scholarly journals Prediction of obstructive coronary artery disease after Rb-82 PET myocardial perfusion imaging and coronary artery calcium scoring using machine learning

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
RJ Metselaar ◽  
JA Van Dalen ◽  
BN Vendel ◽  
M Mouden ◽  
CH Slump ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Artery Calcium ◽  
Positive Family History ◽  
Unseen Data ◽  
Artery Disease ◽  
Rubidium 82

Abstract Funding Acknowledgements Type of funding sources: None. Background Accurate risk stratification in patients with suspected stable coronary artery disease (CAD) is essential for choosing an appropriate treatment strategy but remains challenging in clinical practice. Purpose Our aim was to develop and validate a risk model to predict the presence of obstructive CAD after Rubidium-82 PET and a coronary artery calcium score (CACS) scan using a machine learning (ML) algorithm. Methods We retrospectively included 1007 patients without prior cardiovascular history and  a low-intermediate pre-test likelihood, referred for rest and regadenoson-induced stress Rubidium-82 PET combined with a CACS scan. Multiple features were included in the ML model; PET derived features such as summed difference score and flow values, CACS, cardiovascular risk factors (cigarette smoking, hypertension, hypercholesterolemia, diabetes, positive family history of CAD), medication; age; gender; body mass index; creatinine serum values; and visual PET interpretation. An XGBoost ML algorithm was developed using a subset of 805 patients to predict obstructive CAD by using 5-fold cross validation in combination with a grid search. Obstructive CAD during follow-up was defined as a significant stenosis during invasive coronary angiography, a percutaneous coronary intervention or a coronary artery bypass graft procedure. The ML algorithm was validated with unseen data of the remaining 202 patients. Results Application of the XGBoost algorithm resulted in an area under the curve (AUC) of 0.93 using the training data (n = 805) and an AUC of 0.89 using the unseen data (n = 202) in predicting obstructive CAD. The strongest predictors were the CAC-scores and quantitative PET derived features. The classical risk factors and medication hardly provided an added value in the prediction of obstructive CAD. Conclusion The developed ML algorithm is able to provide individualized risk stratification by predicting the probability of obstructive CAD.  Although validation with a larger dataset could result in a more well defined performance range, this model already shows potential to be implemented in the diagnostic workflow.

scholarly journals Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population- A Five Years Retrospective Study

2017 ◽  
Vol 11 (2) ◽  
pp. 79-84
Author(s):  
Syed Dawood Md Taimur ◽  
Mashhud Zia Chowdhury ◽  
Md Enamul Hakim
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Positive Family History ◽  
Arterial Disease ◽  
Coronary Angiogram ◽  
Vessel Disease ◽  
Artery Disease ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown.Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between presence of PAD and severity of CAD. Material &Methods: This five years retrospective study was conducted at invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, severity of coronary artery and peripheral artery disease.Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension were detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 88.3% and 58.4% had positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients 52 had both coronary and peripheral arterial disease which was statistically significant (p<.014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. Peripheral angiogram revealed 51.9% had superficial femoral artery disease, 24.7% had anterior tibial artery disease, 26% had posterior tibial artery disease, 15.6% had common iliac artery and common femoral artery disease and 2.6% had renal artery disease.Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.University Heart Journal Vol. 11, No. 2, July 2015; 79-84

Breast artery calcium noted on screening mammography is predictive of high risk coronary calcium in asymptomatic women: a case control study

VASA ◽  
2013 ◽  
Vol 42 (6) ◽  
pp. 429-433 ◽  
Author(s):  
Martin E. Matsumura ◽  
Crystal Maksimik ◽  
Matthew W. Martinez ◽  
Michael Weiss ◽  
James Newcomb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Screening Mammography ◽  
Artery Disease ◽  
The Relationship ◽  
Asymptomatic Women ◽  
Cad Risk

