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Tag Archives: coronary artery disease

Is angiography overused for the investigation of suspected coronary disease? A single-centre study

April 2014 Br J Cardiol 2014;21:77 doi:10.5837/bjc.2014.012 Online First

Is angiography overused for the investigation of suspected coronary disease? A single-centre study

Colin J Reid, Mark Tanner, Conrad Murphy

Abstract

Introduction For many years coronary angiography (CA) has been used as the gold standard in the assessment of coronary artery disease (CAD), and even a normal result is considered a worthwhile outcome.1 However, concern has been raised about the use and overuse of what is an invasive and expensive procedure.2-4 We examined our cardiac catheter database to assess our diagnostic yield in terms of detecting CAD, and also in terms of subsequent referral for coronary revascularisation, whether this be by percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG), in a population of patients being assessed for possible CAD.

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CTCA outperforms ETT in patients with stable chest pain and low-to-intermediate predicted risk

July 2013 Br J Cardiol 2013;20:108 doi:10.5837/bjc.2013.025 Online First

CTCA outperforms ETT in patients with stable chest pain and low-to-intermediate predicted risk

Toby Rogers, Michael Michail, Simon Claridge, Andrew Cai, Kathy Marshall, Jonathan Byrne, Narbeh Melikian, Khaled Alfakih

Abstract

Introduction For many years, the exercise tolerance test (ETT) has been the first-line investigation in patients presenting with stable chest pain. However, equivocal and false-positive results often lead to additional investigations. In recent years, computed tomography (CT) coronary angiography (CTCA) has been demonstrated to have excellent negative predictive value, making it a useful test to rule out obstructive coronary artery disease (CAD).1-3 In 2010, the UK National Institute for Health and Care Excellence (NICE) published clinical guideline 95: ‘Chest pain of recent onset’. This guideline advocates the use of a new risk estimatio

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Iterative reconstruction algorithms allow greater diagnostic certainty in 64-slice platforms: CAPIR results

June 2013 Br J Cardiol 2013;20:67–71 doi:10.5837/bjc.2013.18

Iterative reconstruction algorithms allow greater diagnostic certainty in 64-slice platforms: CAPIR results

Peter McKavanagh, Lisa Lusk, Peter A Ball, Tom R Trinick, Ellie Duly, Gerard M Walls, Sarah McCusker, Mohammad Alkhalil, Claire Louise McQuillan, Mark T Harbinson, Patrick M Donnelly

Abstract

Introduction The use of cardiac computerised tomography (CT) in the UK is changing. National Institute for Health and Clinical Excellence (NICE) clinical guideline 95 (CG95) defined its role in the assessment of stable chest pain patients.1 Further, recent NICE diagnostics guidance 3 (DG3) has recommended the use of newer scanners for difficult patients and specifically addressed the concerns about the effective radiation dose (ED) of earlier CT platforms.2 However, the commercial availability of the latest CT scanners is not yet widespread within the National Health Service (NHS). The 64-detector CT is presently the workhorse of the NHS and

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Left pleuropericardial agenesis and coronary artery disease

August 2012 Br J Cardiol 2012;19:124–5 doi:10.5837/bjc.2012.023

Left pleuropericardial agenesis and coronary artery disease

Pankaj Kaul

Abstract

Introduction Left pleuropericardial agenesis is a developmental abnormality that results in the heart and the left lung sharing a common coelomic cavity. This abnormality manifests due to failure of mesodermal ingrowth from the lateral body wall to close off the left pleuropericardial canal and also the failure of development of the left pleuropericardial membrane. Although pre-operative diagnosis is very unusual, partial agenesis can precipitate catastrophic complications of chamber or appendage incarceration. Complete agenesis results in incompletely understood effects on the right ventricular geometry due to luxation of heart into an extre

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August 2012 Br J Cardiol 2012;19:134–8 doi:10.5837/bjc.2012.025

Early and late survival after surgical revascularisation for left main coronary artery stenosis in stent era

