Suresh Sharma

Comparison of Lipid Management in Patients With Coronary Versus Peripheral Arterial Disease

Peripheral arterial disease (PAD), similar to coronary artery disease (CAD), is a significant predictor of cardiovascular morbidity and mortality. Guidelines recommend a low-density lipoprotein (LDL) goal of <100 mg/dl for both groups. We assessed whether lipid control and statin use were as aggressively applied to PAD as to patients with CAD. This retrospective study of patients with the diagnosis of CAD, PAD, or both CAD and PAD compared lipid levels and statin use. For comparison of statins, we used a statin potency unit (1 potency unit=10 mg of simvastatin). Among 11,134 subjects (CAD 9,563, PAD 596, and both CAD and PAD 975), mean LDL in the PAD group was higher than the CAD (92 vs 83 mg/dl, respectively, p<0.001) and the combined CAD and PAD groups (92 vs 80 mg/dl, respectively, p<0.001). Fewer patients with PAD achieved a target LDL of <100 mg/dl compared with CAD (62% vs 78%, respectively, p<0.001) and the combined group (62% vs 79%, respectively, p<0.001). Similar differences were noted for a target LDL of <70 mg/dl. Compared with the CAD group, a lesser number of patients with PAD received statin therapy (76% vs 100%, respectively, p<0.001) with lower mean potency unit (5.3 vs 8.1, respectively, p<0.001). In conclusion, our study demonstrated lower use and less aggressive application of statins in patients with PAD compared with patients with CAD, ensuing lower mean LDL in the CAD and combined PAD and CAD groups. Our study suggests that physicians are more aggressive with lipid control in patients with CAD compared with patients with PAD alone.

Percutaneous Closure of a Coronary Artery-to-Vein Graft Anastomotic Pseudoaneurysm Presenting as Acute Coronary Syndrome after Recent Coronary Artery Bypass Grafting

Pseudoaneurysm formation has been reported in degenerated coronary artery saphenous vein bypass grafts, as well as in native coronary arteries after interventional procedures or blunt trauma. In contrast, pseudoaneurysm formation arising from the anastomotic site of native coronary vessels soon after coronary artery bypass grafting is rare, and neither the clinical presentation of this phenomenon nor its treatment is well described. We present the case of a 63-year-old man, a recent coronary artery bypass grafting patient, who presented with acute coronary syndrome due to a large and expanding pseudoaneurysm of the saphenous vein-to-ramus intermedius artery graft anastomosis. After several attempts, we successfully treated the pseudoaneurysm by means of percutaneous coil embolization. To our knowledge, this is the first report of acute coronary syndrome secondary to a pseudoaneurysm at the coronary artery-saphenous vein graft anastomosis. In addition, this appears to be the first report of the percutaneous treatment of such a pseudoaneurysm by means of coil embolization.

EFFECT OF AGGRESSIVE LIPID THERAPY ON PROGRESSION OF CAROTID ARTERY STENOSIS: A LONGTERM FOLLOW UP STUDY

The relationship of serum lipid levels, aggressive statin use and progression of carotid stenosis (CS) severity has not been well studied. We assessed the correlation between aggressive risk modification, statin use, and lipid levels with progression of carotid artery stenosis and incidence of

DISPARITIES IN LIPID MANAGEMENT IN PATIENTS WITH PERIPHERAL ARTERY DISEASE VERSUS CORONARY ARTERY DISEASE: COMPARISON BETWEEN ATP III AND 2013 AHA/ACC GUIDELINES

Recent studies using ATP III guidelines show that peripheral artery disease (PAD) patients have less optimal lipid control compared to those with coronary artery disease (CAD). Our study aimed to compare lipid management in patients with PAD, CAD and CAD with PAD by applying the new 2013 guidelines

COMPARISON OF LIPID CONTROL AMONG DIABETICS WITH NONCORONARY ATHEROSCLEROTIC VASCULAR DISEASE VERSUS CORONARY ARTERY DISEASE

methods: We retrospectively identified 3,336 patients with DM and known atherosclerotic vascular disease between January 2009 and March 2012, for whom lipid levels were available. We compared demographic variables, lipid levels and statin use in diabetics with CHD alone versus diabetics with one or more NCVD (peripheral artery disease, carotid stenosis or abdominal aortic aneurysm). To enable comparison of the doses of various statins, we used statin potency unit where 1 potency unit = 10mg of Simvastatin.

Solitary Coronary Artery : A Rare Coronary Anomaly

A 57-year-old man presented with chest pain suggestive of obstructive coronary artery disease. Coronary angiography revealed a rudimentary left main coronary artery arising from the left sinus of Valsalva. A large right coronary artery was visualized arising from the right sinus of Valsalva and

EVALUATION OF MICRO CORONARY EDGE DISSECTION AND CORONARY ARTERY PLAQUE PROLAPSE POST CORONARY ARTERY PERCUTANEOUS INTERVENTION USING OPTICAL COHERENCE TOMOGRAPHY

Prevalence, characterization and clinical relevance of intimal micro edge dissection (IMED) and Plaque Prolapse (PP) post Percutaneous Intervention (PCI) utilizing Optical Coherence Tomography (OCT). Retrospective review of 185 OCT studies performed post PCI were reviewed by two independent