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Coronary Artery Disease: HELP
Articles from Cyprus
Based on 38 articles published since 2008
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These are the 38 published articles about Coronary Artery Disease that originated from Cyprus during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Screening for Atherosclerotic Cardiovascular Risk Using Ultrasound. 2016

Nicolaides, Andrew / Panayiotou, Andrie G. ·Department of Vascular Surgery, Imperial College, London, United Kingdom; Department of Surgery, Nicosia Medical School, University of Nicosia, Nicosia, Cyprus. Electronic address: anicolai@cytanet.com.cy. · Cyprus International Institute for Environmental and Public Health in association with the Harvard T.H. Chan School of Public Health, Cyprus University of Technology, Limassol, Cyprus. ·J Am Coll Cardiol · Pubmed #26988946.

ABSTRACT: -- No abstract --

2 Review Meta-Analysis of the Prognostic Impact of Anemia in Patients Undergoing Percutaneous Coronary Intervention. 2016

Kwok, Chun Shing / Tiong, Denise / Pradhan, Ashish / Andreou, Andreas Y / Nolan, James / Bertrand, Olivier F / Curzen, Nick / Urban, Philip / Myint, Phyo K / Zaman, Azfar G / Loke, Yoon K / Mamas, Mamas A. ·Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom; Department of Cardiology, Royal Stoke Hospital, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom. · Department of Medicine, Royal Preston Hospital, Preston, United Kingdom. · Department of Cardiology, Limassol General Hospital, Kato Polemidia, Cyprus. · Department of Cardiology, Quebec Heart-Lung Institute, Laval University, Laval, Canada. · Department of Cardiology, University of Southampton, Southampton, United Kingdom. · Department of Cardiology, La Tour Hospital, Geneva, Switzerland. · Epidemiology Group, University of Aberdeen, Aberdeen United Kingdom. · Department of Cardiology, Freeman Hospital, Newcastle University, Newcastle, United Kingdom. · Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom. · Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, United Kingdom; Department of Cardiology, Royal Stoke Hospital, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom. Electronic address: mamasmamas1@yahoo.co.uk. ·Am J Cardiol · Pubmed #27342283.

ABSTRACT: Anemia is common in patients undergoing percutaneous coronary intervention (PCI), and current guidelines fail to offer recommendations for its management. This review aims to examine the relation between baseline anemia and mortality, major adverse cardiovascular events (MACE), and major bleeding in patients undergoing PCI. We searched MEDLINE and EMBASE for studies that evaluated mortality and adverse outcomes in anemic and nonanemic patients who underwent PCI. Data were collected on study design, participant characteristics, definition of anemia, follow-up, and adverse outcomes. Random effects meta-analysis of risk ratios was performed using inverse variance method. A total of 44 studies were included in the review with 230,795 participants. The prevalence of baseline anemia was 26,514 of 170,914 (16%). There was an elevated risk of mortality and MACE with anemia compared with no anemia-pooled risk ratio (RR) 2.39 (2.02 to 2.83), p <0.001 and RR 1.51 (1.34 to 1.71), p <0.001, respectively. The risk of myocardial infarction and bleeding with anemia compared with no anemia was elevated, pooled RR 1.33 (1.07 to 1.65), p = 0.01 and RR 1.97 (1.03 to 3.77), p <0.001, respectively. The risk of mortality per unit incremental decrease in hemoglobin (g/dl) was RR 1.19 (1.09 to 1.30), p <0.001 and the risk of mortality, MACE, and reinfarction per 1 unit incremental decrease in hematocrit (%) was RR 1.07 (1.05 to 1.10), p = 0.04, RR 1.09 (1.08 to 1.10) and RR 1.06 (1.03 to 1.10), respectively. The prevalence of anemia in contemporary cohorts of patients undergoing PCI is significant and is associated with significant increases in postprocedural mortality, MACE, reinfarction, and bleeding. The optimal strategy for the management of anemia in such patients remains uncertain.

3 Clinical Trial The contribution of NOS3 variants to coronary artery disease: A combined genetic epidemiology and computational biochemistry perspective. 2019

Teralı, Kerem / Ergören, Mahmut Çerkez. ·Department of Medical Biochemistry, Faculty of Medicine, Near East University, Nicosia 99138, North Cyprus. Electronic address: kerem.terali@neu.edu.tr. · Department of Medical Biology, Faculty of Medicine, Near East University, Nicosia 99138, North Cyprus, Cyprus. ·Int J Biol Macromol · Pubmed #30447355.

ABSTRACT: Cardiovascular diseases, particularly coronary artery disease (CAD) and myocardial infarction, are the leading cause of death among people worldwide. CAD is exceedingly complex in its interplay of environment and genetics, with numerous genetic loci contributing to its heritability. Here, we aim at looking into the effects of the NOS3 c.894G>T and 27-bp VNTR polymorphisms on susceptibility to CAD in a population of Turkish Cypriots, at seeing whether these effects correlate with plasma lipid levels and at predicting the functional consequences of each polymorphism tested. A total of 50 subjects with CAD and 100 otherwise healthy subjects were included in the present case-control study. Genomic DNA was extracted from peripheral blood samples, and the two NOS3 polymorphisms were determined by restriction endonuclease analysis of PCR amplicons. Complementary methods of statistical analysis and computational modeling were employed accordingly to achieve the aims above. Our findings show that the 27-bp VNTR polymorphic locus, but not the c.894G>T polymorphic locus, is associated with CAD and that it may regulate NOS3 pre-mRNA splicing in a length-dependent manner. Overall, along with additional, yet-to-be ascertained susceptibility markers the 27-bp VNTR 4a/4b marker may be employed in risk stratification in community-level screening for CAD among Turkish Cypriots.

4 Clinical Trial Evidence for contribution of the y chromosome in atherosclerotic plaque occurrence in men. 2014

Voskarides, Konstantinos / Hadjipanagi, Despina / Papazachariou, Louiza / Griffin, Maura / Panayiotou, Andrie G. ·1 Laboratory of Molecular and Medical Genetics, Department of Biological Sciences, Molecular Medicine Research Center, University of Cyprus , Nicosia, Cyprus . ·Genet Test Mol Biomarkers · Pubmed #24720269.

ABSTRACT: Diseases such as atherosclerosis and coronary artery disease demonstrate disparate population prevalence or present with variable severity in men and women. While the usual explanation points to hormonal status, the role of the Y chromosome has been implicated, but not sufficiently studied. We genotyped six markers of the male-specific region of the Y chromosome, representing the major haplogroups (YAP, G, I, J, K, and R) in 373 male participants of the "Cyprus Study" with ultrasonic data on subclinical atherosclerosis. Of the five major haplogroups identified, two (J and K) accounted for roughly 67% of the Y-chromosome variance among these Greek Cypriot men. Carriers of haplogroup K had a 2.5-fold higher age-adjusted risk for having an atherosclerotic plaque present in any of the four bifurcations scanned, compared to men with other Y-chromosome lineages (OR=2.51; 95% CI=1.18 to 5.33; p=0.017). Carriers of the YAP haplogroup had about 50% less risk for having a plaque in the femoral bifurcation versus the rest (OR=0.46; 95% CI=0.27 to 0.77; p<0.001). We show a possible contribution of the Y chromosome in atherosclerotic phenotypes in men adding to the previous findings for coronary artery disease. Additional studies are warranted as evidence suggests that the Y chromosome could serve as a biomarker for the health status of men.

