Age and chest computed tomography severity score are predictors of long-COVID.

INTRODUCTION: About one-third of acute coronavirus disease 2019 (COVID-19) survivors have suffered from persisting symptoms called long-COVID. Clinical factors such as age and intensity (moderate or acute) of COVID-19 have been found to be associated with long-COVID. Many tissues might be damaged functionally or structurally during acute COVID-19 which can be detected by blood assays and chest computed tomography (CT). We aimed to evaluate the relationship between long-COVID and the initial findings of blood assays and chest CT as possible predictors. METHODOLOGY: The study included patients with acute COVID-19. Laboratory tests and chest CT were obtained from each patient at the time of admission to the hospital. Chest CT was evaluated for pneumonic involvement and severity score. Multivariable regression model was created to find the factors that were independently associated with long-COVID. RESULTS: There were 60 (38.2%) patients with long-COVID and 97 (61.8%) without. Baseline demographic, laboratory and chest CT parameters were similar in both groups, except for age, chronic lung disease and chest CT severity score (46.9 ± 15.1 years vs 52.6 ± 15.9 years, p = 0.03; 11.7% vs 3.1%, p = 0.03 and 10.3 ± 9.6 vs 6.5 ± 7.6, p = 0.02, respectively). In multivariable model, chest CT severity score (OR: 1.059, 95% CI: 1.002-1.119, p = 0.04) and age (OR: 0.953, 95% CI: 0.928-0.979, p < 0.001) were independently associated with long-COVID. CONCLUSIONS: Chest CT severity score and age were independently associated with long-COVID and may be used to predict the future risk of long-COVID.

Breast arterial calcification is associated with sarcopenia in peri- and post-menopausal women.

PURPOSE: Breast arterial calcification (BAC) refers to medial calcium deposition in breast arteries and is detectable via mammography. Sarcopenia, which is characterised by low skeletal muscle mass and quality, is associated with several serious clinical conditions, increased morbidity, and mortality. Both BAC and sarcopenia share common pathologic pathways, including ageing, diabetes, and chronic kidney disease. Therefore, this study evaluated the relationship between BAC and sarcopenia as a potential indicator of sarcopenia. METHODS: This study involved women aged >40. BAC was evaluated using digital mammography and was defined as vascular calcification. Sarcopenia was assessed using abdominal computed tomography. The cross-sectional skeletal mass area was measured at the third lumbar vertebra level. The skeletal mass index was obtained by dividing the skeletal mass area by height in square meters(m2). Sarcopenia was defined as a skeletal mass index of ≤38.5 cm2/m2. A multivariable model was used to evaluate the relationship between BAC and sarcopenia. RESULTS: The study involved 240 participants. Of these, 36 (15 %) were patients with BAC and 204 (85 %) were without BAC. Sarcopenia was significantly higher among the patients with BAC than in those without BAC (72.2 % vs 17.2 %, P < 0.001). The multivariable model revealed that BAC and age were independently associated with sarcopenia (odds ratio[OR]: 7.719, 95 % confidence interval[CI]: 3.201-18.614, and P < 0.001 for BAC and OR: 1.039, 95 % CI: 1.007-1.073, P = 0.01 for age). CONCLUSION: BAC is independently associated with sarcopenia. BAC might be used as an indicator of sarcopenia on screening mammography.

Coronary artery calcification score is increased in patients with isolated coronary artery ectasia.

PURPOSE: Coronary artery calcification (CAC) is an indicator of coronary atherosclerosis and is associated with future adverse cardiac events. Isolated coronary artery ectasia (CAE) is defined as localized or diffuse dilation of the coronary arteries without coronary stenosis. The aim of this study was to assess the relationship between CAC and isolated CAE. METHODS: Thirty-four patients with isolated CAE and 50 controls subjects, with normal coronary arteries, were enrolled in the study. Baseline demographic features and atherosclerosis risk factors were similar in both groups. RESULTS: Patients with CAE had higher total CAC than control subjects (84±111 vs. 33.5±103.5; p<0.001). There was also a significant correlation between per-segment CAC and ectatic segment length (r=0.32; p=0.01) but no correlation with diameter (r=0.09; p=0.5). CONCLUSION: Patients with isolated CAE had higher CAC than control subjects, suggesting that atherosclerosis may be involved in the pathogenesis of isolated CAE. Patients with isolated CAE may have increased cardiovascular risk and should receive appropriate risk stratification and relevant medical treatment.

