Aneurysm, Dissecting ; complications ; Coronary Aneurysm ; complications ; Coronary Artery Disease ; complications ; Female ; Humans ; Middle Aged

Arterio-Arterial Fistula ; complications ; Coronary Artery Disease ; complications ; Coronary Stenosis ; complications ; Female ; Humans ; Middle Aged

BACKGROUND: Recent studies suggested that the association of acute glucose variability and diabetic complications was not consistent, and that A1c variability representing long term glucose fluctuation may be related to coronary atherosclerosis in patients with type 1 diabetes. In this study, we attempt to determine whether or not A1c variability can predict coronary artery disease (CAD) in patients with type 2 diabetes. METHODS: We reviewed data of patients with type 2 diabetes who had undergone coronary angiography (CAG) and had been followed up with for 5 years. The intrapersonal standard deviation (SD) of serially-measured A1c levels adjusted by the different number of assessments among patients (adj-A1c-SD) was considered to be a measure of the variability of A1c. RESULTS: Among the 269 patients, 121 of them had type 2 diabetes with CAD. In patients with A1c > or =7%, the mean A1c levels and A1c levels at the time of CAG among the three groups were significantly different. The ratio of patients with CAD was the highest in the high adj-A1c-SD group and the lowest in the low adj-A1c-SD group (P=0.017). In multiple regression analysis, adj-A1c-SD was an independent predictor for CAD in subjects with A1c > or =7% (odds ratio, 2.140; P=0.036). CONCLUSION: Patients with higher A1c variability for several years showed higher mean A1c levels. A1c variability can be an independent predictor for CAD as seen in angiographs of patients with type 2 diabetes with mean A1c levels over 7%.
Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Glucose ; Humans

Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Disease ; therapy ; Dextrocardia ; complications ; therapy ; Female ; Humans ; Stents

Coronary Angiography ; Coronary Disease ; Humans ; Liver ; Non-alcoholic Fatty Liver Disease/complications*

To investigate the association of pancreatic steatosis with coronary atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who underwent coronary computed tomography angiography(CCTA)in our center due to chest pain were enrolled from January 2016 to February 2019. According to the CCTA findings,patients were divided into normal group,mild-to-moderate coronary atherosclerosis group and severe coronary atherosclerosis group. CT attenuation of pancreas and spleen was measured on abdominal non-enhanced CT,and the CT attenuation indexes including the difference between pancreatic and splenic attenuation (P-S) and the ratio of pancreas-to-spleen attenuation (P/S) were calculated. Analysis of variance or Kruskal-Wallis rank test were used to assess differences among each group. Logistic regression analysis was used to analyze the risk factors of severe coronary stenosis. The accuracy of P/S in predicting severe coronary artery stenosis was assessed by receiver operator characteristic (ROC) curve analysis. A total of 173 consecutive T2DM patients were enrolled. These patients included 27 patients with normal coronary artery (15.6%),124 patients with mild to moderate stenosis (71.7%),and 22 patients with severe stenosis (12.7%). There were significant differences in CT attenuation of pancreas (=11.543,=0.003),P-S (=11.152,=0.004) and P/S (=11.327,=0.004) among normal coronary artery group,mild and moderate stenosis group,and severe stenosis group. The CT attenuation of pancreatic head,body,and tail significantly differed in patients with coronary artery stenosis (=14.737,=0.001). After adjusting for confounding factors,multiple Logistic regression showed that P/S (=0.062,95%=0.008-0.487,=0.008) was still significantly associated with the severe coronary artery stenosis. The area under the ROC curve of P/S for the diagnosis of severe coronary artery stenosis was 0.701,and the optimal cutoff point was 0.660. CT attenuation of pancreas and CT attenuation indexes are associated with the severity of coronary stenosis in T2DM patients,suggesting that pancreatic steatosis may be used as one of the indicators for predicting severe coronary artery stenosis.
Coronary Angiography ; Coronary Artery Disease ; complications ; Coronary Stenosis ; Diabetes Mellitus, Type 2 ; complications ; Humans ; Pancreas ; pathology ; Predictive Value of Tests

