Coronary artery disease in East and South Asians: differences observed on cardiac CT

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318929
Author(s):  
Alexander Chua ◽  
Daniel Adams ◽  
Damini Dey ◽  
Ron Blankstein ◽  
Timothy Fairbairn ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Ethnic Differences ◽  
Cardiac Ct ◽  
South Asians ◽  
Coronary Calcification ◽  
Calcified Plaque ◽  
Luminal Stenosis ◽  
Artery Disease

Epidemiological studies have observed East Asians (EAs) are significantly less likely to develop or die from coronary artery disease (CAD) compared with Caucasians. Conversely South Asians (SAs) develop CAD at higher rate and earlier age. Recently, a range of features derived from cardiac CT have been identified which may further characterise ethnic differences in CAD. Emerging data suggest EAs exhibit less coronary calcification and high-risk, non-calcified plaque compared with Caucasians on CT, with no difference in luminal stenosis. In contrast, SAs exhibit similar to higher coronary calcification and luminal stenosis, smaller luminal dimensions and more high-risk, non-calcified plaque than Caucasians. Beyond demonstrating ethnic differences in CAD, cardiac CT may enhance and individualise cardiovascular risk stratification in EAs and SAs. While data thus far in EAs have demonstrated calcium score and CT-derived luminal stenosis may incrementally predict cardiovascular risk beyond traditional risk scores, there remains a paucity of data assessing its use in SAs. Future studies may clarify the prognostic value of cardiac CT in SAs and investigate how this modality may guide preventative therapy and coronary intervention of CAD in EAs and SAs.

scholarly journals Medical Prior Knowledge Guided Automatic Detection of Coronary Arteries Calcified Plaque with Cardiac CT

Electronics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2122
Author(s):  
Mengxue Zhao ◽  
Xiangjiu Che ◽  
Hualuo Liu ◽  
Quanle Liu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Object Detection ◽  
Prior Knowledge ◽  
Coronary Arteries ◽  
Cardiac Ct ◽  
Medical Images ◽  
Calcified Plaque ◽  
Artery Disease ◽  
Plaque Detection

Calcified plaque in coronary arteries is one major cause and prediction of future coronary artery disease risk. Therefore, the detection of calcified plaque in coronary arteries is exceptionally significant in clinical for slowing coronary artery disease progression. At present, the Convolutional Neural Network (CNN) is exceedingly popular in natural images’ object detection field. Therefore, CNN in the object detection field of medical images also has a wide range of applications. However, many current calcified plaque detection methods in medical images are based on improving the CNN model algorithm, not on the characteristics of medical images. In response, we propose an automatic calcified plaque detection method in non-contrast-enhanced cardiac CT by adding medical prior knowledge. The training data merging with medical prior knowledge through data augmentation makes the object detection algorithm achieve a better detection result. In terms of algorithm, we employ a deep learning tool knows as Faster R-CNN in our method for locating calcified plaque in coronary arteries. To reduce the generation of redundant anchor boxes, Region Proposal Networks is replaced with guided anchoring. Experimental results show that the proposed method achieved a decent detection performance.

Coronary Calcium Risk Score and Cardiovascular Risk

2020 ◽  
Vol 19 (3) ◽  
pp. 280-284 ◽  
Author(s):  
Angelica Lehker ◽  
Debabrata Mukherjee
Keyword(s):  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Prospective Study ◽  
Coronary Calcification ◽  
Incremental Value ◽  
Artery Disease ◽  
A Prospective Study

: The association between the presence of coronary artery calcium (CAC) and the risk of coronary artery disease (CAD) has been appreciated for decades. In this review, we critically appraise the role of CAC based on computerized tomography in contemporary risk stratification. Available evidence suggests that the measurement of CAC is a useful modality in many patients for more precise risk stratification and prognostic determination. Whether newer CAC score incorporating extra coronary calcification will add incremental value, especially for stroke and other non-coronary vascular outcomes, needs a prospective study.

