Evaluation of Breast Vascular Calcifications as a Predictor for Coronary Artery Calcification

Background. Cardiovascular diseases are one of the main causes of death among women, and current prevention paradigms may not be sufficient in this group. In this context, it has been suggested that the detection of breast vascular calcifications can improve the screening and assessment of the risk of cardiovascular diseases in apparently healthy women.Objective: to study the role of breast vascular calcifications as a potential predictor for coronary artery calcification. Material and methods. Examinations were made in 123 patients who underwent digital mammography and cardiac computed tomography to estimate a coronary artery calcium score.Results. The use of the Wilcoxon-Mann-Whitney W-test for abnormal distribution showed a relationship between the presence of breast vascular calcifications and calcium score (p< 0.001), and that between aortic wall calcification and calcium score (p< 0.001).Conclusion. Breast vascular calcifications detected by mammography are an indicator of a higher frequency of coronary artery calcification and, apparently, a predictor for the increased risk of cardiovascular disease.

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Evaluation of the Correlation between the rs4918 Polymorphism of AHSG Gene and Coronary Artery Calcification in Patients with Coronary Artery Disease

Cardiogenetics ◽

10.3390/cardiogenetics10020007 ◽

2020 ◽

Vol 10 (2) ◽

pp. 33-41

Author(s):

Zeynab Ahmadihosseini ◽

Morteza Moeinian ◽

Saeed Nazemi ◽

Sepideh Elyasi ◽

Amir Hooshang Mohammadpour

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Calcium Score ◽

Control Group ◽

Healthy Individuals ◽

Increased Risk ◽

Significant Difference ◽

The Mean ◽

Artery Disease

Objectives: Fetuin-A is a circulating calcification inhibitor that prevents coronary artery calcification (CAC) by increasing calcium phosphate solubility and inhibiting VSMC differentiation and apoptosis. In this study, we investigated the correlation between rs4918 and CAC in patients with coronary artery disease (CAD). Methods: Forty-two healthy individuals and eighty-one CAD patients were recruited in the present study. The CAC score (CACS) was measured by CT angiography and the genotype analysis of rs4918 single-nucleotide polymorphism SNP was performed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Results: The CACS was significantly higher in CAD patients compared to healthy individuals (p < 0.001); however, there was no significant difference between the mean CACS in the presence and absence of rs4918 (p = 0.792). The mean calcium score of the left main coronary artery (LMCA) was significantly lower in carriers of the rs4918 allele (p = 0.036). The frequency of rs4918 SNP was almost similar in the control group and CAD patients (p = 0.846). Conclusions: in patients with CAD, we found no significant association between rs4918 SNP and CACS, indicating that carriers of this allele are not at increased risk of developing cardiovascular diseases compared with those without.

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P4451Screening for Coronary Artery Disease USing Primary Evaluation with Cardiac CT (SUSPECT) in Aviation Medicine in the Royal Netherlands Air Force

European Heart Journal ◽

10.1093/eurheartj/ehz745.0851 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

R B Grobben ◽

E Frijters ◽

B K Velthuis ◽

R T A Beekmann ◽

R Rienks ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Air Force ◽

Cardiac Ct ◽

Cardiac Computed Tomography ◽

False Negative ◽

Calcium Score ◽

Negative Results ◽

Increased Risk ◽

Artery Disease

Abstract Background Military aircrew are subjected to both stress and excessive G-forces, which may be associated with an increased risk of coronary artery disease (CAD) and sudden cardiac death. Annual cardiac screening has therefore been implicated using exercise testing, which suffers from both false-positive and false-negative results. In this study, we have evaluated the prevalence of CAD in military aircrew using cardiac computed tomography (CT), and assessed whether cardiac CT would be a useful screening tool within this population. Methods Prospective, single-center, cohort study in 250 asymptomatic aircrew >40 years old in the Royal Netherlands Air Force. Included subjects underwent cardiac CT, in addition to the routine annual check-up that included an electrocardiogram, exercise test and laboratory analysis. Primary endpoint was obstructive CAD, defined as a coronary stenosis ≥50%. Secondary endpoints were non-obstructive CAD (<50% stenosis) and coronary artery calcium score (CACS) >100. Results Of the first 108 inclusions, mean age was 49 years (range 40–57), 99% were male and mean body mass index was 25.8 (SD 2.6). The prevalence of hypertension was 8%, hypercholesterolemia 9% and familial heart disease was noted in 22%. 16% were active smokers and none had diabetes. Obstructive CAD was observed in 2% of patients, non-obstructive CAD in 40% and CACS >100 in 11%. All subjects with obstructive CAD on cardiac CT underwent coronary artery angiography, which confirmed a stenosis >70% that required revascularization. Conclusion In asymptomatic military aviation aircrew >40 years old currently active in the Royal Netherlands Air Force, the prevalence of obstructive and non-obstructive CAD was 2% and 40%, respectively Acknowledgement/Funding Royal Netherlands Air Force

