1.
Coronary artery disease with normal lipids and low coronary artery calcium in two women with high lipoprotein(a).
Haxhi, J, Pershwitz, G, Thompson, PD
Journal of clinical lipidology. 2020;(2):186-188
Abstract
We present 2 patients with elevated levels of lipoprotein (a) and significant coronary artery disease despite having little coronary artery calcification. Clinicians should be aware that patients with elevated lipoprotein (a) may have important coronary artery disease with low coronary artery calcification scores.
2.
Statin-associated rhabdomyolysis with acute renal failure complicated by intradialytic NSTEMI: a review of lipid management considerations.
Kar, S, Chockalingam, A
American journal of therapeutics. 2013;(1):57-60
Abstract
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are associated with myopathy, myalgias, myositis, and rhabdomyolysis. Rhabdoymyolysis is a rare complication and may cause acute renal failure, which may be fatal. In such cases, alternative therapies should be considered. In this review, we attempted to elucidate the lipid management options in patients with rhabdomyolysis and coronary artery disease. We also describe a case report of a patient who developed rhabdomyolysis from dual antilipid therapy followed by acute renal failure and non-ST elevation myocardial infarction. Such a complex case has not been reported in the literature, and lipid management options may include niacin, omega 3-fatty acids, or bile acid sequestrants. Once alternative therapies are initiated, monitoring a patient closely with evaluation for associated adverse events should be performed.
3.
Diagnostic value of 123I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) in patients with chest pain. Comparison with rest-stress 99mTc-tetrofosmin SPECT and coronary angiography.
Kawai, Y, Morita, K, Nozaki, Y, Ohkusa, T, Sakurai, M, Tamaki, N
Circulation journal : official journal of the Japanese Circulation Society. 2004;(6):547-52
Abstract
BACKGROUND Basic and clinical studies have indicated that 15-(p-[(123)I] iodophenyl)-3-(R, S) methylpentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) can identify ischemic myocardium without evidence of myocardial infarction by the regional decline of tracer uptake. The present study compared BMIPP SPECT with rest-stress myocardial perfusion imaging (MPI) findings and coronary angiography (CAG) in 150 patients with acute chest pain. METHODS AND RESULTS Patients with acute chest pain who underwent all of the following tests were selected: MPI at rest-stress, BMIPP SPECT at rest and CAG. Organic coronary artery stenosis (>or=75%) was observed in 46 patients, 27 patients had total or subtotal coronary occlusion by spasm in the spasm provocation test on CAG and the remaining 77 patients had no significant coronary artery stenosis or spasm. The sensitivity of BMIPP at rest to detect organic stenosis was significantly higher (54%) than that of rest-MPI (33%, p<0.005), but lower than that of stress-MPI (76%, p=0.05). The sensitivity of BMIPP at rest to detect spasm was significantly higher (63%) than that of both rest-MPI (15%; p<0.001) and stress-MPI (19%; p<0.001). Overall, the sensitivity of BMIPP at rest to detect both organic stenosis and spasm was significantly higher (58%) than that of rest-MPI (26%; p<0.001), despite having no significance with that of stress-MPI (55%). The specificity was not significantly different among the three imaging techniques. CONCLUSION Resting BMIPP SPECT is an alternative method to stress MPI for identifying patients with not only organic stenosis but also spasm without the need for a stress examination.
4.
Coronary arteriomegaly in a patient with Ehlers-Danlos syndrome and multiple aneurysms--a case report.
Dieter, RS, Murtaugh, T, Black, J, Russell, DC
Angiology. 2003;(6):733-6
Abstract
The authors report a case of coronary arteriomegaly in a patient with Ehlers-Danlos syndrome and multiple aneurysms who presented with myocardial infarction. Coronary arteriography revealed distal "pruning" of vessels without occlusive disease. Fibroblast cultures excluded Ehlers-Danlos syndrome types IV and VII. Literature review suggests this may represent a previously unidentified vascular syndrome.
5.
[Computerized helicoidal tomography of the coronary arteries vs coronary angiography].
Sierra-Galán, LM, Hernández-López, JE, Portos-Silva, JM
Archivos del Instituto de Cardiologia de Mexico. 2000;(6):569-79
Abstract
INTRODUCTION The calcium score (CS) of the coronary arteries by computed tomography (CT) is an useful procedure for the diagnosis of obstructive coronary disease (OCD), with an average sensitivity of 82 +/- 6%, specificity of 88 +/- 2%, positive predictive value (PPV) of 57 +/- 7% and negative predictive value (NPV) of 96 +/- 2%. The objective of this trial was to compare helicoidal CT Scan with the traditional method and define sensitivity, specificity, Positive predictive value and negative predictive value against the coronary angiography. METHODS From June of 1998 to March of 1999, one hundred and sixty six patients with coronary arteries CT were studied. The CT was done with an ELSCINT-CT Twin equipment and a software for the quantification of the coronary arteries CS in Hounsfield units. In forty one, coronary angiography was performed. A significant obstructive lesion was defined as > or = 70% of luminal stenosis in at least one artery, or > or = 50% in the left main and > or = 50% if some other artery was involved. This group was divided in accordance to the CS in two subgroups: A with a CS < or = 150 and B those with a CS > or = 151. RESULTS In group A, 45% had significative lesions vs 95% in group B (p = 0.001). The sensitivity was 65%, specificity 95%, PPV 64% and the NPV 92%. Relative risk 2.08 (CI 95% 1.38-3.54) and Odds ratio 21.6 (CI 95% 2.43-191.37). CONCLUSIONS Even though the small sample, CT is an useful procedure for the diagnosis of the OCD.