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Coronary artery disease (CAD) is caused by atheromatous blockage of coronary vessels leading to acute coronary events that usually occur when a plaque ruptures and a thrombus forms. CAD is a known cause of significant cardiovascular events, accounting for more than 50% of the deaths in western countries, and most of the patients with CAD remain asy...
Similar publications
This research was aimed at exploring the application value of optical coherence tomography (OCT) images under adaptive segmentation algorithm in the early diagnosis of coronary heart disease (CHD). Eighty-two patients with CHD were included, who were to undergo coronary angiography (CAG) to confirm their condition. According to the diagnostic crite...
Citations
... Vascular dysfunction is increasingly recognized as a significant non-traditional risk factor that contributes to the elevated CVD risk in several populations. Specifically, reductions in vascular endothelial function assessed with brachial artery flow-mediated dilation (BA-FMD), increases in arterial stiffness measured via carotidfemoral pulse wave velocity (cfPWV), and higher coronary artery calcium (CAC) score are associated with cardiovascular events and all-cause mortality in several high-risk populations [8][9][10][11][12][13]. Individuals with prediabetes exhibit macrovascular and microvascular dysfunction and measures of vascular function including BA-FMD, cfPWV, and CAC score are known to worsen as blood glucose levels rise [14][15][16][17][18][19]. ...
Background
Prediabetes is a growing public health concern that increases the risk of major adverse cardiovascular events (MACE). Vascular dysfunction worsens with hyperglycemia and is associated with MACE in several high-risk populations. However, it is unknown whether vascular dysfunction contributes to MACE in prediabetes. We hypothesized that vascular dysfunction is associated with elevated risk of MACE in prediabetes.
Methods
We conducted an observational study of 5742 adults (age 54.9 ± 11.5 years, 54% female) in the Framingham Offspring and Generation III cohorts. Prediabetes was defined using the ADA criteria. Endothelial function was determined via brachial artery flow-mediated dilation (BA-FMD), aortic stiffness via carotid-femoral pulse wave velocity (cfPWV), and coronary artery calcium (CAC) score via computed tomography. Stepwise selection models evaluated BA-FMD, cfPWV, and CAC score by prediabetes status. The association of BA-FMD, cfPWV, and CAC score with time to MACE was assessed via Cox proportional hazards regression.
Results
Individuals with prediabetes had lower BA-FMD and higher cfPWV and CAC score (p < 0.001). In stepwise selection models, age, sex, smoking history, systolic blood pressure, triglycerides, high-density lipoprotein, low-density lipoprotein, and fasting glucose related to vascular dysfunction. After adjusting for traditional cardiovascular risk factors, BA-FMD (HR [95% CI], 0.93 [0.90,0.97]; p < 0.001) and CAC score >100 [HR [95% CI], 4.15 [2.24, 7.70]; p < 0.001)] were associated with MACE in prediabetes while cfPWV was not (p = 0.051).
Conclusions
Vascular dysfunction measured by BA-FMD independently associates with MACE in prediabetes. Therapies that target vascular dysfunction may reduce CVD risk in prediabetes.
... In affluent countries, CHD is a primary cause of death and disability in individuals older than 35 years (Sanchis-Gomar et al., 2016). It can be asymptomatic but is characterized by atherosclerosis in coronary arteries, which is the building up of plaque in the main arteries that supply the heart muscle resulting in a decreased blood flow (Salehi et al., 2021;Shreya et al., 2021). The plaque buildup may calcify and rupture over a period, which may result in thrombosis of the coronary arteries (usually atherosclerosis; Salehi et al., 2021;Shreya et al., 2021). ...
... It can be asymptomatic but is characterized by atherosclerosis in coronary arteries, which is the building up of plaque in the main arteries that supply the heart muscle resulting in a decreased blood flow (Salehi et al., 2021;Shreya et al., 2021). The plaque buildup may calcify and rupture over a period, which may result in thrombosis of the coronary arteries (usually atherosclerosis; Salehi et al., 2021;Shreya et al., 2021). The initial clinical manifestation of CHD in patients is angina or the diagnoses of angina pectoris, which is associated with worse clinical outcomes regardless of the presence of myocardial ischemia on noninvasive testing (J. Brown et al., 2021;De Luca et al., 2018). ...
... CHD is a cause of significant cardiovascular events, and there is an equal susceptibility to CHD in men and women. Still, women tend to have a better risk profile at a younger age and vice-versa in old age (Shreya et al., 2021). However, CHD is caused by atheromatous blockage of coronary vessels leading to acute coronary events that often occur when a plaque ruptures and a thrombus forms, and most patients tend to remain asymptomatic (Shreya et al., 2021). ...