5 Article Vitamin D Deficiency is not Associated with Higher Levels of SYNTAX Score. 2019

Cerit, Levent / Cerit, Zeynep. ·Department of Cardiology, Near East University, Faculty of Medicine, Nicosia, Cyprus. · Department of Pediatric Cardiology, Near East University, Nicosia, Cyprus. ·Braz J Cardiovasc Surg · Pubmed #30810675.

ABSTRACT: OBJECTIVE: To evaluate the association between serum vitamin D (vitD) level and SYNTAX (synergy between percutaneous coronary intervention with taxus and cardiac surgery) score (SS). METHODS: The medical records of consecutive patients, who underwent coronary artery bypass graft surgery, were retrospectively reviewed. The study group consisted of 158 patients. Biochemical, clinical, and echocardiographic parameters and SS were evaluated in all patients. The patients were divided into 2 groups according to SS (≥23= high, <23= low). RESULTS: The high SYNTAX score (HSS) group was older and had higher body mass index, C-reactive protein (CRP), low-density lipoprotein, and fasting plasma glucose level than the low SYNTAX score (LSS) group. The HSS group had lower high-density lipoprotein and vitD level than the LSS group. The HSS group had a higher prevalence of diabetes mellitus (DM), hypertension (HT), hyperlipidemia (HL), and current smoking patients than the LSS group. On univariate analysis, age, HT, DM, HL, smoking, CRP, and serum vitD level were associated with HSS. On multivariate analysis, HT, DM, and HL were independent predictors of HSS (odds ratio [OR]: 2.137, 95% confidence interval [CI]: 1.468-2.935, P<0.001; OR: 3.559, 95% CI: 2.763-5.927, P<0.001; OR: 2.631, 95% CI: 1.529-3.438, P<0.001; respectively). CONCLUSION: In our study, we have found out that HT, DM, and HL were independent predictors of HSS. Serum vitD level was not found to be an independent predictor of HSS.

6 Article The use of ACE INDEL polymorphism as a biomarker of coronary artery disease (CAD) in humans with Mediterranean-style diet. 2019

Temel, Sehime Gulsun / Ergoren, Mahmut Cerkez / Yilmaz, Izel / Oral, Haluk Barbaros. ·Department of Medical Genetics, Faculty of Medicine, Uludag University, Bursa, Turkey. · Department of Medical Biology, Faculty of Medicine, Near East University, 99138 Nicosia, Cyprus; Experimental Health Sciences Research Center (DESAM), Near East University, 99138 Nicosia, Cyprus. Electronic address: mahmutcerkez.ergoren@neu.edu.tr. · Department of Medical Immunology, Institute of Health Sciences, Uludag University, Bursa, Turkey. · Department of Immunology, Faculty of Medicine, Uludag University, Bursa, Turkey. ·Int J Biol Macromol · Pubmed #30414419.

ABSTRACT: The ACE INDEL gene polymorphisms are strongly associated with CAD. Therefore, the present study was undertaken to investigate the relationship between ACE INDEL polymorphism and CAD in Turkish Cypriots whose are expected to have Mediterranean-style diet. 273 Turkish Cypriot descent volunteer subjects (186 controls and 87 CAD patients) participated in this study. Genotyping for the ACE INDEL polymorphism was performed by PCR-RFLP analysis. Biochemical parameters except the glucose and triglyceride lipid level were all within normal limits. Glucose level was found significant (p = 0.019) and triglyceride level was observed at the borderline for significance (p = 0.050) in participants according to WHO guidelines. With the respect to the genotype and allele distributions of ACE INDEL, the results showed statistically significant in CAD patients (p = 0.034) and not significant (p = 0.190) in controls. Haplotype analysis showed that D allele was more frequent in patients compared to controls. Thus, there is a statistically significant association with CAD disease with DD genotypes (p = 0.030) in Turkish Cypriot population. The results indicated that ACE INDEL polymorphism is an important predictor of coronary artery disease in Turkish Cypriots. Although 47% of the studied Turkish Cypriot population carry the D allele (p = 0.07), protocols should be developed for prevention strategies immediately.

7 Article Gender Differences in Patients with Anxiety after Coronary Artery Bypass Surgery. 2018

Guzelhan, Yalcin / Conkbayir, Cenk / Ugurlucan, Murat / Yildiz, Cenk Eray / Alpagut, Ufuk / Bozbuga, Nilgun. ·Psychiatry Clinic, Istanbul Education and Research Hospital, Istanbul, Turkey. · Department of Cardiology, Near East University, Nicosia, Cyprus. · Department of Cardiovascular Surgery, Istanbul University Medical Faculty, Istanbul, Turkey. ·Heart Surg Forum · Pubmed #29893673.

ABSTRACT: OBJECTIVE: The present study was designed to evaluate the relationship between gender and coexisting anxiety in patients undergoing coronary artery surgery. Materials and Methods: A total of 137 patients (41 women and 96 men with a mean age 66.1 ± 6.0 years) patients underwent state and trait anxiety evaluation at baseline (preoperatively) and at six months after (postoperatively) coronary artery bypass graft (CABG). Anxiety symptoms were assessed at enrollment using the Spielberger State-Trait Anxiety Inventory (STAI). Psychological, social, clinical, and surgical data were assessed statistically. Results: There were statistically significant differences between female and male patient characteristics for the mean age, mean education year, and mean body mass index. The women were found to be statistically younger and less educated, and more likely to be overweight, diabetic, and hyperlipidemic. The mean hospitalization time, wound infection, and extreme postoperative pain complaints were found to be higher in the female group. 61 patients (33 female and 28 male) (44.5%) were classified as presenting clinically significant anxiety symptoms (STAI score of ≥ 40). The female patients' STAI scores were significantly higher than men in state and trait anxiety, both preoperatively and six months postoperatively. Postoperatively, there was not any significant decrease in the level of trait anxiety when comparing the level of state anxiety in female patients.  Conclusion: Even after adjusting for known risk factors for compromised STAI, women do not show the same long-term quality benefits of CABG surgery that men do. The results indicate that the STAI is a valuable instrument for identifying and supporting patients with higher levels of anxiety, which can aid in determining patients that may have poor adjustment after CABG surgery.

8 Article Impact of Genetic Defects on Coronary Atherosclerosis among Turkish Cypriots. 2017

Conkbayir, Cenk / Fahrioglu Yamaci, Rezan / Gencer, Pinar / Barin, Burc / Yucel, Genco / Yildiz, Cenk Eray / Ugurlucan, Murat / Basak, A Nazli. ·Department of Cardiology, Near East University, Nicosia, Cyprus. · Department of Molecular Biology and Genetics, Bogazici University, NDAL, Istanbul, Turkey. · Department of Biomedical Engineering, Near East University, Nicosia, Cyprus. · Department of Cardiology, American Hospital, Istanbul, Turkey. · Institute of Cardiology, Istanbul University, Istanbul, Turkey. · Department of Cardiovascular Surgery, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey. ·Heart Surg Forum · Pubmed #29087287.

