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Coronary Artery Disease: HELP
Articles by Anastasios Athanasiadis
Based on 6 articles published since 2008
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Between 2008 and 2019, A. Athanasiadis wrote the following 6 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Guideline [Diagnostics and therapy of chronic stable coronary artery disease : new guidelines of the European Society of Cardiology]. 2014

Athanasiadis, A / Sechtem, U / Anonymous4260811. ·Zentrum für Innere Medizin, Kardiologie, Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Deutschland, anastasios.athanasiadis@rbk.de. ·Herz · Pubmed #25384852.

ABSTRACT: The European Society of Cardiology (ESC) guidelines on the management of stable coronary artery disease published in 2013 give practical recommendations for diagnostics and therapy. The approach depends on the clinical picture and symptoms of the patient, the severity and extent of ischemia, the degree and location of coronary stenoses, additional cardiac findings and finally on non-cardiac comorbidities. The selection of suitable diagnostic tools is based on the tabulated pretest probability for the presence of coronary artery disease which plays an important and central role in the diagnostic algorithm. An invasive approach is recommended only in patients with severe angina, i.e. a Canadian Cardiovascular Society (CCS) angina grading scale of ≥ CCS3 or in patients who are at high risk for death or myocardial infarction based on the results of the test used for detection of ischemia. Detailed therapeutic recommendations are given for medicinal and interventional or surgical therapy. Medicinal therapy includes drugs both for relief of symptoms and prevention of cardiovascular events. Recommendations are also given for the use of new antianginal drugs. A PCI is only indicated in vessels causing ischemia which can be verified by using fractional flow reserve measurements. The indications for PCI now also include patients with a low SYNTAX score and multivessel disease or left main stenosis; however, the optimal strategy should be individually determined in heart team discussions.

2 Review Testing in Patients With Stable Coronary Artery Disease - The Debate Continues. 2016

Sechtem, Udo / Mahrholdt, Heiko / Ong, Peter / Athanasiadis, Anastasios / Schäufele, Tim. ·Robert-Bosch-Krankenhaus. ·Circ J · Pubmed #26984588.

ABSTRACT: The major guidelines on stable coronary artery disease recommend revascularizing patients with large areas of myocardium at risk. The algorithms on how to prove that such high risk is present differ considerably. The opinions on the use of coronary CT (calcium scoring and angiography) vary widely. This review aims to summarize the recommendations of the major guidelines, commenting on differences between the guidelines and discussing whether extending the role of coronary CT angiography should be considered in the light of new CT data.

3 Review Structural and Functional Coronary Artery Abnormalities in Patients With Vasospastic Angina Pectoris. 2015

Ong, Peter / Aziz, Ahmed / Hansen, Henrik Steen / Prescott, Eva / Athanasiadis, Anastasios / Sechtem, Udo. ·Department of Cardiology, Robert Bosch Krankenhaus. ·Circ J · Pubmed #26084380.

ABSTRACT: Coronary spasm is involved in many clinical scenarios, such as stable angina, acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical coherence tomography have been applied to study the coronary pathology in patients with vasospastic angina. Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis. They share the common pathophysiological phenomenon of vascular smooth muscle hyperreactivity leading to spasm caused by various factors that may also overlap. Focal coronary spasm is related to epicardial atherosclerosis and in the presence of obstructive coronary artery disease it may be useful to treat the lesion to prevent further spasm. The aim of this article is to review structural and functional coronary artery abnormalities in patients with vasospastic angina.

4 Article Coronary microvascular dysfunction assessed by intracoronary acetylcholine provocation testing is a frequent cause of ischemia and angina in patients with exercise-induced electrocardiographic changes and unobstructed coronary arteries. 2014

Ong, Peter / Athanasiadis, Anastasios / Hill, Stephan / Schäufele, Tim / Mahrholdt, Heiko / Sechtem, Udo. ·Department of Cardiology, Robert Bosch Hospital, Stuttgart, Germany. ·Clin Cardiol · Pubmed #24719338.

ABSTRACT: BACKGROUND: The exercise electrocardiogram (ECG) is a standard examination in patients with suspected coronary artery disease. However, despite a pathologic result, many patients undergoing diagnostic coronary angiography do not have any significant epicardial stenosis. In this study, we assessed the relation between a pathologic exercise ECG and coronary microvascular dysfunction in response to intracoronary acetylcholine (ACh) provocation in patients without any relevant epicardial stenosis. HYPOTHESIS: Coronary microvascular dysfunction is significantly more often in patients with angina, unobstructed coronary arteries and a pathologic exercise stress test compared to those without pathologic stress test. METHODS: This study recruited 137 consecutive patients with exertional angina pectoris who underwent diagnostic coronary angiography between September 2008 and April 2011 (68% women; mean age, 63 ± 10 years). In none of the patients was there a stenosis of >50%. All patients underwent an exercise ECG before angiography and intracoronary ACh provocation testing for assessment of coronary vasomotor responses directly after angiography. RESULTS: The exercise ECG showed an abnormal result in 69 patients (50%; ST-segment depression ≥0.1 mV and/or reproduction of the patient's usual symptoms). The ACh test revealed a coronary vasomotor abnormality (reproduction of the patient's symptoms, ischemic ECG shifts ± diffuse distal vasoconstriction) in 87 patients (64%). Such a result was significantly more often found in patients with a pathologic exercise ECG (50/69 [72%] vs 19/69 [28%], P = 0.034). There were no other statistically significant differences between patients with and those without pathologic exercise ECG. CONCLUSIONS: Coronary microvascular dysfunction is frequently found in patients with exertional angina pectoris and unobstructed coronary arteries. Such a finding is found significantly more often in presence of a pathologic exercise ECG.

5 Article [Update coronary artery disease: important progresses in acute and chronic therapy]. 2012

Athanasiadis, Anastasios / Sechtem, Udo. ·Robert-Bosch-Krankenhaus, Zentrum für Innere Medizin III, Stuttgart. anastasios.athanasiadis@rbk.de ·MMW Fortschr Med · Pubmed #22624267.

ABSTRACT: -- No abstract --

6 Article [Cardiac computed tomography and magnetic resonance imaging in patients with coronary artery disease]. 2010

Sechtem, U / Geissler, A / Athanasiadis, A / Ong, P / Mahrholdt, H. ·Abteilung für Kardiologie, Robert-Bosch-Krankenhaus, Auerbachstrasse 110, 70376, Stuttgart, Deutschland. udo.sechtem@rbk.de ·Internist (Berl) · Pubmed #20372868.

ABSTRACT: Coronary angiography by computed tomography (CTCA) is most suitable for symptomatic patients with an intermediate likelihood to exclude a coronary stenosis as the cause of the symptoms. It would also be appropriate in a patient in whom an equivoval stress test result has led to uncertainty about the patient's further management. CTCA may occasionally be acceptable in a high risk symptomatic patient who refuses the necessary invasive coronary angiography if the results of CTCA are likely to alter patient management.The main indication for cardiac magnetic resonance imaging (CMR) is for pharmacologic stress testing. If such a test is indicated, dobutamine stress CMR is an alternative to stress echocardiography and adenosine perfusion CMR is the alternative to nuclear myocardial perfusion imaging but without radiation. Late gadolinium enhancement CMR is the current gold standard for the assessment of myocardial scars and hence is well suited to predict recovery of function in dysfunctional myocardial regions following revascularisation (viability testing).