Coronary heart disease (CHD) stands out as the predominant cardiovascular condition,
... Thereafter, a robust body of literature has grown demonstrating the powerful ability of CACS to predict cardiovascular events and guide therapies [4]. To help medical professionals with risk assessment and the development of customized preventative measures, CACS is essential for detecting and measuring calcified plaques inside coronary arteries [5]. ...
Background: Cardiovascular risk assessment relies heavily on coronary calcium scoring. With an emphasis on varying slice increments, this study investigates the effectiveness of true and virtual non-contrast reconstructions on photon-counting CT. Reconstruction methods’ effects on calcium severity classifications are critical to the improvement in imaging techniques. Methods: This study comprised 77 participants (mean age: 63 ± 10 years, 43% female), of whom 0 had a coronary artery calcium score (CACS) of zero. In contrast to true non-contrast (TNC) 3 × 3 mm, the reconstructions included TNC 3 × 1.5 mm, virtual non-contrast (VNC) 3 × 3 mm, and VNC 3 × 1.5 mm. Agatston units served as the basis for classifications into standard clinical diagnostic categories. Results: High concordance between acquisition types was revealed by interclass correlation values (0.97–0.99). Comparing TNC 3 × 1.5 mm reconstructions to their VNC counterparts, misclassifications were less common (Cohen Kappa = 0.94). (K = 0.83–0.85). Significant differences in the average calcium scores and rates of misclassification highlighted the impact of reconstruction methods on precise evaluations. Conclusions: VNC methods demonstrated high agreement; however, with a small rate of misclassifications as compared to the gold standard method. VNC CACS may help optimize workflows but may need differing cutoffs as compared to traditional methods.
... Natomiast obecnie do oceny CAC zazwyczaj stosuje się bezkontrastową wielorzędową tomografię komputerową. Dzięki tej technice można wykryć nawet bardzo nieznaczne zwapniałe zwężenia, co jest niemożliwe w przypadku standardowych testów diagnostycznych [31]. ...
Insulin resistance refers to the diminished response of insulin-sensitive tissues to insulin signaling. Recent observational studies increasingly indicate that insulin resistance may be one of the risk factors for the development of cardiovascular disease. The article focuses on the molecular basis of this phenomenon. In insulin resistance, hyperinsulinemia is observed, followed by impaired glucose metabolism, which subsequently leads to the development of inflammation due to triggering inflammatory signaling pathways and production of pro-inflammatory cytokines. Inflammation contributes to the formation of reactive oxygen species, which further exacerbate insulin resistance and promote the formation of atherosclerotic plaques. In turn reactive oxygen species indirectly contribute to reduced endothelial NO production, leading to vasoconstriction and increased blood pressure. Insulin resistance also stimulates vascular smooth muscle hypertrophy, a key contributor to hypertension and cardiovascular disease.
... Згідно з останніми дослідженнями, окрім КТкоронарографії важливим інструментом для стратифікації серцево-судинного ризику у безсимптомних пацієнтів є визначення індексу коронарного кальцію за шкалою Agatston (CAC Score) [9,10]. Даний метод проводиться з ЕКГ-синхронізацією та без використання контрастної речовини, що надає йому економічної ефективності та широкої доступності [11]. Керуючись оновленою у 2022 році системою CAD-RADS 2.0, ступінь коронарокальцинозу поділяють на пʼять категорій: Р0: CAC Score = 0 -відсутність коронарного кальцію, Р1: CAC Score = 1-100, P2: CAC Score = 101-300, P3: CAC Score = 301-999, P4: CAC Score > 1000 [8]. ...
