Abstract P373: Higher Plaque Volume but Not Density of Coronary Artery Calcium is Associated With Left Ventricular Mass

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Nketi I Forbang ◽  
Erin Michos ◽  
Matthew Allison ◽  
Isac Thomas ◽  
Robyn McClelland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Coronary Artery ◽  
Left Ventricular Mass ◽  
Coronary Artery Calcium ◽  
Left Ventricular ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Ventricular Mass ◽  
Unit Increase

Coronary artery calcium (CAC) predicts future cardiovascular disease (CVD) events, including heart failure (HF), improves risk stratification beyond traditional CVD risk factors, and is associated with a higher left ventricular mass (LVM), a HF risk factor. Recent findings from the MESA have shown that for a given CAC volume, higher CAC density was inversely associated with incident CVD. It remains uncertain whether CAC volume and density associate differently with LVM. In a multi-ethnic cohort of community dwelling individuals free from clinical CVD at recruitment, we determined the independent cross-sectional associations of baseline CAC volume and density, measured by non-contrast cardiac CT, with LVM, measured by MRI. In 2432 participants with prevalent CAC (density can only be assessed in those with CAC > 0), the mean age was 66 ± 10 years, 59% were men, 50% were European-, 22% were African-, 20% were Hispanic-, and 13% were Chinese-Americans. Median (25-75 th ) CAC volume was 78 (23-259) mm 3 , mean CAC density was 2.7 ± 0.7, and mean LVM was 151 ± 41 grams. CAC density and natural log ( ln ) CAC volume were correlated (correlation coefficient=0.60, P-value < 0.01). Multivariable linear regression models investigated associations of ln (CAC volume) and CAC density with LVM. Model 1 adjusted for demographics (age, sex, and ethnicity) and body surface area. Model 2 included Model 1 plus CVD risk factors (smoking status, fasting glucose, total and HDL cholesterol, systolic blood pressure, and use of medications for hypertension, diabetes, and abnormal lipids). In fully adjusted models one log unit increase in CAC volume as associated with 1.7 gram increase in LVM (Beta = 1.7, 95% CI: 0.7 to 2.6, P < 0.01). In contrast, a unit increase in CAC density was associated with 1.9 gram decrease in LVM (Beta = -1.9, 95% CI: -3.9 to 0.1, P = 0.07). Higher CAC volume, but not CAC density, was cross-sectionally associated with higher LVM; a risk factor for HF. Higher calcium density of coronary artery plaques may not be a hazard for ischemic heart disease mediated increase in LVM. Future studies should determine independent associations of CAC volume and density with incident HF.

scholarly journals Cardiovascular Risk Factors Impact on the Severity of Coronary Artery Disease among Acute ST-Elevation Myocardial Infarction Patients in the United Arab Emirates

2021 ◽  
pp. 1-9
Author(s):  
Vijay Chander Vinod ◽  
Vijay Chander Vinod ◽  
Zuhair Eltayeb Yousif
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Coronary Artery ◽  
Multivessel Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Vessel Disease ◽  
St Elevation ◽  
Artery Disease ◽  
The Impact

Objective: To define the impact of the cardiovascular risk factors on the extent of Coronary Artery Disease in STEMI patients and to identify the common prevalent risk factors that are unrecognized or poorly treated resulting in STEMI among the UAE population. Methods: Retrospective cohort on patients presented to Mediclinic City Hospital from 2011-2016 who underwent Primary Percutaneous Coronary Intervention (PCI) for confirmed ST-Elevation Myocardial Infarction (STEMI). Results: Of the total 104 STEMI patients, 91% were males. Mean (+SD) of 53 (+12.5) years of age. 73% were less than 60 years old. The most prevalent risk factor was hypertension (42%). 38% of diabetics had an HbA1C of >7%. 14% of the dyslipidemic had above target lipid levels in spite of Statin. 100% of the study population had at least 1 risk factor, ≥2 risk factors (97%), ≥3 risk factors (82%). 50% had 1 or more incidental risk factors diagnosed after admission. Dyslipidemia (36%) was the commonest incidental risk factor. The total risk factor counts increased significantly when the incidental or poorly treated risk factors were added to the initial risk factors on admission. Anterior Wall STEMI (38%) was the commonest. Left Anterior Descending Coronary Artery (48%) was the commonest culprit vessel. The majority had Triple Vessel Disease (37%). 37% developed in-hospital complications. Multivessel disease patients had more risk factors than in single-vessel disease but the association between the number of risk factors and disease severity was not statistically significant. The odds of multivessel disease increased with cumulative risk factor categories, but there was no significant trend association. Conclusion: Our study attempted to determine the impact of CVD risk factors on the severity of CAD among STEMI patients who underwent primary PCI. Contrary to other studies, there was no statistical difference noted in the prevalence of CVD risk factors between the single-vessel and multivessel disease. The study did prove that the incidental or under-diagnosed or inadequately treated risk factors had an impact on the severity of CAD. The study stress that every single CVD risk factor should be treated with equal importance. Statistically significant associations need to be confirmed in future studies with a larger number of patients.

