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Coronary Artery Disease: HELP
Articles from Mexico
Based on 98 articles published since 2008
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These are the 98 published articles about Coronary Artery Disease that originated from Mexico during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline Coronary computed tomographic imaging in women: An expert consensus statement from the Society of Cardiovascular Computed Tomography. 2018

Truong, Quynh A / Rinehart, Sarah / Abbara, Suhny / Achenbach, Stephan / Berman, Daniel S / Bullock-Palmer, Renee / Carrascosa, Patricia / Chinnaiyan, Kavitha M / Dey, Damini / Ferencik, Maros / Fuechtner, Gudrun / Hecht, Harvey / Jacobs, Jill E / Lee, Sang-Eun / Leipsic, Jonathan / Lin, Fay / Meave, Aloha / Pugliese, Francesca / Sierra-Galán, Lilia M / Williams, Michelle C / Villines, Todd C / Shaw, Leslee J / Anonymous3891033. ·Weill Cornell Medicine, USA. Electronic address: qat9001@med.cornell.edu. · Piedmont Healthcare, USA. · UT Southwestern Medical Center, USA. · University of Erlangan, Germany. · Cedars-Sinai Medical Center, USA. · Deborah Heart and Lung Center, USA. · Maipu Diagnosis, Argentina. · William Beaumont Hospital, USA. · Oregon Health & Science University, USA. · Medical University of Innsbruck, Austria. · Mount Sinai Health System, USA. · NYU Langone Medical Center, USA. · Severance Hospital, South Korea. · Providence Healthcare, Canada. · Weill Cornell Medicine, USA. · Ignacio Chavez National Institute for Cardiology, Mexico. · William Harvey Research Institute, UK. · American British Cowdray Medical Center, Mexico. · British Heart Foundation, UK. · Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, USA. ·J Cardiovasc Comput Tomogr · Pubmed #30392926.

ABSTRACT: This expert consensus statement from the Society of Cardiovascular Computed Tomography (SCCT) provides an evidence synthesis on the use of computed tomography (CT) imaging for diagnosis and risk stratification of coronary artery disease in women. From large patient and population cohorts of asymptomatic women, detection of any coronary artery calcium that identifies females with a 10-year atherosclerotic cardiovascular disease risk of >7.5% may more effectively triage women who may benefit from pharmacologic therapy. In addition to accurate detection of obstructive coronary artery disease (CAD), CT angiography (CTA) identifies nonobstructive atherosclerotic plaque extent and composition which is otherwise not detected by alternative stress testing modalities. Moreover, CTA has superior risk stratification when compared to stress testing in symptomatic women with stable chest pain (or equivalent) symptoms. For the evaluation of symptomatic women both in the emergency department and the outpatient setting, there is abundant evidence from large observational registries and multi-center randomized trials, that CT imaging is an effective procedure. Although radiation doses are far less for CT when compared to nuclear imaging, radiation dose reduction strategies should be applied in all women undergoing CT imaging. Effective and appropriate use of CT imaging can provide the means for improved detection of at-risk women and thereby focus preventive management resulting in long-term risk reduction and improved clinical outcomes.

2 Review Epigenetic Programming of Synthesis, Release, and/or Receptor Expression of Common Mediators Participating in the Risk/Resilience for Comorbid Stress-Related Disorders and Coronary Artery Disease. 2018

Zapata-Martín Del Campo, Carlos Manuel / Martínez-Rosas, Martín / Guarner-Lans, Verónica. ·Department of Psychiatry, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México 14080, Mexico. carlos.zapata@cardiologia.org.mx. · Department of Psychiatry, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México 14080, Mexico. martin.martinez@cardiologia.org.mx. · Department of Psychiatry, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México 14080, Mexico. veronica.guarner@cardiologia.org.mx. ·Int J Mol Sci · Pubmed #29670001.

ABSTRACT: Corticotrophin releasing factor, vasopressin, oxytocin, natriuretic hormones, angiotensin, neuregulins, some purinergic substances, and some cytokines contribute to the long-term modulation and restructuring of cardiovascular regulation networks and, at the same time, have relevance in situations of comorbid abnormal stress responses. The synthesis, release, and receptor expression of these mediators seem to be under epigenetic control since early stages of life, possibly underlying the comorbidity to coronary artery disease (CAD) and stress-related disorders (SRD). The exposure to environmental conditions, such as stress, during critical periods in early life may cause epigenetic programming modifying the development of pathways that lead to stable and long-lasting alterations in the functioning of these mediators during adulthood, determining the risk of or resilience to CAD and SRD. However, in contrast to genetic information, epigenetic marks may be dynamically altered throughout the lifespan. Therefore, epigenetics may be reprogrammed if the individual accepts the challenge to undertake changes in their lifestyle. Alternatively, epigenetics may remain fixed and/or even be inherited in the next generation. In this paper, we analyze some of the common neuroendocrine functions of these mediators in CAD and SRD and summarize the evidence indicating that they are under early programming to put forward the theoretical hypothesis that the comorbidity of these diseases might be epigenetically programmed and modified over the lifespan of the individual.

