scholarly journals Prognostic value of coronary artery calcium score in hospitalized COVID-19 patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Motoc ◽  
M L Luchian ◽  
S Lochy ◽  
D Belsack ◽  
J Magne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Predictive Value ◽  
Cardiovascular Events ◽  
Hospital Treatment ◽  
Major Adverse Cardiovascular Events ◽  
Imaging Data ◽  
Coronary Syndrome

Abstract Background The association between known cardiovascular risk factors and poor prognosis of patients diagnosed with coronavirus disease 2019 (COVID-19) has been recently emphasized (1). Coronary artery calcium (CAC) score assessed by computed tomography (CT) is considered a risk modifier in primary prevention of cardiovascular disease and has shown to improve cardiovascular risk prediction in addition to classical risk factors (2). Purpose We hypothesized that the absence of CAC might have an additional predictive value for an improved cardiovascular outcome of hospitalized COVID-19 patients. Methods We prospectively included 310 consecutive hospitalized patients with COVID-19. Thirty patients with a history of coronary artery disease were excluded.Low dose non-contrast chest CT was performed in all patients at admission. Visual assessment of CAC in every coronary artery was obtained by using an ordinal scoring of 0, 1, 2 or 3 corresponding to absent, mild, moderate or severe CAC score. A total score was calculated by summing the score of each vessel, which was further categorized as 0 (undetectable), 1–3 (mild), 4–5 (moderate) and ≥6 (severe). (Figure 1). Demographics, medical history, clinical characteristics, laboratory findings, imaging data, in–hospital treatment and outcomes were retrospectively analyzed. A composite endpoint of major adverse cardiovascular events (MACE) was defined as all-cause mortality and cardiovascular events (heart failure, myocarditis, arrhythmia, acute coronary syndrome, stroke, pulmonary embolism). Results Two-hundred eighty patients (63.2±16.7 years old, 57.5% male) were included in the analysis. One hundred thirty one (46.7%) patients had a CAC score of zero. MACE-rate was 24.2% (68 patients). Multivariate logistic regression showed that the absence of CAC was inversely associated with MACE (OR 0.264, 95% 0.071–0.981, p=0.047), with a negative predictive value (NPV) of 81.4%, sensitivity 70%, specificity 55%, independent of age, risk factors or disease severity (Table 1). Conclusion The absence of CAC translated into a low risk for MACE in COVID-19 patients, even in the presence of cardiac risk factors, which reinforces the idea that the assessment of CAC score in COVID-19 patients could be a useful marker for patients risk stratification and management. Future directions should focus on the implementation of CAC score into mid-term and long-term follow-up of this particular population, to provide a more precise and earlier estimation of cardiovascular risk FUNDunding Acknowledgement Type of funding sources: None. Figure 1 Table 1

scholarly journals Prognostic Value of Coronary Artery Calcium Score in Hospitalized COVID-19 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Maria-Luiza Luchian ◽  
Stijn Lochy ◽  
Andreea Motoc ◽  
Dries Belsack ◽  
Julien Magne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Negative Predictive Value ◽  
Coronary Artery Calcium ◽  
Predictive Value ◽  
Qualitative Assessment ◽  
Hospital Treatment ◽  
Major Adverse Cardiovascular Events ◽  
Imaging Data ◽  
Laboratory Findings

Background: The association of known cardiovascular risk factors with poor prognosis of coronavirus disease 2019 (COVID-19) has been recently emphasized. Coronary artery calcium (CAC) score is considered a risk modifier in the primary prevention of cardiovascular disease. We hypothesized that the absence of CAC might have an additional predictive value for an improved cardiovascular outcome of hospitalized COVID-19 patients.Materials and methods: We prospectively included 310 consecutive hospitalized patients with COVID-19. Thirty patients with history of coronary artery disease were excluded. Chest computed tomography (CT) was performed in all patients. Demographics, medical history, clinical characteristics, laboratory findings, imaging data, in-hospital treatment, and outcomes were retrospectively analyzed. A composite endpoint of major adverse cardiovascular events (MACE) was defined.Results: Two hundred eighty patients (63.2 ± 16.7 years old, 57.5% male) were included in the analysis. 46.7% patients had a CAC score of 0. MACE rate was 21.8% (61 patients). The absence of CAC was inversely associated with MACE (OR 0.209, 95% CI 0.052–0.833, p = 0.027), with a negative predictive value of 84.5%.Conclusion: The absence of CAC had a high negative predictive value for MACE in patients hospitalized with COVID-19, even in the presence of cardiac risk factors. A semi-qualitative assessment of CAC is a simple, reproducible, and non-invasive measure that may be useful to identify COVID-19 patients at a low risk for developing cardiovascular complications.