scholarly journals Association of cardiovascular disease risk factors with coronary artery calcium volume versus density

Heart ◽  
2017 ◽  
Vol 104 (2) ◽  
pp. 135-143 ◽  
Author(s):  
Isac C Thomas ◽  
Brandon Shiau ◽  
Julie O Denenberg ◽  
Robyn L McClelland ◽  
Philip Greenland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Density Score ◽  
Volume Score

ObjectivesRecently, the density score of coronary artery calcium (CAC) has been shown to be associated with a lower risk of cardiovascular disease (CVD) events at any level of CAC volume. Whether risk factors for CAC volume and CAC density are similar or distinct is unknown. We sought to evaluate the associations of CVD risk factors with CAC volume and CAC density scores.MethodsBaseline measurements from 6814 participants free of clinical CVD were collected for the Multi-Ethnic Study of Atherosclerosis. Participants with detectable CAC (n=3398) were evaluated for this study. Multivariable linear regression models were used to evaluate independent associations of CVD risk factors with CAC volume and CAC density scores.ResultsWhereas most CVD risk factors were associated with higher CAC volume scores, many risk factors were associated with lower CAC density scores. For example, diabetes was associated with a higher natural logarithm (ln) transformed CAC volume score (standardised β=0.44 (95% CI 0.31 to 0.58) ln-units) but a lower CAC density score (β=−0.07 (−0.12 to −0.02) density units). Chinese, African-American and Hispanic race/ethnicity were each associated with lower ln CAC volume scores (β=−0.62 (−0.83to −0.41), −0.52 (−0.64 to −0.39) and −0.40 (−0.55 to −0.26) ln-units, respectively) and higher CAC density scores (β= 0.41 (0.34 to 0.47), 0.18 (0.12 to 0.23) and 0.21 (0.15 to 0.26) density units, respectively) relative to non-Hispanic White.ConclusionsIn a cohort free of clinical CVD, CVD risk factors are differentially associated with CAC volume and density scores, with many CVD risk factors inversely associated with the CAC density score after controlling for the CAC volume score. These findings suggest complex associations between CVD risk factors and these components of CAC.

Coronary artery calcium and plaque association with left ventricular mass, assessed by multi-row detector computed tomography

2010 ◽  
Vol 21 (7) ◽  
pp. 428-434 ◽  
Author(s):  
Paul M. Madaj ◽  
Sandeep R. Pagali ◽  
Yasmin S. Hamirani ◽  
Sameer Raina ◽  
Subu Nair ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Left Ventricular Mass ◽  
Coronary Artery Calcium ◽  
Left Ventricular ◽  
Ventricular Mass

Abstract 16191: Association of Left Ventricular Mass Progression With Heart Failure Events: Implications for Understanding the Hispanic Paradox

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nestor Vasquez ◽  
Cecilia Castro-Diehl ◽  
Un Jung Lee ◽  
Gregory Burke ◽  
Alain G Bertoni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ethnic Groups ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
Healthy Population ◽  
Ventricular Mass ◽  
Unit Increase ◽  
Cox Proportional Hazard Models ◽  
Relative Change

