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Chen X, Zhao J, Cai Q, Chen R, Wu W, Wang P, Zhang G, Zhen J. Relationship between Coronary Artery Calcium Score and Coronary Stenosis. Cardiol Res Pract 2023; 2023:5538111. [PMID: 38144902 PMCID: PMC10746374 DOI: 10.1155/2023/5538111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 12/26/2023] Open
Abstract
Background The coronary artery calcium score (CACS) is commonly employed to quantify the degree of calcification in coronary atherosclerosis. Indeed, increased coronary stenosis severity is associated with a progressive increase in CACS. Objectives This study sought to explore the association between CACS and coronary stenosis of ≥50% and ≥70%. Methods We conducted a retrospective analysis of patient data collected between July 1, 2017, and March 3, 2022, at Jiangmen Central Hospital. A total of 208 patients, presenting with both symptomatic and asymptomatic manifestations and suspected coronary artery disease (CAD), were included. Statistical analyses included ROC curve assessments, subgroup analyses based on age, and comparisons of CACS values against the presence of coronary stenosis ≥50% and ≥70%. Results Ultimately, 208 patients were included, with a median age of 65.0 years and a median CACS of 115.7 (interquartile range: 13.7-369.4). A CACS threshold of ≥1300 demonstrated a specificity of 100% for coronary stenosis of ≥50%. Notably, the percentage of patients with obstructive CAD showing CACS = 0 was significantly higher in those under 65 years (15.1%) compared to patients over 65 years (3.8%) (P=0.005). The inflection point, at which the risk probability for coronary stenosis of ≥50% shifted from being a protective factor to a risk factor, was observed when CACS fell within the range of 63.3 to 66.0. Conclusion CACS demonstrates good performance for the detection of coronary artery stenosis.
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Affiliation(s)
- Xinyan Chen
- Department of Cardiology, Guangdong Medical University, Zhanjiang, Guangdong 524000, China
- Department of Cardiology, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, China
| | - Jianbin Zhao
- Department of Cardiology, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, China
| | - Qingqing Cai
- Department of Cardiology, Guangdong Medical University, Zhanjiang, Guangdong 524000, China
| | - Rong Chen
- Department of Cardiology, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, China
| | - Wenhao Wu
- Department of Cardiology, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, China
| | - Peng Wang
- Department of Network Information, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, China
| | - Gaoxing Zhang
- Department of Cardiology, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, China
| | - Jinhuan Zhen
- Department of Cardiology, Guangdong Medical University, Zhanjiang, Guangdong 524000, China
- Department of Cardiology, Kaiping Second People's Hospital, Jiangmen, Guangdong 529300, China
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Bikmoradi A, Roshanaei G, Moradkhani S, Fatahi A. Impact of inhalation aromatherapy with Damask Rose ( Rosa damascena) on stress, anxiety and hemodynamic parameters of patients undergoing coronary angiography: a single blind randomized clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:753-761. [PMID: 34018381 DOI: 10.1515/jcim-2020-0415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/26/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Coronary arteries angiography is used commonly for diagnosing cardiovascular diseases. In spite of the low risk of coronary artery angiography method, it could lead to stress, anxiety and consequently hemodynamic changes in patients. This study aimed to assess the effects of inhalation aromatherapy with Rosa damascena on stress, anxiety, and hemodynamic parameters of patients undergoing coronary angiography. METHODS A single-blind randomized clinical trial was conducted on 98 patients in Besat Educational Hospital, Hamadan, Iran. Before coronary angiography, patients at aromatherapy group inhaled five drops of 40% Rosa damascena for 20 min and in the control group, patients inhaled distilled water. Stress, anxiety, and hemodynamic parameters were measured before and after the intervention using DASS-21 questionnaire and checklist. RESULTS Data were analysed by SPSS 16 software using descriptive and inferential statistics such as paired t-test and non-parametric tests. There were significant differences in terms of stress and anxiety severity in patients at aromatherapy group (p=0.005) and control group (p=0.001). There were significant differences in terms of hemodynamic parameters such as heart rate (p=0.001), mean arterial pressure (p=0.001), systolic (p=0.003) and diastolic blood pressure (p=0.001) and SpO2 (p=0.02). CONCLUSIONS Inhalation aromatherapy with Rosa damascena can significantly decrease stress and anxiety severity and improve hemodynamic parameters of patients undergoing coronary angiography. REGISTRY NUMBER This study has registered with the number IRCT201702019759N8 at Iranian Registry Clinical Trial.