Coronary artery disease (CAD) is a leading cause of mortality and disability worldwide. CT coronary angiography is a fast and non-invasive method for diagnosing coronary artery pathology. To standardize the assessment of CT coronary angiography results, the CAD-RADS (Coronary Artery Disease – Reporting and Data System) was developed, which is based on determining the degree of coronary artery stenosis. According to recent studies, in addition to CT coronary angiography, an important tool for cardiovascular risk stratification in asymptomatic patients is the assessment of coronary calcium score using the Agatston scale (CAC Score). Aim. To assess the relationship and degree of correlation between the CAC Score and the presence of significant coronary artery stenosis when combining CAC Score and CT coronary angiography. Materials and Methods. The data of 464 patients from the National Institute of Cardiovascular Surgery were analyzed. These patients presented with typical or atypical angina symptoms and had a low or moderate risk of coronary artery disease between September 1, 2024, and January 15, 2025. All patients underwent clinical examination, risk factor assessment, CAC Score evaluation, and CT coronary angiography. Patients with atherosclerosis were divided into two groups: those with non-significant stenosis and those with significant stenosis (≥50% in the left main coronary artery or ≥70% in the major epicardial coronary arteries). Results. The study included 464 patients, predominantly male (55.6%), with a mean age of 59 ± 10.22 years. Atherosclerotic coronary artery disease was detected in 273 patients (58.8%). Based on the CAD-RADS, 24.54% of patients had CAD-RADS 1, 31.14% had CAD-RADS 2, 16.12% had CAD-RADS 3, 20.88% had CAD-RADS 4A, 5.49% had CAD-RADS 4B, and 1.83% had CAD-RADS 5. In the first group (non-significant stenosis), there were 196 patients (71.8%), while the second group (significant stenosis) included 77 patients (28.2%). The median CAC Score in the first group was 24.5 (1–103.25), while in the second group, it was 271.5 (88–666.5), p<0.001. A moderately strong positive correlation was found between the CAC Score and the presence of significant coronary artery stenosis (ρ=0.635, p<0.001). ROC curve analysis shows that the optimal cutoff value of the CAC Score for detecting significant stenosis was 282, with a sensitivity of 48.7%, specificity of 88.8%, and an AUC of 0.819. Conclusions. The study identified a statistically significant correlation between the level of coronary calcification and the presence of significant stenosis. The CAC Score is a reliable prognostic marker for significant coronary artery stenosis in patients with suspected coronary artery disease.
... Coronary artery calcium (CAC) scoring utilizes computed tomography to measure the density of calcification within the coronary vasculature and has been identified as a suitable surrogate for the total atherosclerotic burden [10]. CAC scores of zero are associated with low risk for CVD [11]. ...
Cardiovascular disease is the leading cause of morbidity and mortality in patients with end-stage kidney disease (ESKD). To date, no trial has been adequately powered to evaluate the effects of different dialysis modalities on cardiovascular events or mortality. To properly assess the risks and benefits of each modality for individual patients, it is crucial to understand the unique cardiovascular risk factors in patients undergoing dialysis. This review explores the existing literature on cardiovascular risk assessment in this population. It examines the mechanisms contributing to increased risk, including volume overload, blood pressure abnormalities, mineral bone disorder, vascular calcification, uremia, anemia, and chronic inflammation. Additionally, we discuss data from trials assessing cardiovascular outcomes and compare various dialysis modalities, including in-center hemodialysis, frequent dialysis, nocturnal dialysis, and peritoneal dialysis.
... CACS has been widely studied and has been shown to be significantly associated with CAD especially in asymptomatic patients but also in symptomatic patients [18]. Also the Framingham study which is ongoing project has suggested strong association of CACS with CAD. ...
Background: Ischemic heart disease is the major cause of morbidity and mortality. The diagnosis of chronic coronary syndrome is a challenge as most of the diagnostic investigation are either invasive or involve radiation or contrast material. The aim of our study was to find a scoring system comprising diagnostic parameters which are non-invasive and involve minimal radiation or contrast material and yet have high diagnostic yield. Methods: In this non-randomized study conducted at KRL hospital Islamabad from Oct 2022 to Aug 2024, we took baseline characteristics and calculated Non Invasive, Minimal Radiation score (NIMR score) comprising risk factors, ETT, coronary calcium score and age of the patients, aged 18 and above. They then underwent CCTA to look for CAD. The association of the CAD with the score was checked using regression analysis on IBM SPSS version 26. Results: Out of total 150 participants, 60% were male, mean age with SD was 50.54 ± 7.82 and age ranged from 40-67 years. CAD was more prevalent in male and increased with increasing age. On Univariate analysis, NIMR score both as continuous variable and as categorical variable emerged as strong predictor of CAD (OR: 2.45, 95% CI: 1.84-3.25, pValue: 0.000) and (OR: 64.09, 95% CI: 14.53-282.74, pValue: 0.000) respectively. On multivariate analysis also the NIMR score was strong predictor of CAD both as continuous variable (OR: 2.43, 95%CI: 1.83-3.24, pValue: 0.000) and as categorical variable (OR: 67.11, 95%CI: 14.47-311.14, pValue: 0.000). Conclusion: In conclusion, NIMR score, which is non-invasive, with minimal radiation and no contrast material involvement is a strong predictor of CAD in low and intermediate risk patients and very applicable in day to day clinical practice.
... The presence of microcalcifications at the coronary CT is a high-risk criterion of instability [143]. At the cardiac CT, an elevated coronary artery calcium score (CAC) is correlated with the severity of CAD and increased cardiovascular morbidity [144][145][146][147]. In fact, calcified coronary lesions present specific challenges, are characterized by higher complication rates, and require a dedicated therapeutic approach [148]. ...
