scholarly journals The Effect of Vitamin D on Coronary Atherosclerosis: A Propensity Score Matched Case–Control Coronary CTA Study

2021 ◽  
Vol 8 (8) ◽  
pp. 85
Author(s):  
Gudrun Feuchtner ◽  
Simon Suppersberger ◽  
Christian Langer ◽  
Christoph Beyer ◽  
Stefan Rauch ◽  
...  
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Coronary Atherosclerosis ◽  
Case Control ◽  
Vitamin D Supplementation ◽  
Plaque Burden ◽  
Retrospective Case ◽  
Calcified Plaque ◽  
Stenosis Severity ◽  
Mixed Plaque

Background: Vitamin D supplementation may be associated with lower cardiovascular (CV) events, but the data are controversial. It remains speculative whether vitamin D supplementation has a direct effect on coronary atherosclerosis. We therefore set out to assess the influence of vitamin D supplementation on the coronary atherosclerosis profile quantified by coronary computed tomography angiography (CTA) in a retrospective case–control cohort study. Methods: 176 patients (age: 62.4 ± 10.4) referred to coronary CTA for clinical indications were included. A total of 88 patients receiving vitamin D supplementation (mean duration 65.3 ± 81 months) were 1:1 propensity score matched with 88 controls for age, gender, smoking, arterial hypertension, positive family history, dyslipidemia, and diabetes. Coronary stenosis severity (CAD-RADSTM), mixed plaque burden (weighted for non-calcified), high-risk-plaque (HRP) features, and plaque density (HU) were quantified by CTA. Serum 25-hydroxyvitamin D (OH)-levels were measured in 138 patients and categorized into four groups (0: <20 ng/mL; 1: 20–40 ng/mL; 2: 40–60 ng/mL; and 3: >60 ng/mL) and compared with CTA. Results: The prevalence of atherosclerosis by CTA was similar in both groups (75.6% versus 74.3%, p = 0.999), >50% coronary stenosis was slightly higher in controls (p = 0.046), but stenosis severity score (CAD-RADS) was not different (p = 0.106). Mixed plaque burden (weighted for non-calcified) was lower in patients receiving vitamin D supplementation (p = 0.002) and high-risk-plaque prevalence was markedly lower (3.8% versus 32%, p < 0.001). CT plaque density (HU) was higher (p < 0.001) in the vitamin D group. Patients with serum vitamin D (OH) levels >60 ng/mL had higher plaque density (p = 0.04), indicating more calcified and less vulnerable plaque. Conclusions: In this retrospective case–control cohort study, vitamin D supplementation was associated with less high-risk plaque, less non-calcified plaque burden, and a higher calcified plaque independent of CV risk factors.

scholarly journals Coronary atherosclerosis profile in patients with end-stage liver disease prior to liver transplantation due to alcoholic fatty liver: a coronary CTA study

2020 ◽  
Vol 31 (1) ◽  
pp. 494-503
Author(s):  
Fabian Steinkohl ◽  
Fabian Barbieri ◽  
Thomas Senoner ◽  
Sylvia Strobl ◽  
Armin Finkenstedt ◽  
...  
Keyword(s):  
Liver Disease ◽  
High Risk ◽  
Coronary Atherosclerosis ◽  
Plaque Burden ◽  
Coronary Cta ◽  
End Stage Liver Disease ◽  
Stenosis Severity ◽  
Mixed Plaque ◽  
End Stage ◽  
Fatty Plaque

Abstract Objectives To assess the coronary atherosclerosis profile by coronary computed tomography angiography (CTA) in patients with end-stage liver disease (ESLD) due to alcohol-related liver disease (ARLD) evaluated for liver transplantation (LT), in a retrospective matched case-controlled cohort study. Methods One hundred forty patients (age 60.6 years ± 9.8, 20.7% females) who underwent coronary CTA were included. Seventy patients with ESLD due to ARLD (ESLD-alc) were propensity score (1:1) matched for age, gender, and the major 5 cardiovascular risk factors with healthy controls. CTA analysis included the following: stenosis severity according to CAD-RADS as (0) = no, (1) minimal < 25%, (2) mild 25–50%, (3) moderate 50–70%, and (4) severe > 70% stenosis, total mixed plaque burden weighted for non-calcified component (G-score) and high-risk plaque criteria (Napkin-Ring, low attenuation plaque, spotty calcification, positive remodeling). Results Prevalence of coronary artery disease (CAD) was high (84.4%) in the ESLD-alc group but similar to controls. Stenosis severity was similar (CAD-RADS, 1.9 vs. 2.2, p = 0.289). High-grade stenosis (> 70%) was observed in 12.5% of ESLD-alc patients. High-risk plaques were less frequent in the ESLD-alc cohort as compared to controls (4.5% vs. 37.5%, p < 0.001), and total mixed plaque burden was lower (G-score, 4.9 versus 7.4, p = 0.001). Plaque density was lower in controls (56.6HU ± 3.2 vs. 91.3HU ± 4.5, p = 0.007) indicating more lipid-rich in controls, but higher mixed fibro-calcific plaque component in those with alcohol-related ESLD. Conclusion Patients with alcohol-related ESLD exhibit more mixed fibro-calcified plaques but less plaque with high-risk features and less fibro-fatty plaque burden, while total CAD prevalence is high. Key Points • Patients with ESLD prior to LT have a high total prevalence of CAD and stenosis severity, which is similar to those of healthy controls with an identical cardiovascular risk profile. • Patients with ESLD prior to LT due to alcohol abuse have more calcific but less fibro-fatty plaque and less high-risk plaque. • CTA seems to be a useful imaging technique for risk stratification prior to LT.