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Affiliation(s)
- Ali Bikmoradi
- Department of Health Economics and Management, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghodratollah Roshanaei
- Department of Biostatistics and Epidemiology, Modeling Non-Communicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirin Moradkhani
- Department of Pharmacognosy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azad Fatahi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Bikmoradi A, Roshanaei G, Moradkhani S, Fatahi A. Impact of Inhalation Aromatherapy with Damask Rose on Anxiety of Patients Undergoing Coronary Angiography: A Single-Blind Randomized Controlled Clinical Trial. ACTA ACUST UNITED AC 2020. [DOI: 10.30699/ajnmc.28.2.93] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Diagnostic and Prognostic Value of Coronary Computed Tomography Angiography in Patients with Severe Calcification. J Cardiovasc Transl Res 2020; 14:131-139. [PMID: 32239435 DOI: 10.1007/s12265-020-09977-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
Our aim was to analyze its diagnostic and prognostic value in patients with high coronary calcium score (CCS). A total of 113 patients with CCS > 400 were included. Significant coronary artery disease (CAD) was defined as stenosis ≥ 50%. Invasive coronary angiography and major cardiovascular events were recorded. The CCS and heart rate during the acquisition were significantly lower in the diagnostic coronary computed tomography angiography (CCTA) group. The cut-off value of CCS to establish the diagnostic utility of CCTA was 878. The rate of cardiovascular events was 9.3%. The positive predictive value of CCTA to detect significant CAD was 73.5% and the negative predictive value for predicting cardiovascular events was 96%. In patients with high CCS, CCTA is useful to evaluate CAD, especially when the CCS is lower or equal to 878; moreover, the prognostic value of CCTA is better in patients where significant CAD has been ruled out.
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de Agustín JA, Gómez de Diego JJ, Marcos-Alberca P, Mahía P, Rodrigo JL, Luaces M, Núñez-Gil IJ, Ferreiros J, Bustos A, Cabeza B, García-Fernández MÁ, Macaya C, Pérez de Isla L. Impact of Calcium Score on Agreement Between Multidetector Computed Tomography and Invasive Coronary Angiography. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2018; 71:105-109. [PMID: 28528881 DOI: 10.1016/j.rec.2017.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/04/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES Multidetector computed tomography (MDCT) has been demonstrated as a feasible alternative to invasive coronary angiography (ICA). However, contradictory results have been reported regarding the effect of coronary artery calcium score (CS) on the diagnostic accuracy of MDCT. Our aim was to assess the agreement of MDCT and ICA and to evaluate the influence of CS on this agreement. METHODS We enrolled 266 consecutive patients who underwent evaluation with 64-slice MDCT and ICA. Standard CS software tools were used to calculate the Agatston score. Stenosis was qualitatively classified as mild, moderate, or severe by 1 blinded observer and the results were compared with those of ICA, which was used as the gold standard. RESULTS The mean age of the patients was 65.4 ± 11.2 years, and 188 patients (70.3%) were men. A total of 484 segments with coronary stenosis ≥ mild were qualitatively evaluated and quantified with MDCT. Noninvasive measurements were concordant with ICA in 402 stenoses (83.05%; Kappa, 0.684), with no significant differences between vessels and with no statistically significant influence of CS on this agreement (OR, 0.93; 95%CI, 0.76-1.09; P = .21). Multidetector computed tomography had high sensitivity, specificity, positive predictive value, and negative predictive value on a per-segment, per-vessel, and per-patient basis. CONCLUSIONS Non-ICA using MDCT showed good agreement with ICA in the qualitative quantification coronary stenosis and CS had no significant impact on this agreement.
