Potential determinants of coronary calcium score in a population at intermediate cardiovascular risk

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Brusq ◽  
V Bongard ◽  
E Berard ◽  
D Taraszkiewicz ◽  
J Ferrieres
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Multinomial Logistic Regression ◽  
Calcium Score ◽  
Coronary Calcium ◽  
Coronary Calcium Score ◽  
High Calcium ◽  
History Of

Abstract Background Understanding determinants of coronary calcium score could lead to the development of new preventive actions for reducing cardiovascular risk. Our hypothesis is that major cardiovascular risk factors are linked with coronary calcium score, but the parameters associated with moderate or high scores could be different. Purpose The aim of our study was to explore the potential determinants of moderate and high elevation of coronary calcium score in a population of patients at intermediate cardiovascular risk. Methods We conducted a cross-sectional analysis, using data from a prospective cohort. Our study population was composed of people presenting with cardiovascular risk factors, who were referred by their attending physician for a complete assessment of their risk factors and for screening for silent cardiovascular disease. People in secondary prevention could also be referred. Coronary calcium score was assessed by cardiac CT scan. We used the following categories for classifying patients according to their coronary calcium score: low (0–100 AU (Agatston units)); moderate (101–300 AU) and high calcium score (greater than 300 AU). We performed a descriptive analysis and then we built a multinomial logistic regression model, using the low calcium score category as reference. Results Among the 1585 patients included in the database, we analyzed data from 1402 individuals who beneficiated from coronary calcium scoring. The sample included 714 (51%) men, and 144 (10%) people with a history of cardiovascular disease. Mean age was 59 yrs. Data from the multivariate analysis showed that age (OR=1.07; 95% CI [1.054–1.091] for 1-year increase), gender (OR=0.461; 95% CI [0.330–0.643] for women versus men) and smoking more than 20 cigarettes per day (OR=2.893; 95% CI [1.207–6.935]) were associated with a moderate calcium score. Variables associated with a high calcium score were: age (OR=1.097; 95% CI [1.076–1.119] for 1-year increase), gender (OR=0.221; 95% CI [0.151–0.323] for women vs men), treated dyslipidemia (OR=2.108; 95% CI [1.467–3.027]), treated hypertension (OR=2.199; 95% CI [1.523–3.175]), and history of cardiovascular disease (OR=4.138; 95% CI [2.510–6.823]). Conclusions In this study, well-known and modifiable cardiovascular risk factors are associated with calcium score. However, our results highlight that determinants of moderate and high scores may be different. While tobacco is associated with a higher risk of moderate calcium score, hypertension and dyslipidemia appear to be preferentially linked with the highest scores. It is thus appropriate that the 2019 ESC/EAS guidelines for dyslipidemias have classified patients with hypertension and dyslipidemia in the high risk category. Funding Acknowledgement Type of funding source: None

Coronary Calcium Score May Replace Cardiovascular Risk Factors as Primary Risk Stratification Tool Before Kidney Transplantation

2016 ◽  
Vol 100 (10) ◽  
pp. 2177-2187 ◽  
Author(s):  
Simon Winther ◽  
Morten Bøttcher ◽  
Hanne S. Jørgensen ◽  
Kirsten Bouchelouche ◽  
Lars C. Gormsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Cardiovascular Risk ◽  
Risk Stratification ◽  
Cardiovascular Risk Factors ◽  
Calcium Score ◽  
Coronary Calcium ◽  
Coronary Calcium Score ◽  
Risk Stratification Tool

scholarly journals Cardiovascular risk factors in adolescents with a family history of cardiovascular disease