ABSTRACT: BACKGROUND: The distribution of gene variants in the Turkish Cypriot population with coronary artery disease has not been investigated. In this study, we sought to research different genetic variants in the susceptibility to coronary artery disease and to identify possible associations between various clinical parameters and the genes involved in blood coagulation as well as glucose and lipid metabolism among the Turkish Cypriots and compared the results with the respective Turkish patients from Turkey. Methods: A total of 187 individuals with coronary artery disease, namely 87 Turkish Cypriot individuals from Northern Cyprus, and 100 Turkish patients from Turkey, were investigated. The presence of CAD was documented with coronary angiography. The genetic susceptibility to coronary artery disease in the cohorts was studied using the variants FV Leiden (G1691A), Factor V R2 mutation (FVR2)(H1299R), PTH (G20210A), FXIII (V34L), β-Fibrinogen (-455 G>A), PAI-1 (4G/5G), HPA1 (a/b), MTHFR [C677T] and [A1298C], ACE (I/D), Apo B (R3500Q), and Apo E, in addition to the well-known risk factors associated with coronary artery disease. RESULTS: Age, male sex, diabetes mellitus, hyperlipidemia, triglycerides, HDL, and triglyceride/HDL ratio were significantly associated with (P < .05); LDL (P = .05) and total cholesterol (P = .08) was marginally associated with coronary artery disease in the Turkish Cypriot population. The mutations in the MTHFR [C677T] gene variant were marginally higher in the Turkish Cypriot cohort when compared with the Turkish patients from Turkey (P = .06). No significant direct association of any of the gene variants with coronary artery disease in the Turkish Cypriot cohort could be defined. Several of the genetic variants were associated indirectly with the risk factors for coronary artery disease in Turkish Cypriots. MTHFR [A1298C] was found to be marginally associated with low HDL cholesterol (P = .08). MTHFR [C677] wild-type allele was significantly associated with a decreased rate of high LDL cholesterol (P < .05). The HPA-1 a/b variant was significantly associated with an increased rate of high total cholesterol levels (P < .05). Conclusion: Turkish Cypriot patients with coronary artery disease may be more affected by secondary factors, such as diabetes, hypertension, obesity, and sedentary life style when compared with genetic factors, which may be responsible for coronary artery disease.

9 Article Relationship between Vitamin D and the development of atrial fibrillation after on-pump coronary artery bypass graft surgery. 2017

Cerit, Levent / Kemal, Hatice / Gulsen, Kamil / Ozcem, Barcin / Cerit, Zeynep / Duygu, Hamza. ·Near East University, Nicosia, Cyprus. Email: drcerit@hotmail.com. · Near East University, Nicosia, Cyprus. ·Cardiovasc J Afr · Pubmed #27701486.

ABSTRACT: BACKGROUND: Vitamin D deficiency is associated with many diverse cardiovascular disorders, such as hypertension, heart failure, stroke, coronary artery disease and atrial fibrillation. The relationship between Vitamin D and the development of atrial fibrillation after coronary artery bypass surgery (CABG) has not been studied. Therefore, we assessed the relationship between Vitamin D and the development of postoperative atrial fibrillation (POAF) after CABG. METHODS: Medical records of consecutive patients who underwent CABG surgery were retrospectively reviewed for the development of atrial fibrillation in the postoperative period. Vitamin D, other biochemical parameters, and clinical and echocardiographic parameters were evaluated in all patients. The independent variables for the development of postoperative atrial fibrillation were defined and their predictive values were measured. RESULTS: The study group consisted of 128 patients, of whom 41 (32%) developed POAF. Age, diabetes mellitus, chronic obstructive pulmonary disease, history of transient ischaemic attack/stroke, heart failure, left atrial diameter, platelet:largecell ratio, and creatinine, urea, uric acid, calcium and potassium levels were identified as important variables for the development of POAF. However, with logistic regression analysis, chronic obstructive pulmonary disease (OR: 28.737, 95% CI: 0.836-16.118, p < 0.001), heart failure (OR: 15.430, 95% CI: 0.989-7.649, p = 0.006), diabetes mellitus (OR: 11.486, 95% CI: 0.734-11.060, p = 0.001) and left atrial diameter (OR: 1.245, 95% CI: 0.086-6.431, p = 0.011) appeared as independent variables predicting the development of POAF. CONCLUSION: In our study, although there was a significant negative correlation between Vitamin D and left atrial diameter, Vitamin D level was not an independent predictor for POAF.

10 Article The relation between vitamin B12 and SYNTAX score. 2017

Cerit, Levent / Duygu, Hamza / Gulsen, Kamil / Kemal, Hatice / Tosun, Ozgur / Ozcem, Barcin / Cerit, Zeynep / Gunsel, Aziz. ·Near East University, Cyprus. drcerit@hotmail.com. ·Kardiol Pol · Pubmed #27391912.

ABSTRACT: BACKGROUND: Vitamin B12 is required in the metabolism of homocysteine. Vitamin B12 deficiency has been implicated in endothelial dysfunction and cardiovascular disease via hyperhomocysteinaemia. However, the association of vitamin B12 and the severity of coronary artery disease has not been studied to date. AIM: This study was conducted with the aim of evaluating the relationship between vitamin B12 and SYNTAX score. METHODS: Medical records of consecutive patients who underwent coronary artery bypass grafting surgery were retrospectively reviewed. The study group consisted of 127 patients. Vitamin B12, other biochemical parameters, clinical and echocardiographic parameters, and SYNTAX score were evaluated for all patients. RESULTS: Patients with vitamin B12 deficiency had a higher prevalence of cardiovascular risk factors such as diabetes mellitus, and history of transient ischaemic attack/stroke and heart failure. The SYNTAX score was significantly higher in patients with vitamin B12 deficiency (29.2 ± 4.9 vs. 22.5 ± 4.5, p < 0.05). CONCLUSIONS: In our study, we found a significant relationship between vitamin B12 deficiency and SYNTAX score, demon-strating the severity and complexity of coronary artery disease.

11 Article Aerobic, resistance and combined training and detraining on body composition, muscle strength, lipid profile and inflammation in coronary artery disease patients. 2016

Theodorou, Anastasios A / Panayiotou, George / Volaklis, Konstantinos A / Douda, Helen T / Paschalis, Vassilis / Nikolaidis, Michalis G / Smilios, Ilias / Toubekis, Argyris / Kyprianou, Dimitris / Papadopoulos, Ioannis / Tokmakidis, Savvas P. ·a Department of Health Sciences , European University Cyprus , Nicosia , Cyprus. · b School of Physical Education and Sport Science , University of Thrace , Komotini , Greece. · c School of Physical Education and Sport Science , University of Thessaly , Trikala , Greece. · d School of Physical Education and Sports Science at Serres , Aristotle University of Thessaloniki , Serres , Greece. ·Res Sports Med · Pubmed #27258806.

