• Title/Summary/Keyword: coronary artery disease(CAD)

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Coronary Artery Disease Reporting and Data System: A Comprehensive Review

  • Parveen Kumar;Mona Bhatia
    • Journal of Cardiovascular Imaging
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    • v.30 no.1
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    • pp.1-24
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    • 2022
  • The Coronary Artery Disease Reporting and Data System (CAD-RADS) is a standardized reporting method for coronary computed tomography angiography (CCTA). It summarizes the findings of CCTA in 6 categories ranging from CAD-RADS 0 (complete absence of coronary artery disease) to CAD-RADS 5 (total occlusion of at least one vessel). It is applied on per patient basis for the highest grade of the stenotic lesion. The CAD-RADS also provides categoryspecific treatment recommendations, helping patient management. The main objectives of the CAD-RADS are to improve the consistency in reporting, facilitate the communication between interpreting and referring clinicians, recommend the best course of patient management, and produce consistent data for quality improvement, research and education. However, CAD-RADS has many limitations, resulting into the misclassification of the observed findings, misinterpretation of the final category, and misguidance for the treatment based upon the single score. In this review, the authors discuss the CAD-RADS categories and modifiers, along with the strengths and limitations of this new classification system.

Clinical Characteristics of Coronary Artery Disease Patients by Comorbidity of Diabetes Mellitus (당뇨병을 동반한 관상동맥질환자의 임상적 특성)

  • Choi, Eun-Ha;Song, Mi-Soon
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.1-10
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    • 2011
  • Purpose: The study was conducted to find out clinical characteristics for coronary artery disease patients with diabetes mellitus. Methods: We retrospectively reviewed the electronic medical records which included the data of 6,792 patients, who had been diagnosed coronary artery disease (CAD) such as angina or acute myocardial infarction and admitted to a university hospital in Seoul from January, 2005 to November, 2010. Results: Of the 6,792 patients, 43% had been diagnosed diabetes as comorbidity. The CAD patients with diabetes had lower left ventricular ejection fraction, stayed longer at hospital, and spent on more time from the first symptom to hospital visit than those without diabetes. In addition, they were more likely to have multi vessel coronary artery disease. Conclusion: The CAD patients with diabetes lay on the various factors which can make more worsen condition. Hence, we need to pay attention to specialized nursing care and patient education for the CAD patients with diabetes.

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CT Imaging Findings in Non-Atherosclerotic Coronary Artery Disease (다양한 비죽상경화 관상동맥 질환의 CT 영상 소견)

  • Jongmin Park;Byunggeon Park;Eun-Ju Kang;Jongmin Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.70-83
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    • 2022
  • Acute coronary syndrome (ACS) is mainly caused by atherosclerotic coronary artery disease (CAD); however, it can also occur in patients with non-atherosclerotic CAD. Conventional coronary angiography only shows the lumen of arteries, indicating the presence of stenosis or dilatation. Thus, it has limited value in evaluating the coronary artery wall and offers low specificity for diagnosing CAD. Coronary CT angiography provides additional information, including the depiction of the concerned vessel and the aorta, as well as the pulmonary artery, which permits the diagnosis of non-atherosclerotic CAD and the differentiation of various causes of the disease. In this review, we present the pathophysiology and CT imaging features of non-atherosclerotic CAD.

Visualization of Borderline Coronary Artery Lesions by CT Angiography and Coronary Artery Disease Reporting and Data System (관상동맥 질환 판독과 자료 체계와 CT 혈관조영술에서의 경계성 관상동맥 병변)

  • Hyewon Park;Yu-Whan Oh;Ki Yeol Lee;Hwan Seok Yong;Cherry Kim;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.297-307
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    • 2024
  • Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

CT Assessment of Myocardial Perfusion and Fractional Flow Reserve in Coronary Artery Disease: A Review of Current Clinical Evidence and Recent Developments

  • Chun-Ho Yun;Chung-Lieh Hung;Ming-Shien Wen;Yung-Liang Wan;Aaron So
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1749-1763
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    • 2021
  • Coronary computed tomography angiography (CCTA) is routinely used for anatomical assessment of coronary artery disease (CAD). However, invasive measurement of fractional flow reserve (FFR) is the current gold standard for the diagnosis of hemodynamically significant CAD. CT-derived FFRCT and CT perfusion are two emerging techniques that can provide a functional assessment of CAD for risk stratification and clinical decision making. Several clinical studies have shown that the diagnostic performance of concomitant CCTA and functional CT assessment for detecting hemodynamically significant CAD is at least non-inferior to that of other routinely used imaging modalities. This article aims to review the current clinical evidence and recent developments in functional CT techniques.

Updates in the Management of Coronary Artery Disease (관동맥질환 치료의 최신 지견)

  • Yang, Dong-Heon;Chae, Shung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.87-93
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    • 2005
  • Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary Intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCI. In the management of patients with 57 segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but mote complete. Recently published evidences in the pharmacologic therapy including antiplatelet and stalin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

Insertion/Deletion Polymorphism of the Angiotensin Converting Enzyme Gene in Coronary Artery Disease in Southern Turkey