3 Review Lipid phosphate phosphatase 3 in vascular pathophysiology. 2018

Busnelli, Marco / Manzini, Stefano / Parolini, Cinzia / Escalante-Alcalde, Diana / Chiesa, Giulia. ·Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy. Electronic address: marco.busnelli@unimi.it. · Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy. · Instituto de Fisiología Celular, División de Neurociencias Universidad Nacional Autónoma de México, Cd. Mx., 04510, Mexico. · Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy. Electronic address: giulia.chiesa@unimi.it. ·Atherosclerosis · Pubmed #29518748.

ABSTRACT: LPP3 is an integral membrane protein belonging to a family of enzymes (LPPs) that display broad substrate specificity and catalyse dephosphorylation of several lipid substrates, including lysophosphatidic acid and sphingosine-1-phosphate. In mammals, the LPP family consists of three enzymes named LPP1, LPP2 and LPP3, which are encoded by three independent genes, PLPP1, PLPP2 and PLPP3, respectively (formerly known as PPAP2A, PPAP2C, PPAP2B). These three enzymes, in vitro, do not seem to differ for catalytic activities and substrate preferences. However, in vivo targeted inactivation of the individual genes has indicated that the enzymes do not have overlapping functions and that LPP3, specifically, plays a crucial role in vascular development. In 2011, two genome-wide association studies have identified PLPP3 as a novel locus associated with coronary artery disease susceptibility. Shortly after these reports, tissue specific inactivation of PLPP3 in mice highlighted a specific role for LPP3 in vascular pathophysiology and, more recently, in atherosclerosis development. This review is aimed at providing an updated overview on the function of LPP3 in embryonic cardiovascular development and on the experimental and clinical evidences relating this enzyme to vascular cell functions and cardiovascular disease.

4 Review Innate Immunity in Coronary Disease. The Role of Interleukin-12 Cytokine Family in Atherosclerosis. 2018

Posadas-Sánchez, Rosalinda / Vargas-Alarcón, Gilberto. ·Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. · Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. ·Rev Invest Clin · Pubmed #29513302.

ABSTRACT: Atherosclerosis is a chronic, progressive, and multifactorial disease modulated by genetic and environmental factors. In recent years, the paradigm that explained atherosclerosis as resulting from a complex interaction between factors not accessible to medical intervention, and modifiable risk factors has changed. In this paradigm, alterations in lipid metabolism were the pivotal concept of atherosclerosis as a chronic degenerative disease. In the last years, an increasing number of observations have shown that the innate and adaptive immune responses to lipoprotein deposition and oxidation in the arterial wall significantly influence atherosclerosis. Currently, it is well recognized that the pathogenesis of atherosclerosis and its complications involves the inflammatory process, which includes the participation of several cytokines. Besides the classic cytokines involved in this process, the role of the interleukin-12 (IL-12) family has been recently demonstrated. This review describes our current understanding about the role of the family of IL-12 in atherosclerosis considering the participation of the genes that encode these cytokines in the genetic susceptibility to developing this disease.

5 Review QRS-fragmentation: Case report and review of the literature. 2018

Illescas-González, Edgar / Araiza-Garaygordobil, Diego / Sierra Lara, Jorge Daniel / Ramirez-Salazar, Aristoteles / Sierra-Fernández, Carlos / Alexanderson-Rosas, Erick. ·National Institute of Cardiology Ignacio Chávez, Mexico. Electronic address: edgarillescasmd@hotmail.com. · National Institute of Cardiology Ignacio Chávez, Mexico. · Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chávez, Mexico. · Coronary Care Unit, National Institute of Cardiology Ignacio Chávez, Mexico. ·Arch Cardiol Mex · Pubmed #28130029.

ABSTRACT: Fragmentation of QRS complex (QRSf) is an easily evaluable, non-invasive electrocardiographic parameter that represents depolarisation anomalies and has been associated with several adverse outcomes, such as sudden death, fibrosis, arrhythmic burden, and a worse prognosis in different conditions, including coronary artery disease (CAD). The case is presented of a 69-year old male referred due to symptoms of chronic stable angina. His electrocardiogram showed sinus rhythm, absence of Q waves, but the presence of QRSf in the inferior leads and V4-V6. A Tc-99 myocardial perfusion SPECT scan revealed a fixed perfusion defect in the inferolateral region, corresponding to the finding of QRSf. QRSf is an easily valuable electrocardiographic marker with relative sensitivity, but poor specificity. Its routine clinical application could contribute to an increase in the suspicion of coronary artery disease. CONCLUSION: The presence of fragmented QRS represents distortion of signal conduction and depolarisation, which is related to myocardial scar or myocardial fibrosis.

