Abstract 195: Peripheral Blood S100A8 and S100A12 Gene Expression Correlate with Coronary Calcium Score and Percent Diameter Stenosis in Patients by CT-Angiography

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
James A Wingrove ◽  
Michael R Elashoff ◽  
Szilard Voros ◽  
Gregory S Thomas ◽  
Steven Rosenberg
Keyword(s):  
Gene Expression ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Peripheral Blood ◽  
Calcium Score ◽  
Maximum Diameter ◽  
Agatston Score ◽  
Individual Gene ◽  
Highly Correlated ◽  
Whole Heart

Background— Coronary artery disease (CAD) can vary by coronary artery calcification (CAC) and extent of stenosis. A previously described peripheral blood 23-gene expression score (GES) was validated for discrimination of obstructive CAD and shown to correlate with maximum % diameter stenosis (%DS), however, its relation to CAC has not been analyzed in detail. S100A12, a component of the score, has been correlated with calcification in a transgenic mouse model. Methods— A total of 398 patients from the COMPASS trial ( NCT01117506 ) had both core-lab analyzed CT-angiography (CTA) and GES. CAC was determined as whole-heart Agatston score and per-patient maximum %DS by CTA. GES was measured by RT-PCR according to Corus CAD protocols (CardioDx, Palo Alto, CA). Individual gene expression levels were analyzed for significance relative to CAC and %DS by age and sex-adjusted logistic regression. Results— Patients were 50% male; 50/398 had obstructive CAD (≥50% stenosis by core-lab CTA). Both CAC and %DS were highly correlated with overall GES (p< 10-16). Genes significantly associated with %DS were expressed predominantly in either lymphocyte or myeloid cells (circles and squares in figure respectively, bottom quadrants) whereas no lymphocyte genes and a larger set of myeloid-specific genes were associated with CAC (squares in figure, left quadrants); S100A8 and S100A12 showed the strongest associations with CAC (p = 0.006). Conclusion— Gene expression significance for %DS appears to reflect increased neutrophil to lymphocyte ratio whereas neutrophil gene up-regulation appears correlated with CAC, the strongest association being seen with S100A8 and S100A12.

scholarly journals Calcium scoring: a personalized probability assessment predicts the need for additional or alternative testing to coronary CT angiography

2020 ◽  
Vol 30 (10) ◽  
pp. 5499-5506
Author(s):  
Judit Simon ◽  
Lili Száraz ◽  
Bálint Szilveszter ◽  
Alexisz Panajotu ◽  
Ádám Jermendy ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Coronary Ct Angiography ◽  
Calcium Score ◽  
Final Decision ◽  
Operating Characteristics ◽  
Coronary Cta ◽  
Coronary Ct ◽  
Cutoff Values

Abstract Objective To assess whether anthropometrics, clinical risk factors, and coronary artery calcium score (CACS) can predict the need of further testing after coronary CT angiography (CTA) due to non-diagnostic image quality and/or the presence of significant stenosis. Methods Consecutive patients who underwent coronary CTA due to suspected coronary artery disease (CAD) were included in our retrospective analysis. We used multivariate logistic regression and receiver operating characteristics analysis containing anthropometric factors: body mass index, heart rate, and rhythm irregularity (model 1); and parameters used for pre-test likelihood estimation: age, sex, and type of angina (model 2); and also added total calcium score (model 3) to predict downstream testing. Results We analyzed 4120 (45.7% female, 57.9 ± 12.1 years) patients. Model 3 significantly outperformed models 1 and 2 (area under the curve, 0.84 [95% CI 0.83–0.86] vs. 0.56 [95% CI 0.54–0.58] and 0.72 [95% CI 0.70–0.74], p < 0.001). For patients with sinus rhythm of 50 bpm, in case of non-specific angina, CACS above 435, 756, and 944; in atypical angina CACS above 381, 702, and 890; and in typical angina CACS above 316, 636, and 824 correspond to 50%, 80%, and 90% probability of further testing, respectively. However, higher heart rates and arrhythmias significantly decrease these cutoffs (p < 0.001). Conclusion CACS significantly increases the ability to identify patients in whom deferral from coronary CTA may be advised as CTA does not lead to a final decision regarding CAD management. Our results provide individualized cutoff values for given probabilities of the need of additional testing, which may facilitate personalized decision-making to perform or defer coronary CTA. Key Points • Anthropometric parameters on their own are insufficient predictors of downstream testing. Adding parameters of the Diamond and Forrester pre-test likelihood test significantly increases the power of prediction. • Total CACS is the most important independent predictor to identify patients in whom coronary CTA may not be recommended as CTA does not lead to a final decision regarding CAD management. • We determined specific CACS cutoff values based on the probability of downstream testing by angina-, arrhythmia-, and heart rate–based groups of patients to help individualize patient management.

scholarly journals P976 Can calcium score predict the appropriate treatment for high risk patients? (a 5 years follow up study)

