusions: Significant number of patients has short sleep time and suffering from CAD. [ABSTRACT FROM AUTHOR]

Bone mineral density (BMD) is a complex trait with high missing heritability. Numerous evidences have shown that BMD variation has a relationship with coronary artery disease (CAD). This relationship may come from a common genetic basis called pleiotropy. By leveraging the pleiotropy with CAD, we may be able to improve the detection power of genetic variants associated with BMD. Using a recently developed conditional false discovery rate (cFDR) method, we jointly analyzed summary statistics from two large independent genome wide association studies (GWAS) of lumbar spine (LS) BMD and CAD. Strong pleiotropic enrichment and 7 pleiotropic SNPs were found for the two traits. We identified 41 SNPs for LS BMD (cFDR < 0.05), of which 20 were replications of previous GWASs and 21 were potential novel SNPs that were not reported before. Four genes encompassed by 9 cFDR-significant SNPs were partially validated in the gene expression assay. Further functional enrichment analysis showed that genes corresponding to the cFDR-significant LS BMD SNPs were enriched in GO terms and KEGG pathways that played crucial roles in bone metabolism (adjP < 0.05). In protein–protein interaction analysis, strong interactions were found between the proteins produced by the corresponding genes. Our study demonstrated the reliability and high-efficiency of the cFDR method on the detection of trait-associated genetic variants, the present findings shed novel insights into the genetic variability of BMD as well as the shared genetic basis underlying osteoporosis and CAD. [ABSTRACT FROM AUTHOR]

Accumulated evidence indicates that polymorphisms in human leukocyte antigens (HLA) are associated with susceptibility to coronary artery disease (CAD). However, whether HLA-DQB1 alleles are correlated with susceptibility to CAD is unclear. In this study, significantly lower frequencies of the allele groups (DQB1*03:01:01G and DQB1*05:03:01G) and the genotypes (DQB1*03:01:01G/DQB1*03:01:01G and DQB1*03:01:01G/DQB1*05:03:01G) were observed in the CAD group compared with that in the controls. However, notably higher frequencies of DQB1*04:01:01G and genotype DQB1*05:01:01G/DQB1*03:01:01G were observed in the CAD patients than in the controls. Further analysis in subgroups showed that DQB1*03:01:01G was present at a significantly lower frequency in both female and male CAD patients compared with the corresponding controls; however, DQB1*04:01:01G was overtly high only in male CAD patients. CAD patients with diabetes showed a negative association with DQB1*03:01:01G and DQB1*05:03:01G and a positive association with DQB1*04:01:01G, DQB1*03:02:01G and DQB1*03:03:02G. Results of logistic regression analysis indicated that DQB1*03:01:01G and DQB1*05:03:01G were significantly associated with reduced susceptibility to CAD, but DQB1*04:01:01G, DQB1*03:02:01G and DQB1*03:03:02G had no correlation with CAD. Together, these findings indicate that CAD in Southern Han Chinese is negatively associated with HLA-DQB1*03:01:01G and DQB1*05:03:01G, and males with HLA-DQB1*04:01:01G are likely to have high risk for CAD. [ABSTRACT FROM AUTHOR]

This study explores the analysis of a new stent geometry from two typical stents used to treat the coronary artery disease. Two different finite element methods are applied with different boundary conditions to investigate the stenosis region. Computational fluid dynamics (CFD) models including fluid-structure interaction are used to assess the haemodynamic impact of two types of coronary stents implantation: (1) type 1-based on a strut-link stent geometry and (2) type 2-a continuous helical stent. Using data from a recent clinical stenosis, flow disturbances and consequent shear stress alterations introduced by the stent treatment are investigated. A relationship between stenosis and the induced flow fields for the two types of stent designs is analysed as well as the correlation between haemodynamics and vessel wall biomechanical factors during the initiation and development of stenosis formation in the coronary artery. Both stents exhibit a good performance in reducing the obstruction artery. However, stent type 1 presents higher radial deformation than the type 2. This deformation can be seen as a limitation with a long-term clinical impact. [ABSTRACT FROM AUTHOR]

Platelet membrane bedecked with a wide array of receptors offers a platform to regulate platelet responsiveness, thrombotic propensity, inflammatory disposition, and immune reactivity under diverse pathophysiological conditions. Ectopic proteolytic cleavage of such receptors irreversibly inactivates receptor-mediated intracellular signaling governing cellular functions, further releases soluble fragments into circulation which might modulate functions of target cells. Glycoprotein VI-(GPVI) is a membrane glycoprotein expressed in platelets and megakaryocytes. Platelet GPVI surface expression is enhanced following acute ischemic events like myocardial infarction and cerebral stroke, serves as an imminent diagnostic tool independent of markers of tissue necrosis, and is associated with poor prognosis. Platelets undergo GPVI shedding and thereby contribute to soluble plasma levels of sGPVI, with distinct diagnostic and prognostic attributes. This review summarizes the functional significance and mechanistic basis whereby GPVI surface availability is up- or downregulated on platelets and the impact of GPVI in diagnostic, prognostic, and therapeutic strategies in diseases where platelets play a regulatory role. Further, we also highlight how novel non-invasive platelet-based diagnostic and therapeutic strategies have evolved utilizing GPVI for lesion-directed antithrombotic therapy or to counteract atherosclerotic disposition to ameliorate care of patients particularly in the context of cardio-cerebro-vascular medicine. [ABSTRACT FROM PUBLISHER]