6 Review Coronary flow capacity: concept, promises, and challenges. 2017

van de Hoef, Tim P / Echavarría-Pinto, Mauro / Escaned, Javier / Piek, Jan J. ·AMC Heart Center, Academic Medical Center - University of Amsterdam, Room B2-250, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. t.p.vandehoef@amc.uva.nl. · AMC Heart Center, Academic Medical Center - University of Amsterdam, Room B2-250, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. · Department of Cardiology, ISSSTE General Hospital, Querétaro, Mexico. · Faculty of Medicine, Autonomous University of Querétaro, Querétaro, Mexico. · Cardiovascular Institute, Hospital Universitario Clinico San Carlos, Madrid, Spain. ·Int J Cardiovasc Imaging · Pubmed #28353034.

ABSTRACT: The vasodilator capacity of the coronary circulation is an important diagnostic and prognostic characteristic, and its accurate assessment is therefore an important frontier. The coronary flow capacity (CFC) concept was introduced to overcome the limitations associated with the use of coronary flow reserve (CFR) for this purpose, which are related to the sensitivity of CFR to physiological alterations in systemic and coronary hemodynamics. CFC was developed from positron emission tomography, and was subsequently extrapolated to invasive coronary physiology. These studies suggest that CFC is a robust framework for the identification of clinically relevant coronary flow abnormalities, and improves identification of patients at risk for adverse events over the use of CFR alone. This Review will discuss the concept of CFC, its promises in the setting of ischaemic heart disease, and its challenges both in theoretical and practical terms.

7 Review Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies. 2017

Martínez-González, Brenda / Reyes-Hernández, Cynthia Guadalupe / Quiroga-Garza, Alejandro / Rodríguez-Rodríguez, Víctor E / Esparza-Hernández, Claudia N / Elizondo-Omaña, Rodrigo E / Guzmán-López, Santos. ·Faculty of Medicine, Human Anatomy Department and University Hospital "Dr. Jose Eleuterio González", Universidad Autonoma de Nuevo León (UANL), Monterrey NL, Mexico. ·Ann Thorac Cardiovasc Surg · Pubmed #28202895.

ABSTRACT: There is a significant variety of vascular conduits options for coronary bypass surgery. Adequate graft selection is the most important factor for the success of the intervention. To ensure durability, permeability, and bypass function, there must be a morphological similarity between the graft and the coronary artery. The objective of this review was to analyze the morphological characteristics of the grafts that are most commonly used in coronary bypass surgery and the coronary arteries that are most frequently occluded. We included clinical information regarding the characteristics that determine the behavior of the grafts and its permeability over time. Currently, the internal thoracic artery is the standard choice for bypass surgery because of the morphological characteristics of the wall that makes less prone to developing atherosclerosis and hyperplasia. The radial and right gastroepiploic arteries are the following second and third best options, respectively. The ulnar artery is the preferred choice when other conduits are not feasible.

8 Review Association of G308A and G238A Polymorphisms of the TNF-α Gene with Risk of Coronary Heart Disease: Systematic Review and Meta-analysis. 2016

Pulido-Gómez, Karely / Hernández-Díaz, Yazmín / Tovilla-Zárate, Carlos Alfonso / Juárez-Rojop, Isela Esther / González-Castro, Thelma Beatriz / López-Narváez, María Lilia / Alpuin-Reyes, Mariela. ·División Académica de Ciencias de la Salud, Jalpa de Méndez, Tabasco, Mexico. · División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico. · División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México. · División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico. Electronic address: thelma.glez.castro@gmail.com. · Hospital General de Yajalón, Secretaría de Salud, Yajalón, Chiapas, México. ·Arch Med Res · Pubmed #28262198.

ABSTRACT: BACKGROUND AND AIMS: It is widely acknowledged that coronary heart disease (CHD) has a genetic influence. One of the most promising candidate genes is tumor necrosis factor-alpha (TNF-α). Although there have been several positive studies associating the TNF-α gene and CHD, the evidence is not entirely consistent. The aim of the study was to evaluate the role of the TNF-α gene in CHD using combined evidence by generating a meta-analysis and a systematic review of all published data. METHODS: Meta-analysis and systematic review were conducted using 27 articles of genetic association studies of the TNF-α gene variants (G308A and G238A) and CHD. To analyze the association we used allelic, additive, dominant and recessive models. Moreover, we conducted a subanalysis by populations using the same four models. RESULTS: TNF-α variant G308A showed a significant association with CHD but only when the analysis comprised the whole population. In addition, the variant G238A yielded the same outcome in the Asian population. CONCLUSIONS: Genetic polymorphisms at positions -308 and -238 in the promoter region of the TNF-α gene may be useful as predictive factors for CHD.

9 Review [Dyslipidemia and hypertension]. 2016

Alvirde-García, Ulices. ·Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México. ·Gac Med Mex · Pubmed #27603889.

ABSTRACT: Most of the recent observational studies have failed to find an association between dairy intake and increased risk of cardiovascular disease, coronary heart disease and stroke, regardless of milk fat content. The purpose of this review is to examine the published research on the relationship between milk products containing milk fat and cardiovascular health. Despite their saturated fat content, there is no clear evidence of an association between dairy intake and an increased risk of cardiovascular disease (CVD). Consequently, the current dietary recommendations to restrict saturated fat should be assessed for every case.

