Comparing coronary artery calcium and thoracic aorta calcium for prediction of all-cause mortality and cardiovascular events on low-dose non-gated computed tomography in a high-risk population of heavy smokers

2010 ◽  
Vol 209 (2) ◽  
pp. 455-462 ◽  
Author(s):  
Peter C. Jacobs ◽  
Mathias Prokop ◽  
Yolanda van der Graaf ◽  
Martijn J. Gondrie ◽  
Kristel J. Janssen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
High Risk ◽  
Thoracic Aorta ◽  
Coronary Artery Calcium ◽  
Cardiovascular Events ◽  
Low Dose ◽  
High Risk Population ◽  
All Cause Mortality ◽  
Heavy Smokers

Coronary Artery Calcium Can Predict All-Cause Mortality and Cardiovascular Events on Low-Dose CT Screening for Lung Cancer

2012 ◽  
Vol 198 (3) ◽  
pp. 505-511 ◽  
Author(s):  
Peter C. Jacobs ◽  
Martijn J. A. Gondrie ◽  
Yolanda van der Graaf ◽  
Harry J. de Koning ◽  
Ivana Isgum ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiovascular Events ◽  
Low Dose ◽  
Ct Screening ◽  
Low Dose Ct ◽  
All Cause Mortality

Coronary artery calcium evaluation by electron beam computed tomography and its relation to new cardiovascular events

2000 ◽  
Vol 86 (5) ◽  
pp. 495-498 ◽  
Author(s):  
Nathan D Wong ◽  
Jeffrey C Hsu ◽  
Robert C Detrano ◽  
George Diamond ◽  
Harvey Eisenberg ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Electron Beam ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiovascular Events ◽  
Electron Beam Computed Tomography

Abstract 07: Association of Social Network Characteristics With Cardiovascular Health and Coronary Artery Calcium in South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nilay S Shah ◽  
Mark D Huffman ◽  
Sadiya S Khan ◽  
John A Schneider ◽  
Juned Siddique ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Social Network ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Cardiovascular Health ◽  
South Asians ◽  
High Risk Population ◽  
Lower Odds

Introduction: South Asian Americans (SAs) have disproportionately high burden of poor cardiovascular health (CVH) and CVD, which may be influenced by people within their social network (SN). We examined the association of SN characteristics and SN member (“alter”) health with CVH and coronary artery calcium (CAC) in SAs to identify targets for CVD prevention in this high-risk community. Hypothesis: Smaller SN size and worse alter health is associated with poor CVH and CAC in SAs. Methods: In 699 SAs in the MASALA Study, SN characteristics (size, density, proportion of kin or SA ethnicity), alter health status (self-report of an alter with high blood pressure [HTN], hyperlipidemia [HL], heart disease, diabetes, or stroke), CVH score (0-14, based on poor, intermediate, or ideal blood pressure, cholesterol, glucose, physical activity, diet, weight, and smoking), and CAC data were collected between 2016-2018. Multiple logistic regression evaluated the association of SN characteristics or alter health with prevalent CVH and CAC. Results: Participants were mean age 59±9 years and 43% women. Mean CVH score was 8.9±1.9, median CAC score 8 (range 0 - 4217). SNs were mean 6±3 people, density 79±26%, 72±28% kin, 88±23% SA ethnicity; 48% had an alter with HTN, 42% with HL, 18% with heart disease, 40% with diabetes, and 2% with stroke. A 1-person larger SN size was associated with a 19% higher odds of ideal vs. poor CVH in men (p=0.02), and an 11% lower odds of CAC in women (p=0.05, Table). In men, having at least 1 alter with HTN or HL was associated with a 58% or 54% lower odds of ideal vs. poor CVH (p=0.03, p=0.04), and having at least 1 alter with HL was associated with a 78% higher odds of CAC (p=0.05). No associations were seen between other SN characteristics, nor alters with other CVD risk factors, and CVH or CAC. Conclusions: In SAs, larger SN size was associated with better CVH. Having a SN member with HTN or HL may be associated with poorer CVH and CAC. Interventions to increase SN size or target SN member CVH may promote CVH in this high-risk population.

scholarly journals Therapeutic Implications of Coronary Artery Calcium Using Cardiac Computed Tomography

2007 ◽  
Vol 1 ◽  
pp. CMC.S330 ◽  
Author(s):  
Adonis Saremi ◽  
Rohit Arora
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Arterial Calcification ◽  
Future Research ◽  
Heart Patients ◽  
Framingham Risk ◽  
Asymptomatic Patients ◽  
Plaque Development