Abstract P040: GlycA, a Novel Inflammatory Marker, and Subclinical Coronary Atherosclerosis in the Multicenter AIDS Cohort Study (MACS)

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Oluwaseun E Fashanu ◽  
Martin Tibuakuu ◽  
Di Zhao ◽  
James D Otvos ◽  
Todd T Brown ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Coronary Atherosclerosis ◽  
Inflammatory Marker ◽  
Prevalence Ratio ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Calcified Plaque ◽  
Mixed Plaque

Background: Inflammation may link HIV infection to cardiovascular disease (CVD). GlycA, a novel nuclear magnetic resonance (NMR) biomarker of systemic inflammation, has been associated with incident CVD events in the general population. The relation between GlycA and the presence, extent and composition of subclinical coronary plaque in men with HIV infection (HIV+) or at risk for HIV (HIV-) is unknown. Methods: This is a cross-sectional analysis of 935 men enrolled in MACS with plasma measurement of GlycA and non-contrast cardiac CT and/or coronary CT angiography. We used multivariable adjusted Poisson and linear regression to assess associations of GlycA with prevalent coronary atherosclerosis and plaque extent, respectively. Results: Mean ± SD age was 54 ± 7 yrs; 31% were black, and 63% HIV+ with 81% having undetectable viral load (VL). GlycA levels were higher in HIV+ compared to HIV- men (397 ± 68 vs 380 ± 60 μmol/L, p=0.0001), and higher for those with detectable VL vs. undetectable (413 ± 79 vs 393 ± 65 μmol/L, p=0.004). After adjusting for demographic and CVD risk factors, every 1 SD increment in GlycA was associated with an increased prevalence of coronary artery calcium (CAC>0) (prevalence ratio: 1.09, 95% CI: 1.03-1.15), coronary stenosis ≥ 50% (1.20, 1.02-1.41), and calcified plaque (1.12, 1.02-1.23); p for all < 0.03. These associations remained significant after adjusting for other inflammatory markers and did not differ by HIV status. Among men with plaque, GlycA was positively associated with the extent of CAC, total plaque and mixed plaque ( Table ). Associations were weaker in HIV+ men for total and mixed plaque (P interaction = 0.003 and 0.03, respectively). GlycA was not associated with non-calcified plaque. Conclusion: HIV+ men have higher levels of GlycA than HIV- men. Higher GlycA is positively and independently associated with subclinical coronary atherosclerosis. Whether modification of GlycA through lifestyle or pharmacotherapy can reduce coronary plaque burden and future CVD events requires further study.

scholarly journals Focal pericoronary adipose tissue attenuation is related to plaque presence, plaque type, and stenosis severity in coronary CTA

2021 ◽  
Author(s):  
Runlei Ma ◽  
Marly van Assen ◽  
Daan Ties ◽  
Gert Jan Pelgrim ◽  
Randy van Dijk ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Coronary Arteries ◽  
Plaque Burden ◽  
Severe Stenosis ◽  
Plaque Type ◽  
Plaque Development ◽  
Calcified Plaque ◽  
Stenosis Severity ◽  
Dual Source ◽  
Artery Disease

Abstract Objectives To investigate the association of pericoronary adipose tissue mean attenuation (PCATMA) with coronary artery disease (CAD) characteristics on coronary computed tomography angiography (CCTA). Methods We retrospectively investigated 165 symptomatic patients who underwent third-generation dual-source CCTA at 70kVp: 93 with and 72 without CAD (204 arteries with plaque, 291 without plaque). CCTA was evaluated for presence and characteristics of CAD per artery. PCATMA was measured proximally and across the most severe stenosis. Patient-level, proximal PCATMA was defined as the mean of the proximal PCATMA of the three main coronary arteries. Analyses were performed on patient and vessel level. Results Mean proximal PCATMA was −96.2 ± 7.1 HU and −95.6 ± 7.8HU for patients with and without CAD (p = 0.644). In arteries with plaque, proximal and lesion-specific PCATMA was similar (−96.1 ± 9.6 HU, −95.9 ± 11.2 HU, p = 0.608). Lesion-specific PCATMA of arteries with plaque (−94.7 HU) differed from proximal PCATMA of arteries without plaque (−97.2 HU, p = 0.015). Minimal stenosis showed higher lesion-specific PCATMA (−94.0 HU) than severe stenosis (−98.5 HU, p = 0.030). Lesion-specific PCATMA of non-calcified, mixed, and calcified plaque was −96.5 HU, −94.6 HU, and −89.9 HU (p = 0.004). Vessel-based total plaque, lipid-rich necrotic core, and calcified plaque burden showed a very weak to moderate correlation with proximal PCATMA. Conclusions Lesion-specific PCATMA was higher in arteries with plaque than proximal PCATMA in arteries without plaque. Lesion-specific PCATMA was higher in non-calcified and mixed plaques compared to calcified plaques, and in minimal stenosis compared to severe; proximal PCATMA did not show these relationships. This suggests that lesion-specific PCATMA is related to plaque development and vulnerability. Key Points • In symptomatic patients undergoing CCTA at 70 kVp, PCATMAwas higher in coronary arteries with plaque than those without plaque. • PCATMAwas higher for non-calcified and mixed plaques compared to calcified plaques, and for minimal stenosis compared to severe stenosis. • In contrast to PCATMAmeasurement of the proximal vessels, lesion-specific PCATMAshowed clear relationships with plaque presence and stenosis degree.

