The relation between coronary tortuosity and calcium score in patients with chronic stable angina and normal coronaries by CT angiography

Tahlawi, Mohammad El; Sakrana, Amal Abdelsattar; Elmurr, Abdelrahman; Gouda, Mohamed; Tharwat, Mohamed

doi:10.1016/j.atherosclerosis.2016.01.029

Cited by 25 publications

(33 citation statements)

References 20 publications

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“…While 20% of our patients fell in this category, a significant higher percentage has been reported by others, even at shorter follow-up [14,22]. This raises the question about the nature of the angina like chest pain that patients complain of, which could be explained by either calcified epicardial vessels or microcirculation disease [4,[23][24][25][26] or else non-cardiac in origin, e.g. gastroesophageal reflux, psychiatric disorders or musculoskeletal [27].…”

Section: Data Interpretationmentioning

confidence: 55%

Angina in Patients with Non-obstructive Coronary Angiograms: Six-years Follow-up

Vancheri

Milino

Henein

et al. 2017

ICFJ

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Background and Aim: About one third of patients undergoing coronary angiography for angina have non-obstructive coronary artery disease (CAD). Until recent years the prognosis has been thought to be favourable and no treatment were recommended. More recently, an increased risk of cardiovascular (CV) events has been documented in these patients compared with a general population. We aimed to evaluate the long term persistence of angina and the occurrence of major CV events in patients with stable angina and non-obstructive CAD.Methods: We retrospectively evaluated all patients with effort angina referred to the cardiac catheterization laboratory of the Cardiovascular Unit, University of Catania, Sicily, between 1st July 2008 and 31st December 2009, because of a clinical suspicion of myocardial ischemia, without obstructive CAD, defined as <50% stenosis of left main stem or <70% in any epicardial coronary artery.Results: Among 2574 patients (2025 men and 549 women) referred for diagnostic coronary angiography, 151 (5.8%) had non-obstructive coronary angiograms. Six-years follow-up was available in 127 patients (63 men and 64 women). Persistence of angina was reported in 20.4%. Four patients (3.1%) had acute myocardial infarction and two (1.6%) had stroke.Conclusion: During a six-years follow-up, persistence of angina and occurrence of acute major CV events were found in a significant proportion of patients with stable angina and non-obstructive coronary angiograms.

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Section: Data Interpretationmentioning

confidence: 55%

Angina in Patients with Non-obstructive Coronary Angiograms: Six-years Follow-up

Vancheri

Milino

Henein

et al. 2017

ICFJ

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“…Oz et al [27] showed that VD insufficiency was associated with subclinical atherosclerosis, assessed using CIMT. Additionally, recent clinical trials have shown that CT was associated with subclinical atherosclerosis and increased coronary artery calcification (CAC) score even in the absence of significant obstructive lesions [5]. VD insufficiency was independently associated with CAC score and subclinical atherosclerosis [28].…”

Section: Discussionmentioning

confidence: 99%

“…CT is generally attributed to age-dependent, pathologic changes of elastic material in the vessel, and hypertension due to elongation and dilatation of the arteries with left ventricular hypertrophy [3,4]. A recent clinical trial showed that CT was associated with subclinical atherosclerosis and increased coronary artery calcification, even in the absence of significant obstructive lesion [5]. …”

