scholarly journals LIFETIME MARIJUANA USE IS ASSOCIATED WITH INCREASED RISK OF ABDOMINAL AORTIC-ILIAC CALCIUM AND NOT CORONARY ARTERY CALCIUM BY MIDDLE AGE

2016 ◽  
Vol 67 (13) ◽  
pp. 1982
Author(s):  
Jamal S. Rana ◽  
Reto Auer ◽  
Eric Vittinghoff ◽  
Mark Pletcher ◽  
Norrina Allen ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Middle Age ◽  
Marijuana Use ◽  
Abdominal Aortic ◽  
Increased Risk

Abstract 031: Diastolic Blood Pressure, Coronary Artery Calcium, and Cardiac Outcomes in the Multi-ethnic Study of Atherosclerosis

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
John W McEvoy ◽  
Faisal Rahman ◽  
Mahmoud Al Rifai ◽  
Michael Blaha ◽  
Khurram Nasir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Diastolic Blood Pressure ◽  
Coronary Artery Calcium ◽  
J Curve ◽  
Increased Risk ◽  
All Cause Mortality

Diastolic blood pressure (BP) has a J-curve relationship with coronary heart disease and death. Because this association is thought to reflect reduced coronary perfusion at low diastolic BP, our objective was to test whether the J-curve is most pronounced among persons with coronary artery calcium. Among 6,811 participants from the Multi-Ethnic Study of Atherosclerosis, we used Cox models to examine if diastolic BP category is associated with coronary heart disease events, stroke, and mortality. Analyses were conducted in the sample overall and after stratification by coronary artery calcium score. In multivariable-adjusted analyses, compared with diastolic BP of 80 to 89 mmHg (reference), persons with diastolic BP <60 mmHg had increased risk of coronary heart disease events (HR 1.69 [95% confidence interval 1.02-2.79]) and all-cause mortality (HR 1.48 [95% confidence interval 1.10-2.00]), but not stroke. After stratification, associations of diastolic BP <60 mmHg with events were present only among participants with coronary artery calcium >0. Diastolic BP <60 mmHg was not associated with events when coronary artery calcium was zero. We also found no interaction in the association between low diastolic BP and events based on race. In conclusion, diastolic blood pressure <60 mmHg was associated with increased risk of coronary heart disease events and all-cause mortality in the sample overall, but this association appeared strongest among individuals with elevated CAC; suggesting that added caution may be needed when pursuing intensive BP treatment targets among persons with subclinical atherosclerosis.

Risk results from screening for a high cardiovascular disease risk by means of traditional risk factor measurement or coronary artery calcium scoring in the ROBINSCA trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Van Der Aalst ◽  
S.J.A.M Denissen ◽  
M Vonder ◽  
J.-W.C Gratema ◽  
H.J Adriaansen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Risk Score ◽  
Coronary Artery Calcium ◽  
Preventive Treatment ◽  
Low Risk ◽  
Funding Source ◽  
Cvd Risk ◽  
Increased Risk

Abstract Aims Screening for a high cardiovascular disease (CVD) risk followed by preventive treatment can potentially reduce coronary heart disease (CHD)-related morbidity and mortality. ROBINSCA (Risk Or Benefit IN Screening for CArdiovascular disease) is a population-based randomized controlled screening trial that investigates the effectiveness of CVD screening in asymptomatic participants using the Systematic COronary Risk Evaluation (SCORE) model or Coronary Artery Calcium (CAC) scoring. This study describes the distributions in risk and treatment in the ROBINSCA trial. Methods and results Individuals at expected elevated CVD risk were randomized (1:1:1) into the control arm (n=14,519; usual care); screening arm A (n=14,478; SCORE, 10-year fatal and non-fatal risk); or screening arm B (n=14,450; CAC scoring). Preventive treatment was largely advised according to current Dutch guidelines. Risk and treatment differences between the screening arms were analysed. 12,185 participants (84.2%) in arm A and 12,950 (89.6%) in arm B were screened. 48.7% were women, and median age was 62 (InterQuartile Range 10) years. SCORE screening identified 45.1% at low risk (SCORE&lt;10%), 26.5% at intermediate risk (SCORE 10–20%), and 28.4% at high risk (SCORE≥20%). According to CAC screening, 76.0% were at low risk (Agatston&lt;100), 15.1% at high risk (Agatston 100–399), and 8.9% at very high risk (Agatston≥400). CAC scoring significantly reduced the number of individuals indicated for preventive treatment compared to SCORE (relative reduction women: 37.2%; men: 28.8%). Conclusion We showed that compared to risk stratification based on SCORE, CAC scoring classified significantly fewer men and women at increased risk, and less preventive treatment was indicated. ROBINSCA flowchart Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): Advanced Research Grant

scholarly journals 430 Relation of blood pressure to coronary artery calcium and mortality