Abstract 14240: Thoracic Aortic Calcium for the Prediction of Stroke Mortality: The Coronary Artery Calcium Consortium

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Olufunmilayo H Obisesan ◽  
Albert D Osei ◽  
Daniel Berman ◽  
Zeina Dardari ◽  
S M Iftekhar Uddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Predictive Value ◽  
Prediction Models ◽  
Prior History ◽  
Stroke Mortality ◽  
History Of ◽  
Traditional Risk Factors

Introduction: Thoracic aortic calcium(TAC) is an important marker of extra-coronary atherosclerosis with known predictive value for all-cause mortality. We sought to explore the predictive value of TAC for stroke mortality, independent of the more established coronary artery calcium score. Methods: The Coronary Artery Calcium(CAC) Consortium is a retrospectively assembled database of 66,636 patients aged ≥18 years with no prior history of cardiovascular disease, who had CAC scans done for risk stratification and were followed-up for an average of 12±4years. CAC scans capture a view of the adjacent thoracic aorta, enabling us to assess TAC at no extra cost. TAC was analyzed as present or not present and we restricted analysis to those with this information available. To account for competing risks for death from other causes, we utilized multivariable-adjusted competing risk regression models adjusted for traditional cardiovascular risk factors (age, sex, hypertension, hyperlipidemia, cigarette smoking, diabetes, family history of CHD) and CAC score. We report the relationship between TAC and stroke mortality using sub-distribution hazard ratios(SHR) with 95% CI. Results: There were 41,066 patients with information on TAC, 110 of whom had stroke mortality. The mean age of participants was 53.8±10.3 years, with 34.4% female. The unadjusted SHR for stroke mortality among those who had TAC compared to those who did not was 8.80(95%CI:5.97,12.98). After adjusting for traditional risk factors and CAC score, the SHR was 2.21(95%CI:1.39,3.49). The fully adjusted SHR for females was 3.42(95%CI:1.74,6.73) while for males it was 1.55(95%CI:0.83,2.90). Conclusion: TAC was predictive of stroke mortality independent of traditional risk factors and CAC, more so in females. The presence of TAC appears to be an independent marker of stroke mortality risk though further research is needed to study its incremental value over existing cardiovascular risk prediction models.

scholarly journals Risk factors for major adverse cardiovascular events after the first acute coronary syndrome

2021 ◽  
Vol 53 (1) ◽  
pp. 817-823
Author(s):  
Marjo Okkonen ◽  
Aki S. Havulinna ◽  
Olavi Ukkola ◽  
Heikki Huikuri ◽  
Arto Pietilä ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Syndrome

scholarly journals Effect of Naltrexone-Bupropion on Major Adverse Cardiovascular Events in Overweight and Obese Patients With Cardiovascular Risk Factors

JAMA ◽  
2016 ◽  
Vol 315 (10) ◽  
pp. 990 ◽  
Author(s):  
Steven E. Nissen ◽  
Kathy E. Wolski ◽  
Lisa Prcela ◽  
Thomas Wadden ◽  
John B. Buse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Obese Patients

scholarly journals Surviving a Decade or More After Coronary Revascularization in a Middle Eastern Population: The Impact of Diabetes Mellitus.

2021 ◽  
Author(s):  
Imad A Alhaddad ◽  
Ramzi Tabbalat ◽  
Yousef Khader ◽  
Zaid Elkarmi ◽  
Zaid Dahabreh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Coronary Revascularization ◽  
Middle Eastern ◽  
Index Procedure ◽  
Repeat Revascularization ◽  
Study Population

Abstract Introduction and aimsThere is scarcity of studies that evaluate cardiovascular events and repeat revascularization among Middle Eastern patients who have long-term survival after coronary artery revascularization. In this study, patients who survived at least 10 years after percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) were assessed for the evolution of cardiovascular risk factors, occurrence of acute cardiovascular events and the need for further coronary revascularization procedures after the index coronary revascularization. Patients were classified according to the presence or absence of diabetes mellitus (DM) at baseline. MethodsThe study enrolled consecutive ambulatory or in-patients who had PCI or CABG at least 10 years prior to enrollment. Collected data included cardiovascular risk factors at the time of the index revascularization and evolution of risk factors since then, occurrence of cardiovascular events and the need for coronary revascularization after the index procedure. Events were compared between patients with DM and no DM at baseline. ResultsThe study population consisted of 891 consecutive patients with 351 patients (39.4%) had DM and 540 patients (60.6%) had no DM. Of all patients, 123 (13.8%) were females with the DM group had more females compared to no DM group (19.7 vs 10%, p <0.001). Mean age of the study population at baseline was 53.9 + 8.8 years for DM patients and 53.0 + 9.8 years for no DM patients (p=0.16). At baseline, the DM group had more hypertension (70.9% vs 27.6%, p<0.0001), more dyslipidemias (12% vs 5.2%, p=0.001) but less smokers compared to no DM group (44.4% vs 58.3%, p<0.001). DM and no DM groups had similar proportion of PCI (65.5% vs 68.3%, p=0.42) and CABG at baseline (34.5% vs 31.7%, p=0.43).The mean time elapsed since the index coronary revascularization was 13.5 + 3.5 years for DM patients and 14.4 + 4.8 years for no DM (p=0.02). Following the index revascularization procedure, ACS events occurred in 40.7% of diabetic patients and in 41.6% in no DM patients (p=0.82). Heart failure and stroke developed in similar proportions in the DM and no DM groups (12.5% vs 13.3%, p=0.51) and (4.6% vs 5.9%, p=0.75) respectively. Repeat revascularization after the index procedure showed that DM group had more PCI compared to no DM group (52.7% vs 45.4%, p= 0.04) but proportions of CABG (7.1% vs 9.8%, p=0.20). ConclusionsIn this retrospective observation of Middle Eastern patients who survived at least a decade after coronary revascularization, DM group had more hypertension and dyslipidemias but less smokers compared to no DM at baseline. During follow up, DM group required more PCI revascularization compared with no DM group.

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