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Association between Vitamins and Minerals with Antioxidant Effects and Coronary Artery Calcification in Adults and Older Adults: A Systematic Review

Current Pharmaceutical Design ◽

10.2174/1381612825666190722101954 ◽

2019 ◽

Vol 25 (22) ◽

pp. 2474-2479 ◽

Cited By ~ 1

Author(s):

Alisson Diego Machado ◽

Gustavo Rosa Gentil Andrade ◽

Jéssica Levy ◽

Sara Silva Ferreira ◽

Dirce Maria Marchioni

Keyword(s):

Systematic Review ◽

Older Adults ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Serum Levels ◽

Antioxidant Compounds ◽

Increased Risk ◽

Coronary Events ◽

Antioxidant Effects

Background: Coronary Artery Calcification (CAC) is considered an important cardiovascular risk factor. There is evidence that CAC is associated with an increased risk of atherosclerosis, coronary events and cardiovascular mortality. Inflammation is one of the factors associated with CAC and despite the interest in antioxidant compounds that can prevent CAC, its association with antioxidants remains unclear. Objective: This study aimed to systematically review the association between vitamins and minerals with antioxidant effects and CAC in adults and older adults. Methods: We conducted a systematic review using PubMed for articles published until October 2018. We included studies conducted in subjects aged 18 years and older with no previous cardiovascular disease. Studies involving animal or in vitro experiments and the ones that did not use reference methods to assess the CAC, dietary intake or serum levels of vitamin or mineral were excluded. Results: The search yielded 390 articles. After removal of duplicates, articles not related to the review, review articles, editorials, hypothesis articles and application of the inclusion and exclusion criteria, 9 articles remained. The results of the studies included in this systematic review suggest that magnesium is inversely associated with CAC and results on the association between CAC and vitamin E have been conflicting. Conclusion: Additional prospective studies are needed to elucidate the role of these micronutrients on CAC.

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Association between the Severity of Nonalcoholic Fatty Liver Disease and the Risk of Coronary Artery Calcification

Medicina ◽

10.3390/medicina57080807 ◽

2021 ◽

Vol 57 (8) ◽

pp. 807

Author(s):

Chien-Chih Chen ◽

Wei-Chien Hsu ◽

Han-Ming Wu ◽

Jiun-Yi Wang ◽

Pei-Yu Yang ◽

...

Keyword(s):

Computed Tomography ◽

Cardiovascular Risk ◽

Liver Disease ◽

Coronary Artery ◽

Fatty Liver ◽

Multidetector Computed Tomography ◽

Coronary Artery Calcification ◽

Fatty Liver Disease ◽

Calcium Score ◽

Left Main

Background and Objectives: There are limited data on the association between severity of non-alcoholic fatty liver disease (NAFLD) and coronary artery calcification. This study investigated sonographic diagnosed NAFLD and coronary artery calcium score (CAC) as detected by cardiac multidetector computed tomography in general populations. Materials and Methods: A total of 545 patients were enrolled in this study. NAFLD was diagnosed by ultrasonography examination and CAC score were evaluated by cardiac multidetector computed tomography. The association between NAFLD and artery calcium score stage was determined by logistic regression analysis and Spearman correlation coefficient analysis. Results: Of all the participants, 437 (80.2%) had ultrasonography-diagnosed NAFLD and 242 (44%) had coronary artery calcification (CAC > 0). After adjustment for cardiovascular risk factors, the risk of developing coronary artery calcification was 1.36-fold greater in the patients with different severity of NAFLD compared to those without NAFLD (OR = 1.36, 95% CI = 1.07–1.77, p = 0.016). The highest OR for separate coronary artery calcification was 1.98 (OR = 1.98, 95% CI = 1.37–2.87, p < 0.001) in the left main artery, and the risk was still 1.71-fold greater after adjustments (OR = 1.71, 95% CI = 1.16–2.54, p = 0.007). Conclusions: This cross-sectional study demonstrated that the severity of NAFLD was associated with the presence of significant coronary artery calcification, especially in the left main coronary artery, suggesting increasing the cardiovascular risk.