  • Acarturk, Esmeray;Attila, Gulen;Bozkurt, Abdi;Akpinar, Onur;Matyar, Selcuk;Seydaoglu, Gulsah
    • BMB Reports
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    • v.38 no.4
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    • pp.486-490
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    • 2005
  • Genetic factors are important in the pathogenesis of coronary artery disease (CAD). Angiotensin converting enzyme (ACE) gene insertion(I)/deletion(D) polymorphism is one of the genetic factor found to be related with CAD. We investigated the association between I/D polymorphism of the ACE gene and the presence of CAD. Threehundred and seven patients (187 males and 120 females, aged between 35-80, mean $54.3{\pm}9.8$ years) who underwent diagnostic coronary angiography were included in the study. ACE I/D polymorphism was detected by polymerase chain reaction. Of the 307, 176 had CAD. The most frequently observed genotype in all subjects was ID (47.9 %). However, in patients with CAD the frequency of II genotype was lower whereas DD genotype was higher compared to the controls (p < 0.05). The number of D allele carrying subjects were also higher (p < 0.05) in CAD patients. The logistic regression analysis indicated that the ACE D allele is an independent risk factor (odds ratio = 1.48, 95% CI = 1.01-2.18, p < 0.05). In conclusion, the I/D polymorphism of ACE gene (carrying D allele) is an independent risk factor for CAD in the studied Turkish population.

Mindfulness Meditation Experiences among Patients with Coronary Artery Disease: A Phenomenological Study (관상동맥질환자의 마음챙김 명상에 대한 경험: 현상학적 연구)

  • Song, Yeoungsuk;Song, Taeyun;Lee, Jong Young;Yoo, Young Sook;Kwon, So-Hi
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.21-28
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    • 2015
  • Purpose: This study was aimed to explore and describe the experiences of mindfulness meditation (mindfulness- based stress reduction, MBSR) among patients with coronary artery disease (CAD) as a method of cardiac rehabilitation. Methods: In-depth interviews was conducted with 7 participants with CAD post percutaneous coronary intervention. Main question was 'what is your experiences with MBSR?' Colaizzi's seven steps of phenomenological analysis was used for eliciting embedded meanings. Results: Five theme clusters were found; rediscovery of mindfulness meditation, obtaining self-control for stress management, self-worth, feeling of happiness, and looking into myself. Conclusion: This study provides a profound picture on the experiences of mindfulness meditation among participants with coronary artery disease. MBSR can help patients with CAD in reducing stress and to enhance their cardiac rehabilitations. It is hoped that mindfulness meditation can be used in clinical setting as a part of cardiac rehabilitation program.

Nutrients and Individual Fatty Acids Intake Patterns in the Coronary Artery Disease Patients with Different Degrees of Stenosis (관상동맥질환자에서 병변의 협착정도에 따른 일반영양소 및 개별지방산의 섭취양상)

  • 김수연
    • Journal of Nutrition and Health
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    • v.30 no.8
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    • pp.976-986
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    • 1997
  • Coronary artery disease (CAD) such as angina pectoris and myocardial infarction(MI) have been considered the major cause of death for decaddes . THeir incidence and prevalence are still increasing . Numerous studies have been done on the risk factor analysis of CAD in Western countries. Since the diet in Western countries is different from that in Korea it is difficult to assume that the Korean diet has the same effects as its western counterpeart on the development of CAD . THus the gudidelines for the Western CAD patients can no totally be applied to Koreans. This study was conducted to investigate the relationship between diet and CAD in Koreans. Subjects were comprised of patients admitted to the hospital for chest pain with poxxilbe CAD (men 129, women 65) . They were divided into the following three groups according to angiographic results ; angiogrphically normal coronary artery group (control), single vessel disease group(SVD) and multiple vessel disease group (MVD) . Intakes of dietary fatty acids and other nutrients were assessed by the semiquantitative food frequency method. Blood was also obtained from subjects for serum lipid analysis. Serum lipid profiles of men were clearly different form those of women. For men, serum choesterol levels (or LDL or LDL/HDL) seemed to be higher in the MVD group compared to the control and SVD groups, while TG level was significantly higher in the MVD group for women. Both men and women showed significantly higher caloric , fiber and vitamins C and A intakes in the MVD group than in the other two groups. Higher caloric intakes was due to higher intakes of carbohydrate and protein rather than fat intake. In terms of fatty acids intake, there were no significant differences among the three groups . Smoking seemed to have great effect on eating patterns in CAD patients. Smokers and ex-smokers showed significantly higher intakes of most nutrients including individual fatty acids that non-smokers. The results of stepwise regression showed that moderate alcohol intake decreases LDL levels and increases HDL levels and smoking seems to lowe HDL levels in CAD patients.

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Effects of Three Recumbent Postures on Autonomic Nervous System in Patients with Coronary Artery Disease

  • Kim, Wuon-Shik;Hwang, In-Kyoung;Choi, Hyoung-Min
    • International Journal of Vascular Biomedical Engineering
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    • v.3 no.2
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    • pp.10-16
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    • 2005
  • Because patients with coronary artery disease (CAD) have depressed vagal modulation and the mortality risk from acute myocardial infarction is lower in patients with higher vagal modulation, methods that can increase vagal modulation are desirable in patients with CAD. We intended to inspect the effect of recumbent posture on vagal modulation. By using angiography, 33 patients with abnormal (CAD group) and 33 patients with normal coronary arteries (control group) were studied. The nonlinear as well as the linear characteristics of heart rate variability (HRV) were analyzed on these patients in three recumbent postures: namely, the supine, right lateral decubitus, and left lateral decubitus postures. The lower the normalized high-frequency power (nHF) in the supine or left lateral decubitus posture, the higher the increase in the nHF when the posture was changed from supine or left lateral decubitus to right lateral decubitus in both groups of patients. Right lateral decubitus posture can lead to the highest vagal modulation and the lowest sympathetic modulation among the three recumbent postures in both normal and patients with CAD. Therefore, the right lateral decubitus posture can be used as an effective physiologic vagal enhancer in patients with CAD.

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