Defining The Incidence And Patient Profile Of Incidental Coronary Artery Calcification On Non-cardiac Computed Tomography: An Opportunity To Identify Subclinical Coronary Atherosclerosis.

2020 ◽  
Vol 14 (3) ◽  
pp. S54
Author(s):  
R. Vishwanath ◽  
J. Iordanou ◽  
V. Singh ◽  
S. Gorgis ◽  
H. Papukhyan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Coronary Atherosclerosis ◽  
Cardiac Computed Tomography ◽  
Patient Profile

P5339Association between high-sensitive troponin I and subclinical coronary atherosclerosis in well-controlled HIV-infected adults

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Vassara ◽  
S Siwamogsatham ◽  
W Buddhari ◽  
M Tumkosit ◽  
C Ketloy ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Coronary Atherosclerosis ◽  
Troponin I ◽  
Cardiac Computed Tomography ◽  
Agatston Score ◽  
Cross Sectional ◽  
Potential Biomarker ◽  
High Sensitive Troponin

Abstract Background and objectives Patients with human immunodeficiency virus (HIV) infection live longer and the prevalence of coronary heart disease is increasing among them. High-sensitive troponin I (hs-TnI) is associated with coronary artery calcification as determined by non-contrast cardiac computed tomography (CT) in general population without established cardiovascular disease (CVD). Nevertheless, the relationship in well-controlled HIV-infected patients has not been validated. Design and methods A cross-sectional study among HIV-infected adults aged >50 years free from known CVDs. All subjects underwent non-contrast cardiac CT and blood test for serum hs-TnI was concomitantly performed. Relationship between Agatston score, a parameter used to quantify coronary artery calcification and serum hs-TnI level was analysed using spearman correlation and logistic regression models. Results A total of 338 HIV-infected adults (median age 54 years, 62% men) were included. All of them were in antiretroviral therapy with a median 18 years of exposure. The median CD4 cell count was 614 cell/mm3, 98% were virologically suppressed. Hs-TnI was correlated with coronary artery calcification with the correlation coefficient of 0.287 (p<0.0001). Multivariated logistic regression analysis demonstrated that serum hs-TnI concentration was associated with an increased odd of coronary artery calcification (Agatston score>0) (OR 1.64; 95% CI, 1.05–2.56, p=0.029). To detect coronary artery calcification, using the hs-TnI in addition to Thai CV risk score slightly increased the ROCAUC from 0.6827 to 0.692 (p=0.45). Distribution of CAC score over hs-TnI Conclusion Among well-controlled HIV-infected patients without established CVDs, hs-TnI concentration was associated with coronary artery calcification. This could be a potential biomarker for an early risk stratification of subclinical coronary atherosclerosis in this population. The association with long-term adverse cardiovascular outcome needs to be validated in the future study.

Progression of coronary artery calcification by cardiac computed tomography

Herz ◽  
2015 ◽  
Vol 40 (6) ◽  
pp. 863-868 ◽  
Author(s):  
Amir A. Mahabadi ◽  
N. Lehmann ◽  
I. Dykun ◽  
T. Müller ◽  
H. Kälsch ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Cardiac Computed Tomography

scholarly journals Association Between Muscle Quality Measured by Abdominal Computed Tomography and Subclinical Coronary Atherosclerosis

2020 ◽  
Author(s):  
Min Jung Lee ◽  
Hong-Kyu Kim ◽  
Eun Hee Kim ◽  
Sung Jin Bae ◽  
Kyung Won Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Coronary Atherosclerosis ◽  
Abdominal Muscle ◽  
Muscle Quality ◽  
Muscle Area ◽  
Cross Sectional

Objective: Low muscle mass was known to be associated with cardiovascular diseases. However, only few studies investigated the association between muscle quality and subclinical coronary atherosclerosis. Thus, we evaluated whether muscle quality measured by abdominal computed tomography is associated with the risk of coronary artery calcification. Approach and Results: We conducted a cross-sectional study on 4068 subjects without cardiovascular disease who underwent abdominal and coronary computed tomography between 2012 and 2013 during health examinations. The cross-sectional area of the skeletal muscle was measured at the L3 level (total abdominal muscle area, total abdominal muscle area) and segmented into normal attenuation muscle area, low attenuation muscle area, and intramuscular adipose tissue. We calculated the normal attenuation muscle area/total abdominal muscle area index, of which a higher value reflected a higher proportion of good quality muscle (normal attenuation muscle area) and a lower proportion of myosteatosis (low attenuation muscle area and intramuscular adipose tissue). In women, as the normal attenuation muscle area/total abdominal muscle area quartiles increased, the odds ratios (95% CIs) for significant coronary artery calcification (>100) consistently decreased (0.44 [0.24–0.80], 0.39 [0.19–0.81], 0.34 [0.12–0.98]; P =0.003) after adjusting for cardiovascular risk factors including visceral fat area and insulin resistance. In men, the odds ratios in the Q2 group were significantly lower than those in the Q1, but the association was attenuated in Q3–4 after adjustment. Conclusions: A higher proportion of good quality muscle was strongly associated with a lower prevalence of significant coronary artery calcification after adjustment, especially in women. Poor skeletal muscle quality may be an important risk factor for subclinical coronary atherosclerosis.