2017 ◽  
Vol 46 (4) ◽  
pp. 326 ◽  
Author(s):  
Rohit Vohra ◽  
Minakshi Bansal ◽  
Neelam Grover ◽  
Parveen Bhardwaj ◽  
Pancham Kumar
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Family History ◽  
Cardiovascular Risk Factors ◽  
History Of

scholarly journals SUN-300 Improvement in Cardiovascular Risk Factors in Long Term Follow up of Hypopituitary Septagenarian and Octagenarian Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Isabella Naves Rosa ◽  
Alexandre Anderson S M Soares ◽  
Luciana Ansaneli Naves
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Calcium Score ◽  
Coronary Calcium Score ◽  
Framingham Score ◽  
Long Term Follow Up ◽  
Pituitary Macroadenomas

Abstract Background: Hypopituitarism in the elderly population is an underdiagnosed condition and may increase co-morbidities in glucose metabolism, dyslipidemia and cardiovascular risk factors. Pituitary macroadenomas are benign tumors, which prevalence is unknown in aged people, and is frequently associated to impairment in pituitary function. Objective: The aim of this study is to identify cardiovascular risk factors in hypopituitary septagenarians and octagenarians by diagnosis and after long term follow up of pituitary dysfunction. Methods: This is a retrospective observational study and the patients were recruited and selected from a service registry in a tertiary medical center. We included patients aged from 70-99 years with the diagnosis of pituitary macroadenomas, evaluated hormonal and biochemical parameters, cardiovascular risk scores were calculated by diagnosis and compared after long term follow up. All patients signed informed consent. Results: Thirty five patients were included, 21 patients aged 70-75 years (72.61 yo), 7 patients 76-80 years (77.28yo), 7 patients 81-99 years (89.28 yo). All tumors were macroadenomas, 40% of them Non Functioning Pituitary Macroadenomas, mean maximal diameter 3.4 cm (2.9-.4.3), 40% of them submitted to surgery, 14% adjuvant radiotherapy, 20% presented previous apoplexy. Co-morbidities were frequent by diagnosis, 85.71% presented Hypertension, 37.14% Diabetes, 62.8% Hypercholesterolemia and 45.71% Hypertriglyceridemia. Hypopituitarism was present in 71.42%, GH deficiency in 37.14%, hypogonadism in 60%, central hypothyroidism in 54.28%, adrenal insufficiency in 31.42%, 51.42 % presented more than two combined deficiencies. Analysis of cardiovascular risk prediction in total cohort showed, 57.14% of patients presented reduction of Framingham Score and 45.71% in Coronary Calcium Score, during mean time follow up of 13.09 years (3-32 years after diagnosis). According to ages, Framingham score and Coronary Calcium Score reduced respectively in 66% and 33.3% (70-75 yo), 57.15% and 85.71% (76-80 yo) and 42.85% and 28.57% (81-99 yo), during long term follow up. Discussion and Conclusion: In this study, most of hypopituitary aged patients presented reduction of cardiovascular risk factors during long term treatment and follow up, despite replacement with corticosteroids and gonadal steroids. Considering the importance of early diagnosis and the lack of data observed in the medical literature, larger scale studies should be performed with the objective to assess of the risk benefit ratio of hormonal replacement in metabolic control in septagenarian and octogenarian patients.

Performance of coronary calcium score and epicardial fat volume in early diagnostic of coronary artery disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Agoston Coldea ◽  
A Zlibut ◽  
C Cionca ◽  
I Muresan ◽  
D Horvat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Calcium Score ◽  
Coronary Calcium ◽  
Coronary Calcium Score ◽  
Epicardial Fat Volume ◽  
Artery Disease ◽  
Fat Volume

