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Previous studies reported that sleeping disorders were associated with presence and severity of coronary artery disease (CAD). We aimed to evaluate the relationship between the angiographic progression of CAD with sleep quality. We enrolled 690 patients who had angiography history with diagnosis of chronic CAD, requiring new angiography according to clinical, and laboratory evaluation among 1654 patients with complaint of stable angina. Previous and new coronary angiography images of patients were compared to evaluate the presence of angiographic progression using quantitative coronary analysis measurement. A 1:2 propensity score matching was performed. Thus, the patient population was divided into two groups including non-progressors group (n = 156) and progressors group (n = 78). Groups were compared in terms of sleep quality and disorder using Pittsburgh Sleep Quality Index (PSQI) and STOP-Bang questionnaire. Progressors had shorter sleep duration, higher PSQI score indicating poorer sleep quality and higher STOP BANG score indicating increased sleep apnea risk than non-progressors (p < 0.05). The multivariate logistic regression analysis determined that night shift work (OR: 1.38, p = 0.04), sleep duration difference (OR: 1.25, p = 0.03), poorer sleep quality (OR: 2.08, p = 0.01), high STOP BANG score (OR: 1.86, p = 0.004), and high risk of sleep apnea (OR: 3.84, p = 0.008) were independently associated with significant risk of angiographic CAD progression. Our findings suggested that angiographically proven chronic CAD progression was associated with poor sleep quality including high apnea risk. Selected patients should be subjected to an advanced evaluation including sleep study to diagnose sleep disorders such as sleep apnea. Treatment of sleep disorders can support existing medical and/or invasive treatments in chronic CAD and improve outcomes. • Coronary artery disease progression was associated with poor sleep quality. • Patients with coronary artery disease should be evaluated for sleep disorders. • The questionnaires, can be used easily and cost-free as a screening test. • Treatment of sleep disorders can support existing treatments and improve outcomes. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence indicated that apolipoprotein B (apoB) was the principal lipid determinant of coronary artery disease (CAD). Nevertheless, the connection between apoB and angiographic progression of CAD remained undetermined. Methods: Five hundred and forty-four CAD patients with twice coronary computed tomography angiography experiences were enrolled. The Gensini scoring system was used to assess angiographic progression. Incident angiographic progression was defined as an annual change rate of the Gensini score of > 1 point. The predictive efficacy of baseline apoB levels for angiographic progression was assessed using a receiver operating characteristic (ROC) curve. For comparative purposes, patients were categorized into three groups according to their baseline apoB tertiles. Furthermore, discordance analyses defined by the median were performed to assess the superiority of apoB over lipoprotein cholesterol in predicting angiographic progression of CAD. Results: Angiographic progression was observed in 184 patients (33.8%) during a follow-up period of 2.2-year. The area under the ROC curve was 0.565 (0.522–0.607, P = 0.013). The incidence of angiographic progression was elevated with increasing apoB tertile after adjusting for confounding factors [odds ratio (OR) for the medium apoB tertile: 1.92, 95% confidence interval (CI): 1.15–3.19, P = 0.012; OR for the high apoB tertile: 2.05, 95%CI:1.17–3.60, P = 0.013]. Additionally, discordance analyses showed that the higher apoB group had a significantly higher risk of CAD progression in the fully adjusted model (all P < 0.05). Conclusions: ApoB could be used as an accurate and comprehensive indicator of angiographic progression in patients with CAD. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the correlation of atherogenic index of plasma (AIP) with angiographic progression of coronary artery disease (CAD). AIP was defined as the base 10 logarithm of the ratio of the triglyceride to high-density lipoprotein cholesterol concentration. The extent of coronary lesion was assessed by the Gensini Score (GS) system and angiographic progression was defined as the GS rate of change per year >1 point. A total of 896 patients with suspected CAD who underwent coronary computed tomography angiography twice at intervals of >6 months were included. Baseline AIP was positively correlated with remnant cholesterol (r =.644, P <.001). When patients were assigned into four groups according to baseline AIP quartiles, the incidence of CAD progression significantly increased across the quartiles of AIP (Q1 [lowest]: 23.7 vs Q2: 29.9 vs Q3: 33.9 vs Q4 [highest]: 34.8%; P =.042). After multivariate adjustment, the odds ratio for CAD progression was 1.89 when comparing the highest to the lowest quartile of AIP (95% confidence interval: 1.18–3.02; P =.008). Therefore, AIP was independently correlated with angiographic progression of CAD beyond conventional risk factors, suggesting that AIP may play a role in early risk stratification as a simple surrogate of residual risk. [ABSTRACT FROM AUTHOR]

Objectives: Hydroxychloroquine (HCQ), an anti-malarial drug, is widely used in the treatment of rheumatic diseases. However, the benefits of HCQ in the treatment of Takayasu arteritis (TA) remain unclear, especially in terms of alleviation of vascular progression. Methods: This longitudinal observational retrospective study was based on the East China TA cohort. Patients received routine treatment with prednisone and immunosuppressants. Fifty TA patients who underwent magnetic resonance angiography two times within a 1.5-year follow-up period of monitoring vascular changes were divided into HCQ and non-HCQ groups according to whether HCQ was prescribed. Changes in angiographic features were compared. Multivariate Cox regression analysis was employed to further validate the results. Results: Of 50 TA patients, 21 were prescribed HCQ. The two groups shared a similar disease course, vascular types, prednisone with immunosuppressants intervention strategy, globin level, and disease remission rate at 6 months. The HCQ group showed greater reduction in the inflammatory indices erythrocyte sedimentation rate and C-reactive protein (CRP) level (p < .05), and a significantly lower incidence of angiographic progression than the non-HCQ group (19.0% vs. 51.7%, p = .035). After adjustment for age and usage of tocilizumab, angiographic progression was found to be independently associated with CRP (hazard ratio [95% confidence interval], HR [95% CI]: 1.102 [1.000-1.024], p = .046), and the usage of HCQ (HR [95% CI]: 0.266 [0.075-0.940], p = .040). Conclusion: HCQ enhanced the anti-inflammatory effect of routine treatment strategies with prednisone and immunosuppressants, and alleviated angiographic progression in TA. [ABSTRACT FROM AUTHOR]

We assessed the role of fibrinogen levels on angiographic progression and long-term survival among 111 patients with coronary disease enrolled in the Armed Forces Regression Study (AFREGS). Baseline fibrinogen levels and quantitative coronary angiography were performed initially and at 30 months. Progression or nonregression of coronary disease was more prevalent in patients with high fibrinogen than patients with normal fibrinogen (66.1% vs 45.5%; P = .022). Twelve-year cardiovascular (CV) mortality was substantially higher if fibrinogen was elevated (17.9% vs 3.6%, P = .016). Among patients with elevated fibrinogen and angiographic progression or nonregression, there were 10 deaths and all were CV. Elevated levels of fibrinogen predict the angiographic progression of existing coronary disease and likelihood of CV death. Among patients with elevated levels of fibrinogen, angiographic progression identifies a significantly increased likelihood of a fatal CV event. [ABSTRACT FROM AUTHOR]