Incorporating coronary calcification by computed tomography into CHA2DS2-VASc score: impact on cardiovascular outcomes in patients with atrial fibrillation

EP Europace ◽  
2021 ◽  
Author(s):  
Tom Kai Ming Wang ◽  
Nicholas Chan ◽  
Paul C Cremer ◽  
Mohamed Kanj ◽  
Bryan Baranowski ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Cardiac Computed Tomography ◽  
Multivariable Analysis ◽  
Coronary Calcification ◽  
Major Adverse Cardiovascular Events ◽  
Anticoagulation Management ◽  
Disease Parameter

Abstract Aims CHA2DS2-VASc score is widely utilized for risk stratification and guiding anticoagulation in patients with atrial fibrillation (AF). Cardiac computed tomography (CCT) routinely performed for pulmonary vein isolation (PVI) can also identify coronary artery calcifications (CAC). We evaluated the frequency and outcomes of incorporating CAC into the CHA2DS2-VASc score in AF patients undergoing PVI. Methods and results Consecutive patients in a prospective PVI registry during 2014–18 having CCT within 1 year of PVI were studied. Reclassification of CHA2DS2-VASc score and associations between CAC as a binary variable detected on CCT with clinical characteristics, stroke as primary endpoint, death, myocardial infarction, and major adverse cardiovascular events (MACE) were analysed. Amongst 3604 AF patients, 2238 (62.1%) had CAC detected on CCT and was associated with most traditional cardiovascular risk factors. Coronary artery calcification was independently associated with all pre-specified endpoints adjusting for clinical parameters in multivariable analysis. Adjusting for CHA2DS2-VASc score, CAC was associated with stroke (hazards ratio 3.64, 95% confidence interval 1.25–10.6, P = 0.018), death (2.26, 1.29–3.98, P = 0.006), and MACE (2.08, 1.36–3.16, P = 0.001) during 2.8 ± 1.6-year follow-up. Incorporating CAC as a vascular disease parameter of CHA2DS2-VASc score, anticoagulation decision-making would be revised in 723 (20.1%) patients, including an additional 488 (13.5%) patients where anticoagulation would be now indicated. Conclusion Coronary artery calcification is prevalent in AF patients undergoing PVI and independently associated stroke, death and MACE even when adjusted for traditional CHA2DS2-VASc score. Adding CAC as vascular component to the CHA2DS2-VASc score requires further research as it potentially modified the anticoagulation management in 20% of our AF cohort.

scholarly journals Appropriate utilization of cardiac computed tomography for the assessment of stable coronary artery disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Hammer ◽  
Muhtashim Mian ◽  
Levi Elhadad ◽  
Mary Li ◽  
Idan Roifman
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Imaging ◽  
Cardiac Computed Tomography ◽  
The United States ◽  
Appropriate Use ◽  
Potential Cost ◽  
Cardiac Computed Tomography Angiography ◽  
Artery Disease

Abstract Background Appropriate use criteria (AUC) have been developed in response to growth in cardiac imaging utilization and concern regarding associated costs. Cardiac computed tomography angiography (CCTA) has emerged as an important modality in the evaluation of coronary artery disease, however its appropriate utilization in actual practice is uncertain. Our objective was to determine the appropriate utilization of CCTA in a large quaternary care institution and to compare appropriate utilization pre and post publication of the 2013 AUC guidelines. We hypothesized that the proportion of appropriate CCTA utilization will be similar to those of other comparable cardiac imaging modalities and that there would be a significant increase in appropriate use post AUC publication. Methods We employed a retrospective cohort study design of 2577 consecutive patients undergoing CCTA between January 1, 2012 and December 30, 2016. An appropriateness category was assigned for each CCTA. Appropriateness classifications were compared pre- and post- AUC publication via the chi-square test. Results Overall, 83.5% of CCTAs were deemed to be appropriate based on the AUC. Before the AUC publication, 75.0% of CCTAs were classified as appropriate whereas after the AUC publication, 88.0% were classified as appropriate (p < 0.001). The increase in appropriate utilization, when extrapolated to the Medicare population of the United States, was associated with potential cost savings of approximately $57 million per year. Conclusions We report a high rate of appropriate use of CCTA and a significant increase in the proportion of CCTAs classified as appropriate after the AUC publication.

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