Dumbor L Ngaage, Franco Sogliani, Augustine Tang

Abstract

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October 2011 Br J Cardiol 2011;18(Suppl 3):s1-s12 doi:10.5837/bjc.2011.s04

Community-based angina clinics and the therapeutic management of patients with coronary artery disease

Drs Thornton-Chan and colleagues

Abstract

The objective of this study was to look at how well patients with coronary artery disease are managed, and whether community-based angina clinics might be an alternative, or even more beneficial, to these patients compared with hospital-based clinics. Patients with coronary artery disease need regular follow-ups to review their lifestyle and medications, and to ensure angina symptoms are well controlled. Heart rates should be checked regularly as high heart rate is associated with increased risk of myocardial ischaemia. In this study, 41 patients with coronary artery disease were assessed at a community-based angina clinic. Our results showe

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Is there a role for 64-multi-detector CT coronary angiography in octogenarians? A single-centre experience

February 2010 Br J Cardiol 2010;17:40-3

Is there a role for 64-multi-detector CT coronary angiography in octogenarians? A single-centre experience

Nevin T Wijesekera, Simon P G Padley, Gonzalo Ansede, Robert P Barker, Michael B Rubens

Abstract

Introduction Very elderly individuals are the fastest growing segment of most Western populations, with those aged 80 and older projected to triple in number by the middle of this century.1,2 The prevalence of coronary artery disease is high in this age group, and diagnostic investigations are being used with increasing frequency when angina is poorly controlled by medical therapy. However, due to more extensive disease and less functional reserve, invasive investigations have a higher complication rate in the very elderly than in younger patients.3 Therefore, non-invasive tests that identify those patients most likely to benefit from invasiv

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July 2009 Br J Cardiol 2009;16:192–3

Coronary artery disease – need for better terminology

George Thomas

Abstract

Introduction Coronary artery disease (CAD) forms the bulk of adult cardiology. Spectacular advances have been made in the diagnosis and treatment of CAD, but the diagnostic terminology has not kept pace with these developments. The babel of terms like Q-wave infarction, non-Q infarction, ST elevation infarction, non-ST elevation infarction, etc. does not reflect the present-day realities. The term ‘acute coronary syndrome’ is too vague. A case of acute myocardial infarction successfully reperfused is no longer an ‘infarction’. There is a need to describe these cases of ‘aborted infarctions’ and ‘threatened infarctions’.1 A pro

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September 2008 Br J Cardiol 2008;15:261-5

Renal and cardiac arterial disease: parallels and pitfalls

Timothy Bonnici, David Goldsmith

Abstract

Introduction Renal artery stenosis (RAS), traditionally the preserve of the nephrologist, is a condition of increasing interest to the cardiologist. Ninety per cent of RAS is caused by atherosclerosis and the risk factors for renal atherosclerosis and coronary atherosclerosis are the same. Furthermore, the presence of RAS alters the prognosis of co-existent cardiac disease, most notably cardiac failure and ischaemic heart disease, both directly1–3 and via its sequelae of renal failure and hypertension. Finally, the treatments for the disease, both medical and interventional, are familiar to the cardiologist, who can employ much of the knowl

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September 2008 Br J Cardiol 2008;15:266–8

Radiation dose from cardiac investigations: a survey of cardiac trainees and specialists

Edward D Nicol, Eliana Reyes, Katherine Stanbridge, Kate Latus, Claire Robinson, Michael B Rubens, S Richard Underwood

Abstract

Introduction The use of ionising radiation within cardiology is widespread with both myocardial perfusion scintigraphy (MPS) and conventional invasive coronary angiography (CA) being common diagnostic investigations for coronary artery disease. In the UK, some 70,000 MPS were performed in 20001 and over 205,000 CA in 2005.2 The use of ionising radiation is likely to increase further with the advent of cardiac multi-detector X-ray computed tomography (MDCT) and X-ray computed tomographic angiography (CTA). Furthermore, all these investigations are deemed to involve moderate- or high-dose radiation.3 Previous studies have shown poor knowledge o

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