Coronary Artery Disease in an Asymptomatic Population Undergoing a Multidetector Computed Tomography (MDCT) Coronary Angiography.

AIM: To assess the prevalence of coronary artery disease (CAD) in asymptomatic subjects using multidetector computed tomography (MDCT) and its relationships to demographic and clinical risk factors. MATERIAL AND METHOD: We enrolled consecutive asymptomatic volunteers with no evidence of ischemic heart disease that underwent MDCT for the early detection of CAD. All MDCT findings were correlated with demographic and risk factors. A total of 2820 coronary segments were analyzed in 188 asymptomatic subjects (150 males and 38 females), aged 54.4 +/- 7.4 years. RESULTS: A total of 128 (68%) demonstrated MDCT findings compatible with CAD; of these 111 (86.7%) had non-significant (diameter stenosis /= 50%). Compared with older subjects (mean age 56+/-8 years), younger subjects had a lower prevalence of MDCT findings of CAD 55.5% vs. 12.5%, respectively (P<0.001), regardless of risk factors. Males had more CAD (mostly non-significant) compared with females (109 [72.7%] vs. 19 [50.3%], respectively; P= 0.007). Subjects with >/= 2 risk factors had a higher prevalence of CAD in general and significant CAD in particular (P<0.001). CONCLUSION: CAD in asymptomatic population seems to be not uncommon. Using MDCT a high prevalence of non-significant and low prevalence of significant CAD was discovered in middle age asymptomatic population.

Coronary artery disease among hypertensive patients undergoing coronary computed tomography angiography.

OBJECTIVE: Coronary artery disease (CAD) is a leading cause of morbidity and mortality in hypertensive patients. However, the true prevalence of CAD in hypertensive patients is unknown. The aim of our study was to investigate the relationship between CAD and hypertension in patients undergoing coronary computed tomography (CT) angiography (CCTA). METHODS: Three hundred and fifty-two consecutive patients were referred for cardiac evaluation, 125 with hypertension and 227 without hypertension. There were no statistical differences between the groups in several parameters: age, sex, and CAD risk factors. CAD was defined as coronary atherosclerosis, with obstructive or nonobstructive lesions. CCTA was performed, and findings were compared between patients with hypertension and those without. RESULTS: CAD was present in 103 (82%) hypertensive and 164 (72%) normotensive patients (P < 0.0001). Obstructive CAD was twice as common in hypertensive patients, and they had more plaques per coronary segment than did normotensive patients. Patients with hypertension duration of at least 10 years had more segments with CAD. CONCLUSION: CAD is more prevalent and severe in hypertensive patients than in normotensive patients. CAD severity increases with hypertension duration. CCTA may help to identify high-risk patients needing further evaluation for subclinical ischemia.

Coronary artery disease among asymptomatic diabetic and nondiabetic patients undergoing coronary computed tomography angiography.

OBJECTIVES: The aim of this study was to determine the prevalence and severity of coronary artery disease (CAD) and the plaque composition in asymptomatic diabetic and nondiabetic patients undergoing coronary computed tomography angiography (CCTA). BACKGROUND: CAD is the major cause of death among patients with diabetes. The true prevalence of CAD in asymptomatic diabetic patients, however, remains unknown. MATERIALS AND METHODS: A total of 328 consecutive patients (each with at least one risk factor or abnormal stress-test results) were referred for cardiac evaluation, 42 with diabetes and 286 without diabetes, all asymptomatic for cardiac-related symptoms. Groups were matched for age, sex, and CAD risk factors. CAD was defined as coronary atherosclerosis, with obstructive or nonobstructive lesions. CCTA was performed and findings compared between patients with diabetes and those without. RESULTS: CAD was present in 39 (93%) diabetic patients and in 211 (73%) nondiabetic patients (P=0.006). Obstructive CAD was more common in diabetic patients than in nondiabetic patients (29 vs. 6.6%, respectively; P<0.0001). In diabetic patients, more coronary segments with atherosclerosis per patient were detected (5.5 segments/patient vs. 2.8 segments/patient in nondiabetics; P<0.0001). The total Agatston score was significantly higher in diabetic patients vs. nondiabetic patients (370+/-96 and 79.9+/-16, respectively; P<0.0001). CONCLUSION: Our results indicate a high prevalence (93%) of CAD in asymptomatic diabetic patients with either nonobstructive or obstructive lesions. CCTA may be a useful imaging modality for selecting patients at high risk who would benefit most from further evaluation for subclinical ischemia.

Paraoxonase activity following exercise-based cardiac rehabilitation program.

PURPOSE: The effect of gender on paraoxonase activity was determined in 37 ischemic heart disease patients who underwent a 12-week aerobic exercise training program. METHODS: Paraoxonase activity was measured by its arylesterase activity (spectrophotometrically, at 250 degrees C, wavelength 270 nm). RESULTS: A 16.7% increase in paraoxonase activity was found following the 12-week exercise program. In addition, there was a significant gender effect with higher mean paraoxonase levels among women during both preexercise (20.8%) and postexercise (24.2%) testing. CONCLUSIONS: Aerobic exercise training was found to be an effective means in inducing plasma levels elevation of the antioxidative, antiatherogenic paraoxonase in patients with coronary artery disease, and particularly in female patients.