ABSTRACT: Fifty-six elderly individuals diagnosed with coronary artery disease participated in the study and were divided into four groups: an aerobic exercise group, a resistance exercise group, a combined (aerobic + resistance) exercise group and a control group. The three exercise groups participated in 8 months of exercise training. Before, at 4 and at 8 months of the training period as well as at 1, 2 and 3 months after training cessation, muscle strength was measured and blood samples were collected. The resistance exercise caused significant increases mainly in muscle strength whereas aerobic exercise caused favourable effects mostly on lipid and apolipoprotein profiles. On the other hand, combined exercise caused significant favourable effects on both physiological (i.e. muscle strength) and biochemical (i.e. lipid and apolipoprotein profile and inflammation status) parameters, while the return to baseline values during the detraining period was slower compared to the other exercise modalities.

12 Article Bilateral earlobe creases and left main coronary artery disease. 2016

Andreou, Andreas Yiangou. ·Department of Cardiology, Limassol General Hospital, Limassol, Cyprus. y.andreas@yahoo.com. ·Kardiol Pol · Pubmed #27150241.

ABSTRACT: -- No abstract --

13 Article PCA-based polling strategy in machine learning framework for coronary artery disease risk assessment in intravascular ultrasound: A link between carotid and coronary grayscale plaque morphology. 2016

Araki, Tadashi / Ikeda, Nobutaka / Shukla, Devarshi / Jain, Pankaj K / Londhe, Narendra D / Shrivastava, Vimal K / Banchhor, Sumit K / Saba, Luca / Nicolaides, Andrew / Shafique, Shoaib / Laird, John R / Suri, Jasjit S. ·Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. · Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan. · Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India. · Department of Radiology, University of Cagliari, Italy. · Vascular Screening and Diagnostic Centre, London, England, United Kingdom; Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus. · CorVasc Vascular Laboratory, 8433 Harcourt Rd #100, Indianapolis, IN, USA. · UC Davis Vascular Center, University of California, Davis, CA, USA. · Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA; Point-Of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), Pocatello, ID, USA. Electronic address: jasjit.suri@atheropoint.com. ·Comput Methods Programs Biomed · Pubmed #27040838.

ABSTRACT: BACKGROUND AND OBJECTIVE: Percutaneous coronary interventional procedures need advance planning prior to stenting or an endarterectomy. Cardiologists use intravascular ultrasound (IVUS) for screening, risk assessment and stratification of coronary artery disease (CAD). We hypothesize that plaque components are vulnerable to rupture due to plaque progression. Currently, there are no standard grayscale IVUS tools for risk assessment of plaque rupture. This paper presents a novel strategy for risk stratification based on plaque morphology embedded with principal component analysis (PCA) for plaque feature dimensionality reduction and dominant feature selection technique. The risk assessment utilizes 56 grayscale coronary features in a machine learning framework while linking information from carotid and coronary plaque burdens due to their common genetic makeup. METHOD: This system consists of a machine learning paradigm which uses a support vector machine (SVM) combined with PCA for optimal and dominant coronary artery morphological feature extraction. Carotid artery proven intima-media thickness (cIMT) biomarker is adapted as a gold standard during the training phase of the machine learning system. For the performance evaluation, K-fold cross validation protocol is adapted with 20 trials per fold. For choosing the dominant features out of the 56 grayscale features, a polling strategy of PCA is adapted where the original value of the features is unaltered. Different protocols are designed for establishing the stability and reliability criteria of the coronary risk assessment system (cRAS). RESULTS: Using the PCA-based machine learning paradigm and cross-validation protocol, a classification accuracy of 98.43% (AUC 0.98) with K=10 folds using an SVM radial basis function (RBF) kernel was achieved. A reliability index of 97.32% and machine learning stability criteria of 5% were met for the cRAS. CONCLUSIONS: This is the first Computer aided design (CADx) system of its kind that is able to demonstrate the ability of coronary risk assessment and stratification while demonstrating a successful design of the machine learning system based on our assumptions.

14 Article A new method for IVUS-based coronary artery disease risk stratification: A link between coronary & carotid ultrasound plaque burdens. 2016

Araki, Tadashi / Ikeda, Nobutaka / Shukla, Devarshi / Londhe, Narendra D / Shrivastava, Vimal K / Banchhor, Sumit K / Saba, Luca / Nicolaides, Andrew / Shafique, Shoaib / Laird, John R / Suri, Jasjit S. ·Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. · Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan. · Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA. · Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India. · Department of Radiology, University of Cagliari, Italy. · Vascular Screening and Diagnostic Centre, London, England, United Kingdom; Vascular Diagnostic Center, University of Cyprus, Nicosia, Cyprus. · CorVasc Vascular Laboratory, Indianapolis, IN, USA. · UC Davis Vascular Center, University of California, Davis, CA, USA. · Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA. Electronic address: jasjit.suri@atheropoint.com. ·Comput Methods Programs Biomed · Pubmed #26707374.

ABSTRACT: Interventional cardiologists have a deep interest in risk stratification prior to stenting and percutaneous coronary intervention (PCI) procedures. Intravascular ultrasound (IVUS) is most commonly adapted for screening, but current tools lack the ability for risk stratification based on grayscale plaque morphology. Our hypothesis is based on the genetic makeup of the atherosclerosis disease, that there is evidence of a link between coronary atherosclerosis disease and carotid plaque built up. This novel idea is explored in this study for coronary risk assessment and its classification of patients between high risk and low risk. This paper presents a strategy for coronary risk assessment by combining the IVUS grayscale plaque morphology and carotid B-mode ultrasound carotid intima-media thickness (cIMT) - a marker of subclinical atherosclerosis. Support vector machine (SVM) learning paradigm is adapted for risk stratification, where both the learning and testing phases use tissue characteristics derived from six feature combinational spaces, which are then used by the SVM classifier with five different kernels sets. These six feature combinational spaces are designed using 56 novel feature sets. K-fold cross validation protocol with 10 trials per fold is used for optimization of best SVM-kernel and best feature combination set. IRB approved coronary IVUS and carotid B-mode ultrasound were jointly collected on 15 patients (2 days apart) via: (a) 40MHz catheter utilizing iMap (Boston Scientific, Marlborough, MA, USA) with 2865 frames per patient (42,975 frames) and (b) linear probe B-mode carotid ultrasound (Toshiba scanner, Japan). Using the above protocol, the system shows the classification accuracy of 94.95% and AUC of 0.95 using optimized feature combination. This is the first system of its kind for risk stratification as a screening tool to prevent excessive cost burden and better patients' cardiovascular disease management, while validating our two hypotheses.

15 Article Reliable and Accurate Calcium Volume Measurement in Coronary Artery Using Intravascular Ultrasound Videos. 2016

Araki, Tadashi / Banchhor, Sumit K / Londhe, Narendra D / Ikeda, Nobutaka / Radeva, Petia / Shukla, Devarshi / Saba, Luca / Balestrieri, Antonella / Nicolaides, Andrew / Shafique, Shoaib / Laird, John R / Suri, Jasjit S. ·Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. · Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India. · Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA. · Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan. · Department MAIA, Computer Vision Centre, Cerdanyola del Vallés, University of Barcelona, Barcelona, Spain. · Department of Radiology, University of Cagliari, Cagliari, Italy. · Vascular Screening and Diagnostic Centre, London, UK. · Vascular Diagnostic Centre, University of Cyprus, Nicosia, Cyprus. · CorVasc Vascular Laboratory, 8433 Harcourt Rd #100, Indianapolis, IN, USA. · UC Davis Vascular Centre, University of California, Davis, CA, USA. · Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA. Jasjit.Suri@atheropoint.com. · Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA. Jasjit.Suri@atheropoint.com. · Department of Electrical Engineering, University of Idaho (Affl.), Moscow, ID, USA. Jasjit.Suri@atheropoint.com. ·J Med Syst · Pubmed #26643081.