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Stanciu ◽  
M Gurzun ◽  
S Dumitrescu ◽  
F Naftanaila ◽  
A Spanu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Bypass Graft ◽  
Calcium Score ◽  
Agatston Score ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

Abstract Coronary artery calcium score (CAC) measures the calcium contained in the artery wall and it is evaluated using multi-slice cardiac CT and CAC represents a useful tool for appreciating the burden of coronary atherosclerosis and for determining the risk for cardiovascular events. The purpose of this study is that CAC can be use for guiding treatment strategy in patients classified as high risk based on Framingham score . We prospectively enrolled 64 pts (79% male), 62,7+/-5 year, between 2002-2017. All included patients were considered high risk based on EuroSCORE model. A multislice heart CT scan was performed for every patient with CAC score determination quantified with the Agatston score and expressed as Agatston Units (AU). The patients were divided in 3 groups according to the treatment that they received during the 5 years follow up: optimal medical treatment for coronary artery disease (OMT) – 35.9% (23), percutaneous coronary angioplasty (PCA) – 29.7% (19) and coronary artery bypass graft (CABG) – 34.4%. The CAC score for pts treated by OMT vs CABG +/_ PCA were compared using the ROC curves. CAC score was statistically significantly superior in CABG+ PCA patients versus OMT (AUC: 0.96, p &lt; 0.001 vs AUC 0.42, p = 0.212). Also, a comparison of CAC score score for CABG vs OMT revealed the same results (AUC: 0.96, p&lt; 0.001 vs AUC: 0.42, p = 0.264). OMT vs CABG + PCA presented a cut-off value of 382 AU with a specificity of 90% and a sensitivity of 95%. OMT vs CABG presented a cut-off value of 530 AU with a specificity of 89% and a sensitivity of 95%. In conclusion, CAC score has a good predictability and sensitivity in determining the outcome and can be a promising tool to guide therapy in high risk patients, mainly regarding medical vs surgical treatment for coronary artery disease.

scholarly journals 128 Head-to-head Comparison of whole-heart coronary MR and 40/64 slice multidetector-CT angiography for detection of coronary artery stenosis

2008 ◽  
Vol 10 (Suppl 1) ◽  
pp. A29
Author(s):  
Anne-Catherine Pouleur ◽  
le Polain Jean-Benoit ◽  
Joelle Kefer ◽  
Céline Goffinet ◽  
Jean-Louis Vanoverschelde ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ct Angiography ◽  
Coronary Artery Stenosis ◽  
Multidetector Ct ◽  
Artery Stenosis ◽  
Whole Heart ◽  
Multidetector Ct Angiography

scholarly journals Sinogram-Affirmed Iterative Reconstruction Negatively Impacts the Risk Category Based on Agatston Score: A Study Combining Coronary Calcium Score Measurement and Coronary CT Angiography

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Wei Wang ◽  
Yan E. Zhao ◽  
Li Qi ◽  
Chang Sheng Zhou ◽  
Meng Jie Lu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Calcium Score ◽  
Coronary Calcification ◽  
Artery Stenosis ◽  
Agatston Score ◽  
Risk Category ◽  
Gradual Reduction ◽  
Coronary Ct ◽  
Risk Categories

Purpose. To assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on risk category for coronary artery disease by combining coronary calcium score measurement and coronary CT angiography (CCTA). Materials and Methods. Eighty-nine patients (64.0% male) older than 18 years (64.4±10.3 years) underwent coronary artery calcium scanning and prospectively ECG-triggered sequential CCTA examination. All raw data acquired in coronary artery calcium scanning were reconstructed by both filtered back projection (FBP) and SAFIRE algorithms with 5 different levels. Objective image quality and calcium quantification were evaluated and compared between FBP and all SAFIRE levels by the Sphericity Assumed test or Greenhouse-Geisser ε correction coefficient. Coronary artery stenosis was assessed in CCTA. Risk categories of all patients and of the patients with coronary artery stenosis in CCTA were compared between FBP and all SAFIRE levels by the Friedman test. Results. The reconstruction protocol from traditional FBP to SAFIRE 5 was associated with a gradual reduction in CT value and image noise (P<0.001) but associated with a gradual improvement in the signal-to-noise ratio (P<0.001). There was a gradual reduction in coronary calcification quantification (Agatston score: from 73.5 in FBP to 38.1 in SAFIRE 5, P<0.001) from traditional FBP to SAFIRE 5. There was a significant difference for the risk category between FBP and all levels of SAFIRE in all patients (from 3.5 in FBP to 3.2 in SAFIRE 5, P<0.001) and in the patients with coronary artery stenosis in CCTA (from 4.0 in FBP to 3.6 in SAFIRE 5, P<0.001). Conclusions. SAFIRE significantly reduces coronary calcification quantification compared to FBP, resulting in the reduction of risk categories based on the Agatston score. The risk categories of the patients with coronary artery stenosis in CCTA may also decline. Thus, SAFIRE may lead risk categories to underestimate the existence of significant coronary artery stenosis.

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