scholarly journals The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?

2021 ◽  
Vol 8 (11) ◽  
pp. 157
Author(s):  
Gudrun Maria Feuchtner ◽  
Christoph Beyer ◽  
Christian Langer ◽  
Sven Bleckwenn ◽  
Thomas Senoner ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Age Groups ◽  
Calcium Score ◽  
High Risk Population ◽  
Risk Population ◽  
Stenosis Severity ◽  
Artery Disease

(1) Background: Whether coronary computed tomography angiography (CTA) or the coronary artery calcium score (CACS) should be used for diagnosis of coronary heart disease, is an open debate. The aim of our study was to compare the atherosclerotic profile by coronary CTA in a young symptomatic high-risk population (age, 19–49 years) in comparison with the coronary artery calcium score (CACS). (2) Methods: 1137 symptomatic high-risk patients between 19–49 years (mean age, 42.4 y) who underwent coronary CTA and CACS were stratified into six age groups. CTA-analysis included stenosis severity and high-risk-plaque criteria (3) Results: Atherosclerosis was more often detected based on CTA than based on CACS (45 vs. 27%; p < 0.001), 50% stenosis in 13.6% and high-risk plaque in 17.7%. Prevalence of atherosclerosis was low and not different between CACS and CTA in the youngest age groups (19–30 y: 5.2 and 6.4% and 30–35 y: 10.6 and 16%). In patients older than >35 years, the rate of atherosclerosis based on CTA increased (p = 0.004, OR: 2.8, 95%CI:1.45–5.89); and was higher by CTA as compared to CACS (34.9 vs. 16.7%; p < 0.001), with a superior performance of CTA. In patients older than 35 years, stenosis severity (p = 0.002) and >50% stenosis increased from 2.6 to 12.5% (p < 0.001). High-risk plaque prevalence increased from 6.4 to 26.5%. The distribution of high-risk plaque between CACS 0 and >0.1 AU was similar among all age groups, with an increasing proportion in CACS > 0.1 AU with age. A total of 24.9% of CACS 0 patients had coronary artery disease based on CTA, 4.4% > 50% stenosis and 11.5% had high-risk plaque. (4) Conclusions: In a symptomatic young high-risk population older than 35 years, CTA performed superior than CACS. In patients aged 19–35 years, the rate of atherosclerosis was similar and low based on both modalities. CACS 0 did not rule out coronary artery disease in a young high-risk population.

scholarly journals The atherosclerosis profile by coronary CTA compared to the coronary artery calcium score (CACS) in a young symptomatic high-risk population between 19 and 49 years

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Plank ◽  
C Beyer ◽  
C Langer ◽  
T Senoner ◽  
S Bleckwenn ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Age Groups ◽  
Calcium Score ◽  
High Risk Population ◽  
Coronary Cta ◽  
Risk Population ◽  
Stenosis Severity

Abstract Background Whether the coronary artery calcium score (CACS) or coronary CTA should be used in young high-risk adults for screening of coronary artery disease (CAD), is an open debate and data sparse. Aims To evaluate the coronary atherosclerosis profile by coronary computed tomography angiography (CTA) in a young symptomatic high-risk population (age, 19–49 years) in comparison with the coronary artery calcium score (CACS). Methods and results 1137 symptomatic high-risk patients between 19–49 years (mean 42.4y; 33.2%females) with suspected CAD who underwent CTA and CACS were assigned into 6 age groups (19–30; 31–35; 36–40; 41–45; 46–47; 48–49y).CTA-analysis included stenosis severity (CADRADS) and high-risk-plaque (“HRP”) criteria. Atherosclerosis was more often detected by CTA than by CACS (45% vs. 27%; p&lt;0.001), &gt;50% stenosis in 13.6% and HRP in 17.7%. Prevalence of atherosclerosis was low and not different between CACS and CTA in the youngest (19–30y:5.2% and 6.4%; 30–35y:10.6% and 16%). Above &gt;35 years, atherosclerosis detection by CTA increased (p=0.004, OR: 2.8, 95% CI: 1.45–5.89); and was higher by CTA as compared to CACS (34.9% vs 16.7%; p&lt;0.001). CTA outperformed CACS among all higher age groups &gt;35 years, with an increasing gap towards a superior performance of CTA along with age: Above 35 years, stenosis severity (CADRADS) (p=0.002) and &gt;50% stenosis increased from 2.6% to 12.5% (p&lt;0.001). The rate of HRP increased linearly with age from 6.4% to 26.5%.The distribution of HRP into CACS0 and CACS&gt;0.1AU was similar among all age groups (CACS 0:45.1% had HRP), with an increasing proportion of HRP in CACS&gt;0.1AU with age. 24.9% of CACS 0 patients had CAD by CTA, 4.4% &gt;50% stenosis and 11.5% HRP. Conclusion Above 35 years of age, CTA outperforms CACS with an increasing power. Between 19 and 35 years, CACS 0 does not reliably rule out CAD and high-risk-plaque; hence for “noRISK100%safety”, CTA is superior.(#eachlifematters) FUNDunding Acknowledgement Type of funding sources: None. 30 YOM diabetic, CACS 0 and HRP by CTA Atherosclerosis vs age: CACS vs CTA

scholarly journals Bicuspid aortic valve is associated with less coronary artery calcium and coronary artery disease burden by computed tomography