ABSTRACT: Quantitative assessment of calcified atherosclerotic volume within the coronary artery wall is vital for cardiac interventional procedures. The goal of this study is to automatically measure the calcium volume, given the borders of coronary vessel wall for all the frames of the intravascular ultrasound (IVUS) video. Three soft computing fuzzy classification techniques were adapted namely Fuzzy c-Means (FCM), K-means, and Hidden Markov Random Field (HMRF) for automated segmentation of calcium regions and volume computation. These methods were benchmarked against previously developed threshold-based method. IVUS image data sets (around 30,600 IVUS frames) from 15 patients were collected using 40 MHz IVUS catheter (Atlantis® SR Pro, Boston Scientific®, pullback speed of 0.5 mm/s). Calcium mean volume for FCM, K-means, HMRF and threshold-based method were 37.84 ± 17.38 mm(3), 27.79 ± 10.94 mm(3), 46.44 ± 19.13 mm(3) and 35.92 ± 16.44 mm(3) respectively. Cross-correlation, Jaccard Index and Dice Similarity were highest between FCM and threshold-based method: 0.99, 0.92 ± 0.02 and 0.95 + 0.02 respectively. Student's t-test, z-test and Wilcoxon-test are also performed to demonstrate consistency, reliability and accuracy of the results. Given the vessel wall region, the system reliably and automatically measures the calcium volume in IVUS videos. Further, we validated our system against a trained expert using scoring: K-means showed the best performance with an accuracy of 92.80%. Out procedure and protocol is along the line with method previously published clinically.

16 Article Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology. 2015

Gyberg, Viveca / De Bacquer, Dirk / De Backer, Guy / Jennings, Catriona / Kotseva, Kornelia / Mellbin, Linda / Schnell, Oliver / Tuomilehto, Jaakko / Wood, David / Rydén, Lars / Amouyel, Philippe / Bruthans, Jan / Conde, Almudena Castro / Cifkova, Renata / Deckers, Jaap W / De Sutter, Johan / Dilic, Mirza / Dolzhenko, Maryna / Erglis, Andrejs / Fras, Zlatko / Gaita, Dan / Gotcheva, Nina / Goudevenos, John / Heuschmann, Peter / Laucevicius, Aleksandras / Lehto, Seppo / Lovic, Dragan / Miličić, Davor / Moore, David / Nicolaides, Evagoras / Oganov, Raphael / Pająk, Andrzej / Pogosova, Nana / Reiner, Zeljko / Stagmo, Martin / Störk, Stefan / Tokgözoğlu, Lale / Vulic, Dusko / Anonymous4140844. ·Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden. vivecagyberg@gmail.com. · Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. vivecagyberg@gmail.com. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. Dirk.DeBacquer@UGent.be. · Department of Public Health, Ghent University, Ghent, Belgium. Dirk.DeBacquer@UGent.be. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. guy.debacker@ugent.be. · Department of Public Health, Ghent University, Ghent, Belgium. guy.debacker@ugent.be. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. c.jennings@imperial.ac.uk. · Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK. c.jennings@imperial.ac.uk. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. k.kotseva@imperial.ac.uk. · Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK. k.kotseva@imperial.ac.uk. · Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden. linda.mellbin@ki.se. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. linda.mellbin@ki.se. · Forschergruppe Diabetes e.V. at the Helmholtz Center, Munich, Germany. Oliver.Schnell@lrz.uni-muenchen.de. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. jaakko.tuomilehto@thl.fi. · Centre for Vascular Prevention, Danube-University Krems, Krems, Austria. jaakko.tuomilehto@thl.fi. · Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. jaakko.tuomilehto@thl.fi. · Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain. jaakko.tuomilehto@thl.fi. · Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia. jaakko.tuomilehto@thl.fi. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. d.wood@imperial.ac.uk. · Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK. d.wood@imperial.ac.uk. · Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, 171 76, Stockholm, Sweden. Lars.Ryden@ki.se. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. Lars.Ryden@ki.se. · Institut Pasteur de Lille, Inserm U744, Université Lille Nord de France, 1 rue du Professeur Calmette B.P. 245, 59019, Lille, France. Philippe.amouyel@pasteur-lille.Fr. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. jan.bruthans@seznam.cz. · Center for Cardiovascular Prevention, 1st School of Medicine, Charles University and Thomayer Hospital, Vídeňská 800, 140 59, Prague, Czech Republic. jan.bruthans@seznam.cz. · Cardiac Rehabilitation Unit, Cardiology Department, Hospital Universitario La Paz, Madrid, Spain. almudenacastroconde@yahoo.es. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. renata.cifkova@ftn.cz. · Center for Cardiovascular Prevention, 1st School of Medicine, Charles University and Thomayer Hospital, Vídeňská 800, 140 59, Prague, Czech Republic. renata.cifkova@ftn.cz. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. j.deckers@erasmusmc.nl. · Thoraxcenter's Department of Cardiology, Dr Molewaterplein 50, 3000 DR, Rotterdam, The Netherlands. j.deckers@erasmusmc.nl. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. johan.desutter@ugent.be. · Department of Internal Medicine, University of Ghent, De Pintelaan 185, 9000, Ghent, Belgium. johan.desutter@ugent.be. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. mdilic@bih.net.ba. · Clinical Center University of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina. mdilic@bih.net.ba. · Department of Cardiology of Shupyk's Medical Academy of Postgraduate Education, 9 Dorohozhyts'ka str, Kiev, 04112, Ukraine. marinadolzhenko@mail.ru. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. a.a.erglis@stradini.lv. · University of Latvia, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, Riga, 1002, Latvia. a.a.erglis@stradini.lv. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. zlatko.fras@telemach.net. · Preventive Cardiology Unit, Division of Internal Medicine, University Medical Centre Ljubljana, Zaloška 7, 1525, Ljubljana, Slovenia. zlatko.fras@telemach.net. · Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia. zlatko.fras@telemach.net. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. dgaita@cardiologie.ro. · Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie "Victor Babes", Timisoara, Romania. dgaita@cardiologie.ro. · Department of Cardiology, National Heart Hospital, 65, Konyovitsa, 1309, Sofia, Bulgaria. ngotcheva@abv.bg. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. igoudev@cc.uoi.gr. · Cardiology Department of Medical School, University of Ioannina, Ioannina, Greece. igoudev@cc.uoi.gr. · Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany. E_Heuschma_P@klinik.uni-wuerzburg.de. · Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. E_Heuschma_P@klinik.uni-wuerzburg.de. · Clinical Trial Center Würzburg, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany. E_Heuschma_P@klinik.uni-wuerzburg.de. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. alius@cardio.it. · Clinic of Cardiovascular Diseases of Vilnius University, Santariskiu 2, 08661, Vilnius, Lithuania. alius@cardio.it. · Heart and Vascular Medicine of Vilnius University Hospital Santariskiu Clinics, Santariskiu 2, 08661, Vilnius, Lithuania. alius@cardio.it. · Kuopio University Hospital, Rakennus 5/6. Kerros, Puijonlaaksontie 2, 70210, Kuopio, Finland. seppo.lehto@varkaus.fi. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. draganl1@sbb.rs. · Clinic for Internal Medicine Intermedica, Jovana Ristica 20/2, 18000, Nis, Serbia. draganl1@sbb.rs. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. d.milicic@mail.inet.hr. · University of Zagreb School of Medicine and University Hospital Centre Zagreb, Kispaticeva 12, HR-10000, Zagreb, Croatia. d.milicic@mail.inet.hr. · The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. David.Moore@amnch.ie. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. evnicor@cytanet.com.cy. · University of Nicosia Medical School, Nicosia General Hospital, 2029 Strovolos, Nicosia, Cyprus. evnicor@cytanet.com.cy. · National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, 10 Petroverigsky per, 101990, Moscow, Russia. oganov@gnicpm.ru. · Department of Epidemiology and Population Studies, Faculty of Health Sciences, Jafiellonian University Medical College, Grzegórzecka 20, 31-531, Cracow, Poland. andrzej.pajak@uj.edu.pl. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. NPogosova@gnicpm.ru. · Federal Health Centre and Department of Chronic Noncommunicable Diseases Prevention, National Research Centre for Preventive Medicine, 10 Petroverigsky per, 101953, Moscow, Russia. NPogosova@gnicpm.ru. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. zreiner@kbc-zagreb.hr. · University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia. zreiner@kbc-zagreb.hr. · Department of Heart failure and Valve Disease, Skåne University Hospital, Lund, Sweden. Martin.Stagmo@skane.se. · Comprehensive Heart Failure Centre and Department of Medicine I, University of Würzburg, Straubmühlweg 2a, 97078, Würzburg, Germany. Stoerk_S@medizin.uni-wuerzburg.de. · European Society of Cardiology, Les Templiers, 2035 route des Colles, CS 80179 BIOT, 06903, Sophia Antipolis Cedex, France. lalet@hacettepe.edu.tr. · Hacettepe University, 06690, Ankara, Turkey. lalet@hacettepe.edu.tr. · Centre for Medical Research, School of Medicine, University of Banja Luka, Vuka Karadzica 6, 78000, Banja Luka, Republic of Srpska, Bosnia and Herzegovina. dule@blic.net. ·Cardiovasc Diabetol · Pubmed #26427624.

