Comparison of Electron Beam Computed Tomography With Intracoronary Ultrasound and Coronary Angiography for Detection of Coronary Atherosclerosis

Baumgart, Dietrich; Schmermund, Axel; Goerge, Guenter; Haude, Michael; Ge, Junbo; Adamzik, Michael; Sehnert, Cornelia; K, Altmaier; Groenemeyer, Dietrich H.W.; Seibel, Rainer; Erbel, Raimund

doi:10.1016/s0735-1097(97)00147-2

Cited by 273 publications

(139 citation statements)

References 33 publications

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“…In addition, calcification is a measure of stabilized plaque but may not always account for the noncalcified plaque burden (ie, the type that is vulnerable for rupture). Nonetheless, studies have found that CAC can reliably predict future adverse cardiovascular events, correlates well with cardiac computed tomography angiography findings of significant angiographic stenosis, 45 is cost-effective, 46 and provides an additive benefit to existing cardiovascular risk assessment tools. 47 The beneficial role of CAC in cardiovascular risk assessment of type 2 diabetes has been well established.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Coronary Artery Calcium Scores Between Patients With Psoriasis and Type 2 Diabetes

et al. 2016

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IMPORTANCEPsoriasis is associated with an increased risk of cardiovascular diseases. Subclinical atherosclerosis in patients with psoriasis has not been compared with other conditions associated with increased cardiovascular risk and more rigorous cardiovascular disease screening, such as type 2 diabetes. OBJECTIVE To assess the burden of asymptomatic coronary atherosclerosis measured by coronary artery calcium score in patients with moderate to severe psoriasis compared with patients with type 2 diabetes and healthy controls.DESIGN, SETTING, AND PARTICIPANTS Three single-center, cross-sectional studies were performed in patients recruited from specialty outpatient clinics with moderate to severe psoriasis without type 2 diabetes (recruited from November 1, 2013, through April 31, 2015), patients with type 2 diabetes without psoriasis or other inflammatory diseases (recruited from July 1, 2009, through June 20, 2011), and age-and sex-matched healthy controls without psoriasis, type 2 diabetes, or other inflammatory diseases (recruited from July 1, 2009, through June 20, 2011).EXPOSURES Psoriasis, type 2 diabetes, and healthy control effect on coronary artery calcium score. MAIN OUTCOMES AND MEASURES Coronary artery calcium measured by Agatston score.RESULTS A total of 387 individuals participated in the study. Mean (SD) age was 51 (7.7), 52 (8.0), and 52 (8.0) years in the psoriasis, type 2 diabetes, and healthy control cohorts, respectively. There were 64 men (49.6%) in each group, and most patients were white (119 [92.2%], 123 [95.3%], and 128 [99.2%] in the psoriasis, type 2 diabetes, and healthy control cohorts, respectively). Patients with psoriasis had low cardiovascular risk measured by the Framingham Risk Score but had a high prevalence of cardiovascular and cardiometabolic risk factors, similar to patients with type 2 diabetes. In a fully adjusted model, psoriasis was associated with coronary artery calcium (Tobit regression ratio, 0.89; P < .001) similar to the association in type 2 diabetes (Tobit regression ratio, 0.79; P = .04). Likelihood ratio testing revealed incremental value for psoriasis in a fully adjusted model (χ 2 = 4.48, P = .03) in predicting coronary artery calcium. Psoriasis was independently associated with the presence of any coronary artery calcium (odds ratio, 2.35; 95% CI, 1.12-4.94) in fully adjusted models, whereas the association of coronary artery calcium with type 2 diabetes was no longer significant after adding body mass index to the model (odds ratio, 2.18; 95% CI, 0.75-6.35).CONCLUSIONS AND RELEVANCE Patients with psoriasis have increased coronary artery calcium by mean total Agatston scores, similar to that of patients with type 2 diabetes, suggesting that patients with psoriasis harbor high rates of subclinical atherosclerosis beyond adjustment for body mass index. Major educational efforts for patients and physicians should be undertaken to reduce the burden of cardiovascular disease in patients with psoriasis.