10 Review [Treatment of hypertension in patients with coronary arterial disease]. 2016

Rosas-Peralta, Martín / Borrayo-Sánchez, Gabriela / Madrid-Miller, Alejandra / Ramírez-Arias, Erick / Pérez-Rodríguez, Gilberto. ·División de Investigación en Salud, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. mrosas_peralta@hotmail.com. ·Rev Med Inst Mex Seguro Soc · Pubmed #27428346.

ABSTRACT: Reports of randomized controlled trials and prospective observational studies provide the most reliable data on the association between blood pressure and coronary heart disease (CHD). The totality of the evidence indicate a strong association between blood pressure and coronary heart disease, which is continuous at levels of less than 115 mm Hg of systolic. In general, 60 to 69 years of age, 10 lower mm Hg systolic blood pressure is associated with lower risk of one-fifth of a coronary heart disease event. The size and shape of this Association are consistent in all regions, for men and women and life-threatening events such as stroke and myocardial infarction. Trials that compared active treatment with placebo or no treatment have shown that the benefits of reducing blood pressure with different classes of drugs (e.g., diuretics, beta-blockers, ACE inhibitors, calcium antagonists) are quite similar, with about a fifth of reduction in coronary heart disease. The important points in this review are: First, that the relative benefit to the decline in blood pressure for the prevention of coronary heart disease appears to be constant in a range of different populations. Second, it is likely that considerable benefit with blood pressure low below thresholds of "traditional" blood pressure (140/90 mm Hg), especially in those with high absolute risk. Third, start, reduce with caution -especially in adult- and keep the maximum tolerance of blood pressure reduction is an issue more important than the choice of the initial agent.

11 Review [Association between IGF system and PAPP-A in coronary atherosclerosis]. 2016

Fierro-Macías, Alfonso Eduardo / Floriano-Sánchez, Esaú / Mena-Burciaga, Victoria Michelle / Gutiérrez-Leonard, Hugo / Lara-Padilla, Eleazar / Abarca-Rojano, Edgar / Fierro-Almanzán, Alfonso Edmundo. ·Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México, DF, México. Electronic address: fierromacias@hotmail.com. · Laboratorio Multidisciplinario de Investigación, Escuela Militar de Graduados de Sanidad, Secretaría de la Defensa Nacional (SEDENA), México, DF, México. · Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México, DF, México. · Departamento de Hemodinamia, Hospital Central Militar, Secretaría de la Defensa Nacional (SEDENA), México, DF, México. · Departamento de Cirugía, Hospital General Regional N.(o) 66, Instituto Mexicano del Seguro Social (IMSS), Ciudad Juárez, Chihuahua, México. ·Arch Cardiol Mex · Pubmed #26906607.

ABSTRACT: Atherosclerosis is a condition that involves multiple pathophysiological mechanisms and whose knowledge has not been fully elucidated. Often, scientific advances on the atherogenic pathophysiology generate that molecules not previously considered in the scene of this disease, were attributed actions on the onset or progression of it. A representative example is the study of a new mechanism involved in the atherogenic process, consisting of the association between the insulin-like growth factor (IGF) system and pregnancy-associated plasma protein-A (PAPP-A). Insulin-like growth factor system is a family of peptides that include 3 peptide hormones, 4 transmembrane receptors and 6 binding proteins. Insulin-like growth factor-1 (IGF-1) is the main ligand of the IGF system involved in coronary atherosclerosis. IGF-1 exerts its effects via activation of the IGF-1R receptor on vascular smooth muscle cells or macrophages. In vascular smooth muscle cells promotes migration and prevents apoptosis which increases plaque stability while in macrophages reduces reverse cholesterol transport leading to the formation of foam cells. Regulation of IGF-1 endothelial bioavailability is carried out by IGFBP proteases, mainly by PAPP-A. In this review, we address the mechanisms between IGF system and PAPP-A in atherosclerosis with emphasis on molecular effects on vascular smooth muscle cells and macrophages.

12 Review [Dextrocardia, aortic coarctation and coronary artery disease. A case report and review of the literature]. 2016

Guzmán-Guillén, Karol Andrea / Hernández-Fonseca, César Eduardo / Cossio-Torrico, Paloma Eunise / Criales-Vera, Sergio Andrés / Zavaleta-López, Daniel / Buendía-Hernández, Alfonso. ·Departamento de Cardiología Clínica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. Electronic address: karolandreagg@hotmail.com. · Departamento de Cardiología Clínica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. · Departamento de Radiología e Imagen, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. · Departamento de Cardiología Pediátrica, Clínica de Chiapas, Chiapas, México. · Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. ·Arch Cardiol Mex · Pubmed #26556223.

