Examining the Influence of Gender, Age, and Dominance on the Caliber of Normal Coronary Arteries in the South Indian Population.

Background The diameter of coronary arteries serves as a potential predictor of coronary artery diseases (CADs) that can lead to sudden death. Factors such as gender, age, and coronary artery dominance play a role in influencing the size of normal coronary arteries. The outcome of coronary interventions, to a certain extent, depends on luminal size. Given the considerable variability in luminal size within the normal population, establishing the baseline size of normal coronary arteries in a specific population can aid in estimating the severity of coronary disease and predicting the outcome of interventional procedures. The current study focuses on estimating the luminal diameter of normal coronary arteries within the context of age, gender, and cardiac dominance in the South Indian population. Methods A retrospective study was conducted utilizing coronary angiograms with normal findings from 453 patients, comprising 257 males and 196 females, with a mean age of 54.66±10.66 years. These patients attended the outpatient service of the Cardiology Department at Amrita Institute of Medical Sciences, Kochi, a quaternary care center, between 2015 and 2017. The luminal diameter of coronary arteries is represented as mean±SD in millimeters. Results In the present study, we noted that the largest coronary artery was the left main coronary artery (LMCA, 3.59±0.58 mm), followed by the left anterior descending artery (LAD, 3.50±0.52 mm), the left circumflex artery (LCX, 3.31±0.57 mm), and the right coronary artery (RCA, 3.18±0.57 mm). We further broke down the statistics to evolve a gender pattern. In the raw comparison of data, the luminal size of coronary arteries in males was greater than in females, and statistical significance was noted in all except LAD. In males, the largest coronary artery was LMCA (3.70±0.60 mm), followed by LAD (3.54±0.48 mm), LCX (3.36±0.58 mm), and RCA (3.25±0.62 mm). In females, no significant size difference was observed between LMCA (3.45±0.53 mm) and LAD (3.46±0.55 mm). Females exhibited an increase in the size of LMCA with advancing age. Regardless of right or left cardiac dominance, LMCA was consistently larger than RCA in both genders. However, in cases of co-dominance, only males demonstrated significantly larger LMCA. Conclusion Precise knowledge of the size of normal coronary arteries and their influence by gender, age, and dominance can be crucial for the comprehensive evaluation of CADs and the success of interventional procedures.

Improving Diagnosis of Hepatitis C Virus Infection Using Hepatitis C Core Antigen Testing in a Resource-Poor Setting.

INTRODUCTION: We compared the hepatitis C virus (HCV) core antigen test with the HCV RNA assay to confirm anti-HCV results to determine whether the HCV core antigen test could be used as an alternative confirmatory test to the HCV RNA test. METHODS: Sera from 156 patients were analyzed for anti-HCV and HCV core antigen using a chemiluminescent microparticle immunoassay (Architect i2000SR) and for HCV RNA using the artus HCV RG RT-PCR Kit (QIAGEN) in a Rotor-Gene Q instrument. RESULTS: The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 77.35%, 100%, 100%, and 89.38%, respectively. HCV core antigen levels showed a good correlation with those from HCV RNA quantification (r =0.872). However, 13 samples with a viral load of less than 4000 IU/mL were negative in the HCV core antigen assay. All gray-zone reactive samples were also RNA positive and were positive on repeat testing. CONCLUSIONS: The Architect HCV core antigen assay is highly specific and has an excellent positive predictive value. At the present level of sensitivity (77%), the study is still relevant in a low-income setting in which most of the HCV-positive patients would go undiagnosed, since HCV RNA testing is not available and/or not affordable. HCV core antigen testing can also help determine the true burden of infection in a population, considering the fact that almost 50% of the anti-HCV positive cases are negative for HCV RNA.

Improving Diagnosis of Hepatitis C Virus Infection Using Hepatitis C Core Antigen Testing in a Resource-Poor Setting

Abstract INTRODUCTION: We compared the hepatitis C virus (HCV) core antigen test with the HCV RNA assay to confirm anti-HCV results to determine whether the HCV core antigen test could be used as an alternative confirmatory test to the HCV RNA test. METHODS: Sera from 156 patients were analyzed for anti-HCV and HCV core antigen using a chemiluminescent microparticle immunoassay (Architect i2000SR) and for HCV RNA using the artus HCV RG RT-PCR Kit (QIAGEN) in a Rotor-Gene Q instrument. RESULTS: The diagnostic sensitivity, specificity, and positive and negative predictive values of the HCV core antigen assay compared to the HCV RNA test were 77.35%, 100%, 100%, and 89.38%, respectively. HCV core antigen levels showed a good correlation with those from HCV RNA quantification (r =0.872). However, 13 samples with a viral load of less than 4000 IU/mL were negative in the HCV core antigen assay. All gray-zone reactive samples were also RNA positive and were positive on repeat testing. CONCLUSIONS: The Architect HCV core antigen assay is highly specific and has an excellent positive predictive value. At the present level of sensitivity (77%), the study is still relevant in a low-income setting in which most of the HCV-positive patients would go undiagnosed, since HCV RNA testing is not available and/or not affordable. HCV core antigen testing can also help determine the true burden of infection in a population, considering the fact that almost 50% of the anti-HCV positive cases are negative for HCV RNA.