ABSTRACT: BACKGROUND: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. METHODS: A total of 6187 patients (18-80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012-2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. RESULTS: A total of 2846 (46%) patients had no diabetes, 1158 (19%) newly diagnosed diabetes and 2183 (35%) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60%, respectively. A blood pressure target of <140/90 mmHg was achieved in 68, 61, 54% and a LDL-cholesterol target of <1.8 mmol/L in 16, 18 and 28%. Patients with newly diagnosed and previously known diabetes reached an HbA1c <7.0% (53 mmol/mol) in 95 and 53% and 11% of those with previously known diabetes had an HbA1c >9.0% (>75 mmol/mol). Of the patients with diabetes 69% reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (≈40 %) and only 27% of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. CONCLUSIONS: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.

17 Article Shape-based approach for coronary calcium lesion volume measurement on intravascular ultrasound imaging and its association with carotid intima-media thickness. 2015

Araki, Tadashi / Ikeda, Nobutaka / Dey, Nilanjan / Acharjee, Suvojit / Molinari, Filippo / Saba, Luca / Godia, Elisa Cuadrado / Nicolaides, Andrew / Suri, Jasjit S. ·Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan (T.A.) · Division of Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan (N.I.) · Point of Care Devices, Global Biomedical Technologies, Inc, Roseville, California USA (N.D., S.A., J.S.S.) · Biolab, Department of Electronics, Politecnico di Torino, Torino, Italy (F.M.) · Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy (L.S.) · Institut Hospital del Mar d'Investigacions Mèdiques, Hospital del Mar, Barcelona, Spain (E.C.G.) · Vascular Screening and Diagnostic Center, London, England (A.N.) · Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus (A.N.) · Diagnostic and Monitoring Division, AtheroPoint, LLC, Roseville, California USA (J.S.S.) · and Department of Electrical Engineering (Affiliate), Idaho State University, Pocatello, Idaho USA (J.S.S.). ·J Ultrasound Med · Pubmed #25715368.

ABSTRACT: OBJECTIVES: Coronary calcification plays an important role in diagnostic classification of lesion subsets. According to histopathologic studies, vulnerable atherosclerotic plaque contains calcified deposits, and there can be considerable variation in the extent and degree of calcification. Intravascular ultrasound (IVUS) has demonstrated its role in imaging coronary arteries, thereby displaying calcium lesions. The aim of this work was to develop a fully automated system for detection, area and volume measurement, and characterization of the largest calcium deposits in coronary arteries. Furthermore, we demonstrate the correlation between the coronary calcium IVUS volume and the neurologic risk biomarker B-mode carotid intima-media thickness (IMT). METHODS: Our system automatically detects the frames with calcium, identifies the largest calcium region, and performs shape-based volume measurements. The carotid IMT is measured by using AtheroEdge software (AtheroPoint, LLC) on B-mode ultrasound imaging. RESULTS: Our database consists of low-contrast IVUS videos and corresponding B-mode images from 100 patients. Our experiments showed that the correlation between calcium volumes and carotid IMT was higher for the left carotid artery compared to the right carotid artery (r = 0.066 for the left carotid artery and 0.121 for the right carotid artery). We obtained 97% accuracy for automated calcium detection compared against the scoring given by our expert radiologists. Furthermore, we benchmarked shape-based volume measurement against the conventional method, which used integration of regions and showed a correlation of 84%. CONCLUSIONS: Since carotid IMT is an independent prognostic factor for myocardial infarction, and calcium lesions are correlated with stroke risk, we believe that this automated system for calcium volume measurement could be useful for assessing patients' cardiovascular risk.

18 Article Improved correlation between carotid and coronary atherosclerosis SYNTAX score using automated ultrasound carotid bulb plaque IMT measurement. 2015

Ikeda, Nobutaka / Gupta, Ajay / Dey, Nilanjan / Bose, Soumyo / Shafique, Shoaib / Arak, Tadashi / Godia, Elisa Cuadrado / Saba, Luca / Laird, John R / Nicolaides, Andrew / Suri, Jasjit S. ·Division of Cardiovascular Medicine, National Centre for Global Health and Medicine (NCGM), Tokyo, Japan. · Department of Radiology, Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York, USA. · Point of Care Devices, Global Biomedical Technologies, Inc., Roseville, California, USA. · CorVasc Vascular Laboratory, Indianapolis, Indiana, USA. · Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. · IMIM-Hospital del Mar, Barcelona, Spain. · Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.) di Cagliari-Polo di Monserrato, Università di Cagliari, Cagliari, Italy. · University of California at Davis Vascular Center, Davis, California, USA. · Vascular Screening and Diagnostic Centre, London, UK; Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus. · Point of Care Devices, Global Biomedical Technologies, Inc., Roseville, California, USA; Diagnostic and Monitoring Division, AtheroPoint™ LLC, Roseville, California, USA; Electrical Engineering Department (Aff.), Idaho State University, Pocatello, Idaho, USA. Electronic address: jasjit.suri@atheropoint.com. ·Ultrasound Med Biol · Pubmed #25638311.