Introduction: Hispanics have been described as paradoxically having a higher prevalence of cardiovascular (CV) risk factors (RFs) but lower CV mortality compared to non-Hispanic Whites (NHW). The association of left ventricular mass (LVM) change with heart failure (HF) has not been well studied and variability across race-ethnic groups is unknown. Methods: MESA participants with LVM measurements by cardiac MRI at baseline and exam 5 (10-year interval) were included and followed for HF events after exam 5. LVM was calculated as the percentage of the predicted value based on height, weight and sex in a healthy population. LVM absolute (exam 5 - baseline) and relative change were compared across race-ethnic groups (Hispanics, non-Hispanic blacks [NHB], NHW, Chinese). HF RFs included hypertension, diabetes and obesity. The association between LVM change with incident HF events was evaluated using age-gender adjusted Cox proportional hazard models. Results: Among 2,981 participants (mean age 60 years, 53% female, 20% Hispanics, 42% NHW, 25% NHB, 13% Chinese) LVM at both exams was higher in NHB followed by Hispanics, whereas NHW and Chinese had the lowest LVM (Table) . Over 10-years, NHB had the highest LVM relative change (+4.4%) and Hispanics had the lowest (+1.7%). HF RFs were more prevalent in NHB and Hispanics compared to the other groups (p<0.01). After a mean follow-up time from exam 5 of 6.4 years, an 18% increase in HF risk was seen per 5-unit increase in LVM in the total population. In race-ethnicity stratified analyses, this association was seen only in NHB (22% increase in HF risk per 5-unit LVM increase, p=0.01), and Hispanics (34% increase in HF risk per 5-unit LVM increase, p<0.01). Conclusions: Hispanics and NHBs had a high burden of HF risk factors and higher baseline LVM relative to other groups. Hispanics paradoxically exhibited the lowest whereas NHB had the highest degree of LVM change over time, and yet both groups had similarly increased HF risk associated with LVM change.

Abstract P165: Associations of Coronary Artery Calcium Volume and Density With Incident Heart Failure in the Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Nketi I Forbang ◽  
Erin Michos ◽  
Sonia Ponce ◽  
Isac Thomas ◽  
Matthew Allison ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Low Frequency ◽  
P Value ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk ◽  
Incident Heart Failure

Background: Coronary artery calcium (CAC) predicts incident heart failure (HF) independent of cardiovascular disease (CVD) risk factors. In MESA, Components of CAC, volume and density, have opposite associations with incident CVD, such that for a given volume of CAC, higher CAC density is inversely associated with events. The relationship between CAC volume and density with HF is unknown. Methods: We studied 6814 participants in a multi-ethnic, community-based cohort, free from clinical CVD at recruitment. CAC volume and density were measured by non-contrast cardiac CT at the baseline exam (2000-2002). Adjudicated HF events were assessed through 2014, and analysis limited to those with imaging confirmation and estimated ejection fraction (EF). Cox proportional hazard was used to estimate independent associations of baseline CAC volume and density with incident HF: HF with reduced (< 50%), and preserved EF (HFrEF & HFpEF respectively). Results: The mean age was 62 + 10 years, 47% were men, 38% identified as European-, 28% as African-, 22% as Hispanic-, and 12% as Chinese-ethnicity. Average time to 189 HF events (119 HFrEF & 70 HFpEF) was 6.6 years. In unadjusted models, higher CAC volume (HR 1.27 [1.02-1.59], p=0.03), but not CAC density (HR 0.87 [0.67-1.13], p=0.29) was significantly associated with incident HF, non-significant associations were observed with HFrEF, or HFpEF, and no significant associations were observed for all three outcomes after adjustments for demographics and CVD risk factors (Table). Also, in unadjusted analyses, stratified by sex (p-value for interaction = 0.13), higher CAC volume was associated with increased risk for HF (HR 1.37 [1.03-1.81], p=0.03) and HFpEF (HR 1.76 [0.99-3.16], p=0.06), in males only. No significant associations were observed after adjustments. Conclusion: In a multi-ethnic cohort, CAC volume and density were not independently associated with HF, the trend for volume was positive while density was inverse. Low frequency of incident HF in our cohort was an important limitation.