mentioning

confidence: 99%

Vitamin D insufficiency is associated with coronary artery tortuosity

et al. 2017

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A b s t r a c tBackground: Increasing evidence suggests a relationship between vitamin D (VD) insufficiency and cardiovascular disease. Aim:We aimed to investigate the association between serum 25-hydroxyvitamin D (25-OH VD) with coronary tortuosity (CT) in patients with normal or near-normal (< 40% stenosis) coronary arteries. Methods:The present study was cross-sectional and observational. We enrolled 356 consecutive patients who had undergone coronary angiography for suspected ischaemic heart disease and were found to have normal or near-normal coronary arteries. Patients were categorised as VD insufficient (< 30 ng/mL) or VD sufficient (≥ 30 ng/dL). CT was defined as the presence of ≥ three bends (defined as ≥ 45° change in vessel direction) along the main trunk of at least one coronary artery, present both in systole and in diastole. Results:The study populations were divided into two groups according to the presence of CT: patients with CT (n = 103, 29%) and patients without CT (NCT; n = 253, 71%). CT is more frequently seen in elderly women and is positively correlated with hypertension. The incidence of VD insufficiency was significantly higher in the CT group (n = 46, 45%) than in the NCT group (n = 90, 36%; p = 0.005). In further multivariate logistic regression analyses, adjustment for major clinical parameters affecting CT showed statistically significant correlations between 25-OH VD and CT (odds ratio = 0.77, 95% confidence interval 0.66-0.98, p = 0.006). Conclusions: Vitamin D insufficiency was independently associated with coronary tortuosity.Key words: vitamin D insufficiency, coronary tortuosity, coronary artery disease, biomarkers, coronary angiography Kardiol Pol 2017; 75, 2: 174-180 INTRODUCTIONCoronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Coronary angiography is still the gold standard for the diagnosis of CAD, and coronary artery tortuosity (CT) is a common coronary angiography (CAG) finding [1][2][3]. The aetiology and clinical importance of CT are still unclear. CT is generally attributed to age-dependent, pathologic changes of elastic material in the vessel, and hypertension due to elongation and dilatation of the arteries with left ventricular hypertrophy [3,4]. A recent clinical trial showed that CT was associated with subclinical atherosclerosis and increased coronary artery calcification, even in the absence of significant obstructive lesion [5].

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“…Some authors claimed that degeneration of elastin layer of the vessel may be the cause of coronary tortuosity [17]. CorT might induce subclinical atherosclerosis in the absence of significant obstructive lesions [18]. Severe tortuosity in coronary arteries simplifies atherosclerosis [19].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Vitamin B12 in Patients with Coronary Tortuosity

Cerit

Kemal

Günsel

et al. 2016

Preprint

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Background: Vitamin B 12 deficiency has been implicated in endothelial dysfunction and cardiovascular disease via hyperhomocysteinemia. Coronary tortuosity (CorT) is a common coronary angiography finding. The etiology, clinical implication and long term prognosis are still not well clarified. This study was conducted with the aim to evaluate the relationship between CorT and vitamin B12. Subjects and Method: The medical records of consecutive patients, who underwent coronary angiography, were retrospectively reviewed. The study group consisted of 1624 patients. Taking into consideration the inclusion criteria, 212 patients with CorT and 210 patients with normal coronary angiographies (control group) were included in the study. Vitamin B12, other biochemical parameters, clinical and echocardiographic parameters, and CorT score were evaluated in all patients. CorT is defined as fixed 3 bends during both systole and diastole, with each bend ≥45 °. Results: Patients with CorT had higher prevalence of older, female gender, hypertension, current smoking. Vitamin B12 was significantly decreased in patient with CorT (134.7±47.8 vs 239.6±53.8 p<0.001). On multivariate analysis age, female gender, hypertension, diabetes mellitus and vitamin B12 were independent predictors for CorT (OR 1.56; 95% CI: 1.247-1.962; p < 0.001, OR 1.628; 95% CI: 1.376-2.048; p<0.001, OR 1.865; 95% CI: 1.387-2.695; p<0.001, OR 1.362; 95% CI: 1.184-1.726; p<0.001, OR 1.862; 95% CI: 1.486-2.674; p<0.001, respectively). Conclusion: In our study, we have founded a significant relationship between vitamin B12 deficiency and CorT.

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The relation between coronary tortuosity and calcium score in patients with chronic stable angina and normal coronaries by CT angiography

Cited by 25 publications

References 20 publications

Angina in Patients with Non-obstructive Coronary Angiograms: Six-years Follow-up

Angina in Patients with Non-obstructive Coronary Angiograms: Six-years Follow-up

Vitamin D insufficiency is associated with coronary artery tortuosity

Assessment of Vitamin B12 in Patients with Coronary Tortuosity

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