ABSTRACT: Described here is a detailed novel pilot study on whether the SYNTAX (Synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) score, a measure of coronary artery disease complexity, could be better predicted with carotid intima-media thickness (cIMT) measures using automated IMT all along the common carotid and bulb plaque compared with manual IMT determined by sonographers. Three hundred seventy consecutive patients who underwent carotid ultrasound and coronary angiography were analyzed. SYNTAX score was determined from coronary angiograms by two experienced interventional cardiologists. Unlike most methods of cIMT measurement commonly used by sonographers, our method involves a computerized automated cIMT measurement all along the carotid artery that includes the bulb region and the region proximal to the bulb (under the class of AtheroEdge systems from AtheroPoint, Roseville, CA, USA). In this study, the correlation between automated cIMT that includes bulb plaque and SYNTAX score was found to be 0.467 (p < 0.0001), compared with 0.391 (p < 0.0001) for the correlation between the sonographer's IMT reading and SYNTAX score. The correlation between the automated cIMT and the sonographer's IMT was 0.882. When compared against the radiologist's manual tracings, automated cIMT system performance had a lumen-intima error of 0.007818 ± 0.0071 mm, media-adventitia error of 0.0179 ± 0.0125 mm and automated cIMT error of 0.0099 ± 0.00988 mm. The precision of automated cIMT against the manual radiologist's reading was 98.86%. This current automated algorithm revealed a significantly stronger correlation between cIMT and coronary SYNTAX score as compared with the sonographer's cIMT measurements with multiple cardiovascular risk factors. We benchmarked our correlation between the automated cIMT that includes bulb plaque and SYNTAX score against a previously published (Ikeda et al. 2013) AtheroEdgeLink (AtheroPoint) correlation between the automated cIMT that does not include bulb plaque and SYNTAX score and had an improvement of 44.58%. By sampling cIMT in the bulb region, the automated cIMT technique improves the degree of correlation between coronary artery disease lesion complexity and carotid atherosclerosis characteristics.

19 Article Blood lipids among young children in Europe: results from the European IDEFICS study. 2014

De Henauw, S / Michels, N / Vyncke, K / Hebestreit, A / Russo, P / Intemann, T / Peplies, J / Fraterman, A / Eiben, G / de Lorgeril, M / Tornaritis, M / Molnar, D / Veidebaum, T / Ahrens, W / Moreno, L A / Anonymous3000806. ·1] Department of Public Health, Faculty of Medicine and Health Sciences, University Hospital, Ghent University, Ghent, Belgium [2] Department of Health Sciences, Vesalius College, University College Ghent, Ghent, Belgium. · Department of Public Health, Faculty of Medicine and Health Sciences, University Hospital, Ghent University, Ghent, Belgium. · Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. · Epidemiology and Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy. · MVZ Dortmund Dr Eberhard und Partner, Dortmund, Germany. · Department of Primary Health Care, University of Gothenburg, Gothenburg, Sweden. · TIMC-IMAG, CNRS UMR 5525, Coeur et nutrition, Faculté de Médecine de Grenoble, Grenoble, France. · Research and Education Institute of Child Health, Strovolos, Cyprus. · National Institute of Health Promotion, University of Pécs, Gyermekklinika, Pécs, Hungary. · Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia. · 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany. · GENUD (Growth, Exercise, Nutrition and Development) research group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain. ·Int J Obes (Lond) · Pubmed #25219412.

ABSTRACT: BACKGROUND: Measurement of cholesterol and triglyceride (TG) fractions in blood has become standard practice in the early detection of atherosclerotic disease pathways. Considerable attention is given nowadays to the presence of these risk factors in children and to start preventive campaigns early in life. In this context, it is imperative to have valid comparative frameworks for interpretation of lipid levels. The aim of this study is to present sex- and age-specific reference values on blood lipid levels in European children aged 2.0-10.9 years. METHODS: Fasting blood was obtained via either venipuncture or capillary sampling. In 13,579 European non-obese children (50.3% boys), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), TG and TC/HDL-C ratio levels were measured with a point-of-care analyser (Cholestech). Sex- and age-specific reference values were computed with the GAMLSS method with the statistical software R. RESULTS: Reference curves and 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentile values are presented. HDL-C showed a positive trend with age, from 2 years onwards, but was relatively stable above the age of 7. For LDL-C and TC, linear but small age-related trends were seen. The TC/HDL-C values showed a gradual negative trend from the age of 2 up to 6 and were relatively stable afterwards. For TG, no age trend was found (P=0.285). Boys had higher mean HDL-C values than girls (1.414 vs 1.368 mmol l(-1)), and lower TC, LDL-C, TC/HDL-C and TG values (3.981 vs 4.087 mmol l(-1); 2.297 vs 2.435 mmol l(-1); 2.84 vs 3.01mmol l(-1);  and 0.509 vs 0.542 mmol l(-1), respectively). CONCLUSIONS: These new and recent references could serve as a European orientation of blood lipid values in children in the context of standard medical practice and for the purpose of public health screening.

20 Article An excellent collateralization between left internal mammary artery to left external iliac artery. 2014

Özcem, Barçın / Gülşen, Kamil / Cerit, Levent. ·Department of Cardiovascular Surgery, Faculty of Medicine, Near East University, Nicosia-Northern Cyprus. drbarcinozcem@gmail.com. ·Anadolu Kardiyol Derg · Pubmed #24662596.

ABSTRACT: -- No abstract --

21 Article Diagnostic sensitivity of SPECT myocardial perfusion imaging using a pumping cardiac phantom with inserted variable defects. 2013

Chrysanthou-Baustert, Isabelle / Parpottas, Yiannis / Demetriadou, Ourania / Christofides, Stelios / Yiannakkaras, Charalambos / Kaolis, Demetris / Wasilewska-Radwanska, Marta / Fiutowski, Tomasz / Sikora, Franciszek. ·Frederick Research Centre, Nicosia, Cyprus. isabelle.chrysanthou@gmail.com ·J Nucl Cardiol · Pubmed #23709278.

ABSTRACT: BACKGROUND: The diagnostic sensitivity of various SPECT MPI procedures was assessed using a pumping cardiac phantom with variable defects inserted in the myocardial wall of the left ventricle. METHODS AND RESULTS: A diagnostic evaluation of 142 myocardial defects was performed. A diagnosis blinded to prior-known conditions was compared to the known defects severity (transmural, subendocardial) and defects position within the myocardial wall of the left ventricle (apical, anterior, inferior) for three body types (average male, large male, large female). Non-attenuation corrected, attenuation corrected and gated SPECT MPI were performed. The diagnostic sensitivity was improved when applying attenuation correction or gating techniques to identify subendocardial defects in the inferior, anterior and apical segments of the myocardial wall of the left ventricle for all three body types. Transmural defects could be identified without any attenuation correction or gating. CONCLUSIONS: The diagnostic sensitivity was improved when applying AC or GSPECT techniques.

