P3380Longitudinal assessment of coronary atherosclerosis according to baseline and changes of serum hemoglobin level

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K.-B Won ◽  
B K Lee ◽  
A Rizvi ◽  
M Hadamitzky ◽  
M J Budoff ◽  
...  
Keyword(s):  
Coronary Plaque ◽  
Computed Tomographic Angiography ◽  
Hemoglobin Level ◽  
Plaque Volume ◽  
Computed Tomographic ◽  
Group I ◽  
Tomographic Angiography ◽  
Coronary Plaque Volume ◽  
Baseline Hemoglobin

Abstract Introduction Little is known regarding the impact of serum hemoglobin level changes (Δ hemoglobin) on coronary plaque volume. This study evaluated the association between Δ hemoglobin and coronary plaque volume change (PVC) using serial coronary computed tomographic angiography (CCTA). Methods A total of 830 subjects (61±10 years, 51.9% male) who underwent serial CCTA with available hemoglobin levels were analyzed from the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging (PARADIGM) registry. The median inter-scan period was 3.2 (2.5 to 4.4) years. Quantitative assessment of coronary plaques was performed at both scans. All participants were stratified into four groups based on the quartile of baseline hemoglobin levels. Annualized PVC was defined as total PVC divided by inter-scan period. Plaque progression (PP) was defined as plaque volume at follow-up minus plaque volume at index >0. Results Baseline total plaque volume (mm3) was not different among all groups (group I [lowest]: 34.1 (0.0–127.4) vs. group II: 28.8 (0.0–123.0) vs. group III: 49.9 (5.6–135.0) vs. group IV [highest]: 34.3 (0.0–130.7); p=0.235). During follow-up, Δ hemoglobin was related to annualized PVC (β:−0.114; p=0.001) and PP (odds ratio: 0.868; 95% confidence interval: 0.770–0.978; p=0.020). Multiple linear regression models showed that Δ hemoglobin significantly impacted on annualized PVC in only the composite of I and II groups. Conclusion Based on serial CCTA findings, Δ hemoglobin independently impacted on coronary PVC in individuals with low to normal baseline hemoglobin level.

scholarly journals Changes in Coronary Plaque Volume: Comparison of Serial Measurements on Intravascular Ultrasound and Coronary Computed Tomographic Angiography

2018 ◽  
Vol 45 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Rine Nakanishi ◽  
Anas Alani ◽  
Suguru Matsumoto ◽  
Dong Li ◽  
Michael Fahmy ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intravascular Ultrasound ◽  
Coronary Plaque ◽  
Computed Tomographic Angiography ◽  
Plaque Volume ◽  
Coronary Computed Tomography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Serial Measurements ◽  
Coronary Plaque Volume

Serial measurements of coronary plaque volume have been used to evaluate drug efficacy in atherosclerotic progression. However, the usefulness of computed tomography for this purpose is unknown. We investigated whether the change in total plaque volume on coronary computed tomographic angiography is associated with the change in segment plaque volume on intravascular ultrasound. We prospectively enrolled 11 consecutive patients (mean age, 56.3 ± 5 yr; 6 men) who were to undergo serial invasive coronary angiographic examinations with use of grayscale intravascular ultrasound and coronary computed tomography, performed <180 days apart at baseline and from 1 to 2 years later. Subjects underwent 186 serial measurements of total plaque volume on coronary computed tomography and 22 of segmental plaque volume on intravascular ultrasound. We used semiautomated software to examine percentage relationships and changes between total plaque and segmental plaque volumes. No significant correlations were found between percentages of total coronary and segment coronary plaque volume, nor between normalized coronary plaque volume. However, in the per-patient analysis, there were strong correlations between the imaging methods for changes in total coronary and segment coronary plaque volume (r=0.62; P=0.04), as well as normalized plaque volume (r=0.82; P=0.002). Per-patient change in plaque volume on coronary computed tomography is significantly associated with that on intravascular ultrasound. Computed tomographic angiography may be safer and more widely available than intravascular ultrasound for evaluating atherosclerotic progression in coronary arteries. Larger studies are warranted.

scholarly journals Quantitative Evaluation of Coronary Plaque Progression by Computed Tomographic Angiography

2017 ◽  
Vol 44 (5) ◽  
pp. 312-319
Author(s):  
Xiujian Liu ◽  
Guanghui Wu ◽  
Chuangye Xu ◽  
Yuna He ◽  
Lixia Shu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Computed Tomographic Angiography ◽  
Plaque Burden ◽  
Plaque Volume ◽  
Computed Tomographic ◽  
Luminal Area ◽  
The Right ◽  
Tomographic Angiography

