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Tag Archives: coronary artery disease

April 2024 Br J Cardiol 2024;31:43–4 doi:10.5837/bjc.2024.013

The impact of air pollution on atherosclerotic cardiovascular disease development

Clayton Tewma, Justin Lee Mifsud

Abstract

How much does air pollution contribute to ASCVD development? A meta-analysis showed that a low and high air pollution concentration contributes to ASCVD among adults; however, the higher the concentration, the higher the risk of irreparable damage, which can exacerbate morbidity and mortality levels.7 This meta-analysis found that heart rate variability decreased for every 10 µg/m3 increase in PM2.5 within both short- and long-term exposure groups, whereas ASCVD risk increased. In observational studies, which took place in China, Canada, US and South Korea, the hazard ratio (HR) increased significantly in the exposure to different pollutants

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April 2024 Br J Cardiol 2024;31:77 doi:10.5837/bjc.2024.016

Outcomes of PCI of all comers: the experience of a Kuwaiti independent healthcare institution

Telal Mudawi, Waleed Alenezi, Ahmed Amin, Dalia Besada, Asmaa Aly, Assem Fathi, Darar Al-Khdair, Muath Al-Anbaei

Abstract

Introduction Over the past two decades, extensive debates continued to be held to determine the minimum annual percutaneous coronary intervention (PCI) numbers an interventional healthcare institution must meet in order to maintain high-quality performance and ensure patient safety throughout the entirety of patients’ hospital stay. While PCI procedures have become routine, they remain quite complex and potentially risky. Operators’ expertise, cardiac catheter laboratory (Cathlab) team competence and equipment readiness, coronary care unit (CCU) preparedness, and cardiac surgery availability or accessibility, are all essential factors tha

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March 2024 Br J Cardiol 2024;31:36 doi:10.5837/bjc.2024.009

The prevalence of coronary artery disease in patients presenting with ‘non-anginal chest pain’

William Chick, Anita Macnab

Abstract

Introduction Coronary artery disease (CAD) is a significant cause of morbidity and mortality in the UK, and anginal chest pain is the most common manifestation.1,2 Chest pain, however, is one of the most common presenting symptoms in both emergency, primary and secondary care, and can be secondary to a myriad of pathologies. Therefore, the diagnosis of CAD from symptoms alone can prove challenging. Despite developments in both invasive and non-invasive CAD imaging, these investigations are not without risks and cost to the health service. Reduction of unnecessary investigations, while identifying patients most at risk, has been a major motiv

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September 2023 Br J Cardiol 2023;30:106–7 doi:10.5837/bjc.2023.028

NICE guidelines in the Sunderland RACPC cohort study: one size does not fit all

Kerrick Hesse, Zaw Htet, Mickey Jachuck, Nicholas Jenkins

Abstract

Introduction Undifferentiated chest pain places a significant burden on the UK National Health Service (NHS). Up to 50% of the general population experiences chest pain in their lifetime contributing to at least 1% of GP consultations and 5% of accident and emergency (A&E) attendances.1 Chest pain patients have a twofold higher mortality versus age-matched asymptomatic controls.1 One reason is undiagnosed obstructive coronary artery disease (CAD), which has effective treatments to prolong life and improve symptoms.1 The challenge is identifying the patients at greatest risk, providing a timely diagnosis and starting effective treatment. T

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November 2019 Br J Cardiol 2019;26:130–2 doi:10.5837/bjc.2019.039

Depression screening in CAD may provide an opportunity to decrease health outcomes disparities

Adam Prince, Umair Ahmed, Nikhil Sharma, Rachel Bond

Abstract

Introduction Depression is a significant cause of morbidity and mortality in patients with coronary artery disease (CAD), with depressive symptoms affecting up to 45% of patients with CAD.1 Cardiac patients with depressive symptoms experience a 2 to 2.5-fold mortality increase when compared with cardiac patients without depressive symptoms.2 Screening tools include the patient health questionnaire (PHQ), which exists in two- and nine-question formats, with PHQ2 being nearly 90% sensitive and 73% specific for depression,3 and PHQ9 being 88% sensitive and 88% specific for depression.4 We examined the records of patients with CAD in an ambulato

