Diagnostic and predictive value of coronary artery calcification in coronary artery stenosis

BACKGROUND: Early diagnosis of coronary artery diseases (CADs) may lead to more efficient treatments. Coronary artery calcification is considered as a valuable index in detecting CAD using a noninvasive technique. This study was conducted to determine the correlation between coronary artery calcification and coronary artery stenosis in patients with typical chest pain.METHODS: This cross-sectional study was conducted on 760 patients suffering from typical chest pain, in Chamran Hospital, Isfahan, Iran. The patients&nbsp; were all candidates for coronary angiography and were studied for the calcification of coronary artery by fluoroscopy. All patients signed a consent form after the whole procedures were fully explained to them. A fluoroscopic movie was taken from patients (after exposing, and before inserting the angiographic catheter), then the angiography was conducted using Judkins technique.&nbsp; The results of fluoroscopy and angiography were recorded by two cardiologists separately. The presence of any significant stenosis greater than 75% was considered as a sign of severe CAD. The data was analyzed by chi-square test.RESULTS: Abnormal angiogram was found in 402 patients (59.2%). Positive and negative predictive values for calcification were 81.8% and 26%, respectively. Positive and negative predictive values were respectively 87.1% and 63.4% in females, and 79.7% and 47.3% in males. The highest predictive value (100%) was seen in patients under 40 years old. Coronary calcification in patients with abnormal coronary angiogram was found to be 5.4 times greater than those with normal angiogram.&nbsp;CONCLUSION: Considering the high predictive value of coronary artery calcification in fluoroscopy, it can be used as a replacement for screening coronary involvement.Keywords: Calcification, Coronary Vessels, Coronary Disease, Diagnosis</p

PREVALENCE OF PATENT FORAMEN OVALE IN YOUNG PATIENTS WITH CRYPTOGENIC ISCHEMIC STROKE

Abstract &nbsp;&nbsp; BACKGROUND: Patent foramen ovale (PFO) is the most commonly persistent abnormality of fetal origin. PFO has long been recognized as a potential risk factor for ischemic stroke. This study has shown the prevalence of PFO among young patients with cryptogenic stroke. &nbsp;&nbsp; METHODS: In our case-control study we had 32 patients, 18 to 55 years old with cryptogenic stroke and 64 participants among normal population with matched age and sex in control group. We studied them for stroke risk factors like hypertension, diabetes mellitus, ischemic heart disease, dyslipidemia and then election of PFO by contrast trans-thoracic echocardiography. Data entered in SPSS11 and analyzed by Chi-Square and logistic regression. P value less than 0.05 was considered statistically significant. &nbsp;&nbsp; RESULTS: We found that 37.5 % of patients in case group and 7.7 % of patients in controls had PFO and this difference was statistically significant (P = 0.001). They had no significant difference in other atherosclerosis risk factors. In control group we saw small shunt but in stroke group large shunt was more prevalence (P &lt; 0.05).&nbsp; &nbsp;&nbsp; CONCLUSION: Our findings supported this idea that PFO is a predisposing factor for stroke and it had a higher prevalence among patients with cryptogenic stroke. Besides, large shunt was more concomitant with ischemic attack. Then we suggest any patient with undefined cause of stroke must be evaluated for PFO. &nbsp; &nbsp;&nbsp; Keywords: Patent foramen ovale, Stroke, Young. &nbsp;</p