Abstract MP72: Apolipoprotein B and Apolipoprotein B, LDL-C Discordance in Young Adults Are Associated With Coronary Artery Calcification at 25 Year Follow-Up: The Coronary Artery Disease in Young Adults (CARDIA) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ron C Li ◽  
Cheeling Chan ◽  
Allan Sniderman ◽  
Kiang Liu ◽  
Donald Lloyd-Jones ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Risk Factor ◽  
Coronary Artery ◽  
Apolipoprotein B ◽  
Subclinical Atherosclerosis ◽  
Agatston Score ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk

Introduction: High ApoB has been shown to predict cardiovascular disease (CVD) in adults even in the context of low LDL-C. It is not known, however, if high ApoB and high ApoB, low LDL-C discordance in young adults are associated with coronary artery calcium (CAC) in mid-life. Methods: Data were derived from CARDIA, a multicenter study of the development and determinants of CVD risk factors in young adults recruited at ages 18 to 30. All participants with complete baseline CVD risk factor data, ApoB, and year-25 CAC score were included in this study. Baseline lipid fractions and ApoB were measured by standard assays. Year-25 CAC was assessed using two consecutive CT scans with presence of CAC defined as having a positive, non-zero Agatston score using the average of two scans. Baseline ApoB values were divided into tertiles. Four mutually exclusive concordant/discordant groups were created based on median ApoB and LDL-C. Logistic regression was performed for unadjusted and adjusted models. Results: 3496 participants were included [mean age=25±3.6, BMI=24.5±5Kg/m2, 44.4% male, and the following mean lipid values (mg/dL): total cholesterol=177.3±33.1, LDL-C=109.9±31.1, HDL-C=53±12.8, ApoB=90.7±24, median triglycerides=61(IQR 46-83)]. Compared with the lowest ApoB tertile, the middle [OR=1.55 (95% CI 1.22-1.95)] and high [OR=2.35 (95% CI 1.87-2.97)] tertiles exhibited increased odds of developing year-25 CAC in traditional risk factor-adjusted models. High ApoB, low LDL-C discordance was also associated with year-25 CAC in adjusted models [OR=1.57 (95% CI 1.12-2.20)]. Conclusions: These data suggest a dose-response association between ApoB in young adults and presence of mid-life CAC independent of baseline traditional CVD risk factors. High ApoB, low LDL-C discordance was also associated with year-25 CAC, suggesting that ApoB in young adults may help identify individuals with modest LDL-C levels who are at increased risk for subclinical atherosclerosis in mid-life.

Relation of coronary artery calcium to left ventricular mass in African-Americans

2004 ◽  
Vol 93 (4) ◽  
pp. 490-492 ◽  
Author(s):  
Wenjing Tong ◽  
Joao A. Lima ◽  
Hong Lai ◽  
David D. Celentano ◽  
Shupeng Dai ◽  
...  
Keyword(s):  
Coronary Artery ◽  
African Americans ◽  
Left Ventricular Mass ◽  
Coronary Artery Calcium ◽  
Left Ventricular ◽  
Ventricular Mass

scholarly journals A study on the left ventricular hypertrophy among the patients of chronic kidney disease stage third to five

2019 ◽  
Vol 7 (5) ◽  
pp. 1511
Author(s):  
Ashok Vankayala ◽  
Kamal Lochan Behera ◽  
D. S. S. K. Raju ◽  
Suresh Babu Sayana
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Left Ventricular Mass ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Mass Index ◽  
Left Ventricular ◽  
Estimated Gfr ◽  
Ventricular Mass Index ◽  
Ventricular Mass

Background: In Chronic kidney Disease (CKD) a significant risk factor for mortality is Cardiovascular disease (CVD) and the most prevalent cardiovascular risk factor is left ventricular hypertrophy (LVH). Anemia, hypertension and volume overload are risk factors for LVH in CKD. So, the present was aimed at comparing the risk factors between CKD with and without LVH.Methods: A cross sectional study carried out over a 2 year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh. A total of 120 patients are included in this study and divided in to CKD stage III to V based on estimated GFR. Based on 2D echocardiography data CKD cases are further divided in to CKD with LVH and CKD without LVH.Results: The Left ventricular mass index was significant higher in CKD with LVH (128.89±19.28) when compared with CKD without LVH (108.20±10.28). The left ventricular mass index was noted in more number in stage V of CKD. It is also observed that the left ventricular mass index was negatively correlated with haemoglobin and eGFR and was positively correlated with systolic blood pressure and serum NT-proBNP.Conclusions: Present study finding suggested that the incidence of LVH is higher in CKD patients. LVH was positively correlated with hypertension and NT-proBNP and negatively correlated with anemia and estimated GFR.

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