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Plasma F2-Isoprostanes and Coronary Artery Calcification: The CARDIA Study

Clinical Chemistry ◽

10.1373/clinchem.2004.037630 ◽

2005 ◽

Vol 51 (1) ◽

pp. 125-131 ◽

Cited By ~ 97

Author(s):

Myron Gross ◽

Michael Steffes ◽

David R Jacobs ◽

Xinhua Yu ◽

Linda Lewis ◽

...

Keyword(s):

Coronary Artery ◽

Early Development ◽

Coronary Artery Calcification ◽

Continuous Variable ◽

Oxidation Products ◽

Gas Chromatography Mass Spectrometry ◽

Agatston Score ◽

Reactive Protein ◽

Increased Risk ◽

Coronary Artery Atherosclerosis

Abstract Background: Oxidation of lipids in lipoproteins and cells may initiate and enhance the early development of cardiovascular disease. Method and Results: We assayed F2-isoprostanes, oxidation products of arachidonic acid, by gas chromatography–mass spectrometry in a biracial cohort of 2850 young healthy adult men and women. Coronary artery calcification (CAC), a component of coronary artery atherosclerosis, was detectable in 10% of the cohort and appeared to be in its initial stages (Agatston scores <20 in 47% and <100 in 83% of CAC-positive participants). After adjusting for sex, clinical site, age, and race, the presence of any CAC was 24% more likely among those with high vs low concentrations of F2-isoprostanes [odds ratio (OR) = 1.24 per 92.2 pmol/L (32.7 ng/L; 1 SD of F2-isoprostanes); 95% confidence interval (CI), 1.09–1.41]. The OR was only slightly attenuated [1.18 per 92.2 pmol/L (32.7 ng/L); CI, 1.02–1.38] after further adjustment for body mass index, smoking, serum lipids, C-reactive protein, antioxidant supplementation use, diabetes, and blood pressure. As a continuous variable, the Agatston score increased by 6.9% per 92.2 pmol/L (32.7 ng/L) of F2-isoprostane concentration (P <0.01). Whereas CAC prevalence was lower in women than men, mean (SD), F2-isoprostanes were higher in women {190 (108.9) pmol/L [67.4 (38.6) ng/L]} than in men {140.4 (55.6) pmol/L [49.8 (19.7) ng/L]}. Nevertheless, F2-isoprostanes were associated with an increased risk of CAC in both sexes. Conclusion: This association between increased concentrations of circulating F2-isoprostanes and CAC in young healthy adults supports the hypothesis that oxidative damage is involved in the early development of atherosclerosis.

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Role of Selected miRNAs as Diagnostic and Prognostic Biomarkers in Cardiovascular Diseases, Including Coronary Artery Disease, Myocardial Infarction and Atherosclerosis

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8020022 ◽

2021 ◽

Vol 8 (2) ◽

pp. 22

Author(s):

Rashid Mir ◽

Imadeldin Elfaki ◽

Naina Khullar ◽

Ajaz Ahmad Waza ◽

Chandan Jha ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiovascular Diseases ◽

Cardiac Dysfunction ◽

Heart Diseases ◽

Prognostic Biomarkers ◽

Apoptotic Bodies ◽

Artery Disease

Cardiovascular diseases are the leading cause of death worldwide in different cohorts. It is well known that miRNAs have a crucial role in regulating the development of cardiovascular physiology, thus impacting the pathophysiology of heart diseases. MiRNAs also have been reported to be associated with cardiac reactions, leading to myocardial infarction (MCI) and ultimately heart failure (HF). To prevent these heart diseases, proper and timely diagnosis of cardiac dysfunction is pivotal. Though there are many symptoms associated with an irregular heart condition and though there are some biomarkers available that may indicate heart disease, authentic, specific and sensitive markers are the need of the hour. In recent times, miRNAs have proven to be promising candidates in this regard. They are potent biomarkers as they can be easily detected in body fluids (blood, urine, etc.) due to their remarkable stability and presence in apoptotic bodies and exosomes. Existing studies suggest the role of miRNAs as valuable biomarkers. A single biomarker may be insufficient to diagnose coronary artery disease (CAD) or acute myocardial infarction (AMI); thus, a combination of different miRNAs may prove fruitful. Therefore, this review aims to highlight the role of circulating miRNA as diagnostic and prognostic biomarkers in cardiovascular diseases such as coronary artery disease (CAD), myocardial infarction (MI) and atherosclerosis.