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I J Cho ◽  
J H Lee ◽  
S Y Choi ◽  
E J Chun ◽  
S H Park ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery ◽  
Diastolic Blood Pressure ◽  
Coronary Artery Calcium ◽  
Multicenter Observational Study ◽  
J Curve ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Study Population ◽  
Artery Disease

Abstract Background Diastolic blood pressure has a J-curve relation with coronary heart disease and death, but it is debating whether a J-curve association exists in general population. We aimed to assess the relation of blood pressure to mortality, and whether their association is interacted with presence of high coronary artery calcium (CAC). Methods The KOICA registry is a retrospective, multicenter observational study designed to investigate the effectiveness and prognostic value of CAC score for primary prevention of cardiovascular disease in asymptomatic Korean adults. The association between CAC score and blood pressure was assessed. Patients were divided into 2 groups according to the baseline CACS (&gt; 300 and ≤ 300), and all-cause mortality was assessed. Results The study population composed 48903 subjects with a mean age of 54 ± 9. There were 425 (0.9%) deaths during follow-up. At baseline, SBP (systolic blood pressure) more than 110 mmHg and DBP (diastolic blood pressure) more than 80 mmHg was associated with increased risk for CACS &gt; 300. In patients with baseline CACS ≤ 300, all-cause mortality was increased in patients with SBP of 110-119 mmHg (HR 1.47, p = 0.023), 130-139 mmHg (HR 1.72, p = 0.002) and ≥ 140 mmHg (HR 1.47, p = 0.042) compared to SBP of 120-129 mmHg, whereas DBP did not predict all-cause mortality. In contrast, SBP was not associated to all-cause mortality in patients with CACS &gt; 300, whereas DBP &lt; 60 mmHg (HR 3.53, p =0.018) and 70-79 mmHg (HR 2.21, p = 0.042) was associated with increased risk for all-cause mortality compared to DBP of 80-89 mmHg. Conclusion Low DBP was associated with increased risk for all-cause mortality in subjects with high CAC score, suggesting high-risk for coronary artery disease. However, this J-curve relation was not shown in the population with low CAC score.

Abstract 456: Is There a Relationship Between an Elevated Coronary Calcium Score and the Incidence of Kidney or Gallbladder Calculi

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Vishesh Kumar ◽  
Shawn Kelly ◽  
Amol Raizada ◽  
Amornpol Anuwatworn ◽  
Jimmy Yee ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Medical Center ◽  
Calcium Score ◽  
Coronary Calcium ◽  
Calcium Deposition ◽  
Biochemical Basis ◽  
Asymptomatic Patients ◽  
Increased Risk

Background: Elevated calcium score is a marker of increased risk in the development of cardiovascular and cerebrovascular disease. It is unknown whether an elevated coronary artery calcium score is associated with extravascular calcium deposition in disease states such as nephrolithiasis and cholelithiasis. The aim of this study was to explore this relationship in asymptomatic patients who had elective coronary calcium scoring performed at the University of South Dakota Sanford Medical Center. Methods: We performed a retrospective review of data from 38,546 consecutive patients from the coronary calcium screening database. Patients with a history of calculi were identified using ICD-9 codes for calculus of kidney and ureter (592) and cholelithiasis (574). Cases were analyzed according to gender and age groups, and proportions calculated according to calcium score tertile. Results: The results are summarized in Table 1. Overall, the proportion of patients with calculi increases with each rise in the coronary artery calcium score. However, this relationship is best demonstrated in the elderly male and younger female populations. This relationship was further analyzed using a chi-square contrast test. The results, as described in Table 2, indicate that there is a significant relationship between elevated coronary calcium and likelihood of calculi conditions in young females (p=0.0040), however, the proportion in elderly males does not exhibit a statistical difference in proportion (p=0.1143). Conclusion: Elevated coronary artery calcium is associated with an increased likelihood of having a diagnosis of extravascular calculi development such as nephrolithiasis or cholelithiasis. Younger females appear to best demonstrate this relationship. Although the proportions are small, further studies are needed to substantiate a biochemical basis for this relationship.

