Aorto-ostial atherosclerotic coronary artery disease—Risk factor profiles, demographic & angiographic features

AbstractBackgroundThe risk factors along with demographic and angiographic features associated with aorto-ostial atherosclerotic coronary artery disease usually differ from that of non-aorto-ostial atherosclerotic coronary artery disease.ObjectivesThis study was designed to evaluate etiology of aorto-ostial atherosclerotic coronary artery disease involving left main coronary artery (LMCA), right coronary artery or both with consideration of clinical risk factors, demographic and angiographic features.MethodsA total of 7356 angiograms over 2years in continuation were analyzed.Results116 patients were found to have aorto-ostial coronary artery disease with prevalence of 1.5. A total of 95 patients who have complete data were analyzed. Mean age was 59±10years. Prevalence in males was 5.7 times greater than female. Isolated ostial LMCA was 2 times more prevalent than isolated ostial RCA. Hypertension, diabetes and smoking were the main risk factors. 34.7% of the patients had hypercholesterolemia (>180mg/dl) and 26.3% of the patients had hypertriglyceridemia (>150mg/dl). High TC/HDL (>3.5) ratio was seen in 77.9% of the patients. When ostial LMCA group was compared with ostial RCA group hypertriglyceridemia (Odds ratio 9.8, 95% CI, 1.7–4.2, P<0.001) and hypercholesterolemia (Odds ratio 7.05, 95% CI, 1.7–5.7, P<0.001) emerged as independent risk factors for ostial LMCA disease.ConclusionOverall there is 1.5% prevalence of atherosclerotic aorto-ostial disease of coronary arteries among patients of atherosclerotic coronary artery disease and higher proportions of patients are of male sex. Hypercholesterolemia, hypertriglyceridemia and high TC/HDL ratio can be considered as risk factors for aorto-ostial atherosclerotic coronary artery disease

A computational view on nanomaterial intrinsic and extrinsic features for nanosafety and sustainability

In recent years, an increasing number of diverse Engineered Nano-Materials (ENMs), such as nanoparticles and nanotubes, have been included in many technological applications and consumer products. The desirable and unique properties of ENMs are accompanied by potential hazards whose impacts are difficult to predict either qualitatively or in a quantitative and predictive manner. Alongside established methods for experimental and computational characterisation, physics-based modelling tools like molecular dynamics are increasingly considered in Safe and Sustainability-by-design (SSbD) strategies that put user health and environmental impact at the centre of the design and development of new products. Hence, the further development of such tools can support safe and sustainable innovation and its regulation.This paper stems from a community effort and presents the outcome of a four-year-long discussion on the benefits, capabilities and limitations of adopting physics-based modelling for computing suitable features of nanomaterials that can be used for toxicity assessment of nanomaterials in combination with data-based models and experimental assessment of toxicity endpoints. We reviewmodern multiscale physics-based models that generate advanced system-dependent (intrinsic) or time -and environment-dependent (extrinsic) descriptors/features of ENMs (primarily, but not limited to nanoparticles, NPs), with the former being related to the bare NPs and the latter to their dynamic fingerprinting upon entering biological media. The focus is on (i) effectively representing all nanoparticle attributes for multicomponent nanomaterials, (ii) generation and inclusion of intrinsic nanoform properties, (iii) inclusion of selected extrinsic properties, (iv) the necessity of considering distributions of structural advanced features rather than only averages. This review enables us to identify and highlight a number of key challenges associated with ENMs' data generation, curation, representation and use within machine learning or other advanced data-driven models to ultimately enhance toxicity assessment. Finally, the set up of dedicated databases as well as the development of grouping and read-across strategies based on the mode of action of ENMs using omics methods are identified as emerging methodologies for safety assessment and reduction of animal testing.Horizon 2020(H2020)814426Solid state NMR/Biophysical Organic ChemistrySupramolecular & Biomaterials Chemistr

Aorto-ostial atherosclerotic coronary artery disease—Risk factor profiles, demographic &amp; angiographic features

The risk factors along with demographic and angiographic features associated with aorto-ostial atherosclerotic coronary artery disease usually differ from that of non-aorto-ostial atherosclerotic coronary artery disease

Inadequacy of fluoroscopy and electrocardiogram in predicting septal position in RVOT pacing – Validation with cardiac computed tomography

Background: Electrocardiographic (ECG) and fluoroscopic criteria, which are the only available guides to achieve a true septal position during right ventricular outflow tract (RVOT) pacing, have been infrequently validated. We sought to validate these using cardiac computed tomographic angiography (CTA) to confirm lead position within the RVOT septum. Methods: Forty-four patients with permanent pacemaker leads in the RVOT position underwent CTA. Lead positions in RVOT were classified as anterior, free wall, or septal location. Fluoroscopic images were obtained in 4 standard views. Results: Only 19 (43%) patients had lead in true septal position within the RVOT in CTA while 25 patients (57%) were found to have an anterior lead location. Mean QRS axis, QRS duration, negative QRS in lead I, and notching in inferior leads were not significantly different between the two groups. The standard fluoroscopic LAO view showed a rightward-directed lead not only in all 19 patients with septal location, but also in 14/25 patients in the anterior location (p = 0.22), and thus had a sensitivity of 100% but specificity of only 16% in predicting true septal position. The posteriorly directed lead in left lateral view was more accurate in predicting true septal position with good sensitivity (73.7%) and excellent specificity (80%). Conclusions: This study, using validation with CTA, showed that conventional ECG criteria and fluoroscopy are inaccurate in differentiating septal from anterior RVOT pacing. The fluoroscopic lateral view, as corroborated by CTA, is more reliable than the LAO view in predicting septal lead placement

Management standards for stable coronary artery disease in India

Coronary artery disease (CAD) is one of the important causes of cardiovascular morbidity and mortality globally, giving rise to more than 7 million deaths annually. An increasing burden of CAD in India is a major cause of concern with angina being the leading manifestation. Stable coronary artery disease (SCAD) is characterised by episodes of transient central chest pain (angina pectoris), often triggered by exercise, emotion or other forms of stress, generally triggered by a reversible mismatch between myocardial oxygen demand and supply resulting in myocardial ischemia or hypoxia. A stabilised, frequently asymptomatic phase following an acute coronary syndrome (ACS) is also classified as SCAD. This definition of SCAD also encompasses vasospastic and microvascular angina under the common umbrella