Understanding plaque formation in patients at risk for coronary artery disease—the leading cause of morbidity and death in the world—enables physicians to better determine whether and how to treat these individuals. We used computed tomographic angiography to quantitatively evaluate the progression of nonculprit coronary plaques along the full length of the right coronary artery in 21 patients with acute coronary syndrome. Each right coronary artery was analyzed in sequential, 3-mm-long segments, and the minimum luminal area, plaque burden, and plaque volume within each segment were evaluated at baseline and at 12-month follow-up. Serial remodeling of the right coronary artery was also evaluated. In total, 625 arterial segments were analyzed. At 12-month follow-up, the plaque burden had increased slightly by 0.34% (interquartile range [IQR], −4.32% to 6.35%; P=0.02), and the plaque volume was not significantly changed (0.33 mm3; IQR, −3.05 to 3.54; P=0.213). The minimum luminal area decreased 0.05 mm2 (IQR, −1.33 to 0.87 mm2; P=0.012), and this was accompanied by vessel reduction, as evidenced by negative remodeling in 43% of the 625 segments. We conclude that serial computed tomographic angiography can be used to quantitatively evaluate the morphologic progression of coronary plaques.

scholarly journals Imaging Follow-up after Carotid Artery Stenting with Carotid Wallstent Using Computed Tomographic Angiography

2017 ◽  
Vol 45 (1) ◽  
pp. 7-13
Author(s):  
Tatsufumi NOMURA ◽  
Daisuke SASAMORI ◽  
Tadashi NONAKA ◽  
Akira TAKAHASHI ◽  
Yasuyuki YONEMASU ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Carotid Wallstent

P6149Coronary computed tomographic angiography (CTA) for risk stratification in the diagnostic triage of patients undergoing liver transplantation (LT): A long-term outcome study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Strobl ◽  
T Senoner ◽  
A Finkenstedt ◽  
G Widmann ◽  
F Plank ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Calcium Score ◽  
Computed Tomographic Angiography ◽  
Plaque Burden ◽  
Computed Tomographic ◽  
All Cause Mortality ◽  
Stenosis Severity ◽  
Tomographic Angiography

Abstract Background Cardiovascular (CV) risk stratification in patients with end-stage liver disease (ESLD) prior to liver transplantation (LT) is crucial: CV-disease poses a major threat for posttransplant survival. Therefore, our purpose was to assess safety of coronary computed tomographic angiography (CTA) in patients prior to orthotopic LT over a long-term follow up period, and its value for CV risk stratification. Methods In this single center, retrospective observational study 458 patients underwent coronary calcium score (CCS) and coronary CTA for pre-LT risk stratification between 2005 and 2016. CTA was evaluated for 1) stenosis severity (CADRADS: 4-severe>70%/3-intermediate50–70%/2-mild<50%/1-minimal<25%/0=no CAD) 2) plaque burden (SIS, G-score), 3) high–risk plaque features (Napkin Ring Sign, low attenuation plaque, positive remodelling) and 4) Coronary Calcium Score. Primary endpoint was mortality (all-cause and cardiovascular), secondary endpoint major cardiovascular events (MACE). Results Finally 270 patients (79.3% males, age 61±8.5 years) who underwent orthotopic LT were included (mean follow-up 7.5 years±3.1, range 2–13). 87 (32.2%) had CCS zero and 60 (22.2%) CCS >300 Agatston Units (CCS 335.6 AU± 868.9). 248 patients underwent CTA after CCS. The majority had CAD (n=173, 72.3%) by CTA while only 75 (27.7%) had no CAD. 102 patients (38.8%) had minimal-or-mild stenosis<50% (CADRADS 1–2), 34 (12.9%) intermediate and 17 (6.5%) severe stenosis.Out of CCS 0 patients, 13 had non-calcified plaque. All-cause mortality rate was 46 (17.0%), with the majority of patients (43 (93.5%) experiencing non-cardiac death and 3 (6.5%) cardiovascular death due to 1 myocardial infarction and 2 cardiopulmonary failure. CADRADS predicted mortality (Kaplan Meir, p<0.001). On multivariate Cox Regression modell, SIS and G-score predicted all-cause mortality (HR 1.1:p=0.034; 95% CI: 0.649–0.983 and HR 1.1, p=0.029; 95% CI: 1.0–1.6), while Calcium Score did not. There were 6 MACE (3 STEMI, 3 NSTEMI). MACE rate was 0% in CADRADS 0 or 1, 1 in CADRADS-2 and increasing to 5 in CADRADS 3 and 4 groups. Coronary CTA for LT risk stratification Conclusion Cardiac CT is a reliable non-invasive modality for pre-LT assessment of CV-risk over a long-term period, with 0% MACE in patients with no CAD or minimal CAD. CTA allows for an improved CV-risk stratification by stenosis severity (CADRADS) and plaque burden as compared to calcium scoring.