Vascular calcification (VC) is a biological phenomenon characterized by an accumulation of calcium and phosphate deposits within the walls of blood vessels causing the loss of elasticity of the arterial walls. VC plays a crucial role in the incidence and progression of chronic kidney disease (CKD), leading to a significant increase in cardiovascular mortality in these patients. Different conditions such as age, sex, dyslipidemia, diabetes, and hypertension are the main risk factors in patients affected by chronic kidney disease. However, VC may occur earlier and faster in these patients if it is associated with new or non-traditional risk factors such as oxidative stress, anemia, and inflammation. In chronic kidney disease, several pathophysiological processes contribute to vascular calcifications, including osteochondrogenic differentiation of vascular cells, hyperphosphatemia and hypercalcemia, and the loss of specific vascular calcification inhibitors including pyrophosphate, fetuin-A, osteoprotegerin, and matrix GLA protein. In this review we discuss the main traditional and non-traditional risk factors that can promote VC in patients with kidney disease. In addition, we provide an overview of the main pathogenetic mechanisms responsible for VC that may be crucial to identify new prevention strategies and possible new therapeutic approaches to reduce cardiovascular risk in patients with kidney disease.
... Multiple detector spiral CT (MDCT) has become an essential tool in exploring the link between CAT and atherosclerotic burden, as it provides simultaneous assessment of plaque and CAT. Coronary calcium scoring (CAC) is a reliable predictor of coronary events and is used as a surrogate for atherosclerosis burden in research since it correlates positively with plaque burden (37,38). EAT volume (EATv) is positively correlated to CAC (39,40). ...
Background and Objective
Cardiac adipose tissue’s (CAT) role in the pathogenesis of coronary artery disease (CAD) has become a hot topic in the literature in recent years. Cardiac computed tomography (CCT), a cutting-edge imaging modality, has become vital in quantifying and characterizing CAT. CAT is divided into paracardial adipose tissue (PAT), epicardial adipose tissue (EAT), and pericoronary adipose tissue (PCAT). Despite numerous studies investigating the association of EAT and PCAT with CAD, their connection remains equivocal. In this review, we clarify the relationship between EAT and PCAT with atherosclerotic burden, high-risk plaque, major adverse cardiovascular events, and the prediction of CAD through the use of CCT.
Methods
A thorough literature research spanning from January 2004 to May 2024 of the PubMed database was conducted. Only publications in English which included reviews, clinical trials, meta-analyses, and systematic reviews on CAT’s association with CAD were considered. The 63 articles in the review honed in on the influence of CAT metrics obtained mainly by CCT with multiple stages of CAD.
Key Content and Findings
Current evidence supports the interaction between dysfunctioning EAT and PCAT and the release of several molecules within the neighboring coronary arteries which is linked with the development and progression of CAD. EAT is related to coronary plaque synthesis. PCAT underlines ongoing inflammation within the plaques. CAT evaluation provides significant incremental value compared to existing assessment methods. It enables enhanced prognostic judgment and further stratified management of CAD patients.
Conclusions
CAT metrics have the potential to become future biomarkers of CAD. Additional investigations are required to explore the potential of these metrics as composite scores CAD risk prediction.
... CAC is a measure of the amount of calcium in the walls of the coronary arteries, which supply blood to the heart muscle 20 . The presence of calcium is an indicator of atherosclerosis, a condition characterized by the buildup of plaque that can lead to coronary heart disease (CHD) and potentially to heart attacks or other cardiovascular events. ...
This study, for the first time, explores the integration of data science and machine learning for the classification and prediction of coronary artery calcium (CAC) scores. It focuses on tooth loss and patient characteristics as key input features to enhance the accuracy of classifying CAC scores into tertiles and predicting their values. Advanced analytical techniques were employed to assess the effectiveness of tooth loss and patient characteristics in the classification and prediction of CAC scores. The study utilized data science and machine learning methodologies to analyze the relationships between these input features and CAC scores. The research evaluated the individual and combined contributions of patient characteristics and tooth loss on the accuracy of identifying individuals at higher risk of cardiovascular issues related to CAC. The findings indicated that patient characteristics were particularly effective for tertile classification of CAC scores, achieving a classification accuracy of 75%. Tooth loss alone provided more accurate predicted CAC scores with the smallest average mean squared error of regression and with a classification accuracy of 71%. The combination of patient characteristics and tooth loss demonstrated improved accuracy in identifying individuals at higher risk with the best sensitivity rate of 92% over patient characteristics (85%) and tooth loss (88%). The results highlight the significance of both oral health indicators and patient characteristics in predictive modeling and classification tasks for CAC scores. By integrating data science and machine learning techniques, the research provides a foundation for further exploration of the connections between oral health, patient characteristics, and cardiovascular outcomes, emphasizing their importance in advancing the accuracy of CAC score classification and prediction.
