The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium

Wong, Nathan D.; Sciammarella, Maria; Polk, Donna M.; Gallagher, Amy; Miranda-Peats, Romalisa; Whitcomb, Brian W.; Hachamovich, Rory; Friedman, John D.; Hayes, Sean W.; Berman, Daniel S.

doi:10.1016/s0735-1097(03)82532-9

Cited by 25 publications

(33 citation statements)

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“…[3][4][5] Furthermore, the presence and extent of coronary calcification is prognostically important and adds incremental prognostic information beyond that of traditional cardiovascular risk factors. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Therefore, in patients suspected of having CAD, a combined evaluation of both stress MPI and CACS could incrementally add to their correct classification [25][26][27][28][29][30] and could significantly change clinical management.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging

Bybee

Lee

Markiewicz

et al. 2010

Journal of Nuclear Cardiology

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Section: Introductionmentioning

confidence: 99%

Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging

Bybee

Lee

Markiewicz

et al. 2010

Journal of Nuclear Cardiology

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“…The high coronary calcium score did not significantly impair the overall diagnostic accuracy of MSCT for detecting significant coronary stenoses. This finding may be of particular importance for the diabetic patient population, since it has been observed that the prevalence and the extent of coronary calcifications in diabetic patients is higher than in the nondiabetic population [16]. Moreover, advanced atherosclerotic plaque burden may even be present without evident clinical symptoms.…”

mentioning

confidence: 89%

Image assessment and post-processing with multislice CT angiography in highly calcified coronary arteries

Pundziūtė

Schuijf

Bax

et al. 2006

Int J Cardiovasc Imaging

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In response to the article by Cordeiro et al., CT angiography in highly calcified arteries: 2D vs. modified automated 3D approach to identify coronary stenoses (DOI 100.1007/s10554-005-9044-9) Since the introduction of the first generation of computed tomography (CT) in 1972, the technique has undergone many technological innovations. In 1998, mechanical spiral CT with simultaneous acquisition by 4-detector rows has been introduced as a noninvasive imaging modality for direct visualization of the coronary arteries. The reported sensitivities for the detection of significant stenoses with the 4-slice multislice computed tomography (MSCT) systems ranged from 67 to 91%, while the specificities ranged from 75 to 99%, and the negative predictive values were particularly high, reaching up to 97% [1][2][3][4][5][6]. Inadequate image quality mainly due to cardiac and respiratory motion artifacts and severe calcifications, however, resulted in the exclusion of 22% of all coronary segments, which was a major limitation of the technique [7]. Sixteen-slice MSCT scanners with higher temporal and spatial resolution showed better results. The sensitivities ranged between 70 and 98%, whereas the specificities varied between 93 and 98%, with only 4% of coronary segments being excluded as not evaluable [7]. With the introduction of 64-slice MSCT systems, further substantial improvement in image quality is anticipated. The new generation scanners allow gantry rotation time of 330 ms and provide nearly isotropic voxels of 0.4 mm [8]. Leschka et al. [9] performed MSCT in comparison to invasive coronary angiography in 67 patients. All coronary segments were included in the analysis.The authors reported a sensitivity of 94% and a specificity of 97% to detect significant coronary stenoses. Mollet et al.[10] evaluated the performance of 64-slice MSCT in 52 patients. Again, all available coronary segments were included in the evaluation; the sensitivity and specificity for detecting significant coronary stenoses on a segment-persegment basis showed promising results and were 99% and 95%, respectively.Several image post-processing techniques are available to allow clinically useful information to be extracted from several hundreds of individual axial images generated during single MSCT examination of the coronary arteries [8,11]. The evaluation often begins with the scrolling through axial images, which are considered to be the source images for image post-processing. Multiplanar reconstructions (MPRs) are generated from the volume data set reconstructed from axial images in several arbitrary imaging planes. MPRs can be easily and quickly performed on any dedicated workstation, with all available data being represented in the images. Curved MPR (cMPR) enables the entire coronary artery to be displayed in one reconstruction. Two or more images in orthogonal planes are examined to render correct evaluation of coronary lesions. Depending on the vascular tissue densities encountered by each ray in the three-dimensional volume, maximum inte...

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“…13,14 This type of tiered testing has also been advocated for patients with the metabolic syndrome and for those with a family history of premature CHD. 15,16 Another approach is that imaging should not be performed because all of the high FRS patients should be treated to secondary prevention goals and that imaging will not alter this management course. There are no comparative trials on this subject but concern over the added contribution of ischemia to patient management in patients without cardiac symptoms remains an important consideration for high-risk patient subsets.…”

Section: Potential Use Of Rmpi Based On Risk Assessmentmentioning

confidence: 99%

The role of radionuclide myocardial perfusion imaging for asymptomatic individuals

Hendel

Abbott

Bateman

et al. 2011

Journal of Nuclear Cardiology

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The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium

Cited by 25 publications

References 0 publications

Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging

Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging

Image assessment and post-processing with multislice CT angiography in highly calcified coronary arteries

The role of radionuclide myocardial perfusion imaging for asymptomatic individuals

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