22 Article Thrombotic gene polymorphisms and postoperative outcome after coronary artery bypass graft surgery. 2011

Emiroglu, Ozan / Durdu, Serkan / Egin, Yonca / Akar, Ahmet R / Alakoc, Yesim D / Zaim, Cagin / Ozyurda, Umit / Akar, Nejat. ·Department of Cardiovascular Surgery, Nicosia State Hospital, Nalbantoglu Lefkosa Devlet Hastanesi, Ortakoy, Nicosia, Cyprus. ozanemiroglu@gmail.com ·J Cardiothorac Surg · Pubmed #21955693.

ABSTRACT: BACKGROUND: Emerging perioperative genomics may influence the direction of risk assessment and surgical strategies in cardiac surgery. The aim of this study was to investigate whether single nucleotide polymorphisms (SNP) affect the clinical presentation and predispose to increased risk for postoperative adverse events in patients undergoing coronary artery bypass grafting surgery (CABG). METHODS: A total of 220 patients undergoing first-time CABG between January 2005 and May 2008 were screened for factor V gene G1691A (FVL), prothrombin/factor II G20210A (PT G20210A), angiotensin I-converting enzyme insertion/deletion (ACE-ins/del) polymorphisms by PCR and Real Time PCR. End points were defined as death, myocardial infarction, stroke, postoperative bleeding, respiratory and renal insufficiency and event-free survival. Patients were compared to assess for any independent association between genotypes for thrombosis and postoperative phenotypes. RESULTS: Among 220 patients, the prevalence of the heterozygous FVL mutation was 10.9% (n = 24), and 3.6% (n = 8) were heterozygous carriers of the PT G20210A mutation. Genotype distribution of ACE-ins/del was 16.6%, 51.9%, and 31.5% in genotypes I/I, I/D, and D/D, respectively. FVL and PT G20210A mutations were associated with higher prevalence of totally occluded coronary arteries (p < 0.001). Furthermore the risk of left ventricular aneurysm formation was significantly higher in FVL heterozygote group compared to FVL G1691G (p = 0.002). ACE D/D genotype was associated with hypertension (p = 0.004), peripheral vascular disease (p = 0.006), and previous myocardial infarction (p = 0.007). CONCLUSIONS: FVL and PT G20210A genotypes had a higher prevalence of totally occluded vessels potentially as a result of atherothrombotic events. However, none of the genotypes investigated were independently associated with mortality.

23 Article Association rule analysis for the assessment of the risk of coronary heart events. 2009

Karaolis, M / Moutiris, J A / Papaconstantinou, L / Pattichis, C S. ·Department of Computer Science, University of Cyprus, Nicosia, Cyprus. karaolis@acm.org ·Conf Proc IEEE Eng Med Biol Soc · Pubmed #19965088.

ABSTRACT: Although significant progress has been made in the diagnosis and treatment of coronary heart disease (CHD), further investigation is still needed. The objective of this study was to develop a data mining system using association analysis based on the apriori algorithm for the assessment of heart event related risk factors. The events investigated were: myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABG). A total of 369 cases were collected from the Paphos CHD Survey, most of them with more than one event. The most important risk factors, as extracted from the association rule analysis were: sex (male), smoking, high density lipoprotein, glucose, family history, and history of hypertension. Most of these risk factors were also extracted by our group in a previous study using the C4.5 decision tree algorithms, and by other investigators. Further investigation with larger data sets is still needed to verify these findings.

24 Article Quality of life after coronary artery bypass graft surgery in the elderly. 2009

Merkouris, Anastasios / Apostolakis, Efstratios / Pistolas, Dimitrios / Papagiannaki, Vasileia / Diakomopoulou, Eleni / Patiraki, Elissavet. ·Nursing Department, Cyprus University of Technology, Cyprus. anastasios.merkouris@cut.ac.cy ·Eur J Cardiovasc Nurs · Pubmed #18424183.

ABSTRACT: BACKGROUND: The aim of this study is to explore the quality of life of elderly patients after coronary artery bypass graft (CABG) surgery. METHODS: The present study employed a pre-post test design. Sixty three elderly patients (>or=65 years), operated in one big general hospital in Athens, were interviewed before, 4 months and 12 months after CABG with the MacNew Heart disease health-related quality of life questionnaire. RESULTS: The majority of the sample were male (N=48, 76.2%), married (N=49, 77.8%) and pensioners (N=54, 61.7%). After the operation and before discharge 42 (66.6%) patients presented complications. One year after the operation, 45 (80.4%) patients experienced improvement and only 11 (19.6%) deterioration in their reported quality of life. Despite this postoperative improvement in all domains, a high percentage of patients (>60%) continued to report exacerbation in questions related to self confidence and dependence to others indicating an overprotective environment. Approximately one in two patients reported signs of cognitive dysfunction during the postoperative period. Elderly patients knew very little about their disease, especially before the operation (mean=2.03, SD=0.69, R=1-5). Educational level, presence of complications in the immediate postoperative period and reported angina were related to a poorer QoL. CONCLUSION: A high proportion of the patients experienced improvement while a substantial number had exacerbations related to self confidence and dependence to others. An important step to improve this situation might be through the institution of a structured multi-disciplinary rehabilitation program with focus on emotional support, information giving and education to elderly CABG patients and their significant others.

25 Article Prevalence of multifocal atherosclerosis and comorbidity on symptomatic Cypriot inpatients. 2008

Bekos, C / Pieri, L / Angelides, N / Moros, I. ·First Clinic of Thoracic and Cardiovascular Surgery, Division of Vascular Surgery, AHEPA University Hospital, Thessaloniki, Greece. bchris@cytanet.com.cy ·Int Angiol · Pubmed #18974706.

ABSTRACT: AIM: Multifocal atherosclerotic disease or multifocal ischemic pathology (MAD) is an issue gaining a lot of attention by clinicians in recent years, due to its high impact on the morbidity and mortality of vascular patients. The coexistence of coronary artery disease (CAD), peripheral arterial disease (PAD) and carotid disease (CS) is being investigated in this study. METHODS: The study included 556 consecutive inpatients who were admitted to the Nicosia General Hospital in Cyprus for carotid endarterectomy, peripheral arterial reconstruction or coronary artery bypass. All patients were subjected to color duplex examination of the carotid vessels and to lower extremity Doppler study. Cardiac risk screening was performed on patients with PAD and CS. Comorbidity was evaluated by using the Cumulative Illness Rating Scale (CIRS). RESULTS: The prevalence of MAD in atherosclerotic patients was found very high (60.3%). The most frequent comorbidity was the coexistence of PAD and CAD (41.8%). The comorbidity burden of MAD patients, in comparison to that of patients with unifocal atherosclerotic disease, was evaluated to conclude that the burden in the first group (MAD) is significantly higher, not only in relation to the number of clinically relevant diseases that co-exist, but also to the severity of these diseases. Furthermore, functional status is negatively affected by the existence of multifocal ischemic pathology. CONCLUSION: The high prevalence of MAD suggests the necessity of developing a systematic screening approach in the everyday practice. Apart from cardiovascular problems, other diseases affect the clinical situation of these patients. Therefore, it is important to investigate these problems pre- and postoperatively.

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