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Abstract 448: Association of CHADS2 and CHA2DS2-VASc Score with Coronary Atherosclerosis Burden in Nonvalvular Atrial Fibrillation

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.34.suppl_1.448 ◽

2014 ◽

Vol 34 (suppl_1) ◽

Author(s):

Kongkiat Chaikriangkrai ◽

Sama Alchalabi ◽

Sayf Khaleel bala ◽

Mahwash Kassi ◽

Su Min Chang

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Coronary Artery Calcium Score ◽

Cardiac Computed Tomography ◽

Calcium Score ◽

Operating Characteristics ◽

Nonvalvular Atrial Fibrillation ◽

Chads2 Score ◽

History Of ◽

Artery Disease

Background: This study is to examine association of CHADS2 and CHA2DS2-VASc score with coronary artery disease (CAD) in nonvalvular atrial fibrillation (AF) Method: A total of 676 consecutive nonvalvular AF patients without known history of CAD underwent coronary artery calcium score (CACS) evaluation by multi-detector cardiac computed tomography. Clinical characteristics and CACS were compared between different CHADS2 and CHA2DS2-VASc score groups. Results: The cohort comprised of 68% (461 of 676) male with a mean ± SD age of 63 ± 10 years. Median 10-year risk of CAD by Framingham score was 11% (range 2%-53%). Median CHADS2 score was 1 (range 0-6) and median CHA2DS2-VASc score was 2 (range 0-8). Mean ± SD CACS was 215 ± 504. Compared to CHADS2 score ≤ 1, those with CHADS2 score > 1 had higher mean ± SD CACS (359 ± 738 VS 158 ± 359; p<0.001). CHADS2 score > 1 is associated with CACS > 0 (OR 1.751; 95%CI 1.168, 2.624; p 0.007) and CACS > 400 (OR 2.528; 95%CI 1.641, 3.896; p < 0.001). Similarly, compared to CHA2DS2-VASc score ≤ 1, those with CHA2DS2-VASc score > 1 had higher mean ± SD CACS (270 ± 586 VS 150 ± 376; p<0.001). CHA2DS2-VASc score > 1 is associated with CACS > 0 (OR 1.713; 95%CI 1.217, 2.409; p 0.002) and CACS > 400 (OR 2.683; 95%CI 1.678, 4.289; p < 0.001). Receiver operating characteristics of CHADS2 and CHA2DS2-VASc score models for CACS > 400 is shown in the figure. Conclusion: In nonvalvular AF patients, higher CHADS2 and CHA2DS2-VASc score are comparably associated with presence and severity of CAD.

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Role of coronary artery calcium score in the primary prevention of cardiovascular disease

BMJ ◽

10.1136/bmj.n776 ◽

2021 ◽

pp. n776

Author(s):

Khurram Nasir ◽

Miguel Cainzos-Achirica

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery ◽

Primary Prevention ◽

Coronary Artery Calcium ◽

Calcium Score ◽

Coronary Plaque ◽

Preventive Therapy ◽

Atherosclerotic Cardiovascular Disease ◽

International Studies

Abstract First developed in 1990, the Agatston coronary artery calcium (CAC) score is an international guideline-endorsed decision aid for further risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease. This review discusses key international studies that have informed this 30 year journey, from an initial coronary plaque screening paradigm to its current role informing personalized shared decision making. Special attention is paid to the prognostic value of a CAC score of zero (the so called “power of zero”), which, in a context of low estimated risk thresholds for the consideration of preventive therapy with statins in current guidelines, may be used to de-risk individuals and thereby inform the safe delay or avoidance of certain preventive therapies. We also evaluate current recommendations for CAC scoring in clinical practice guidelines around the world, and past and prevailing barriers for its use in routine patient care. Finally, we discuss emerging approaches in this field, with a focus on the potential role of CAC informing not only the personalized allocation of statins and aspirin in the general population, but also of other risk-reduction therapies in special populations, such as individuals with diabetes and people with severe hypercholesterolemia.

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