Determining factors in the development of coronary plates and obstructions
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Abstract
Introduction: Coronary artery disease is the largest cause of mortality in the world. The main risk factors for its development include systemic arterial hypertension and type 2 diabetes mellitus. Objective: To search for predictors of the development of plaques and obstructions in coronary arteries and to determine whether the exercise test is a reliable pretest for coronary angiotomography. Methods: 883 computed tomography reports of coronaries were analyzed. Sociodemographic information, health conditions and results of the exercise test from patients were collected, along with calcium score, percentile and number of arterial segments with significant obstruction. The data were analyzed using descriptive and inferential statistics. Significance was considered for p<0.05. Results: It observed that the statistically significant predictors to the calcium score were male, being over 60 years old, having type 2 diabetes mellitus and systemic arterial hypertension. There was no relationship with high BMI and coronary obstruction. Regarding the exercise test, it was possible to observe that the majority of individuals who were positive in the exercise test, did not have a positive calcium score or significant coronary obstructions. Conclusion: The predictors for the development of coronary plaques and obstructions were male, aged ≥60 years, having type 2 diabetes mellitus and systemic arterial hypertension.
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World Health Organization (WHO). Global status report on noncommunicable diseases 2010. Geneva: World Health Organization, 2010.
Arif S, Bartuś S, Dziewierz A, Chyrchel M, Brzeziński M, Rakowski T, et al. Impact of coronary artery disease presence on the long-term follow-up of carotid artery stenting. Kardiol Pol. 2015;73(4):274-9. http://doi.org/10.5603/KP.a2014.0217
Van Kempen BJ, Ferket BS, Hofman A, Steyerberg EW, Colkesen EB, Boekholdt SM, et al. Validation of a model to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD: the rotterdam ischemic heart disease and stroke computer simulation (RISC) model. BMC Med. 2012;10(1):158. http://doi.org/10.1186/1741-7015-10-158
Sociedade Brasileira de Diabetes (SBD). Diretrizes da Sociedade Brasileira de Diabetes: 2017-2018. São Paulo: Clannad, 2017.
Bittencourt MS, Gowdak LHW. Uso da angiografia coronária por tomografia computadorizada na avaliação prognóstica de pacientes com suspeita de doença arterial coronária. Tese (Doutorado) - Universidade de São Paulo. São Paulo: 2014.
Hosmer Jr DW, Lemeshow S, Sturdivant RX. Logistic regression for matched case-control studies. John Wiley & Sons, 2013.
Gabriel FS, Gonçalves LFG, Melo EV, Sousa ACS, Pinto IMF, Santana SMM, et al. Placa Aterosclerótica à Angiotomografia de Coronárias em Pacientes com Escore de Cálcio Zero. Arq Bras Cardiol. 2018;110(5):420-7. http://doi.org/10.5935/abc.20180063
Arbab-Zadeh A, Carli MFD, Cerci R, George RT, Chen MY, Dewey M, et al. Accuracy of Computed Tomographic Angiography and Single-Photon Emission Computed Tomography–Acquired Myocardial Perfusion Imaging for the Diagnosis of Coronary Artery Disease. Circ Cardiovasc Imaging. 2015;8(10):e003533. http://doi.org/10.1161/CIRCIMAGING.115.003533
Ferreira AM, Marques H, Gonçalves PA, Cardim N. Custo-Efetividade de Diferentes Estratégias Diagnósticas de Doença Coronária Estável em Portugal. Arq Bras Cardiol. 2014;102(4):391-402. http://doi.org/10.5935/abc.20140042
Silva LS, Rochitte CE. Avaliação da tomografia computadorizada com 64 colunas de detectores em pacientes com síndrome coronária aguda. Tese (Doutorado) - Universidade de São Paulo. São Paulo: 2011.
Azevedo CF, Rochitte CE, Lima JA. Escore de cálcio e angiotomografia coronariana na estratificação do risco cardiovascular. Arq Bras Cardiol. 2012;98(6):559-68. http://doi.org/10.1590/S0066-782X2012000600012
Budoff M, Dowe D, Jollis J, Gitter M, Sutherland J, Halamert E, et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the Prospective Multicenter Accuracy (assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) Trial. J Am Coll Cardiol. 2008;52(21):1724-32. http://doi.org/10.1016/j.jacc.2008.07.031
Barros MVL, Rabelo DR, Nunes MCP, Siqueira MHA. Tomografia de coronárias na predição de eventos adversos em pacientes com suspeita de coronariopatia. Arq Bras Cardiol. 2012;99(6):1142-8.
http://doi.org/10.1590/S0066-782X2012005000113
Won HH, Natarajan P, Dobbyn A, Jordan DM, Roussos P, Lage K, et al. Disproportionate contributions of select genomic compartments and cell types to genetic risk for coronary artery disease. PLoS Genet. 2015;11(10):e1005622. https://doi.org/10.1371/journal.pgen.1005622
Oliveira JLM, Hirata M, Souza A, Gabriel FS, Hirata TDC, Tavares IS, et al. Sexo masculino e hipertensão arterial são preditores de placa à angiotomografia das coronárias. Arq Bras Cardiol. 2015;104(5):409-16.
http://doi.org/10.5935/abc.20150028
Cai G, Zhang B, Shi G, Weng W, Ma C, Song Y, et al. The associations between proprotein convertase subtilisin/kexin type 9 E670G polymorphism and the risk of coronary artery disease and serum lipid levels: a meta-analysis. Lipids Health Dis. 2015;14:149. http://doi.org/10.1186/s12944-015-0154-7
Conkbayir C, Burak A, Ökçün EB. Lipid variables related to the extent and severity of coronary artery disease in non-diabetic Turkish Cypriots. Iran J Public Health. 2015;44(9):1196.