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Section: Discussionmentioning

confidence: 99%

Comparison of Coronary Artery Calcium Scores Between Patients With Psoriasis and Type 2 Diabetes

et al. 2016

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“…2 It is now widely accepted that the presence of calcium in coronary arteries is pathognomonic of atherosclerosis, 3 and a close correlation between the atherosclerotic plaque burden and the extent of CAC has been confirmed both by histopathology and intravascular ultrasound, with the total CAC score representing an anatomic measure of overall coronary plaque burden. 4,5 In this context, there has been an exponential increase in interest in cardiac computed tomography as applications expanded from the identification of CAC to noninvasive coronary angiography, through obtaining cross-sectional images of the heart in subsecond scanning times and accurately detecting and quantifying even small areas of CAC. 6 Among inflammatory cells, leukocyte recruitment and the expression of proinflammatory cytokines related to leukocyte activation have been shown to characterize all steps of atherothrombosis.…”

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confidence: 99%

Eosinophils: a new player in coronary atherosclerotic disease

Niccoli

Cosentino

2012

Hypertens Res

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“…A similar study by Rumberger et al 23 , correlating coronary artery calcium quantification on ultrafast tomography in hearts at autopsy and its histopathologic quantification, confirmed these data. Angiographic and coronary artery ultrasound studies have also shown that coronary artery calcification correlates with the load of the atherosclerotic plaque [8][9][10] , and the latter, in turn, correlates with the risk for coronary events [5][6] . Several studies in asymptomatic or symptomatic individuals on coronary artery disease have shown a correlation between coronary artery calcification and obstruction of the lumen of the vessel 9,18,24 .…”

Section: Discussionmentioning

confidence: 99%

“…1), detected on ultrafast computed tomography or electron beam computed tomography, correlates with the load of the atherosclerotic plaque in histological, angiographic, and intravascular ultrasound studies [7][8][9][10] . Ultrafast computed tomography is a noninvasive and very sensitive method to detect calcification in coronary arteries 7 .…”

Section: Distribution Of Coronary Artery Calcium Scores Determined Bymentioning

confidence: 99%

Distribuição dos escores de cálcio coronariano determinados pela tomografia ultra-rápida em 2.253 homens brancos assintomáticos

Meneghelo¹,

Santos

Almeida

et al. 2003

Arq. Bras. Cardiol.

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Meneghelo et al Ultrafast computer tomography in assymptomatic white menCoronary atherosclerosis is one of the major causes of death among us 1 . Atherosclerosis is a multifactorial disease, and the identification of individuals at high risk for coronary events is extremely important, because preventive therapies, such as change in lifestyle and use of drugs, such as statins and acetylsalicylic acid, significantly reduce clinical events and mortality 2 . Classically, the risk stratification of coronary events has been performed through the analysis of a set of risk factors. However, epidemiological data have shown that approximately 25% of the individuals who died suddenly due to cardiac causes had no previous symptoms, and even the classical tools for assessing the risk of coronary events, such as the Framingham scores, have limitations in identifying high-risk individuals 3,4 . Approximately 50% of the coronary deaths and most myocardial infarctions occur in individuals considered at low to intermediate risk, according to clinical and laboratory parameters 3 . Therefore, assessment of subclinical atherosclerosis through imaging techniques may be useful for risk stratification, because evidence exists that the load of the atherosclerotic plaque correlates with the risk of coronary events [5][6] .Coronary artery calcification ( fig. 1), detected on ultrafast computed tomography or electron beam computed tomography, correlates with the load of the atherosclerotic plaque in histological, angiographic, and intravascular ultrasound studies [7][8][9][10] . Ultrafast computed tomography is a noninvasive and very sensitive method to detect calcification in coronary arteries 7 . Evidence exists that the presence of coronary artery calcification on ultrafast computed tomography may be a risk marker of clinical events in coronary artery disease, independent of the risk factors for atherosclerosis [11][12][13][14] . Up to now, coronary artery calcium scores in the Brazilian population have not been reported.This study aimed at describing the distribution of coronary artery calcium scores in a population sample of asymptomatic white Brazilian men undergoing assessment on ultrafast computed tomography. 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, and >65 years. Objective -To describe the distribution of coronary artery calcium scores in a population of asymptomatic white Brazilian men undergoing assessment with ultrafast computed tomography. Methods - Results -

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Comparison of Electron Beam Computed Tomography With Intracoronary Ultrasound and Coronary Angiography for Detection of Coronary Atherosclerosis

Cited by 273 publications

References 33 publications

Comparison of Coronary Artery Calcium Scores Between Patients With Psoriasis and Type 2 Diabetes

Comparison of Coronary Artery Calcium Scores Between Patients With Psoriasis and Type 2 Diabetes

Eosinophils: a new player in coronary atherosclerotic disease

Distribuição dos escores de cálcio coronariano determinados pela tomografia ultra-rápida em 2.253 homens brancos assintomáticos

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