Prognostic value of visually detected coronary artery calcification on unenhanced non-gated thoracic computed tomography for prediction of non-fatal myocardial infarction and all-cause mortality

Background and Objectives: A topic already widely investigated is the negative prognostic value regarding the extent of high sensitive troponin I (hs-TnI) increases among patients with myocardial infarction (MI) and obstructive coronary atherosclerosis compared to a group of patients with MI and non-obstructive coronary atherosclerosis (MINOCA). Thus, the aim of this study was to evaluate the prognostic value concerning the extent of hs-TnI increase on clinical outcomes among patients with a MINOCA working diagnosis. Materials and Methods: We selected 337 consecutive patients admitted to hospital with a working diagnosis of MINOCA. The patients were divided in three groups according to the extent of hs-TnI increase during hospitalization (increase ≤5-times above the limit of the upper norm, >5 and ≤20-times, and >20-times). The study endpoints included all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE; cerebral stroke and transient ischemic attacks, MI, coronary artery revascularization, either percutaneous coronary intervention or coronary artery bypass grafting and all-cause mortality). Results: During the mean follow-up period of 516.1 ± 239.8 days, using Kaplan–Meier survival curve analysis, significantly higher mortality rates were demonstrated among patients from the group with the greatest hs-TnI increase compared to the remaining groups (p = 0.01) and borderline values for MACCE (p = 0.053). Multivariable cox regression analysis did not confirm hs-TnI among factors related to increased MACCE or all-cause mortality rates. Conclusion: While a relationship between clinical outcomes and the extent of the hs-TnI increase among patients with a MINOCA working diagnosis remains, it does not seem to be not as strong as it is in patients with obstructive coronary atherosclerosis.

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Coronary Artery Calcification on Thoracic Computed Tomography Is an Independent Predictor of Mortality in Patients With Bronchiectasis

Journal of Thoracic Imaging ◽

10.1097/rti.0000000000000553 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Michelle C. Williams ◽

Edwin J.R. van Beek ◽

Adam T. Hill ◽

John T. Murchison

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Independent Predictor ◽

Thoracic Computed Tomography

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The Value of Big Endothelin-1 in the Assessment of the Severity of Coronary Artery Calcification

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029618764846 ◽

2018 ◽

Vol 24 (7) ◽

pp. 1042-1049 ◽

Cited By ~ 2

Author(s):

Fang Wang ◽

Tiewei Li ◽

Xiangfeng Cong ◽

Zhihui Hou ◽

Bin Lu ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Laboratory Data ◽

Calcium Score ◽

Enzyme Linked Immunosorbent Assay ◽

Roc Curve Analysis ◽

Preliminary Screening ◽

Endothelin 1 ◽

All Cause Mortality

Progression of coronary artery calcification (CAC) was significantly associated with all-cause mortality, and high coronary artery calcium score (CACS) portends a particularly high risk of cardiovascular events. But how often one should rescan is still an unanswered question. Preliminary screening by testing circulating biomarker may be an alternative before repeat computed tomography (CT) scan. The aim of this study was to investigate the value of big endothelin-1 (bigET-1), the precursor of endothelin-1 (ET-1), in predicting the severity of CAC. A total of 428 consecutively patients who performed coronary computed tomography angiography (CCTA) due to chest pain in Fuwai Hospital were included in the study. The clinical characteristics, CACS, and laboratory data were collected, and plasma bigET-1 was detected by enzyme-linked immunosorbent assay (ELISA). The bigET-1 was positively correlated with the CACS ( r = .232, P < .001), and the prevalence of CACS >400 increased significantly in the highest bigET-1 tertile than the lowest tertile. Multivariate analysis showed that bigET-1was the independent predictor of the presence of CACS >400 (odds ratio [OR] = 1.721, 95% confidence interval [CI], 1.002-2.956, P = .049). The receiver operating characteristic (ROC) curve analysis showed that the optimal cutoff value of bigET-1 for predicting CACS >400 was 0.38 pmol/L, with a sensitivity of 59% and specificity of 68% (area under curve [AUC] = 0.65, 95% CI, 0.58-0.72, P < .001). The present study demonstrated that the circulating bigET-1 was valuable in the assessment of the severity of CAC.

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Coronary artery calcification outperforms thoracic aortic calcification for the prediction of myocardial infarction and all-cause mortality: The Heinz Nixdorf Recall Study

European Journal of Preventive Cardiology ◽

10.1177/2047487313482281 ◽

2013 ◽

Vol 21 (9) ◽

pp. 1163-1170 ◽

Cited By ~ 13

Author(s):

Hagen Kälsch ◽

Nils Lehmann ◽

Marie H Berg ◽

Amir A Mahabadi ◽

Paul Mergen ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Aortic Calcification ◽

Heinz Nixdorf Recall Study ◽

All Cause Mortality ◽

Thoracic Aortic Calcification

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P6158Prognostic value of non-obstructive coronary artery disease detected on coronary computed tomography angiography among subjects with suspected coronary artery disease

European Heart Journal ◽

10.1093/eurheartj/ehz746.0764 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Aljizeeri ◽

M Alali Alfaris ◽

D Ahmed ◽

J Farea ◽

A Elneama ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Computed Tomography Angiography ◽

Prognostic Value ◽

Coronary Computed Tomography Angiography ◽

Cox Models ◽

Coronary Computed Tomography ◽

All Cause Mortality ◽

Artery Disease

Abstract Introduction Coronary Computed Tomography Angiography (CTA) is an established technique for the detection of coronary artery disease (CAD). However, the prognostic value of non-obstructive CAD is not well defined. Thus, the aim of this analysis is to determine the prognostic value of non-obstructive CAD detected on CTA. Methods In the Multi-Center Multi-Ethnic Coronary Computed Tomography Angiography (MECCA) Study, 3209 subjects without known CAD underwent CTA. Patients with obstructive CAD were excluded from this analysis. Patients with ≤70% luminal coronary artery stenosis in vessels other than the left main were classified to have non-obstructive CAD while patients without any plaque were considered to have normal CTA. Patients were followed up for a median duration of 3.4 years for all-cause mortality (ACM). Multivariable Cox models were used to determine the independent predictors of event-free survival. Results A total of 1455 subjects had non-obstructive CAD and 1382 subjects had normal coronary arteries. Subjects with non-obstructive CAD were older (55.9±11 vs 46.2±11 years, p<0.001) and more likely to be males (56.8% vs 50.5%, p=0.001) and had more prevalent traditional risk factors. A total of 83 ACM were observed (4.4% in the non-obstructive group and 1.3% in the normal group, p<0.001). Patients with clinical events were older (61.8±14 vs 50.9±12 years, p<0.001) and have more prevalence of DM (42.2% vs 31.4%, p=0.031) and HTN (72.3% vs 54.3%, p=0.001). In Multivariable Cox models, non-obstructive CAD was associated with increased event rate (Hazard ratio 1.75, 95% CI 1.01–3.01, p=0.45). Kaplan-Meier Survival Curves Conclusions Patients with non-obstructive CAD on CTA have a higher rate of all-cause mortality. Non-obstructive CAD on CTA enhances risk stratification among subjects suspected with CAD and should call for more aggressive guidelines directed medical therapy. Acknowledgement/Funding None

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