ABSTRACT: -- No abstract --

13 Review Effect of statin therapy on plasma proprotein convertase subtilisin kexin 9 (PCSK9) concentrations: a systematic review and meta-analysis of clinical trials. 2015

Sahebkar, A / Simental-Mendía, L E / Guerrero-Romero, F / Golledge, J / Watts, G F. ·Biotechnology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran. · Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia. · Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico. · Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University Townsville, Townsville, Queensland, Australia. · Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia. · Lipid Disorders Clinic, Cardiovascular Medicine, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia. ·Diabetes Obes Metab · Pubmed #26183252.

ABSTRACT: AIMS: To evaluate the magnitude of the effect of statin therapy on plasma proprotein convertase subtilisin kexin 9 (PCSK9) levels through a systematic review and meta-analysis of clinical trials. METHODS: A random-effects model (using DerSimonian-Laird method) and the generic inverse variance method were used for quantitative data synthesis. Heterogeneity was quantitatively assessed using the I(2) index. Sensitivity analyses were conducted using the one-study remove approach. Random-effects meta-regression was performed using an unrestricted maximum likelihood method to evaluate the association between statin-induced elevation of plasma PCSK9 concentrations with duration of treatment and magnitude of LDL cholesterol reduction. RESULTS: A total of 15 clinical trials examining the effects of statin therapy on plasma PCSK9 levels were included. Meta-analysis of data from single-arm statin treatment arms [weighted mean difference (WMD) 40.72 ng/ml, 95% confidence interval (CI) 34.79, 46.65; p < 0.001] and randomized placebo-controlled trials (WMD 22.98 ng/ml, 95% CI 17.95, 28.01; p < 0.001) showed a significant increase in plasma PCSK9 concentrations after statin therapy, irrespective of the type of statin administered in either of the analyses (single-arm or randomized placebo-controlled trial). There was no significant elevation of plasma PCSK9 levels with statin/ezetimibe combination therapy compared with statin monotherapy (WMD 23.14 ng/ml, 95% CI -1.97, 48.25; p = 0.071); however, removal of one study in the meta-analysis yielded a significant result in the sensitivity analysis (WMD 31.41 ng/ml, 95% CI 7.86, 54.97; p = 0.009). CONCLUSIONS: This meta-analysis suggests that statin therapy causes a significant increase in plasma PCSK9 concentrations.

14 Review Coronary Atherosclerosis and Interventional Cardiology. 2015

Peña-Duque, Marco Antonio / Romero-Ibarra, José Luis / Gaxiola-Macías, Manuel Ben Adoniram / Arias-Sánchez, Eduardo A. ·Interventional Cardiology Department, National Institute of Cardiology, Ignacio Chávez, Tlalpan, Mexico City, Mexico. Electronic address: marcopduque@gmail.com. · Interventional Cardiology Department, National Institute of Cardiology, Ignacio Chávez, Tlalpan, Mexico City, Mexico. ·Arch Med Res · Pubmed #26117516.

ABSTRACT: The atherosclerotic process in coronary arteries begins with endothelial dysfunction and may provoke thrombotic total occlusion and myocardial infarction. In this state-of-the-art review, we discuss recent evidence of atheroslerosis, vulnerable plaque, and hemodynamic changes in the coronary tree, as well as the current techniques we implement in the catheterization lab to evaluate coronary stenosis. It is clear that atherosclerosis is a chronic inflammatory condition with several consequences in the coronary tree, however, we are able now to characterize the plaque and to select the appropriate treatment for many patients.

15 Review Current and future trends in multimodality imaging of coronary artery disease. 2015

Alexanderson-Rosas, Erick / Guinto-Nishimura, Gerardo Y / Cruz-Mendoza, Jose Raul / Oropeza-Aguilar, Mariano / De La Fuente-Mancera, Juan Carlos / Barrero-Mier, Alejandro F / Monroy-Gonzalez, Andrea / Juarez-Orozco, Luis Eduardo / Cano-Zarate, Roberto / Meave-Gonzalez, Aloha. ·Department of Nuclear Cardiology, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico. ·Expert Rev Cardiovasc Ther · Pubmed #25912725.

ABSTRACT: Nowadays, there is a wide array of imaging studies available for the evaluation of coronary artery disease, each with its particular indications and strengths. Cardiac single photon emission tomography is mostly used to evaluate myocardial perfusion, having experienced recent marked improvements in image acquisition. Cardiac PET has its main utility in perfusion imaging, atherosclerosis and endothelial function evaluation, and viability assessment. Cardiovascular computed tomography has long been used as a reference test for non-invasive evaluation of coronary lesions and anatomic characterization. Cardiovascular magnetic resonance is currently the reference standard for non-invasive ventricular function evaluation and myocardial scarring delineation. These specific strengths have been enhanced with the advent of hybrid equipment, offering a true integration of different imaging modalities into a single, simultaneous and comprehensive study.