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Barbieri ◽  
S Bleckwenn ◽  
L Stoessl ◽  
F Plank ◽  
C Beyer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Artery Calcium ◽  
Coronary Stenosis ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Stenosis Severity ◽  
Artery Disease

Abstract Background Bicuspid aortic valve (BAV) is associated with genetic defects (NOTCH 1, GATA 5 mutations) and aortopathy. Differences in flow pattern and a genetic predisposition could also affect coronary arteries. Purpose To assess the coronary artery calcium score (CACS) and coronary artery disease (CAD) burden by coronary computed tomography angiography (CTA) in patients with BAV stenosis, as compared to those with tricuspid aortic valve (TAV) stenosis. Methods 47 patients with congenital BAV (68.9 years±12.9, 38.3% females) who underwent cardiovascular CTA for TAVR planning were matched with 47 TAV patients for age, gender, smoking, arterial hypertension, dyslipidemia, diabetes, body-mass-index and chronic kidney disease. The coronary artery calcium score (CACS) (Agatston Units=AU) and coronary stenosis severity by CTA (CADRAD:&lt;25% minimal,&lt;50%milde,50–70%moderate,&gt;70/%severe) were quantified. Results The coronary artery calcium score (CACS) was lower in BAV (237.4 vs. 1013.3AU; p&lt;0.001), and coronary stenosis severity was less (CAD-RAD:p&lt;0.001) as compared to patients with TAV. More patients with BAV had CACS zero (27.7% vs. 0%, p&lt;0.001). The majority (68.1%) of patients with BAV had no or non-obstructive CAD but only 25.5% of tricuspid (p&lt;0.001). Obstructive CAD (&gt;50% stenosis) by CTA was more frequently observed in TAV patients (68.1%; p&lt;0.001). There were no differences in statin use and NOAC, and other co-morbidities such as AF and COPD. Conclusion Patients with BAV have markedly less coronary artery calcium load and yielded less severe coronary stenosis. CTA succeeds to rule out obstructive CAD in the majority of patients with BAV, with adherent implications for TAVR planning. FUNDunding Acknowledgement Type of funding sources: None. 72 YOM with BAV, zero CACS and no CAD CACS was lower in BAV

scholarly journals Bicuspid Aortic Valve Is Associated with Less Coronary Calcium and Coronary Artery Disease Burden

2021 ◽  
Vol 10 (14) ◽  
pp. 3070
Author(s):  
Gudrun Feuchtner ◽  
Sven Bleckwenn ◽  
Leon Stoessl ◽  
Fabian Plank ◽  
Christoph Beyer ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Coronary Calcium ◽  
Retrospective Case ◽  
Artery Disease

(1) Background. Bicuspid aortic valve (BAV) is associated with genetic defects (NOTCH 1, GATA 5) and aortopathy. Differences in the flow patterns and a genetic predisposition could also affect coronary arteries. The objective was to assess the coronary artery calcium score (CACS) and coronary artery disease (CAD) burden by coronary computed tomography angiography (CTA) in patients with BAV stenosis, as compared to stenotic tricuspid aortic valves (TAV). (2) Methods. A retrospective case–control study. A total of 47 patients with BAV stenosis (68.9 years ± 12.9, 38.3% females) who underwent CTA were matched with 47 TAV stenosis patients for age, gender, smoking, arterial hypertension, dyslipidemia, diabetes, body-mass-index and chronic kidney disease. (3) Results. The coronary artery calcium score (CACS) was lower in BAV (237.4 vs. 1013.3AU; p < 0.001) than in TAV, and stenosis severity was less (CAD-RADTM: p < 0.001). More patients with BAV had CACS zero (27.7% vs. 0%; p < 0.001). The majority (68.1%) of patients with BAV had no or non-obstructive CAD but only 25.5% of TAV (p < 0.001). Obstructive CAD (>50% stenosis) by CTA was more frequently observed in patients with TAV (68.1%; p < 0.001). (4) Conclusions and Relevance. Patients with BAV stenosis have markedly less coronary calcium and less severe coronary stenosis. CTA succeeds to rule out obstructive CAD in the majority of BAV, with adherent implications for TAVR planning.

Analyzing the predictive value of coronary artery calcium score to assess coronary artery disease events

2009 ◽  
Vol 10 (3) ◽  
pp. 209-210
Author(s):  
Bassel Artin ◽  
Amol Bahekar ◽  
Ahmad Khraisat ◽  
Rohit Bhuriya ◽  
Sarabjeet Singh ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Predictive Value ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Artery Disease

scholarly journals Coronary Artery Calcium Score: Assessment of SYNTAX Score and Prediction of Coronary Artery Disease

Cureus ◽  
2021 ◽  
Author(s):  
Asma Shabbir ◽  
Sana T Virk ◽  
Jahanzeb Malik ◽  
Shabana Kausar ◽  
Talha B Nazir ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Calcium Score ◽  
Syntax Score ◽  
Artery Disease
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