La tomagrafía computarizada como prueba para diagnosticar enfermedad arterial coronaria con comentarios sobre la aplicación de la teoría de Bayes y la placa vulnerable / Computerized tomography as a coronary artery disease diagnostic test and comments on the Bayes` theory and the vulnerable plaque

Los factores de riesgo en enfermedad arterial coronaria fueron evaluados en historias clínicas y estudios de pruebas de esfuerzos con el protocolo de Duke. Los índices de certeza se definen y utilizan comparándolos con el "el patrón de oro" la arteriografía coronaria. Se establece el valor diagnóstico de la tomagrafía axial computarizada, basándose en los índices de certeza. también se mencionan los estudios intracoronarios para evaluar la placa obstructiva

Risk factors in coronary artery disease were evaluated with the clinical history and the stress test with the Duke protocol. Probability indexes were defined and compared with the gold standard (coronary arteriogram). The diagnostic value of coronary angiotac was established with probability indexes. Intracoronary studies to diagnose vulnerable plaque are also mentioned

Correlation between serum uric acid level and severity of coromry artery / 中国医师进修杂志

ObjectiveTo investigate the correlation between serum uric acid level and severity of coronary artery disease.MethodsThe concentrations of serum uric acid in 112 patients whom had received coronary arteriongraphy(CAG) was measured,among of them,acute coronary artery syndrome (ACS) with 58 cases( ACS group ),stable angina cordis with 25 cases( stable angina cordis group),non-coronary disease with 29 cases(control group).The severity of coronary artery lesion was evaluated by the number of stenosis vessel and Gensini score.They were divided into control group (29 cases),single vessel lesion group (24 cases),double vessel lesion group(26 cases),triple vessel lesion group(33 cases ) according to the number of stenosis vessel and 0-1 score group(29 cases),2-20 scores group(28 cases),21-40 scores group(30 cases),＞40 scores group (25 cases) according to the Gensini score.ResultsThe concentrations of serum uric acid in ACS group were higher than those in control group and stable angina cordis group[ (369.61 ± 91.97 ) μ mol/Lvs. (298.33 ±92.46),(330.43 ±87.42)μmol/L] (P ＜0.05).The concentrations of serum uric acid in control group were lower than those in single vessel lesion group,double vessel lesion group and triple vessel lesion group [(298.33 ±92.46)μmol/L vs. (331.77 ±86.33),(368.24 ±95.21),(396.82 ±94.45) μ mol/L] (P ＜ 0.05).The concentrations of serum uric acid in single vessel lesion group were significantly lower than those in double vessel lesion group and triple vessel lesion group (P ＜ 0.05 ).The concentrations of serum uric acid in 0-1 score group [ (298.33 ± 92.46) μ mol/L] and 2-20 scores group [ (320.77 ± 86.33 ) μ mol/L ] were respectively lower than those in 21-40 scores group [ (366.61 ± 91.97 ) μ mol/L ] and ＞ 40 scores group [ (402.82 ± 91.97 ) μ mol/L](P ＜ 0.05 ).The concentrations of serum uric acid in ＞ 40 scores group was higher than that in 21-40 scores group (P ＜ 0.05 ).Serum uric acid concentrations was positively correlated with the log of Gensini score (r =0.348,P ＜ 0.05 ).ConclusionThe increase in serum uric acid might reflect increase in severity of coronary artery stenosis.

Surgical Management of Arteriosclerosis Obliterans of the Lower Extremities and Aortic Aneurysm in Patients with Ischemic Heart Disease / 日本心臓血管外科学会雑誌

Ischemic heart disease (IHD) poses some serious problems in the surgical treatment of arteriosclerosis obliterans of the lower extremities (ASO) and aortic aneurysm (AA). The surgical management of these vascular diseases in patients with IHD was evaluated. Thirty-five patients had ASO and 31 had AA. All patients underwent coronary arteriogram. IHD was detected in 24 patients (69%) with ASO and in 12 (39%) with AA. The severity of coronary artery disease was graded by the coronary score (CS) proposed by Leaman et al., and the scores were compared with the mode of surgical treatment. In patients with ASO, both the revascularization of coronary arteries (CABG) and of peripheral arteries were performed in one stage in 3 patients with a CS of 16-22. Only arterial revascularization of the lower extremities was performed in 19 patients with a CS of below 5.5. In AA, surgical treatment was performed with consideration of the severity of the coronary artery disease and the surgical approach. Both CABG and aortic reconstruction were performed in one stage in 3 patients with abdominal aortic aneurysm (CS: 9.5-13.5) and in 2 patients with aortic arch aneurysm (CS: 3.5, 8) with a coronary lesion in the left anterior descending branch (LAD). Only aortic repair was performed in 5 patients with a CS below 8 (without LAD lesion). The patients with ASO (CS≤5.5), and those with AA (CS≤8, no LAD lesion) underwent reconstruction only in the arteries of the lower extremities and aortic aneurysms, respectively, without any complications from the associated IHD.