Effect of Sarcopenia on Coronary Atherosclerotic Burden, Lesion Complexity, and Major Cardiovascular Events in Elderly Patients With Acute Coronary Syndrome: A 1-year Follow-up Study.

Sarcopenia is accepted as an indicator of subclinical atherosclerosis. However, its effects on clinical coronary atherosclerotic burden and lesion complexity and major adverse cardiovascular events (MACE) in elderly patients with non-ST elevation myocardial infarction (NSTEMI) are unknown. Therefore, we evaluated these possible effects. Coronary artery disease (CAD) burden and complexity were assessed using the Gensini and TAXus and cardiac surgery (SYNTAX) score, respectively. MACE involving nonfatal myocardial infarction, rehospitalization, ischemic stroke, and total mortality were evaluated after 1 year of the index NSTEMI event. The study included 240 elderly patients; of these, 60 (25%) patients had sarcopenia. The SYNTAX score and Gensini score were similar in both groups (16.8 ± 8.7 vs 17.3 ± 9.2, P = .63 and 67.7 ± 43.9 vs 73.9 ± 45.5, P = .31, respectively). The total MACE rate was significantly higher in patients with sarcopenia than in those without sarcopenia (31.7 vs 14.4%, P = .003). In the multivariate model, age [odds ratio (OR) 1.112, 95% CI: 1.006-1.228, P = .04)], ejection fraction (OR: .923, 95% CI: .897-.951, P < .001), and sarcopenia (OR: 2.262, 95% CI: 1.039-4.924, P = .04) were independently associated with MACE. Sarcopenia was independently associated with MACE but not with CAD burden or complexity in elderly patients with NSTEMI.

Relationship between SYNTAX score and Trans-Atlantic Inter-Society Consensus II classification in patients undergoing diagnostic angiography.

INTRODUCTION: Peripheral artery disease (PAD) is a marker of systemic atherosclerosis and most patients with PAD also have concomitant coronary artery disease (CAD). AIM: There are no published data investigating the relationship between PAD and CAD complexity assessed by a well-accepted classification system such as the SYNTAX score (SS) or Trans-Atlantic Inter-Society Consensus II (TASC II). MATERIAL AND METHODS: The study population consisted of 72 patients who underwent coronary angiography for the assessment of CAD. At the same session, peripheral angiography was performed in cases of suspected PAD. A coronary lesion was defined as significant if it caused a 50% reduction of the luminal diameter by visual estimation in vessels ≥ 1.5 mm. The SYNTAX score was computed by dedicated software. RESULTS: Patients with peripheral artery disease were divided into four groups according to the Trans-Atlantic Inter-Society Consensus II classification. Numbers of patients with peripheral artery disease classified as A, B, C, and D by the Trans-Atlantic Inter-Society Consensus II classification were 27, 16, 18 and 11, respectively. SYNTAX scores for each group from A to D were 10 ±9, 11 ±10, 24 ±13 and 27 ±12, respectively; p for trend < 0.001. CONCLUSIONS: Higher Trans-Atlantic Inter-Society Consensus II classification is associated with higher SYNTAX score in patients who underwent coronary and peripheral diagnostic angiography. It may suggest that arterial atherosclerotic disease complexity is a systemic panvascular phenomenon.

Relation between carotid intima-media thickness and aortic knob width in patients with essential hypertension.

OBJECTIVE: The assessment of subclinical atherosclerosis is important in the evaluation of a hypertensive patient, as it provides information on the severity of the hypertension and the cardiovascular risk. The aim of this study was to determine the usefulness of the aortic knob width measured on chest radiography in the assessment of subclinical atherosclerosis in hypertensive patients. METHOD AND RESULTS: A total of 126 consecutive hypertensive patients were enrolled. In univariate analysis, there was a strong correlation between carotid intima media thickness (CIMT) and aortic knob width (r=0.62, P<0.001). In addition, there were statistically significant correlations between CIMT and age (r=0.42, P<0.001), systolic pressure (r=0.27, P=0.02), diastolic pressure (r=0.28, P<0.03), and pulse pressure (r=0.31, P<0.001). In linear regression analysis, the aortic knob width (ß=0.5, P<0.001), age (ß=0.02, P=0.03), and systolic pressure (ß=0.03, P=0.005) were the only independent predictors of CIMT. CONCLUSION: Observation of aortic knob on chest radiograph in hypertensive patients may provide important predictive information of subclinical atherosclerosis.