The objective of this document is to review the clinical applicability of coronary artery calcium (CAC) scoring in both asymptomatic and symptomatic patients at risk for cardiovascular disease. We begin by describing the pathological basis of atherosclerosis, the characteristic stages of atherosclerotic plaque development, and the mechanism and role of arterial calcification in advanced atherosclerotic lesions. We also explain the utility of CAC scoring in cardiovascular risk assessment, discuss the most current clinical methods for measuring CAC, and examine major clinical studies reporting CAC scores in both asymptomatic and symptomatic heart patients. Lastly, the current recommendations for CAC scoring as stated by the American College of Cardiology/American Heart Association (ACC/AHA) are outlined, and a number of considerations for future research are provided. Atherosclerosis begins when certain factors cause chronic endothelial injury, which eventually leads to the build up of fibrofatty plaques in the intima of arterial blood vessels. In time, blood vessel walls can weaken, thrombi can form and plaques can send emboli to distal sites. There are six characteristic stages of plaque development. Mature plaques may be calcified in an active process comparable to bone remodeling, where calcium phosphate crystals coalesce among lipid particles inside arterial walls. Calcification is only present in atherosclerotic arteries, and the site and levels of calcium are non-linearly and positively associated with luminal narrowing of coronary vessels. Calcification is also postulated to stabilize vulnerable plaques in atherosclerotic vessels. Recent studies have shown that CAC scoring can improve the management of both asymptomatic and symptomatic heart patients. Electron beam computed tomography (EBCT) and Multidetector computed tomography (MDCT) are two fast cardiac CT methods used to measure CAC. No matter what technique one uses, CAC is scored with either the Agatston or the “volume” score system. The ACC/ AHA currently finds it is reasonable for asymptomatic patients with intermediate Framingham risk scores (FRS) to undergo CAC assessment because these patients can be re-stratified into the high risk category if their CAC scores are ≥400. Conversely, CAC measurement in asymptomatic patients with low or high FRS is not warranted. There is also no evidence to suggest that high risk asymptomatic patients with no detectable coronary calcium should not be treated with secondary prevention medical therapy. For symptomatic patients, the ACC/AHA recommends CAC assessment as a second line technique to diagnose obstructive CAD, or when primary testing modalities are not possible or are unclear. Furthermore, they do not recommend the use of CAC measurement to determine the etiology of cardiomyopathy, to help identify patients with acute MI in the emergency room, or to assess the progression or regression of coronary atherosclerosis. Future research needs to incorporate calcium scores with percentile rankings, larger population samples, more women with at least intermediate Framingham risk, sufficient numbers of non-Caucasians, reports on cost-effectiveness, and data on populations with Chronic Kidney Disease, End Stage Renal Disease and Diabetes.

scholarly journals Is there value in prescribing colchicine in coronary artery disease for secondary prevention: a meta-analysis of over 5,000 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.F Sunjaya ◽  
A.P Sunjaya
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Randomized Controlled Trials ◽  
Cardiovascular Events ◽  
Low Dose ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
All Cause Mortality ◽  
Artery Disease

Abstract Introduction Coronary Artery Disease (CAD) is the single greatest cause of mortality and loss of disability adjusted life years (DALYs) worldwide. Inflammation plays a central role in the pathogenesis of atherosclerosis, with numerous evidence from prospective studies indicating that increasing C-reactive protein levels (hs-CRP) are independently associated with increasing risk of cardiovascular events. Colchicine, is an inexpensive, potent anti-inflammatory drug considered as a staple therapy for gout. Recent studies have shown that colchicine use may prove to be useful in the prevention of cardiovascular events. Purpose In patients with coronary artery disease (CAD) does administration of low dose colchicine lead to reduced all-cause mortality, cardiovascular risk and morbidity. Methods A meta-analysis was performed based on randomized controlled trials obtained from Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline and Medline ahead of print published between 2000 and 2020. Main outcome measures include all-cause mortality, cardiovascular events, CRP levels and prevalence of CRP levels less than 2.0 mg/L. Data synthesis and analysis was done using RevMan 5.3 using a random effects model. Results A total of 5 randomized controlled trials, representing 5,430 patients were included in this meta-analysis. Three trials administered colchicine 1 mg/day while the rest were assigned colchicine. 5 mg/day. Administration of colchicine in CAD patients was found to reduce all-cause mortality (RR=0.66, 95% CI: 0.30 to 1.46, p=0.31) and major adverse cardiovascular events (MACE) (RR=0.61, 95% CI: 0.25 to 1.47, p=0.27), although results were non-significant. Reduced CRP levels (Mean difference = −0.88, 95% CI: −1.76 to 0.01, p=0.05) compared to control group as well as a higher prevalence of patients with CRP levels <2.0 mg/L were found (RR=2.27, 95% CI: 0.45 to 11.33, p=0.32), although results were non-significant. Discussion Few studies are available evaluating the benefits of low dose colchicine in CAD patients. The beneficial effects of colchicine has been proposed due to its ability to inhibit neutrophil chemotaxis which may reduce the risk of plaque instability. The use of colchicine for secondary prevention of CAD will require long-term use, which will require the need for preparations that address its intolerance (mostly gastrointestinal) to prevent early discontinuation of the medication. Conclusion There's limited evidence on the benefit of low dose colchicine in CAD patients. Further large scale randomized-controlled trials are needed, and its dose-response relationship ascertained before consideration of its use could be given in CAD patients. Funding Acknowledgement Type of funding source: None

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