Coronary artery disease (CAD) is the leading cause of death worldwide. GWAS have identified > 50 genomic loci for CAD, including ADTRP and MIA3/TANGO1 . However, it is important to determine whether the GWAS genes form a molecular network. In this study, we have uncovered a novel molecular network between ADTRP and MIA3/TANGO1 for the pathogenesis of CAD. We showed that knockdown of ADTRP expression markedly down-regulated expression of MIA3/TANGO1 . Mechanistically, ADTRP positively regulates expression of PIK3R3 encoding the regulatory subunit 3 of PI3K, which leads to activation of AKT, resulting in up-regulation of MIA3/TANGO1 . Both ADTRP and MIA3/TANGO1 are involved in endothelial cell (EC) functions relevant to atherosclerosis. Knockdown of ADTRP expression by siRNA promoted oxidized-LDL-mediated monocyte adhesion to ECs and transendothelial migration of monocytes, inhibited EC proliferation and migration, and increased apoptosis, which was reversed by expression of constitutively active AKT1 and MIA3/TANGO1 overexpression, while the over-expression of ADTRP in ECs blunted these processes. Knockdown of MIA3/TANGO1 expression also promoted monocyte adhesion to ECs and transendothelial migration of monocytes, and vice versa for overexpression of MIA3/TANGO1 . We found that ADTRP negatively regulates the levels of collagen VII and ApoB in HepG2 and endothelial cells, which are downstream regulatory targets of MIA3/TANGOI. In conclusion, we have uncovered a novel molecular signaling pathway for the pathogenesis of CAD, which involves a novel gene-gene regulatory network. We show that ADTRP positively regulates PIK3R3 expression, which leads to activation of AKT and up-regulation of MIA3/TANGO1 , thereby regulating endothelial cell functions directly relevant to atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Coronary artery lesion severity is physiological assessed by fractional myocardial flow reserve (FFR). Angiographic assessment of intermediate severity lesions is problematic as inter-observer variability is significant. Hence one is not sure about the hemodynamic or functional significance of these lesions. FFR is helpful in this situation by assessing functional or hemodynamic significance of these intermediate coronary lesions. An FFR value <0.80 identifies ischemia-causing coronary stenosis with an accuracy of >90% suggesting that intermediate coronary lesion is in fact functionally important. Objective: To determine the correlation between mean lesion length of diffuse intermediate stenosis (40%-70% stenosis) of proximal and mid segment of major coronary arteries and mean fractional flow reserve (FFR). Study duration: From 1-07-2015 to 31-12-2015. Study design: Cross sectional study. Methodology: After approval from hospital Ethical committee and Informed consent, 60 patients with intermediate diffuse lesions on coronary angiography from Faisalabad Institute of Cardiology were enrolled. FFR assessment of diffuse intermediate lesion was done by author. FFR assessment was done using FFR wire during maximal blood flow (hyperemia) which was induced by injecting bolus dose of intracoronary adenosine. The cost of procedure was managed by hospital. Results: In this study, 28.33% (n=17) were between 20-50 years of age, mean+SD was calculated as 55.17+8.04 years, 51.67% (n=31) were male and 48.33% (n=29) were females. Correlation between mean lesion length of diffuse intermediate stenosis (40%-70% stenosis) of proximal and mid segment of major coronary arteries and mean fractional flow reserve (FFR) was recorded it shows that mean lesion length was 24.53+4.78 mm while FFR was recorded as 0.72+0.12, the value of R is -0.1928, technically a negative correlation, the relationship between variables is only weak (the nearer the value is to zero, the weaker the relationship). The value of R2, the coefficient of determination, is 0.0372. Conclusion: The correlation between mean lesion length of diffuse intermediate stenosis (40%-70% stenosis) of proximal and mid segment of major coronary arteries and mean fractional flow reserve (FFR) was weak and did not suggest any hemodynamic significance of diffuse intermediate coronary artery lesions. [ABSTRACT FROM AUTHOR]

Background: Omega-3 fatty acids have a protective role against cardiovascular disease and these protective properties are attributed to its anti-inflammatory effects. Myokines have anti-inflammatory properties and thereby reduce low-grade inflammation. Irisin, as a myokine, is considered to be therapeutic for human metabolic diseases. This study was conducted to determine the effects of Omega-3 fatty acids supplementation on serum irisin in men with coronary artery disease (CAD). Methods: This study was an 8-week randomized, double-blind, placebo-controlled trial. Forty-eight CAD male patients (Omega-3, n = 24; control, n = 24) were randomly assigned to either Omega-3 or control groups by permuted block randomization method. Only the participants with more than 50% stenosis in at least one major coronary vessel were included. Atotal of 3 participants in the control group were excluded from the study. Forty-five participants (Omega-3, n = 24; control, n = 21) completed the study. Participants took Omega-3 fatty acids supplement (720 mg eicosapentaenoic acid plus 480 mg docosahexaenoic acid) or placebo (edible paraffin) for 8 weeks. Serum irisin, high-sensitivity C-reactive protein (hs-CRP), lipid profile and anthropometric indices, body composition, and food intake were assessed before and after intervention. Statistical analyses were performed using SPSS software. Paired t-test was used for evaluating within-group effects from baseline. Variables with normal distribution were compared by independent t-test between 2 groups. Results: Compared to placebo, Omega-3 fatty acids increased serum irisin (P = 0.044) and decreased serum hs-CRP (P = 0.018) and LDL cholesterol (P = 0.031). Omega-3 fatty acids supplementation did not result in any significant changes in anthropometric measurements, blood pressure, serum lipids except for serum LDL, fasting blood glucose, body composition or serum insulin levels (all P > 0.05). Conclusion: Omega-3 fatty acids supplementation could elevate serum irisin in male patients with CAD. Also, these fatty acids may able to decrease serum hs-CRP and LDL cholesterol. [ABSTRACT FROM AUTHOR]