Identification of Specific Coronary Artery Disease Phenotypes Implicating Differential Pathophysiologies

Bibliographic Details
Title: Identification of Specific Coronary Artery Disease Phenotypes Implicating Differential Pathophysiologies
Authors: Jona B. Krohn, Y Nhi Nguyen, Mohammadreza Akhavanpoor, Christian Erbel, Gabriele Domschke, Fabian Linden, Marcus E. Kleber, Graciela Delgado, Winfried März, Hugo A. Katus, Christian A. Gleissner
Source: Frontiers in Cardiovascular Medicine, Vol 9 (2022)
Publisher Information: Frontiers Media S.A., 2022.
Publication Year: 2022
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: coronary artery disease, cardiovascular outcome, cardiovascular mortality, cardiovascular risk, coronary angiography, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Background and AimsThe roles of multiple risk factors of coronary artery disease (CAD) are well established. Commonly, CAD is considered as a single disease entity. We wish to examine whether coronary angiography allows to identify distinct CAD phenotypes associated with major risk factors and differences in prognosis.MethodsIn a cohort of 4,344 patients undergoing coronary angiography at Heidelberg University Hospital between 2014 and 2016, cluster analysis of angiographic reports identified subgroups with similar patterns of spatial distribution of high-grade stenoses. Clusters were independently confirmed in 3,129 patients from the LURIC study.ResultsFour clusters were identified: cluster one lacking critical stenoses comprised the highest percentage of women with the lowest cardiovascular risk. Patients in cluster two exhibiting high-grade stenosis of the proximal RCA had a high prevalence of the metabolic syndrome, and showed the highest levels of inflammatory biomarkers. Cluster three with predominant proximal LAD stenosis frequently presented with acute coronary syndrome and elevated troponin levels. Cluster four with high-grade stenoses throughout had the oldest patients with the highest overall cardiovascular risk. All-cause and cardiovascular mortality differed significantly between the clusters.ConclusionsWe identified four phenotypic subgroups of CAD bearing distinct demographic and biochemical characteristics with differences in prognosis, which may indicate multiple disease entities currently summarized as CAD.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2297-055X
Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2022.778206/full; https://doaj.org/toc/2297-055X
DOI: 10.3389/fcvm.2022.778206
Access URL: https://doaj.org/article/32cb5786b3854752985894cfbaeda8ab
Accession Number: edsdoj.32cb5786b3854752985894cfbaeda8ab
Database: Directory of Open Access Journals
More Details
ISSN:2297055X
DOI:10.3389/fcvm.2022.778206
Published in:Frontiers in Cardiovascular Medicine
Language:English