Abstract 17065: Performance of Cardiovascular Disease Risk Scores to Identify Coronary Artery Calcium Burden in Retired National Football League Players

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Genevieve E Smith ◽  
Jonathan A Drezner ◽  
Camilo Fernandez ◽  
Gregory W Stewart
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
National Football League ◽  
Elite Athlete ◽  
Risk Scores ◽  
Cvd Risk ◽  
Discriminative Ability ◽  
C Statistic ◽  
Increased Risk

Introduction: Coronary artery calcium (CAC) is a robust predictor of coronary events in asymptomatic individuals with latent atherosclerotic cardiovascular disease (CVD). While evidence suggests CAC scoring may augment traditional CVD risk scores in clinical decision making, evidence is limited on the compared ability of CVD risk scores to identify the degree of coronary atherosclerosis as quantified by absolute CAC, particularly in former elite athlete populations. We investigated this in a cohort of retired National Football League (NFL) players. Methods: We analyzed data on 752 retired NFL players (aged 55.2 ± 9.0 years, 53.7% African-American] that underwent health screening and CAC scoring with the NFL Player Care Foundation. Three 10-year CVD risk scores were compared: Framingham Coronary Heart Disease (FCHD), Framingham CVD (FCVD), and Atherosclerotic CVD Risk Pooled Cohort Equations (PCE). Receiver operating characteristic curves were fitted in 3 models: FCHD (Model 1), FCVD (Model 2), and PCE (Model 3, used as reference based on 2013 AHA guidelines). Contrast analyses identified the model with highest discriminative ability (c statistic) versus CAC = 0 for each CAC score category: >0 and <100, 100-400, and >400. Results: Compared to PCE , FCVD exhibited the highest discriminative ability for CAC > 0 and < 100 ( c statistic 0.7071 vs 0.6706, p<0.0001), while FCHD had the lowest for both CAC 100-400 ( c statistic 0.7198 vs 0.7664, p=0.0165) and CAC >400 ( c statistic 0.7728 vs 0.8460, p<0.0001). No additional differences were identified (Figure 1). Conclusion: Traditional CVD risk scores differ in performance to predict absolute CAC among retired NFL players, underscoring a need for refinement of coronary event risk prediction models to enhance the ability of such models to identify, specifically, low CAC, as even low CAC burden confers increased risk compared to CAC absence. This may include accounting for elite athlete-specific characteristics.

Abstract P191: Does ApoB/A1 Ratio Explain the Increased Risk of Cardiovascular Disease in Indian Asians Compared to Europeans?

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Sian-Tsung Tan ◽  
Abtehale Al-Hussaini ◽  
Sunaina Yadav ◽  
Joban Sehmi ◽  
Mika Ala-Korpela ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Hdl Cholesterol ◽  
Cholesterol Ratio ◽  
Chd Risk ◽  
Increased Risk ◽  
Chd Risk Factors

