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RISS 인기검색어
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- 저자 : Siang Jin Terrance Chua (검색결과 2 건)
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Prognostic Value of Coronary Artery Calcium in a Multi-Ethnic Asian Cohort
Shu Yun Heng,Jien Sze Ho,Seyed Ehsan Saffari,Zijuan Huang,Foong Koon Cheah,Siang Jin Terrance Chua,Yung Jih Felix Keng,Lohendran Baskaran,Swee Yaw Tan 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.3
Objective: Coronary artery calcium (CAC) is associated with the presence of coronary atherosclerotic plaque and is a prognostic factor of cardiovascular events. CAC varies among ethnic groups in patients of the same age and gender. Studies on the prognostic value of CAC in a multi-ethnic Asian population have yet to be performed. We aim to study the association of CAC and ethnicity, all-cause mortality, and acute myocardial infarction (AMI). Materials and Methods: This is a retrospective study with a multi-ethnic cohort aged 35–84 years from a single tertiary institution between 2007–2017. The individuals were all clinically referred for cardiac CT calcium scanning. CAC was determined by Toshiba Aquilion One 320 Multi-detector Row CT (Toshiba Medical System). Results: This study had 65% males at an average age of 55 years. In our multivariable analysis of 16561 individuals, CAC is generally higher in the Malay than Chinese ethnic group [odds ratio (OR)=1.30, 95% confidence interval (CI)=1.10–1.55] and did not differ among Indians and Chinese (p=0.400). Increasing CAC was associated with higher all-cause mortality (OR=1.27, 95% CI=1.17–1.36) and AMI (OR=1.50, 95% CI=1.35–1.66) after adjusting for known cardiovascular risk factors. Incorporation of CAC into a model with known cardiovascular risk variables enhanced prediction of all-cause mortality [area under the curve (AUC)=0.78] and AMI (AUC=0.85). Conclusion: This study is the largest performed in a multi-ethnic Asian cohort. Malay ethnicity seems to confer a higher likelihood of coronary calcification compared to the Chinese and Indians. CAC was associated with higher all-cause mortality and AMI and complemented traditional cardiovascular risk factors in risk prediction, confirming its applicability in a multi-ethnic Asian population.
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Swati Vijayan,Quan Yao Ho,Choong Hou Koh,Ian Tatt Liew,Sobhana Thangaraju,Ningyan Wong,Yann Shan Keh,Zi Hui Sharel Ong,Jia Qin Tan,Khung Keong Yeo,Terrance Siang Jin Chua,Terence Kee 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.3
Background: Cardiac evaluation before deceased donor kidney transplant (DDKT) remains a matter of debate. Data on Asian countries and countries with prolonged waiting times are lacking. This study aimed to assess the outcomes of patients referred for DDKT after a cardiac evaluation at an Asian tertiary transplant center. Methods: This single-center retrospective review analyzed patients who were referred for waitlist placement and underwent cardiac stress testing between January 2009 and December 2015. Patients with cardiac symptoms were excluded. The primary outcome was three-point major adverse cardiovascular events (MACE), a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death. Results: Of 468 patients referred for DDKT, 198 who underwent cardiac stress testing (myocardial perfusion studies in 159 patients and stress echocardiography in 39 patients) were analyzed. MACE occurred in 20.7% of the patients over a median follow-up of 4.6 years. Cardiac stress tests were positive for ischemia in 19.7% of the patients. Coronary angiography was performed in 63 patients, including 29 patients with diabetic kidney disease and negative cardiac stress tests. Significant coronary artery disease (CAD) was detected in 27 patients (42.8%), of whom 18 underwent revascularization. MACE was associated with significant CAD on coronary angiography in the multivariable analysis. Cardiac stress test results were not associated with MACE. Amongst diabetic patients who had negative cardiac stress tests, 37.9% had significant CAD on coronary angiography. Conclusions: The cardiovascular disease burden is significant amongst DDKT waitlist candidates. Pretransplant cardiac screening may identify patients with significant CAD at higher risk of MACE.
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