Abstract Background Coronary artery disease (CAD) remains a world leading cause of death, despite the development of traditional risk scores based on the quantification of cardiovascular risk factors. Coronary calcium score (CCS) determined by cardiac computed tomography (CCT) is a noninvasive tool with major implications in early diagnosis and in outcome prediction in CAD patients. Epicardial fat volume (EFV) is a recently described CCT-based diagnostic and prognostic tool of CAD and outcome. Purpose This study sought to investigate the performance of coronary calcium score and EFV in early diagnosing CAD. Methods We conducted a prospective, single-center, cross-sectional study on patients suspected of CAD. All patients were submitted to detailed clinical data, 12-lead electrocardiogram, estimating pretest probability, stress test, echocardiography, CCT imaging. In the study subjects was assessed CCS, EFV and the number of calcified plaques (NoP). The total CCS load was then ranked in the following scoring groups: 0 (no evidence of coronary calcium; reference group), 1–99 (minimal to mild), 100–399 (moderate), and 400–999 (extensive) and ≥1000 (very extensive). The subjects in the study were classified according to the NoP derived from their CCS scans (no plaques, 1–5, 6–10 and more than 10 calcified plaques). CAD was defined as coronary stenosis over 50% of the vessel. Results Among 540 patients (55.8±11.2 years of age; 52% women) met the enrollment criteria, 98 patients presented CAD. Spearman correlation analysis revealed strong correlations between EFV index and CCS (r=0.45; p<0.0001) and between EFV index and NoP (r=0.44; p<0.0001), after adjustment for age, sex, body mass index, hypertension, diabetes and low-density lipoprotein cholesterol. The area under the curve of the receiver-operator curve for CAD prediction by CCS >70.3 UH (cut-off value) was significantly higher (AUC=0.927; p<0.0001) by comparison with EFV index >40.8 ml/m2 (AUC=0.816; p<0.0001) and NoP >4 (AUC=0.928; p<0.0001). The association of all three parameter, CCS, EFV and NoP, increases the prediction power of CAD, providing an AUC of 0.969 with a 0.70 sensibility and 0.95 specificity. Conclusion The combined use of EPV, CCS and NoP has a very high predictive capacity for CAD, regardless of the classic cardiovascular risk factors. This increases the diagnostic capacity of CAD beyond every parameter used alone. Funding Acknowledgement Type of funding source: None

scholarly journals Early Onset of Coronary Artery Calcification in Women With Previous Preeclampsia

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Laura Benschop ◽  
Laura Brouwers ◽  
Gerbrand A. Zoet ◽  
Cindy Meun ◽  
Eric Boersma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Odds Ratio ◽  
Coronary Computed Tomography ◽  
History Of ◽  
Normotensive Pregnancy

Background: Preeclampsia, coronary artery calcification (CAC), and atherosclerotic plaque are risk factors for the development of cardiovascular disease. We determined at what age CAC becomes apparent on coronary computed tomography after preeclampsia and to what extent modifiable cardiovascular risk factors were associated. Methods: We measured cardiovascular risk factors, CAC by coronary computed tomography, and coronary plaque by coronary computed tomography angiography in 258 previously preeclamptic women aged 40-63. Results were compared to 644 age- and ethnicity-equivalent women from the Framingham Heart Study with previous normotensive pregnancies. Results: Any CAC was more prevalent after preeclampsia than after a normotensive pregnancy (20% versus 13%). However, this difference was greatest and statistically significant only in women ages 45 to 50 (23% versus 10%). The degree of CAC advanced 4× faster between the ages of 40 to 45 and ages 45 to 50 in women with a history of preeclampsia (odds ratio, 4.3 [95% CI, 1.5–12.2] versus odds ratio, 1.2 [95% CI, 0.6–2.3]). Women with a preeclampsia history maintained greater advancement of CAC with age into their early 60s, although this difference declined after the perimenopausal years. Women with a previous normotensive pregnancy were 4.9 years (95% CI, 1.8–8.0) older when they had similar CAC scores as previously preeclamptic women. These observations were not explained by the greater prevalence of cardiovascular disease risk factors, and the higher Framingham Risk Scores also observed in women with a history of preeclampsia. Conclusions: Previously preeclamptic women have more modifiable cardiovascular risk factors and develop CAC ≈5 years earlier from the age of 45 years onwards compared to women with normotensive pregnancies. Therefore, women who experienced preeclampsia might benefit from regular cardiovascular screening and intervention before this age. Registration: URL: https://www.trialregister.nl/trial/5406 ; Unique identifier: NTR5531.

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