LaBounty TM, Devereux RB, Lin FY, Weinsaft JW, Min JK. Impact of coronary computed tomographic angiography findings on the medical treatment and control of coronary artery disease and its risk factors. Am J Cardiol. 2009;104(7):873-7. http://doi.org/10.1016/j.amjcard.2009.05.024
Naito R, Miyauchi K, Konishi H, Tsuboi S, Ogita M, Dohi T, et al. Appropriate level of low-density lipoprotein cholesterol for secondary prevention of coronary artery disease. J Atheroscler Thromb. 2016;23(4):413-21. http://doi.org/10.5551/jat.32284
Ogita M, Miyauchi K, Miyazaki T, Naito R, Konishi H, Tsuboi S, et al. Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol. Heart Vessels. 2014;29(1):35-41. http://doi.org/10.1007/s00380-013-0330-5
Trigatti BL, Fuller M. HDL signaling and protection against coronary artery atherosclerosis in mice. J Biomed Res. 2016;30(2):94. http://doi.org/10.7555/JBR.30.20150079
Tavares CAF, Lerario AC. Frequência da doença arterial coronariara (DAC) e características das placas ateroscleróticas avaliadas pela angiotomografia computadorizada multislice em pacientes diabéticos tipo 2 assintomáticos relacionado ao controle glicêmico. Dissertação (Mestrado) - Universidade de São Paulo. São Paulo: 2013.
Nicolau JC, Barbosa CJDG, Franci A, Baracioli LM, Franken M, Lima FG, et al. Do diabetic patients with acute coronary syndromes have a higher threshold for ischemic pain? Arq Bras Cardiol. 2014;103(3):183-91.
http://dx.doi.org/10.5935/abc.20140106
Shaw LJ, Berman DS, Hendel RC, Alazraki N, Krawczynska E, Borges-Neto S, et al. Cardiovascular disease risk stratification with stress single-photon emission computed tomography technetium-99m tetrofosmin imaging in patients with the metabolic syndrome and diabetes mellitus. Am J Cardiol. 2006;97(10):1538-44.
http://doi.org/10.1016/j.amjcard.2005.12.041
Potenza MA, Addabbo F, Montagnani M. Vascular actions of insulin with implications for endothelial dysfunction. Am J Physiol Endocrinol Metab. 2009;297(3):E568-77. http://doi.org/10.1152/ajpendo.00297.2009
Hofmann MA, Drury S, Fu C, Qu W, Taguchi A, Lu Y, et al. RAGE mediates a novel proinflammatory axis: a central cell surface receptor for S100/calgranulin polypeptides. Cell. 1999;97(7):889-901. http://doi.org/10.1016/s0092-8674(00)80801-6
Zhao J, Ge X, Vasco-Correa J, Li Y. Fungal pretreatment of unsterilized yard trimmings for enhanced methane production by solid-state anaerobic digestion. Bioresour Technol. 2014;158:248-52. http://doi.org/10.1016/j.biortech.2014.02.029
Shah RV, Murthy VL, Colangelo LA, Reis J, Venkatesh BA, Sharma R, et al. Association of fitness in young adulthood with survival and cardiovascular risk: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Jama Intern Med. 2016;176(1):87-95. http://doi.org/10.1001/jamainternmed.2015.6309
Whelton SP, Silverman MG, McEvoy JW, Budoff MJ, Blankstein R, Eng J, et al. Predictors of long-term healthy arterial aging: coronary artery calcium nondevelopment in the MESA study. Cardiovasc Imaging. 2015;8(12):1393-400. http://doi.org/10.1016/j.jcmg.2015.06.019
Arslan S, Korkmaz Ö, Özbilüm N, Berkan Ö. Association between NF‑κBI and NF‑κBIA polymorphisms and coronary artery disease. Biomed Rep. 2015;3(5):736-40. http://doi.org/10.3892/br.2015.499
Bastami M, Ghaderian S, Omrani M, Mirfakhraie R, Nariman-Saleh-Fam Z, Mansoori Y, et al. Evaluating the association of common UBE2Z variants with coronary artery disease in an Iranian population. Cell Mol Biol. 2015;61(7):50-4. https://doi.org/10.14715/cmb/2015.61.7.8
Weng L, Taylor KD, Chen Y-DI, Sopko G, Kelsey SF, Merz CNB, et al. Genetic loci associated with nonobstructive coronary artery disease in Caucasian women. Physiol Genomics. 2015;48(1):12-20. http://doi.org/10.1152/physiolgenomics.00067.2015
Goldmeier S, Castro I. A teoria do autocuidado no manejo dos fatores de risco (obesidade, hipertensão e tabagismo) em pacientes pós-infarto agudo do miocárdio. Rev AMRIGS. 2005;49(3):149-54.
Piryaei M, Ghaderian SMH, Vakili H, Zaimkohan H, Ghahhari NM, Golchin MM. Analysis of rs6725887 in the WD Repeat Protein 12 in Association with Coronary Artery Disease in Iranian Patients. Int J Mol Cell Med. 2015;4(3):160-6.
Tavares A. Polimorfismo dos genes do sistema renina-angiotensina-aldosterona e as moléstias cardiovasculares. Rev Bras Hipertens. 2000;7(3):237-42.
Oliveira FRF, Resende ES. Acurácia do teste ergométrico no diagnóstico da estenose coronariana após angioplastia com implante de Stent convencional em pacientes assintomáticos. Dissertação (Mestrado) - Universidade Federal de Uberlândia. Uberlândia: 2012.
Fornitano LD, Godoy MF. Duplo produto elevado como preditor da ausência de coronariopatia obstrutiva de grau importante em pacientes com teste ergométrico positivo. Arq Bras Cardiol. 2006;86(2):139-44.