Establishing Benefit from Vitamin D Supplementation — Adherence to Defined Criteria and Targeting of High-Risk Groups Essential?

2020 ◽  
Vol 24 (8) ◽  
pp. 827-831
Author(s):  
Siobhán McGettigan ◽  
P. Mulkerrin ◽  
P. M. O’Shea ◽  
S. T. O’Keeffe ◽  
E. C. Mulkerrin
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Risk Groups ◽  
Vitamin D Supplementation

P6153High risk plaque by coronary CTA predict cardiac events but not all-cause mortality: long term follow up

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Senoner ◽  
F Plank ◽  
F Babieri ◽  
W Dichtl ◽  
C Beyer ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
High Risk ◽  
Cardiovascular Mortality ◽  
Calcium Score ◽  
Plaque Burden ◽  
Lunar Eclipse ◽  
All Cause Mortality ◽  
Remodeling Index ◽  
Stenosis Severity

Abstract Background Ultra long-term (10 years) outcome data of coronary computed tomography angiography (CTA) for coronary heart disease (CHD) screening are lacking. Novel CTA imaging biomarkers (“high-risk-plaque”) may improve risk stratification. Aims To define CT-imaging predictors for long–term outcomes. Methods 1430 low-to-intermediate-risk patients (mean age 57.9 years; 44.4% females) were included into our prospective cohort study. Coronary Calcium Score (CCS) and CTA were performed. CTA was evaluated for: Stenosis severity (minimal<25%; mild<50%; moderate 50–70%; severe >70%) (CADRADS 1–4), total mixed plaque burden (G-score), high–risk-plaque criteria: 1) low attenuation plaque 2) Napkin-ring (“lunar-eclipse” sign) 3) spotty calcification 4) remodeling index Primary endpoint was all-cause mortality, secondary endpoints cardiovascular mortality and composite (non-fatal and fatal) MACE. Results Over a follow-up of mean 10.55 years ±1.98 (range, 6.1–12.8), all-cause mortality rate was 106 (7.4%), cardiovascular mortality 25 (1.75%) and composite MACE 57 (4%). In patients with negative CTA, cardiovascular mortality was 0% and composite MACE rate 0.2%. Stenosis severity (CADRADS) was the strongest predictor for all 3 endpoints (p<0.001) on multivariate analysis (unadjusted and adjusted for risk factors, p<0.001) but calcium score >100 AU only predicted mortality on the unadjusted multivariate analysis (p=0.045) but not on the adjusted. On multivariate analysis, G-score (p<0.0001), LAP<60HU and the Napkin-Ring predicted composite MACE (p<0.001) but not all-cause mortality, before and after adjusting for risk factors (p=0.007 and 0.001 for LAP<60HU and Napkin-Ring, respectively) while spotty calcification and remodeling index did not. 465 had calcium score zero and in 156 (33.5%) of those, noncalcified fibroatheroma were found (total rate, 11%), 4.9% had >50% stenosis. However only 1 patient with calcium score zero died while there were 6 MACE. High risk plaque with “lunar eclipse” Conclusions Long-term prognosis is excellent if CTA is negative. Stenosis severity by CTA predicts all-cause and cardiovascular mortality, while calcium score predicts only mortality. Plaque burden and the high-risk plaque criteria LAP<60 and Napkin-Ring (syn. “lunar eclipse”) are strong predictors of MACE, but not all–cause mortality. Coronary CTA outperforms calcium scoring for risk stratification.

Evaluation of Vitamin D Supplementation Doses during Pregnancy in a Population at High Risk for Deficiency

2014 ◽  
Vol 81 (6) ◽  
pp. 402-408 ◽  
Author(s):  
Gul Yesiltepe Mutlu ◽  
Elif Ozsu ◽  
Sibel Kalaca ◽  
Aysegul Yuksel ◽  
Yuksel Pehlevan ◽  
...  
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Vitamin D Supplementation
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