Cogan’s syndrome (CS) is a rare inflammatory disorder characterized by interstitial keratitis and vestibuloauditory abnormalities often associated with various systemic manifestations. Involvement of cardiovascular system resembling systemic vasculitis may lead to severe complications and death. The present report describes a case of a female patient with atypical Cogan's syndrome presented with systemic manifestations and severe coronary and femoral artery stenosis. Despite the clinical improvement after glucocorticoids and cyclophosphamide, the patient required double aortocoronal bypass grafting one year letter. During three years follow-up, she was in stable condition, without stenocardial symptoms and claudication and her inflammatory parameters remain normal. This case highlights the rare involvement of coronary arteries without associated large-vessel vasculitis of the aortic arch in CS.
Adult ; Cogan Syndrome ; complications ; Coronary Disease ; etiology ; Female ; Humans

The medical community as a whole is attempting to start preventive therapy for coronary heart disease (CHD) patients earlier in life. However, the main limitations of such interventions are drug resistance and adverse reactions. Additionally, traditional biomarker discovery methods for CHD focus on the behavior of individual biomarkers regardless of their relevance. These limitations have led to attempting novel approaches to multi-dimensionally investigate CHD and identify safe and efficacious therapies for preventing CHD. Recently, the benefit of Chinese medicine (CM) in CHD has been proven by increasing clinical evidence. More importantly, linking CM theory with modern biomedicine may lead to new scientific discoveries. According to CM theory, all treatments for patients should be based on patients' syndromes. A recent epidemiological investigation has demonstrated that blood stasis syndrome (BSS) is the major syndrome type of CHD. BSS is a type of complex pathophysiological state characterized by decreased or impeded blood flow. Common clinical features of BSS include a darkish complexion, scaly dry skin, and cyanosis of the lips and nails, a purple or dark tongue with purple spots, a thready and hesitant pulse, and stabbing or pricking pain fixed in location accompanied by tenderness, mass formation and ecchymosis or petechiae. The severity of BSS is significantly correlated with the complexity of coronary lesions and the degree of stenosis, and is an important factor affecting the occurrence of restenosis after percutaneous coronary intervention. The mechanisms of BSS of CHD patients should be investigated from a modern medicine perspective. Although many studies have attempted to explore the biomedical mechanisms of BSS of CHD, from hemorheological disorders to inflammation and immune responses, the global picture of BSS of CHD is still unclear. In this article, the current status of studies investigating the biomedical mechanisms of BSS of CHD and future perspectives are discussed.
Coronary Disease ; complications ; Humans ; Medicine, Chinese Traditional ; methods

Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; etiology ; Coronary Disease ; etiology ; Humans ; Inflammation ; complications ; Microvascular Angina ; etiology ; Myocardial Ischemia ; etiology

Objective To explore the associations of non-alcoholic fatty liver disease(NAFLD)with the prevalence,severity,and prognosis of coronary heart disease(CHD). Methods A total of 512 hospitalized patients undergoing coronary angiography in our department from June 2013 to June 2015 were enrolled.Fatty liver was judged by ultrasound screening,and Gensini score was calculated according to the result of coronary angiography.Then the independent predictors of CHD were analyzed.The association between NAFLD and cardiovascular endpoints was analyzed during prospective follow-up among 276 CHD patients. Results The CHD prevalence was 76.8% in NAFLD group and 50.7% in non-NAFLD group(P=0.000),the number of target vessels was 2(1,3)and 1(1,3)(P=0.019),and the Gensini score was(29.02±27.62)and(24.04±20.18)(P=0.022),respectively.NAFLD was an independent predictor of CHD(OR=2.28,95%CI=1.54-3.56,P<0.001).The risk of cardiovascular endpoints was not significantly different between NAFLD group and non-NAFLD group(P>0.1).Cox regression analysis showed that NAFLD was not a predictor of cardiovascular endpoints in patients with CHD(HR=0.95,95%CI=0.62-1.58,P=0.691).Conclusion NAFLD is an independent predictor of CHD,and it is related to severity of coronary artery stenosis.However,it can not predict the clinical outcomes of patients with CHD.
Coronary Angiography ; Coronary Disease ; complications ; Humans ; Non-alcoholic Fatty Liver Disease ; complications ; Prevalence ; Prognosis ; Prospective Studies ; Risk Factors