Background: The relationship between breast artery calcification (BAC) noted on mammography and both coronary artery disease and cardiovascular risk remains controversial. Few studies have examined the clinical significance of BAC in asymptomatic women. In the present study we evaluated the relationship between BAC and coronary artery calcium (CAC) as identified by multi-slice CT scanning (MSCT). Patients and methods: Consecutive women (n = 98) with BAC noted on routine mammography but without known coronary artery disease (CAD) were assessed for CAD risk factors and had assessment of coronary calcium by MSCT. A control cohort of consecutive women who were BAC(-) (n = 104) underwent an identical assessment. Results: Women who were BAC(+) were older than those who were BAC(-); otherwise, there were no differences between the 2 groups with regard to traditional cardiac risk factors. Significantly more BAC(+) vs. BAC(-) women were found to have “high risk” CAC scores, defined as CAC > 400 (11.2 % vs. 1.0 %, p = 0.006). However, the rates of CAC scores of 0 were not different between the two groups (50.0 % vs. 54.8 % for BAC(+) and BAC(-) , respectively, p = 0.586). When examined in a multivariate model including the traditional risk factors of diabetes, increasing age, smoking, hyperlipidemia, and family history of CAD, the presence of BAC remained significantly associated with CAC > 400 (OR = 22.6, 95 % CI = 2.1 - 237.1). Conclusions: The presence of breast artery calcium on screening mammography was a strong independent predictor (odds ratio > 22) of high risk coronary artery calcium scores (defined as CAC > 400). The presence of BAC in those with significant CAD risk factors may warrant further evaluation.

scholarly journals Screening for Premature Coronary Artery Disease (CAD) using Coronary Artery Calcium (CAC) Score: A Primary Prevention Pilot Study

2021 ◽  
Vol 16 (1) ◽  
pp. 134-149
Author(s):  
Hamat Hamdi Che Hassan ◽  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Primary Prevention ◽  
Coronary Artery Calcium ◽  
Overweight And Obesity ◽  
Premature Coronary Artery Disease ◽  
History Of ◽  
Artery Disease

Acute Coronary Syndrome (ACS) events can be accelerated by positive family history of young coronary artery disease (CAD). Risk factors assessment sometimes fail to predict ACS occurrence. Additional investigations with coronary artery calcium (CAC) score can be used independently in screening for primary prevention in some population. This was a cross-sectional study in asymptomatic population with first degree relatives (FDR) having premature CAD compared with a matched population with no family history of CAD from September 2017 to March 2018 at the Cardiology Clinic of Univeristi Kebangsaan Malaysia Medical Centre. A total of 36 subjects were recruited with equal number in each group. Female were the majority in each group (66.7%). The FDR group were slightly younger compared to the control group [mean (SD) age 36.9 (4.9) against 38 (3.8), respectively). Both groups represent high risk factors including overweight and obesity, abdominal obesity as well as dyslipidemia. Newly diagnosed dyslipidemia was significant in the group with family history (83.3% versus 44.4%, P<0.01). Both groups were screened either into the low or moderate risk Framingham Risk Score group. CAC score was higher in family history group (11.1% vs 0%, P>0.05). In conclusion, CAC may be irrelevant for screening in younger population. However, the yield of other risk factor is still alarming.

Subclinical coronary artery disease in veteran athletes: is a new preparticipation methodology required?

2018 ◽  
pp. bjsports-2018-099840 ◽  
Author(s):  
Hélder Dores ◽  
Pedro de Araújo Gonçalves ◽  
José Monge ◽  
Rogério Costa ◽  
Luis Tátá ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Exercise Testing ◽  
Myocardial Ischaemia ◽  
Cardiac Ct ◽  
Exercise Tests ◽  
Atherosclerotic Burden ◽  
Artery Disease

