Potential Application of Cardiac Computed Tomography for Early Detection of Coronary Atherosclerosis: From Calcium Score to Advanced Atherosclerosis Analysis

Conte, Edoardo; Mushtaq, Saima; Marchetti, Davide; Mallia, Vincenzo; Belmonte, Marta; Melotti, Eleonora; Pepi, Mauro; Andreini, Daniele

doi:10.3390/jcm10030521

Cited by 4 publications

(4 citation statements)

References 55 publications

(82 reference statements)

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“…Other potential causes include myocardial infarction caused by coronary spasm [45], microembolization [46], and a misdiagnosis of ACS in patients with a variety of different clinical entities, such as myocarditis and Takatsubo cardiopathy, [47], among others. CMRI may be used to rule out potential causes, and is a useful tool for the management of ACS presenting with normal coronary angiography, as it aids diagnosis and adaptation of treatment in a large proportion of cases [48][49][50]. The prognosis of patients with ACS and normal coronary arteries was considered to be excellent, based off of several small studies showing a low recurrence rate of ACS and a high 10-year survival rate [16].…”

Section: Discussionmentioning

confidence: 99%

Risk factor comparison in young patients presenting with acute coronary syndrome with atherosclerotic coronary artery disease vs. angiographically normal coronaries

Jamil

Mesameh

et al. 2021

Int. J. Med. Sci.

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Background: Acute myocardial infarction is a relatively rare phenomenon in the young population. The incidence has nevertheless increased from years past, likely due to the presence of multiple risk factors from an increasingly younger age. Regardless of whether they have atherosclerotic coronary artery disease or normal coronary angiogram, young patients with risk factors for coronary artery disease (CAD), chest pain, and positive troponin, are initially treated in a similar fashion. Our goal was to shed light on whether risk factors between these two groups differ to help guide physicians in clinically determining whether or not an atherosclerotic cardiovascular event has occurred, as well as to potentially identify young patients at risk of acute coronary syndrome (ACS) despite normal coronary arteries. Methods: A retrospective cross sectional study was undertaken over an 8 year period at Tawam Hospital. 576 patients aged 50 or under who underwent coronary angiography were selected for the study. Medical records were analyzed for the patient's demographics and CAD risk factor profile, including the following variables: family history of CAD, smoking status, Body Mass Index category, lipid profile, and diagnosis of hyperlipidemia, diabetes, or hypertension. Details of the coronary angiogram were also reviewed. Results: Statistically significant outcomes included a higher prevalence of diabetes, hyperlipidemia, and smoking history in patients with CAD compared to the patients with normal coronary angiogram. Diabetes was one of the strongest risk factors in CAD patients, with an odds ratio of 1.98 (p= 0.011), followed by hyperlipidemia at 1.85 (p= 0.021). Smoking history had an odds ratio of 2.93 (p <0.001). Conclusion: Risk factors were present in both groups, but significantly more in the CAD group. No particular risk factor stood out for the development of ACS in those with normal coronary arteries, other than mean BMI being slightly higher in this group. Based on our analysis, no single variable can accurately predict the risk for ACS in normal coronaries. To our knowledge, few studies have been done in the young population with angiographically normal coronary arteries to determine possible risk factors for development of ACS. Further research needs to be done to determine whether the risk factors that were common amongst both groups are coincidental, or a cause of ACS in those with normal coronary arteries.

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Section: Discussionmentioning

confidence: 99%

Risk factor comparison in young patients presenting with acute coronary syndrome with atherosclerotic coronary artery disease vs. angiographically normal coronaries

Jamil

Mesameh

et al. 2021

Int. J. Med. Sci.

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“…With advancing technology, CCTA has started to play a crucial role in guiding both invasive and noninvasive treatments for coronary artery disease by providing physiological assessments. However, concerns persist regarding its widespread use, primarily due to potential radiation side effects and the risk of contrast-induced nephropathy [36,37]. As our study has also highlighted, an attractive, cost-effective, and reliable approach may involve combining the TyG and AIP indices with CCTA findings.…”

Section: Discussionmentioning

confidence: 83%

“…The prognostic value of CCTA has received extensive support from various ethnic groups and numerous previous studies. Its selective use in primary prevention settings is endorsed by clinical guidelines [3,37]. CCTA provides a more comprehensive evaluation that goes beyond merely detecting the presence or severity of stenosis.…”