Study on Vitamin D deficiency in patients of diabetes mellitus presenting with Acute Coronary syndrome in a tertiary care hospital in South India

2020 ◽  
Vol 11 (5) ◽  
pp. 49-53
Author(s):  
Archana Bhat ◽  
Arunachalam Ramachandran ◽  
Pradeep Periera ◽  
Akshatha Rao Aroor
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Vitamin D Deficiency ◽  
Coronary Syndrome ◽  
Vitamin D Levels ◽  
Luminal Stenosis ◽  
Artery Disease

Background: Vitamin D, a fat-soluble vitamin has its receptor present in myriad of tissues and it modulates multiple cellular processes. Vitamin D deficiency is reported to be associated with coronary artery disease. Cardiovascular disease is the leading cause of mortality worldwide. Aims and Objective: The primary outcome was to investigate if there is a correlation of 25-OH levels with the percentage of luminal stenosis, as measured with coronary angiogram. The secondary outcome was to determine the differences in angiographically proven luminal stenosis across categories of 25-OH vitamin D levels. Materials and Methods: Thirty patients with acute coronary syndrome with diabetes mellitus were included in this cross-sectional descriptive study. All patients were tested for fasting vitamin D levels, fasting blood sugar, HbA1C and serum creatinine. Detailed history of the patients was recorded. Data was analyzed by the statistical software SPSS version 19 and p value <0.05 was considered significant. Statistical tests like Chi- square, independent t test and log regression was used. Results: In this study 30 patients undergoing coronary angiography for acute coronary syndrome, Vitamin D levels showed severe deficiency in 6.7% (2) cases while mild deficiency was seen in 50% of the cases. Patients with single vessel disease on the coronary angiogram had lower mean HbA1C (9.18) levels in our study. Patients with triple vessel disease had poorly controlled mean HbA1C levels (10.42). Conclusion: In this study we did not find any significant difference between the serum Vitamin D deficiency levels with patients with angiographic severity of the coronary artery disease. Patients with poorly controlled diabetes mellitus had more severe angiographic proven coronary artery disease.

scholarly journals The Relationship Between Coronary Calcification and the Natural History of Coronary Artery Disease

2020 ◽  
Author(s):  
Han-Young Jin ◽  
Jonathan R. Weir-McCall ◽  
Jonathon A. Leipsic ◽  
Jang-Won Son ◽  
Stephanie L. Sellers ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Natural History ◽  
Coronary Calcification ◽  
History Of ◽  
Artery Disease ◽  
The Relationship

scholarly journals Diagnostic and prognostic value of coronary artery calcium score of zero: is it time for guidelines to change?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Arbas Redondo ◽  
D Tebar Marquez ◽  
I.D Poveda Pinedo ◽  
R Dalmau Gonzalez-Gallarza ◽  
S.C Valbuena Lopez ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Invasive Coronary Angiography ◽  
Agatston Score ◽  
Non Invasive ◽  
Artery Disease

Abstract Introduction Cardiac computed tomography (CT) use has progressively increased as the preferred initial test to rule out coronary artery disease (CAD) when clinical likelihood is low. Coronary artery calcium (CAC) detected by CT is a well-established marker for cardiovascular risk. However, it is not recommended for diagnosis of obstructive CAD. Absence of CAC, defined as an Agatston score of zero, has been associated to good prognosis despite underestimation of non-calcified plaques. Purpose To evaluate whether zero CAC score could help ruling out obstructive CAD in a safely manner. Methods Observational study based on a prospective database of patients (pts) referred to cardiac CT between 2017 and 2019. Pts with an Agatston score of zero were selected. Results We included 176 pts with zero CAC score and non-invasive coronary angiography performed. The median duration of follow-up was 23.9 months. Baseline characteristics of the population are shown in Table 1. In 117 pts (66.5%), cardiac CT was indicated as part of their chest pain evaluation. Mean age was 57.2 years old, 68.2% were women and only and 9.4% were active smokers. Normal coronary arteries were found in 173 pts (98.3%). Obstructive CAD, defined as ≥50% luminal diameter stenosis of a major vessel, was present in 1/176 (0.6%); while non-obstructive atherosclerotic plaques were found in 2 pts (1.1%). During follow-up, one patient died of out-of-hospital cardiac arrest. None either suffered from myocardial infarction or needed coronary revascularization. Conclusions In our cohort, a zero CAC score detected by cardiac CT rules out obstructive coronary artery disease in 98.3%, with only 1.7% of non-calcified atherosclerosis plaques and 0.6% of major adverse events. Although further research on this topic is needed, these results support the fact that non-invasive coronary angiography could be avoided in patients with low clinical likelihood of CAD and zero CAC score, facilitating the management of the increasing demand for coronary CT and reduction of radiation dose. Funding Acknowledgement Type of funding source: None

Association between the risk of coronary artery disease in South Asians and a deletion polymorphism in glutathioneS-transferase M1

Biomarkers ◽  
2003 ◽  
Vol 8 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Michael H. Wilson ◽  
Peter J. Grant ◽  
Kirti Kain ◽  
Darren P. Warner ◽  
Christopher P. wild
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
South Asians ◽  
Deletion Polymorphism ◽  
Artery Disease
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