ObjectivePreparticipation evaluation of veteran athletes should focus on accurate cardiovascular (CV) risk stratification and subclinical detection of coronary artery disease (CAD), which is the main cause of sudden cardiac death in this population. We aimed to investigate the effectiveness of current preparticipation methodology used to identify veteran athletes with high coronary atherosclerotic burden.MethodsA total of 105 asymptomatic male athletes aged ≥40 years old, with low to moderate CV risk (Systematic Coronary Risk Estimation <5%) who trained ≥4 hours/week for at least 5 years, were studied. The screening protocol included clinical evaluation, ECG, transthoracic echocardiogram and exercise testing. Cardiac CT was performed to detect CAD, defined as a high atherosclerotic burden according to coronary artery calcium score and coronary CT angiography.ResultsThe majority of the athletes (n=88) engaged in endurance sports, with a median volume of exercise of 66 (44; 103) metabolic equivalent task score/hour/week. Exercise testing was abnormal in 13 (12.4%) athletes, 6 (5.7%) with electrocardiographic criteria for myocardial ischaemia and 7 (6.7%) with exercise-induced ventricular arrhythmias. A high coronary atherosclerotic burden was present in 27 (25.7%) athletes, of whom 11 (40.7%) had CV risk factors and 6 had abnormal exercise tests, including 3 who were positive for myocardial ischaemia.ConclusionsConventional methodology used in preparticipation evaluation of veteran athletes, based on clinical CV risk factors and exercise testing, was poor at identifying significant subclinical CAD. The inclusion of more objective markers, particularly data derived from cardiac CT, is promising for more accurate CV risk stratification of these athletes.

scholarly journals Prognostic value of coronary vascular dysfunction assessed by rubidium-82 PET/CT imaging in patients with resistant hypertension without overt coronary artery disease

2021 ◽  
Author(s):  
Valeria Gaudieri ◽  
Teresa Mannarino ◽  
Emilia Zampella ◽  
Roberta Assante ◽  
Adriana D’Antonio ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Risk Stratification ◽  
Vascular Function ◽  
Vascular Dysfunction ◽  
Left Ventricular ◽  
Pet Ct ◽  
Artery Disease ◽  
Rubidium 82

Abstract Purpose The identification of coronary vascular dysfunction may enhance risk stratification in patients with resistant hypertension (RH). We evaluated if impaired coronary vascular function, assessed by rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) imaging, is associated with increased cardiovascular risk in patients with hypertension without overt coronary artery disease (CAD). Methods We studied 517 hypertensive subjects, 26% with RH, without overt CAD, and with normal stress-rest myocardial perfusion imaging at 82Rb PET/CT. The outcome end points were cardiac death, nonfatal myocardial infarction, coronary revascularization, and admission for heart failure. Results Over a median of 38 months (interquartile range 26 to 50), 21 cardiac events (4.1% cumulative event rate) occurred. Patients with RH were older (p < 0.05) and had a higher prevalence of left ventricular hypertrophy (p < 0.001), a lower hyperemic myocardial blood flow (MBF), and myocardial perfusion reserve (MPR) (both p < 0.001) compared to those without. Conversely, coronary artery calcium content and baseline MBF were not different between patients with and without RH. At univariable Cox regression analysis, age, RH, left ventricular ejection fraction, coronary artery calcium score, and reduced MPR were significant predictors of events. At multivariable analysis, age, RH, and reduced MPR (all p < 0.05) were independent predictors of events. Patients with RH and reduced MPR had the highest risk of events and the major risk acceleration over time. Conclusion The findings suggest that the assessment of coronary vascular function may enhance risk stratification in patients with hypertension.

scholarly journals Distribution of Risk Factors in Patients with Acute Coronary Syndrome – a Hospital Based Study

2003 ◽  
Vol 42 (148) ◽  
Author(s):  
Man B KC ◽  
S Rajbhandari ◽  
D Sharma ◽  
R Malla ◽  
YR Limbu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Disease Risk ◽  
Positive Family History ◽  
Modifiable Risk Factors ◽  
Coronary Syndrome ◽  
Strong Trend ◽  
Artery Disease

A total of 230 patients admitted in coronary care unit of Shahid Gangalal National Heart Centre in betweenNovember 2001 and October 2002 were studied. 157 (68.2%) were male, with mean age of 62.8±11.8 years.Majority of acute coronary syndrome (ACS) events were observed in males with advanced age (> 65 years).About 68% patients with ACS were smoker, the most common modifiable risk factor followed by hypertension,dyslipidaemia and diabetes. A strong trend towards development of coronary artery disease (CAD) wasfound in subjects with positive family history of CAD. Multiple risk factors (2 or more) were present in vastmajority of patients. Modifiable risk factors, with smoking at number one position are more common inacute coronary syndrome patients. Appropriate management of modifiable risk factors is advisable to reducethe incidence of coronary artery disease.Key Words: Coronary Artery Disease, Risk Factors.

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