16 Review [The cardiovascular surgeon and the Syntax score]. 2015

Gómez-Sánchez, Mario / Soulé-Egea, Mauricio / Herrera-Alarcón, Valentín / Barragán-García, Rodolfo. ·Departamento de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. Electronic address: doctormariog@yahoo.com. · Departamento de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. ·Arch Cardiol Mex · Pubmed #25595855.

ABSTRACT: The Syntax score has been established as a tool to determine the complexity of coronary artery disease and as a guide for decision-making among coronary artery bypass surgery and percutaneous coronary intervention. The purpose of this review is to systematically examine what the Syntax score is, and how the surgeon should integrate the information in the selection and treatment of patients. We reviewed the results of the SYNTAX Trial, the clinical practice guidelines, as well as the benefits and limitations of the score. Finally we discuss the future directions of the Syntax score.

17 Review HDL-cholesterol in coronary artery disease risk: function or structure? 2014

Pérez-Méndez, Óscar / Pacheco, Héctor González / Martínez-Sánchez, Carlos / Franco, Martha. ·Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico. Electronic address: opmendez@yahoo.com. · Department of Emergency, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico. · Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico. ·Clin Chim Acta · Pubmed #24333390.

ABSTRACT: High-density lipoproteins (HDL) are inversely related with coronary artery disease (CAD) and HDL-cholesterol is the only standardized and reproducible parameter available to estimate plasma concentration of these lipoproteins. However, pharmacological interventions intended to increase HDL-cholesterol have not been consistently associated to an effective CAD risk reduction. Among patients with a myocardial infarction, 43 and 44% of men and women, respectively, had normal plasma levels of HDL-cholesterol, whereas genetic studies have failed to show a causal association between HDL-cholesterol and CAD risk. Instead, HDL functionality seems to be the target to be evaluated, but the existing methods are still poorly reproducible and far to be adapted to the clinical laboratory. HDL subclasses rise as a potential alternative for the evaluation of CAD risk; HDL subclasses are a surrogate of intravascular metabolism of these lipoproteins and probably of their functionality. Low levels of large HDL and increased proportions of small particles are the most remarkable features associated to an increased risk of type 2 diabetes mellitus (T2DM) or CAD. However, inflammation and other environmental factors are related with abnormal HDL structure, and, as a consequence, more prospective studies are needed to better support the clinical usefulness of HDL subclasses. New insights from proteome and lipidome profiles of HDL will provide potential HDL-related biomarkers in the coming years.

18 Review [Anesthesia for coronary revascularization in patients with Kawasaki disease: case report]. 2013

Urriola-Martínez, Mónica / Molina-Méndez, Francisco. ·Servicio de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México DF, México. Electronic address: monicaurriola@hotmail.com. · Servicio de Anestesiología Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México DF, México. ·Arch Cardiol Mex · Pubmed #24268888.

ABSTRACT: Kawasaki disease is a self-limited vasculitis that occurs predominantly in infants and young children, that is characterized by coronary artery lesions (especially aneurysms). It is one of the leading causes of acquired heart disease in children. The etiology of Kawasaki disease still remains unknown. A hypothesis is that an infectious agent produces clinically apparent disease only in certain genetically predisposed individuals. It also is possible that the disease results from an immunologic response and is triggered by different microbial agents. For unknown reason it dominates in Asians. Treatment is directed to prevent coronary thrombosis and reduce inflammation; it is based on high-dose intravenous immunoglobulin and acetyl salicylic acid, which significantly reduce the risk of coronary artery aneurysms from 25 to 4%. In order to reduce myocardial ischemia, percutaneous coronary interventions and coronary artery bypass graft can be used. There is a lot of information about surgical techniques for coronary artery complications linked to Kawasaki disease, but minimal information about anesthetic techniques; for this reason, we describe the anesthetic management of a patient who required coronary artery bypass graft, and we present a literature review on the topic.

19 Review [Coronary artery disease and cardiac ischemic disease: two different pathologies with different diagnostic procedures]. 2009

Vallejo, Enrique. ·Servicio de Cardiología Nuclear y Tomografía Cardiaca, Instituto Nacional de Cardiología Ignacio Chávez, México, DF. vallejo.enrique@gmail.com ·Arch Cardiol Mex · Pubmed #20191989.

ABSTRACT: Coronary artery disease (CAD) remains the leading cause of death in the Western world, and early detection of CAD allows optimal therapeutic management. The gold standard has always been invasive coronary angiography, but over the years various non-invasive techniques have been developed to detect CAD, including cardiac SPECT and cardiac computed tomography (Cardiac CT). Cardiac SPECT permitted visualization of myocardial perfusion and have focused on the assessment of the hemodynamic consequences of obstructive coronary lesions as a marker of CAD. Cardiac CT focuses on the detection of atherosclerosis rather than ischemia, and permit detection of CAD at an earlier stage. Objectives of this manuscript are to discuss the clinical experience with both modalities and to provide a critical review of the strengths and limitations of Cardiac SPECT and Cardiac CT for the diagnostic and management of patients with suspected CAD or cardiac ischemic disease.