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Affiliation(s)
| | | | | | - Patricia Mahía
- Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain
| | - José Luis Rodrigo
- Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain
| | - María Luaces
- Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain
| | | | - Joaquín Ferreiros
- Departamento de Radiología, Hospital Universitario San Carlos, Madrid, Spain
| | - Ana Bustos
- Departamento de Radiología, Hospital Universitario San Carlos, Madrid, Spain
| | - Beatriz Cabeza
- Departamento de Radiología, Hospital Universitario San Carlos, Madrid, Spain
| | | | - Carlos Macaya
- Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain
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Impacto de la puntuación de calcio en la concordancia entre la tomografía computarizada con multidetectores y la coronariografía invasiva. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Akers SR, Panchal V, Ho VB, Beache GM, Brown RK, Ghoshhajra BB, Greenberg SB, Hsu JY, Kicska GA, Min JK, Stillman AE, Stojanovska J, Abbara S, Jacobs JE. ACR Appropriateness Criteria ® Chronic Chest Pain—High Probability of Coronary Artery Disease. J Am Coll Radiol 2017; 14:S71-S80. [DOI: 10.1016/j.jacr.2017.01.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 11/29/2022]
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Urbonaviciene G, Isaksen C, Urbonavicius S, Buhl JS, Johansen JK, Nielsen AH, Nørgaard KS, Nørgaard A, Frost L. Coronary computed tomography angiography and calcium scoring in routine clinical practice for identification of patients who require revascularization. Arch Cardiovasc Dis 2016; 109:412-21. [PMID: 27215378 DOI: 10.1016/j.acvd.2016.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 10/25/2015] [Accepted: 01/20/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The predictive value of CCTA to predict coronary artery disease is high in particular in the absence of coronary calcification. However, the consideration of both CCTA and the calcium score, in addition to the risk factors to determine the indication for coronary revascularization, has not been yet studied. MATERIALS AND METHODS This study included 2302 patients (mean age: 60±9.8 years, 46% men), without known coronary artery disease (CAD), who underwent 320-row CCTA. Logistic regression, c-statistic and net reclassification improvement (NRI) were used to assess the role of coronary artery calcium score (CACS) in predicting revascularization after CCTA. RESULTS The revascularization rates were 0.75% in patients with a CACS of 0, and there were no adverse events during the follow-up period. The revascularization rates were 3.3% in patients with a CACS of 1-99, 15.4% in patients with a CACS of 100-399, 25.6% in patients with a CACS of 400-999, and 42.4% in patients with a CACS≥1000. The crude and adjusted odds ratios (95% confidence interval) for revascularization per CACS group category were 2.89 (2.53-2.3) and 2.71 (2.33-3.15), respectively; the area under the ROC curve (AUC) was 0.85 (0.83-0.88). The addition of CACS to conventional risk factors improved the accuracy of risk prediction model for revascularization (AUC 0.74 vs 0.63, P=0.001), but it did not reclassify a substantial proportion of patients with positive CACS to risk categories (NRI=-0.023, P=0.66). CONCLUSIONS The 320-row CCTA might rule out CAD in low- to intermediate-risk patients. However, its accuracy in identifying patients who require revascularization is limited. The CACS added to the conventional risk factors did not improve the identification of patients who require revascularization.
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Affiliation(s)
- Grazina Urbonaviciene
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark; Aarhus University, Institute for Clinical Medicine, Aarhus, Denmark.
| | - Christin Isaksen
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark
| | - Sigitas Urbonavicius
- Aarhus University, Institute for Clinical Medicine, Aarhus, Denmark; Viborg Hospital, Department of Vascular Surgery, Viborg, Denmark
| | - Jørgen Selmer Buhl
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark
| | - Jane Kirk Johansen
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark
| | - Agnete Hedemann Nielsen
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark
| | - Kirsten Schou Nørgaard
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark
| | - Aage Nørgaard
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark
| | - Lars Frost
- University Clinic for Development of Innovative Patient Pathways, Silkeborg Hospital, Diagnostic Centre, Silkeborg, Denmark; Aarhus University, Institute for Clinical Medicine, Aarhus, Denmark
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Ortiz-Pérez JT, Bosch X. Comments on exercise echocardiography and multidetector computed tomography for the evaluation of acute chest pain. Response. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2015; 68:165-166. [PMID: 25547376 DOI: 10.1016/j.rec.2014.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 10/17/2014] [Indexed: 06/04/2023]
Affiliation(s)
- José T Ortiz-Pérez
- Servicio de Cardiología, Instituto Clínico del Tórax, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain.
| | - Xavier Bosch
- Servicio de Cardiología, Instituto Clínico del Tórax, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
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Comentarios a la evaluación del dolor torácico agudo mediante ecocardiografía de ejercicio y tomografía computarizada multidetectores. Respuesta. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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