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November 2018 Br J Cardiol 2018;25:133

In brief

BJC Staff

Abstract

Self-monitoring of type 2 diabetes cuts costs Self-monitoring of type 2 diabetes used in combination with an electronic feedback system results in considerable savings on health care costs and also travel costs for patients, especially in sparsely populated areas, a new study shows. The study, carried out in Northern Karelia by the University of Eastern Finland, found that by replacing half of the required follow-up visits for type 2 diabetes with self-measurements and electronic feedback, total costs of glycated haemoglobin monitoring were reduced by nearly 60%. The annual per-patient cost was down from 280 euros to 120 euros. Fewer follow-u

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October 2017 Br J Cardiol 2017;24:(4) doi:10.5837/bjc.2017.028 Online First

Current diagnostic yield of invasive coronary angiography at a district general hospital

Ali Rauf, Sarah Denny, Floyd Pierres, Alice Jackson, Nikolaos Papamichail, Antonis Pavlidis, Khaled Alfakih

Abstract

Introduction Invasive coronary angiography (ICA) remains the cornerstone of diagnosis and treatment of patients with a high likelihood of coronary artery disease (CAD), or those with significant or unstable chest pain symptoms. However, there is always a concern that we overutilise ICA and this exposes patients to a small risk.1 Furthermore, ICA is an expensive procedure and overuse of diagnostic ICA can compete with percutaneous coronary intervention (PCI) and device implantations in hospitals with a single catheter lab. The National Institute of Health and Care Excellence (NICE) 2010 guidelines on stable chest pain, recommended that patien

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August 2017 Br J Cardiol 2017;24:97

In brief

BJCardio Staff

Abstract

A new gene therapy that targets the heart and requires only one treatment session, has been found safe for patients with coronary artery disease, according to a successful trial carried out in Finland (doi: 10.1093/eurheartj/ehx352). The treatment enhances circulation in ischaemic heart muscle and the effects were still visible one year after treatment. The randomised, blinded, placebo-controlled phase 1/2a trial was carried out in collaboration between the University of Eastern Finland, Kuopio University Hospital and Turku PET Centre. The biological bypass is based on gene transfer in which a natural human growth factor, AdVEGF-DΔNΔC, a ne

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April 2017 Br J Cardiol 2017;24:66-7 doi:http://doi.org/10.5837/bjc.2017.009 Online First

Does CTCA improve the diagnostic yield from conventional coronary angiography? A DGH experience

Colin Reid, Mark Tanner, Hatef Mansoubi, Conrad Murphy

Abstract

Introduction Computed tomography coronary angiography (CTCA) is an established and validated alternative to invasive coronary angiography (ICA).1 The extent to which CTCA can replace ICA is controversial.2 The low diagnostic yield from ICA suggest there is ample scope to select patients more efficiently for investigation.3 In 2010, in the UK, the National Institute for Health and Care Excellence (NICE)4 published new guidelines for the investigation of patients with suspected coronary artery disease (CAD), which incorporated CTCA as a first-line investigation.5 In keeping with these guidelines, we ceased to use exercise testing as a primary t

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August 2015 Br J Cardiol 2015;22:101–4 doi:10.5837/bjc.2015.029

Inflammation is associated with myocardial ischaemia

Kushal Pujara, Ashan Gunarathne, Anthony H Gershlick

Abstract

Introduction Coronary heart disease (CHD) is the leading cause of death worldwide. Chronic subclinical inflammation is a key recognised process in the pathogenesis of CHD, and may play an important role in atherogenesis. Figure 1. Atherosclerotic plaque rupture Atherosclerosis is a complex multi-factorial disease process, which is initiated at the endothelium in response to various forms of injurious stimuli (shear stress, oxidative stress, arterial pressure changes) including inflammation. These factors appear to alter the endothelial cell’s capacity to maintain homeostasis and vascular tone and leads to the so-called endothelial ‘dysfun

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