20 Review Coronary artery aneurysms and ectasia: role of coronary CT angiography. 2009

Díaz-Zamudio, Mariana / Bacilio-Pérez, Ulises / Herrera-Zarza, Mary C / Meave-González, Aloha / Alexanderson-Rosas, Erick / Zambrana-Balta, Greby F / Kimura-Hayama, Eric T. ·Department of Radiology and Imaging, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. ·Radiographics · Pubmed #19926755.

ABSTRACT: Coronary artery dilatations-aneurysms and ectasia-are an uncommon and frequently unrecognized incidental finding in patients with coronary artery disease. Aneurysms and ectasia are associated with a vast group of disorders, and the evaluation and characterization of coronary aneurysms and ectasia represent a great diagnostic task with clinical and therapeutic implications. The underlying etiology is variable and includes degenerative, congenital, inflammatory, infectious, toxic, and traumatic causes. Unlike aneurysms, ectasia is more frequently seen in association with atherosclerosis or as a compensatory mechanism in those cases in which a proximal stenosis is noted in the opposite coronary artery; ectasia is also seen in some coronary artery anomalies, such as anomalous origin from the pulmonary artery, or as a result of a high-flow state, as seen in coronary artery fistulas. The diagnostic approach depends on the clinical scenario, and nowadays, noninvasive evaluation with multidetector computed tomography is possible. Imaging assessment should include evaluation of (a) the distribution, (b) maximal diameter, (c) presence or absence of intraluminal thrombi, (d) number, (e) extension, and (f) associated complications such as myocardial infarction. This article presents an overview of the definition, classification, etiology, clinical manifestations, and potential complications of coronary artery aneurysms and ectasia.

21 Review [Pro-inflammatory and anti-inflammatory markers in coronary artery disease and acute ischemic coronary syndrome]. 2009

Fragoso-Lona, José Manuel / Ramírez-Bello, Julián / Cruz-Robles, David / Pérez-Méndez, Oscar / de la Peña, Aurora / Vargas-Alarcón, Gilberto. ·Departamento de Biología Molecular, Grupo de Estudio en Genómica y Proteómica de Enfermedades Cardiovasculares, Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, México D.F., México. ·Arch Cardiol Mex · Pubmed #19545076.

ABSTRACT: Inflammation plays an important role in the development of atherosclerotic lesions, affecting several stages of the atheroma's development going from the initial leukocyte recruitment to the eventual rupture of the unstable atherosclerotic plaque. The inflammatory reactions within coronary atherosclerotic plaques influence the clinical outcome of acute coronary syndromes and coronary artery disease. Recent studies suggest that inflammation markers may reflect different aspects of the atherothrombotic process in relation to the stages of acute coronary syndrome. These markers play an important role in the risk of developing coronary artery disease, and may correlate with its severity. Some cytokines, acute phase proteins, acute phase reactants proteins, and adhesion molecules released from the inflammatory cells may reflect the inflammatory process in atherosclerotic plaques. However, it remains to be determined whether these pro- and anti-inflammation markers may confer risk or protection for cardiovascular disease, or simply reflect the underlying disease process. The analysis of the markers may be useful for the development of new strategies for coronary disease prevention and treatment. Therefore, we need a well-designed evaluation of these markers before their use in the clinical practice.

22 Clinical Trial Lipoprotein(a) and homocysteine potentiate the risk of coronary artery disease in male subjects. 2012

Baños-González, Manuel Alfonso / Anglés-Cano, Eduardo / Cardoso-Saldaña, Guillermo / Peña-Duque, Marco Antonio / Martínez-Ríos, Marco Antonio / Valente-Acosta, Benjamin / González-Pacheco, Héctor / de la Peña-Díaz, Aurora. ·Instituto Nacional de Cardiología Ignacio Chávez, Grupo Genética Intervencionista, Departamentos de Biología Molecular, Hemodinámica, Endocrinología, Unidad Coronaria, Juan Badiano 1, México. ·Circ J · Pubmed #22510820.

ABSTRACT: BACKGROUND: Lipoprotein (Lp(a)) and homocysteine (Hcy) are independent risk factors for coronary artery disease (CAD). Hcy promotes the release of free apo(a) from Lp(a). The high fibrin affinity of free apo(a) inhibits plasminogen binding and plasmin generation. Hyperhomocysteinemia can result from a less active variant of methylene tetrahydrofolate reductase (variant C677T). Because the C677T genotype is estimated to be present in 32.2% of the Mexican population, we took advantage of this prevalence to determine the possible potentiating effect between high plasma Lp(a) and Hcy for increasing the risk of CAD in male patients. METHODS AND RESULTS: First, 222 male patients admitted for coronary angiography were recruited and classified as CAD+ or CAD-. Anthropometric measurements, traditional risk factors, and plasma total Hcy (tHcy) and Lp(a) levels were recorded in both groups. We performed a conditional logistic regression model adjusted for conventional risk factors of CAD and it became clear that Lp(a) ≥30mg/dl was a risk factor for CAD (odds ratio [OR] 5.06, 95% confidence interval [CI] 1.88-13.51, P=0.001), whereas Hcy was not related to CAD (OR 0.44, 95% CI 0.63-2.90, P=0.44). However, when both factors were considered together in an interaction model, high tHcy and high Lp(a) plasma concentrations showed a potentiated effect (OR 10.52, 95% CI 2.18-50.71, P=0.003). CONCLUSIONS: The combination of high Lp(a) and Hcy levels synergistically increases the likelihood of developing CAD in male patients.

