Coronary Artery Calcium Analysis and Reporting on Noncontrast Chest CT Scans: a Paradigm Shift in Prevention

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Harvey S. Hecht
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Paradigm Shift ◽  
Chest Ct ◽  
Ct Scans

scholarly journals 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans

2017 ◽  
Vol 32 (5) ◽  
pp. W54-W66 ◽  
Author(s):  
Harvey S. Hecht ◽  
Paul Cronin ◽  
Michael J. Blaha ◽  
Matthew J. Budoff ◽  
Ella A. Kazerooni ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Chest Ct ◽  
Ct Scans ◽  
Calcium Scoring ◽  
Coronary Artery Calcium Scoring

scholarly journals Visual Assessment of Coronary Artery Calcium in Non-ECG Gated Chest CT: A Multicenter Study

2021 ◽  
Author(s):  
Hideya Yamamoto ◽  
Shinichiro Fujimoto ◽  
Chihiro Aoshima ◽  
Tohru Minamino ◽  
Takashi Fujii ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Obstructive Coronary Artery Disease ◽  
Visual Assessment ◽  
Chest Ct ◽  
Observer Agreement ◽  
Ct Scans ◽  
Agatston Score ◽  
Four Levels ◽  
Good Agreement

Abstract Purpose: We sought to evaluate the visual measurements of coronary artery calcium (CAC) in chest CT without ECG gating, and to compare their predictive abilities for obstructive coronary artery disease (CAD). Methods: We analyzed 163 subjects who underwent both coronary and chest CT examinations at 6 centers within 3 months. Agatston scores were calculated on standard ECG-gated scans and then classified into none (0), mild (1–99), moderate (100–400), and severe (>400) grades. Chest CT images were reconstructed with standard 5.0 mm axial slices. CAC in chest CT scans was measured using two methods: Weston score (sum of the assigned score of each vessel, range: 0–12) and number of slices showing CAC (Ca-slice#). Results: We found excellent inter-observer agreement in the estimates of the Weston score and Ca-slice# (R² = 0.913 and 0.955, respectively). When each of the two scores was divided into four levels, good agreement with the 4-grade Agatston score was observed (kappa value = 0.604 and 0.794, respectively). Of the 155 patients remaining after excluding non-diagnostic studies, obstructed CAD, defined as the presence of ≥70% stenosis on CT angiography, was found in 43 (27%). Receiver-operator characteristic curves of 4-grade hierarchies of Agatston score, Weston score, and Ca-slice# provided similar diagnostic powers to detect obstructed CAD (0.722, 0.706, and 0.718, respectively).Conclusion: The visual assessments of CAC detected by ECG non-gated chest CT scans were in good agreement with the ECG-gated Agatston score and also provided equivalent power to detect obstructive CAD. This study was registered at UMIN-CTR (identifier: UMIN000039178; registered date; Jan 16, 2020)

scholarly journals Visual Assessment of Coronary Artery Calcium in Non-ECG Gated Chest CT: A Multicenter Study

2021 ◽  
Author(s):  
Hideya Yamamoto ◽  
Shinichiro Fujimoto ◽  
Chihiro Aoshima ◽  
Tohru Minamino ◽  
Takashi Fujii ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Obstructive Coronary Artery Disease ◽  
Visual Assessment ◽  
Chest Ct ◽  
Observer Agreement ◽  
Ct Scans ◽  
Agatston Score ◽  
Four Levels ◽  
Good Agreement

Abstract Purpose: We sought to evaluate the visual measurements of coronary artery calcium (CAC) in chest CT without ECG gating, and to compare their predictive abilities for obstructive coronary artery disease (CAD). Methods: We analyzed 163 subjects who underwent both coronary and chest CT examinations at 6 centers within 3 months. Agatston scores were calculated on standard ECG-gated scans and then classified into none (0), mild (1–99), moderate (100–400), and severe (>400) grades. Chest CT images were reconstructed with standard 5.0 mm axial slices. CAC in chest CT scans was measured using two methods: Weston score (sum of the assigned score of each vessel, range: 0–12) and number of slices showing CAC (Ca-slice#). Results: We found excellent inter-observer agreement in the estimates of the Weston score and Ca-slice# (R² = 0.913 and 0.955, respectively). When each of the two scores was divided into four levels, good agreement with the 4-grade Agatston score was observed (kappa value = 0.604 and 0.794, respectively). Of the 155 patients remaining after excluding non-diagnostic studies, obstructed CAD, defined as the presence of ≥70% stenosis on CT angiography, was found in 43 (27%). Receiver-operator characteristic curves of 4-grade hierarchies of Agatston score, Weston score, and Ca-slice# provided similar diagnostic powers to detect obstructed CAD (0.722, 0.706, and 0.718, respectively).Conclusion: The visual assessments of CAC detected by ECG non-gated chest CT scans were in good agreement with the ECG-gated Agatston score and also provided equivalent power to detect obstructive CAD. This study was registered at UMIN-CTR (identifier: UMIN000039178; registered date; Jan 16, 2020)

Abstract P104: Higher Leptin Levels Are Associated With Increased Odds Of Coronary Artery Calcium Progression: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Ct Scans ◽  
Agatston Score ◽  
Cvd Risk ◽  
Ethnic Study ◽  
History Of

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk

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