Efficacy of Coronary Calcium Score in Predicting Coronary Artery Morphology in Patients With Obstructive Coronary Artery Disease

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Coronary artery calcium score (CACS) is an established marker of coronary artery disease (CAD) and has been extensively used to stratify risk in asymptomatic individuals. However, the value of CACS in predicting plaque morphology in patients with advanced CAD is less established. The present analysis aims to assess the association between CACS and plaque characteristics detected by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) imaging in patients with obstructive CAD.

Methods

Seventy patients with obstructive CAD underwent coronary computed tomography angiography (CTA) and 3-vessel NIRS-IVUS imaging were included in the present analysis. The CTA data were used to measure the CACS in the entire coronary tree and the segments assessed by NIRS-IVUS, and these estimations were associated with the NIRS-IVUS measurements at a patient and segment level.

Results

In total, 65 patients (188 segments) completed the study protocol and were included in the analysis. A weak correlation was noted between the CACS, percent atheroma volume (r = 0.271, P = .002), and the calcific burden measured by NIRS-IVUS (r = 0.648, P < .001) at patient-level analysis. Conversely, there was no association between the CACS and the lipid content, or the incidence of high-risk plaques detected by NIRS. Linear regression analysis at the segment level demonstrated an association between the CACS and the total atheroma volume (coefficient, 0.087; 95% CI, 0.024-0.149; P = .008) and the calcific burden (coefficient, 0.117; 95% CI, 0.048-0.186; P = .001), but there was no association between the lipid content or the incidence of high-risk lesions.

Conclusions

In patients with obstructive CAD, the CACS is not associated with the lipid content or plaque phenotypes. These findings indicate that the CACS may have a limited value for screening or stratifying cardiovascular risk in symptomatic patients with a high probability of CAD.

Related collections

Most cited references 35

Record: found
Abstract: not found
Article: not found

2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Frank L. J. Visseren, François Mach, Yvo M. Smulders … (2021)

0 comments Cited 1296 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A prospective natural-history study of coronary atherosclerosis.

Gregg W. Stone, Akiko Maehara, Alexandra J. Lansky … (2011)

Atherosclerotic plaques that lead to acute coronary syndromes often occur at sites of angiographically mild coronary-artery stenosis. Lesion-related risk factors for such events are poorly understood. In a prospective study, 697 patients with acute coronary syndromes underwent three-vessel coronary angiography and gray-scale and radiofrequency intravascular ultrasonographic imaging after percutaneous coronary intervention. Subsequent major adverse cardiovascular events (death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization due to unstable or progressive angina) were adjudicated to be related to either originally treated (culprit) lesions or untreated (nonculprit) lesions. The median follow-up period was 3.4 years. The 3-year cumulative rate of major adverse cardiovascular events was 20.4%. Events were adjudicated to be related to culprit lesions in 12.9% of patients and to nonculprit lesions in 11.6%. Most nonculprit lesions responsible for follow-up events were angiographically mild at baseline (mean [±SD] diameter stenosis, 32.3±20.6%). However, on multivariate analysis, nonculprit lesions associated with recurrent events were more likely than those not associated with recurrent events to be characterized by a plaque burden of 70% or greater (hazard ratio, 5.03; 95% confidence interval [CI], 2.51 to 10.11; P<0.001) or a minimal luminal area of 4.0 mm(2) or less (hazard ratio, 3.21; 95% CI, 1.61 to 6.42; P=0.001) or to be classified on the basis of radiofrequency intravascular ultrasonography as thin-cap fibroatheromas (hazard ratio, 3.35; 95% CI, 1.77 to 6.36; P<0.001). In patients who presented with an acute coronary syndrome and underwent percutaneous coronary intervention, major adverse cardiovascular events occurring during follow-up were equally attributable to recurrence at the site of culprit lesions and to nonculprit lesions. Although nonculprit lesions that were responsible for unanticipated events were frequently angiographically mild, most were thin-cap fibroatheromas or were characterized by a large plaque burden, a small luminal area, or some combination of these characteristics, as determined by gray-scale and radiofrequency intravascular ultrasonography. (Funded by Abbott Vascular and Volcano; ClinicalTrials.gov number, NCT00180466.).