Introduction Coronary heart disease (CHD) mortality is ∼2-fold higher in Indian Asians (IA) than in European Whites (EW). This is not accounted for by conventional CHD risk factors (type-2 diabetes, cigarette smoking, hypertension, obesity, total or HDL cholesterol). The INTERHEART Study has reported that ApoB/A1 ratio is the single strongest risk factor for CHD accounting for ∼50% of CHD risk; the contribution of ApoB/A1 ratio to the excess CHD risk in IA is not known. Hypothesis We tested the hypothesis that ApoB/A1 ratio is higher in IA than EW and accounts for the ∼2-fold excess CHD risk in IA, independent of conventional CHD risk factors. Methodology We studied 1361 IA and 1028 EW men and women aged 35-75 years, participating in the London Life Sciences Population Study. All participants completed a structured health questionnaire and had blood pressure, height, weight, waist-hip ratio, fasting biochemistry measured. Coronary artery calcium (CAC) was measured by electron beam CT; Agatston score >0 was considered to indicate the presence of coronary atherosclerosis. Results Compared to EW, IA were younger, had higher prevalence of diabetes and hypertension, had higher WHR, and were less likely to smoke. Total and HDL cholesterol were lower, but Total-HDL cholesterol ratio was higher in IA ( table ). ApoB/A1 ratio was higher in IA compared to EW [0.71±0.15 vs. 0.67±0.16, p<0.001], and was independent of conventional CHD risk factors (p<0.001). In univariate analysis, ApoB/A1 ratio was associated with CAC in both populations [Odds ratio (OR) for CAC per 1 SD increase in ApoB/A1 ratio: IA 1.17 (1.05-1.30), p=0.006; EW 1.40 (1.23-1.59), p<0.001]. After adjustment for age, gender, and total-HDL cholesterol ratio, there was no association between ApoB/A1 ratio and CAC [OR: IA 0.95 (0.74-1.21), p=0.66; EW 0.98 (0.72-1.33), p=0.88]. Conclusions ApoB/A1 is higher in IA compared to EW, but not independently associated with coronary calcification in either population. ApoB/A1 ratio does not explain the ∼2-fold increased risk of CHD in IA. Europeans Indian Asians P-value N 1028 1361 Age (years) 55.5 54.2 0.002 Male gender (%) 70.3 62.0 <0.0001 Ever Smoked (%) 54.8 15.1 <0.0001 ApoB/A1 ratio 0.67 (0.16) 0.71 (0.15) <0.0001 Total: HDL Cholesterol Ratio 4.12 (1.10) 4.23 (1.03) <0.0001 HDL cholesterol (mmol/L) 1.37 (0.39) 1.24 (0.32) <0.0001 Type-2 Diabetes (%) 8.2 20.1 <0.0001 Treated Hypertension (%) 19.2 31.3 <0.0001 Waist-Hip Ratio 0.92 (0.08) 0.94 (0.08) <0.0001 Coronary artery calcium score greater than 0 (%) 54.1 51.1 0.15 Table: Characteristics of study participants

Abstract P334: Distribution of Coronary Artery Calcium Score in a Multi-Ethnic Admixed Population: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Marcio S Bittencourt ◽  
Alexandre C Pereira ◽  
Henrique L Staniak ◽  
Itamar S Santos ◽  
Rodolfo Sharovsky ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Strong Predictor ◽  
Calcium Score ◽  
Adult Health ◽  
Local Regression ◽  
Final Population ◽  
Increased Risk ◽  
Admixed Population

Introduction: Coronary artery calcium (CAC) is a marker of coronary atherosclerosis burden and is a strong predictor of cardiovascular events and overall mortality, especially in White populations. The distribution of CAC has been determined for a number of predominantly White populations; however, the distribution in ethnically admixed groups has not been well established. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a cohort with 15, 105 participants with an ethnic diversity (White, 52.2%; Brown, 28.2%; Black,16.1%; Asian, 2.5% and Native, 1.0%) is an unique opportunity to explore CAC scores differences among admixed populations. Hypothesis: to compare CAC scores obtained from an admixed population in Brazil with the results from the Multi Ethnic Study of Atherosclerosis (MESA). Methods: From the 15105 participants of ELSA-Brasil, a prospective study that enrolled civil servants aged 35 to 74 years, CAC scoring was performed on 3,400 individuals at the Sao Paulo site. Similar to previous studies, individuals with self-reported cardiovascular diseases or treated diabetes were excluded from the analysis. The final population included 2,753 individuals (men = 54%; median age = 48 years). Percentiles of CAC distribution were estimated using a two-part local regression fitting model, adapted to zero-inflated data and then compared to MESA CAC percentiles. Testing of the predictive role of age (years), sex, and ethnicity was done modeling a zero-inflated distribution for continuous data. Results: For the discrete part of CAC modelling, age, sex and ethnicity were predictors of CAC prevalence (CAC>0). For the ELSA-Brasil sample, increasing age (OR=1.14, p<0.001), male sex (OR: 3.61, p<0.001), and White ethnicity (OR=1.46 (against Blacks), p=0.02) were significantly associated with increased odds of having CAC>0. Different from expected, for the continuous part of CAC modelling, only age (p=0.02) was significantly associated with increased CAC values. Compared to MESA percentiles, the participants or ELSA-Brasil presented, overall, lower CAC values. Conclusions: Among this sample of apparently healthy Brazilian adults, we did observe significant differences in CAC prevalence by ethnicity, sex, and age. In contrast with MESA, the difference regarding the amount of CAC between men and women were smaller, suggesting an increased risk of Brazilian women compared to US women.

scholarly journals Young Obese Women with Polycystic Ovary Syndrome Have Evidence of Early Coronary Atherosclerosis