23 Article Drop-off in positivity rate of stress echocardiography based on regional wall motion abnormalities over the last three decades. 2019

Cortigiani, Lauro / Ramirez, Pamela / Coltelli, Maico / Bovenzi, Francesco / Picano, Eugenio. ·Cardiology Division, San Luca Hospital, Lucca, Italy. · National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico. · Department of Computer Science and Technology, ESTAR, Toscana, Pisa, Italy. · Institute of Clinical Physiology, Biomedicine Department, CNR, CNR Research Campus, Via Moruzzi, 1, 56124, Pisa, Italy. picano@ifc.cnr.it. ·Int J Cardiovasc Imaging · Pubmed #30460582.

ABSTRACT: Previous studies have suggested a decline in positivity of stress cardiac imaging based on regional wall motion abnormalities (RWMA). To assess the rate of RWMA positivity of stress echocardiography (SE) over 3 decades in the same primary care SE lab. We retrospectively assessed the rate of SE positivity in 7626 SE tests (dipyridamole in 5053, dobutamine in 2496, exercise in 77) in consecutive patients with known or suspected coronary artery disease and /or heart failure who performed SE in a primary care referral center from April 1991 to May 2018. Starting April 2005, SE based on RWMA was complemented by assessment of coronary flow velocity reserve (CFVR) of the left anterior descending coronary artery. Starting October 2016, we added left ventricular contractile reserve (LVCR). Starting October 2016, we also added B-lines by lung ultrasound. There was a progressive decline over time in the rate of SE positivity based on RWMA from 24% (1991-1999) to 10% (2000-2009) down to 4% (2010-2018) (p < 0.0001). Positivity rate was 29% with CFVR, 16% with LVCR, and 12% with B-lines. Over three decades, we observed a dramatic decline in SE positivity rate based on classical RWMA. In the last decade, the positivity rate rose sharply thanks to the stepwise introduction of CFVR, LVCR and B-lines as additional positivity criteria in integrated quadruple SE.

24 Article None 2018

Posadas-Sánchez, Rosalinda / Roque-Ramírez, Bladimir / Rodríguez-Pérez, José Manuel / Pérez-Hernández, Nonanzit / Fragoso, José Manuel / Villarreal-Molina, Teresa / Coral-Vázquez, Ramón / Tejero-Barrera, Maria Elizabeth / Posadas-Romero, Carlos / Vargas-Alarcón, Gilberto. ·Departamento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico. · Laboratorio de Nutrigenética y Nutrigenómica, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, Mexico. · Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico. · Laboratorio de Genómica Cardiovascular, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, Mexico. · Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, Mexico. ·Mediators Inflamm · Pubmed #30662365.

ABSTRACT: In an animal model, new evidence has been reported supporting the role of

25 Article An Associative Memory Approach to Healthcare Monitoring and Decision Making. 2018

Aldape-Pérez, Mario / Alarcón-Paredes, Antonio / Yáñez-Márquez, Cornelio / López-Yáñez, Itzamá / Camacho-Nieto, Oscar. ·Instituto Politécnico Nacional, Computational Intelligence Laboratory at CIDETEC, Ciudad de Mexico 07700, Mexico. maldape@ipn.mx. · Universidad Autónoma de Guerrero, Engineering Department, Guerrero 39079, Mexico. aalarcon@uagro.mx. · Instituto Politécnico Nacional, Computational Intelligence Laboratory at CIC, Ciudad de Mexico 07738, Mexico. cyanez@cic.ipn.mx. · Instituto Politécnico Nacional, Computational Intelligence Laboratory at CIDETEC, Ciudad de Mexico 07700, Mexico. ilopezy@ipn.mx. · Instituto Politécnico Nacional, Computational Intelligence Laboratory at CIDETEC, Ciudad de Mexico 07700, Mexico. ocamacho@ipn.mx. ·Sensors (Basel) · Pubmed #30115832.

ABSTRACT: The rapid proliferation of connectivity, availability of ubiquitous computing, miniaturization of sensors and communication technology, have changed healthcare in all its areas, creating the well-known healthcare paradigm of e-Health. In this paper, an embedded system capable of monitoring, learning and classifying biometric signals is presented. The machine learning model is based on associative memories to predict the presence or absence of coronary artery disease in patients. Classification accuracy, sensitivity and specificity results show that the performance of our proposal exceeds the performance achieved by each of the fifty widely known algorithms against which it was compared.

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