Unit:
Κατεύθυνση ΒιοστατιστικήLibrary of the School of Health Sciences
Supervisors info:
Θεόδωρος Παπαϊωάννου, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κίμων Σταματελόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Παναγιώτα Τουλούμη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μελέτη για την πρόβλεψη της ύπαρξης και της βαρύτητας της στεφανιαίας νόσου μέσω υποκλινικών δεικτών αθηρωμάτωσης και αρτηριοσκλήρυνσης
Translated title:
Study for the prediction of the presence and severity of coronary artery disease through subclinical markers of atheromatosis and arteriosclerosis
Summary:
Background: Coronary artery disease (CAD) often coexists with clinical or subclinical atherosclerosis in other arterial beds. In this study, we aimed to assess the utility of a non-invasive vascular multimarker approach for the detection of CAD in patients referred for coronary angiography (CAG).
Methods: This study enrolled 219 consecutive hemodynamically stable patients who were referred to our hospital, for elective CAG. Plaque score in the carotid and common femoral arteries, Intima-media thickness, flow-mediated dilatation (FMD), carotid-to-femoral pulse wave velocity and aortic hemodynamics were assessed, recorded and analysed. The extent of CAD was assessed by CAG according to Gensini score. Follow up was obtained by questionnaires sent by land mail and telephone interview.
Results: After adjustment for confounding factors, among the peripheral vascular markers studied, carotid and femoral plaque score (PS) were the only independent factors of the presence of CAD (OR:2.92 and OR:1.25 respectively). FMD and carotid PS found to be associated with Gensini score>32 (ΟR: 0.82 and OR:1.14, respectively). Median duration of follow-up period was 41 months [25-75 percentile: 32-52months]. In multivariate Cox proportional hazards analysis, for the primary endpoints of the study, after adjusting for age, sex, familial history of cad and systolic blood pressure, carotid PS was the only significant peripheral vascular determinant of the CV events (cardiovascular death or unstable angina or non-fatal acute coronary syndrome), along with diastolic blood pressure.
Conclusions: Our study demonstrated that carotid and femoral PS were significant independent vascular determinants of CAD presence. Furthermore, FMD and carotid PS were significant independent vascular determinants of CAD extent (Gensini score>32). Carotid PS and diastolic blood pressure predicted the occurrence of CV events.
Main subject category:
Health Sciences
Keywords:
Coronary artery disease, Peripheral markers, Atheromatosis, Endothelium, Carotid, Arteriosclerosis, Peripheral artery disease
Number of references:
127
File:
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Lavda Maria Master.pdf
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