In a prospective, multicenter trial of patients randomized to hs-troponin based evaluation and disposition to CCTA, there was no difference in the primary endpoint of patients identified with significant CAD requiring revascularization. But, instead, something miraculous happened.
Individuals were randomly assigned in a 2: Calcium does not collect exclusively at sites with severe stenosis EBCT calcium scores do not identify the location of specific vulnerable lesions Substantial non-calcified plaque is frequently present in the absence of coronary artery calcification There are no proven relationships between coronary artery calcification and the probability of plaque rupture.
Conversely, the presence of calcium does not secure a diagnosis of significant angiographic narrowing. This observed improvement in hard cardiovascular outcomes following CCTA is likely explained by the unique ability of CCTA to not only detect significant epicardial coronary vessel stenosis, but also to diagnose non-obstructive coronary atherosclerosis.
It should be acknowledged, however that coronary CTA in high or irregular heart rates typically is associated with a higher radiation dose. The process generally requires minutes for completion of each view. View Media Gallery Stress echocardiography Stress echocardiography, also known as dobutamine or exercise echocardiography, has several uses; however, in heart failure, this technique is used mainly to assess coronary artery disease.
Research has indicated that EBCT is highly sensitive in detecting coronary artery calcification in comparison to other types of CT. A non-invasive method combining the morphological image of the coronary anatomy with functional imaging of myocardial ischemia is therefore particularly desirable.
Ultrafast CT is being investigated for this proposed use. Dorr and associates stated that clinical studies have consistently shown that there is only a very weak correlation between the angiographically determined severity of CAD and disturbance of regional coronary perfusion.
Often, this is due to pericarditis. The authors reviewed the PROMISE trial outcomes and noted that although the findings are insufficient to conclude the possibility of either harm or benefit from the use of CCTA, a particularly salient feature was that although catheterization was performed in more CCTA patients in the 90 days following noninvasive testing, the likelihood of nonsignificant CAD was significantly lower in the CCTA group 3.
But, if we keep redamaging ourselves three times a day, we may never heal. The highest organ LARs were for lung cancer and, in younger women, breast cancer. Electron beam computed tomography is highly sensitive, but its specificity is low. Main outcome measures were the incidence of atherosclerosis plaques and significant stenosis.
However, they stated that in the era of hs-troponins, CCTA did not identify more patients with significant CAD requiring coronary re-vascularization, shorten hospital stay, or allow for more direct discharge from the ED.
One of the most amazing things I learned in all my medical training was that within about 15 years of stopping smoking, your lung cancer risk approaches that of a lifelong nonsmoker.
Framingham Risk Scoring Tool.
CCTA is generally contraindicated for decompensated heart failure; however, may be considered on a case-by-case basis Abbara et al, The gold standard for diagnosing coronary artery stenosis is cardiac catheterization.
In people with diabetes exercise is thought to improve blood glucose control, which reduces the negative impact of diabetes on vascular health. It does not look like those choosing the drug route will be climbing mountains anytime soon.
Diagnostic accuracy was analyzed in 30 of the 85 patients who underwent additional invasive coronary angiography ICA. More research is needed to establish the effectiveness of EBCT in the role of risk factor reduction and prevention of cardiovascular disease.
Detection and delineation of suspected coronary anomalies in young persons less than 30 years of age with suggestive symptoms e.
Physical activity, at any age, protects against a multitude of chronic health problems including many forms of cardiovascular disease. Both traditional and chronic kidney disease-related cardiovascular risk factors contribute to this high prevalence rate.
HeartCare - Information on Heart Health. BHB Foundation is a not-for-profit organization dedicated to increase awareness about prevention of Heart Disease.
Hypertension in India. High blood pressure (BP) is a major public health problem in India and its prevalence is rapidly increasing among both urban and rural populations.
1, 2 In fact, hypertension is the most prevalent chronic disease in India. The prevalence of hypertension ranges from % in urban adults and % among rural adults. Coronary artery disease (CAD), also known as ischemic heart disease (IHD), refers to a group of diseases which includes stable angina, unstable angina, myocardial infarction, and sudden cardiac death.
It is within the group of cardiovascular diseases of which it is the most common type. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.
Coronary artery disease (CAD), also known as ischemic heart disease (IHD), is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death.
A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Barley is a wonderfully versatile cereal grain with a rich nutlike flavor and an appealing chewy, pasta-like consistency.
Its appearance resembles wheat berries, although it is slightly lighter in color. Heart failure develops when the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues or is able to do so only with an elevated diastolic filling pressure.
See the image below.Prevalence of coronary heart disease in india