scholarly journals Preliminary Pilot Study of Combined Effects of Physical Activity and Achievement of LDL-Cholesterol Target on Coronary Plaque Volume Changes in Patients with Acute Coronary Syndrome

2020 ◽  
Vol 9 (5) ◽  
pp. 1578
Author(s):  
Miho Nishitani-Yokoyama ◽  
Katsumi Miyauchi ◽  
Kazunori Shimada ◽  
Takayuki Yokoyama ◽  
Shohei Ouchi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Acute Coronary Syndrome ◽  
Combined Therapy ◽  
Study Groups ◽  
Coronary Plaque ◽  
Combined Effects ◽  
Plaque Volume ◽  
Coronary Syndrome ◽  
Coronary Plaque Volume

Background: We investigated the combined effects of physical activity (PA) and aggressive low-density lipoprotein cholesterol (LDL-C) reduction on the changes in coronary plaque volume (PV) in patients with acute coronary syndrome (ACS) using volumetric intravascular ultrasound (IVUS) analysis. Methods: We retrospectively analyzed data from two different prospective clinical trials that involved 101 ACS patients who underwent percutaneous coronary intervention (PCI) and assessed the non-culprit sites of PCI lesions using IVUS at baseline and at the follow-up. After PCI, all the patients participated in early phase II comprehensive cardiac rehabilitation. Patients were divided into four groups based on whether the average daily step count, measured using a pedometer, was 7000 steps of more and whether the follow-up LDL-C level was <70 mg/dL. At the time of follow-up, we examined the correlation of changes in the PV with LDL-C and PA. Results: The baseline characteristics of the four study groups were comparable. At the follow-up, plaque regression in both the achievement group (PA and LDL-C reduction) was higher than that in the other three groups. In addition, plaque reduction independently correlated with increased PA and reduction in LDL-C level. Conclusions: Combined therapy of intensive PA and achievement of LDL-C target retarded coronary PV in patients with ACS.

Quantified coronary total plaque volume from computed tomography angiography provides superior 10-year risk stratification

2020 ◽  
Author(s):  
Simon Deseive ◽  
Maximilian Kupke ◽  
Ramona Straub ◽  
Thomas J Stocker ◽  
Alexander Broersen ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Computed Tomographic Angiography ◽  
Study Endpoint ◽  
Plaque Volume ◽  
Coronary Cta ◽  
Computed Tomographic ◽  
Coronary Syndrome ◽  
Coronary Artery Disease Severity ◽  
Net Reclassification Improvement ◽  
Tomographic Angiography

Abstract Aims  Automated coronary total plaque volume (TPV) quantification derived from coronary computed tomographic angiography (CTA) datasets provide exact and reliable assessment of calcified and non-calcified coronary atherosclerosis burden. The aim of this analysis was to investigate the long-term predictive value of TPV. Methods and results  TPV was quantified in 1577 patients undergoing coronary CTA and cardiovascular events were collected during 10.5 years (interquartile range 6.0–11.4) of follow-up. The study endpoint comprised cardiac death and acute coronary syndrome and occurred in 59 (3.7%) patients. Coronary TPV provided additive prognostic value over clinical risk assessed with the Morise Score and coronary artery disease severity (rise in C-index from 0.744 to 0.769, P = 0.03). A category-based reclassification approach combining the Morise Score and TPV revealed superior risk stratification (categorical net reclassification improvement: 0.48 with 95% CI 0.13–0.68, P &lt; 0.001) and resulted in reclassification of 800 (51%) patients compared with the Morise Score alone. The 10-year risk for the study endpoint was 0.6% (95% CI 0–1.3) for patients classified as low risk (n = 807), 4.8% (95% CI 2.4–7.2) for patients at intermediate risk (n = 400), and 10.3% (95% CI 6.6–13.9) for patients at high risk (n = 370) using the combined reclassification approach. Conclusion  Quantification of TPV from coronary CTA permits an improved 10-year cardiovascular risk stratification.

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