0 comments Cited 398 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients.

Matthew Budoff, Leslee J Shaw, Sandy Liu … (2007)

The purpose of this study was to develop risk-adjusted multivariable models that include risk factors and coronary artery calcium (CAC) scores measured with electron-beam tomography in asymptomatic patients for the prediction of all-cause mortality. Several smaller studies have documented the efficacy of CAC testing for assessment of cardiovascular risk. Larger studies with longer follow-up will lend strength to the hypothesis that CAC testing will improve outcomes, cost-effectiveness, and safety of primary prevention efforts. We used an observational outcome study of a cohort of 25,253 consecutive, asymptomatic individuals referred by their primary physician for CAC scanning to assess cardiovascular risk. Multivariable Cox proportional hazards models were developed to predict all-cause mortality. Risk-adjusted models incorporated traditional risk factors for coronary disease and CAC scores. The frequency of CAC scores was 44%, 14%, 20%, 13%, 6%, and 4% for scores of 0, 1 to 10, 11 to 100, 101 to 400, 401 to 1,000, and >1,000, respectively. During a mean follow-up of 6.8 +/- 3 years, the death rate was 2% (510 deaths). The CAC was an independent predictor of mortality in a multivariable model controlling for age, gender, ethnicity, and cardiac risk factors (model chi-square = 2,017, p 1,000, respectively (p 1,000 (p < 0.0001). This large observational data series shows that CAC provides independent incremental information in addition to traditional risk factors in the prediction of all-cause mortality.

0 comments Cited 286 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Christos V. Bourantas

Journal

Journal ID (nlm-ta): J Soc Cardiovasc Angiogr Interv

Journal ID (iso-abbrev): J Soc Cardiovasc Angiogr Interv

Title: Journal of the Society for Cardiovascular Angiography & Interventions

Publisher: Elsevier

ISSN (Electronic): 2772-9303

Publication date PMC-release: 26 March 2024

Publication date Collection: March 2024

Publication date (Electronic): 26 March 2024

Volume: 3

Issue: 3Part B

Electronic Location Identifier: 101308

Affiliations

[a ]Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom

[b ]Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

[c ]Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom

[d ]Institute of Health Informatics, University College London, London, United Kingdom

[e ]Department of Cardiology, Faculty of Medicine, Yuzuncu Yil University Van, Van, Turkey

[f ]Department of Cardiology, Xuzhou Third People’s Hospital, Xuzhou, China

[g ]Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands

[h ]Medis Medical Imaging Systems, Leiden, the Netherlands

[i ]Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, United Kingdom

[j ]Department of Cardiology, University of Galway, Galway, Ireland

[k ]Institute of Cardiovascular Sciences, University College London, London, United Kingdom

[l ]Department of Mechanical Engineering, University College London, London, United Kingdom

Author notes

[∗ ]Corresponding author c.bourantas@ 123456gmail.com

[†]

Co-first authors.

Article

Publisher Item ID: S2772-9303(24)00015-2 Publisher ID: 101308

DOI: 10.1016/j.jscai.2024.101308

PMC ID: 11307846

SO-VID: 9ef235d1-0022-406c-91e5-7271d3c2e2a4

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 2 January 2024

Date revision received : 11 January 2024

Date accepted : 12 January 2024

Efficacy of Coronary Calcium Score in Predicting Coronary Artery Morphology in Patients With Obstructive Coronary Artery Disease

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

Cardiovascular Innovations and Applications

Most cited references 35

2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

A prospective natural-history study of coronary atherosclerosis.

Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients.

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 164

Most referenced authors 932