2007 ◽  
Vol 92 (12) ◽  
pp. 4609-4614 ◽  
Author(s):  
Rupal Shroff ◽  
Angela Kerchner ◽  
Michelle Maifeld ◽  
Edwin J. R. Van Beek ◽  
Dinesh Jagasia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Atherosclerosis ◽  
Polycystic Ovary ◽  
Fat Distribution ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Markers Of Inflammation ◽  
Increased Risk

Abstract Context: Polycystic ovary syndrome (PCOS) is associated with comorbidities that may contribute to increased risk of cardiovascular disease. PCOS is associated with increased risk of metabolic syndrome, dyslipidemia, and diabetes, but it remains unclear whether traditional cardiovascular (CV) risk factors can help predict coronary artery disease in this population. Objective: The objectives of the study were to detect early-onset subclinical coronary atherosclerosis (using coronary artery calcium as a marker) in young women with PCOS, compared with age- and body mass index-matched controls, and to compare traditional CV risk factors and inflammatory markers in the two groups. Design: This was a prospective case-control study. Setting: The study was conducted at a university hospital. Subjects: Twenty-four obese (body mass index ≥ 30 kg/m2) PCOS subjects and 24 obese controls participated. Outcome Measures: Coronary artery calcium, inflammatory markers (high-sensitivity C-reactive protein, IL-6, TNFα, adiponectin, leptin), fasting blood tests (glucose, lipids, insulin), and dual-energy x-ray absorptiometry scan for body fat distribution were measured. Results: Coronary artery calcium was detected in eight of 24 PCOS subjects (33%) and two of 24 controls (8%) (odds ratio 5.5, 95% confidence interval 1.03, 29.45, P &lt; 0.03). Traditional CV risk factors did not differ significantly between the two groups, nor did markers of inflammation or adiposity, body fat distribution, or metabolic parameters with the exception of significantly lower quantitative insulin sensitivity check index (marker for insulin resistance) in the PCOS group (P &lt; 0.05). Conclusions: Young, obese women with PCOS have a high prevalence of early asymptomatic coronary atherosclerosis, compared with obese controls. This increased risk is independent of traditional CV risk factors and novel markers of inflammation. These findings underscore the need to screen and aggressively counsel and treat these women to prevent symptomatic CV disease.

scholarly journals Prognostic value of the coronary artery calcium score in suspected coronary artery disease: a study of 644 symptomatic patients

2019 ◽  
Vol 28 (1) ◽  
pp. 44-50 ◽  
Author(s):  
D. Rijlaarsdam-Hermsen ◽  
M. S. Lo-Kioeng-Shioe ◽  
D. Kuijpers ◽  
R. T. van Domburg ◽  
J. W. Deckers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Calcium Score ◽  
Coronary Revascularisation ◽  
Cardiac Events ◽  
Prognostic Information ◽  
Increased Risk ◽  
Fatal Myocardial Infarction

Abstract Aim The long-term value of coronary artery calcium (CAC) scanning has not been studied extensively in symptomatic patients, but was evaluated by us in 644 consecutive patients referred for stable chest pain. Methods We excluded patients with a history of cardiovascular disease and with a CAC score of zero. CAC scanning was done with a 16-row MDCT scanner. Endpoints were: (a) overall mortality, (b) mortality or non-fatal myocardial infarction and (c) the composite of mortality, myocardial infarction or coronary revascularisation. Revascularisations within 1 year following CAC scanning were not considered. Results The mean age of the 320 women and 324 men was 63 years. Follow-up was over 8 years. There were 58 mortalities, while 22 patients suffered non-fatal myocardial infarction and 24 underwent coronary revascularisation, providing 104 combined endpoints. Cumulative 8‑year survival was 95% with CAC score <100, 90% in patients with CAC score >100 and <400, and 82% with CAC score ≥400 Agatston units. Risk of mortality with a CAC score >100 and ≥400 units was 2.6 [95% confidence interval (CI) 1.23–5.54], and 4.6 (95% CI 2.1–9.47) respectively. After correction for clinical risk factors, CAC score remained independently associated with increased risk of cardiac events. Conclusions Risk increased with increasing CAC score. Patients with CAC >100 or ≥400 Agatston units were at increased risk of major adverse cardiac events and are eligible for preventive measures. CAC scanning provided incremental prognostic information to guide the choice of diagnostic and therapeutic options in many subjects evaluated for chest pain.

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