Section: Discussionmentioning

confidence: 99%

The Triglyceride–Glucose Index Might Be a Better Indicator for Predicting Poor Cardiovascular Outcomes in Chronic Coronary Syndrome

Erdoğan,

İnan,

Genç

et al. 2023

JCM

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This study aimed to explore the potential association between the triglyceride–glucose index (TyG) and the atherogenic index of plasma (AIP)—both considered surrogate markers for atherosclerosis—and major adverse cardiovascular events (MACEs) in patients diagnosed with chronic coronary syndrome (CCS). We conducted a retrospective analysis, encompassing 715 consecutive patients with intermediate CCS risk, who presented at the outpatient clinic between June 2020 and August 2022. MACEs included non-fatal myocardial infarction, hospitalization for heart failure, cerebrovascular events, non-cardiac mortality, and cardiac mortality. The primary outcome was the composite occurrence of MACEs during the follow-up period. For time-to-event analysis of the primary outcome, we employed Kaplan–Meier plots and Cox proportional hazard models. The median age of the overall study population was 55 years, with a median follow-up duration of 17 months. Multivariate Cox regression analysis identified age, hypertension, Coronary Artery Disease–Reporting and Data System score, and TyG index as independent predictors of the primary outcome. Notably, individuals with high TyG levels exhibited a significantly higher primary outcome rate compared to those with low TyG levels (18.7% vs. 3.8%, p < 0.001). Similarly, patients with elevated TyG values demonstrated statistically higher rates of cerebrovascular events, hospitalizations for heart failure, non-fatal myocardial infarctions, non-cardiac mortality, and cardiac mortality. These findings suggest that TyG may serve as a predictive marker for adverse cardiovascular outcomes in patients with CCS.

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“…Atualmente, é realizado por meio da TC sem contraste com auxílio de um eletrocardiograma (ECG) 9 . As placas ateroscleróticas calcificadas são identificadas e quantificadas pelo método de Agaston 32 , no qual as lesões com mais de 130 Unidades Hounsfileld (UH) são multiplicadas pela proporção de sua própria área e ao fim somadas, obtendo assim uma unidade total de possivel acometimento coronariano 4 .…”

Section: Introductionunclassified

Escore De Cálcio Coronariano E Mortalidade: Uma Revisão De Literatura

Cavalieri

Santiago

Aragão

2023

REASE

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O escore de cálcio das artérias coronárias (CAC) é um exame complementar utilizado para estratificar o risco cardiovascular. Atualmente é realizado por meio da tomografica computadorizada sem contraste, que por meio de imagens é possivel identificar e quantificar áreas de calcificação das placas de aterosclerose coronariana e com isso identificar pacientes com maior probabilidade de acometimento cardiovascular futuro. O objetivo dessa reviasão foi avaliar como se relaciona o aumento dos níveis de CAC com a mortalidade por todas as causas. Foi realizada uma busca por trabalhos prévios nas plataformas National Library of Medicine (PubMed) e Biblioteca Virtual em Saúde (BVS) e um total de 29 artigos científicos foram incluídos após a aplicação de critérios de inclusão e exclusão. Através dos estudos analisados, populações com elevados índices de calcificação coronariana, apresentam menor sobrevida e maior taxa de mortalidade em comparação a grupos com menores pontuações. Em relação ao outro extremo, o CAC = 0 se demonstrou como um importante fator de proteção. Em conclusão, o CAC apresenta valor tanto para prever eventos de origem coronariana e mortalidade, quanto para adicionar aos escores de risco tradicionais informações importantes que podem auxiliar em decisões clínicas de maior relevância para esses pacientes.

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Potential Application of Cardiac Computed Tomography for Early Detection of Coronary Atherosclerosis: From Calcium Score to Advanced Atherosclerosis Analysis

Cited by 4 publications

References 55 publications

Risk factor comparison in young patients presenting with acute coronary syndrome with atherosclerotic coronary artery disease vs. angiographically normal coronaries

Risk factor comparison in young patients presenting with acute coronary syndrome with atherosclerotic coronary artery disease vs. angiographically normal coronaries

The Triglyceride–Glucose Index Might Be a Better Indicator for Predicting Poor Cardiovascular Outcomes in Chronic Coronary Syndrome

Escore De Cálcio Coronariano E Mortalidade: Uma Revisão De Literatura

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