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Saydam CD. Subclinical cardiovascular disease and utility of coronary artery calcium score. IJC HEART & VASCULATURE 2021; 37:100909. [PMID: 34825047 PMCID: PMC8604741 DOI: 10.1016/j.ijcha.2021.100909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/14/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Abstract
ASCVD are the leading causes of mortality and morbidity among Globe. Evaluation of patients' comprehensive and personalized risk provides risk management strategies and preventive interventions to achieve gain for patients. Framingham Risk Score (FRS) and Systemic Coronary Risk Evaluation Score (SCORE) are two well studied risk scoring models, however, can miss some (20-35%) of future cardiovascular events. To obtain more accurate risk assessment recalibrating risk models through utilizing novel risk markers have been studied in last 3 decades and both ESC and AHA recommends assessing Family History, hs-CRP, CACS, ABI, and CIMT. Subclinical Cardiovascular Disease (SCVD) has been conceptually developed for investigating gradually progressing asymptomatic development of atherosclerosis and among these novel risk markers it has been well established by literature that CACS having highest improvement in risk assessment. This review study mainly selectively discussing studies with CACS measurement. A CACS = 0 can down-stratify risk of patients otherwise treated or treatment eligible before test and can reduce unnecessary interventions and cost, whereas CACS ≥ 100 is equivalent to statin treatment threshold of ≥ 7.5% risk level otherwise statin ineligible before test. Since inflammation, insulin resistance, oxidative stress, dyslipidemia and ongoing endothelial damage due to hypertension could lead to CAC, ASCVD linked with comorbidities. Recent cohort studies have shown a CACS 100-300 as a sign of increased cancer risk. Physical activity, dietary factors, cigarette use, alcohol consumption, metabolic health, family history of CHD, aging, exposures of neighborhood environment and non-cardiovascular comorbidities can determine CACs changes.
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Xu R, Yang B, Li L, Wang T, Lu X, Luo J, Zhang X, Dong J, Wang Y, Hua Y, Ma Y, Jiao L. Macrocalcification of intracranial vertebral artery may be related to in-stent restenosis: lessons learned from optical coherence tomography. J Neurointerv Surg 2021; 14:neurintsurg-2021-017913. [PMID: 34376557 DOI: 10.1136/neurintsurg-2021-017913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/27/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Calcification has been proven to be a marker of atherosclerosis and is related to an increased risk of ischemic stroke. Additionally, calcification was reported to be prevalent in patients with stenotic lesions of the intracranial vertebral artery. Thus, reliable imaging facilities for evaluating plaque calcification have remarkable significance in guiding stenting and predicting patient outcomes. Optical coherence tomography (OCT) has a unique advantage in its ability to detect calcium and to achieve three-dimensional volumetric calcium characterization. METHODS From March 2017 to September 2018, seven cases of calcified lesions with intracranial vertebral artery stenosis were investigated using OCT, before and after the placement of an Apollo balloon-mounted stent. Transcranial color-coded duplex sonography was performed to identify restenosis with a mean follow-up time of 13.3 months in this case series. RESULTS All calcified lesions were evaluated quantitatively and qualitatively using OCT. Among all cases, five had macrocalcifications and two had spotty calcifications. Severe in-stent restenosis was observed in two cases, both with macrocalcifications. CONCLUSIONS This study suggests a potential relationship between macrocalcifications and the risk of in-stent restenosis of the intracranial vertebral artery. These preliminary findings obtained from a limited sample should be verified by prospective large-scale studies.
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Affiliation(s)
- Ran Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Bin Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Long Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Tao Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Xia Lu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Jichang Luo
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Xiao Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Jia Dong
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yabing Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Yang Hua
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yan Ma
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China .,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China .,China International Neuroscience Institute (China-INI), Beijing, People's Republic of China.,Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China
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Noh DW, Kim S. Associations between coronary artery stenosis detected by coronary computed tomography angiography and the characteristics of health checkup examinees in the Republic of Korea. Radiography (Lond) 2019; 26:22-26. [PMID: 31902450 DOI: 10.1016/j.radi.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study was conducted on healthy adults without a diagnosis related to cardiovascular disease to investigate the associations between asymptomatic coronary artery stenosis and the characteristics of health checkup examinees. METHODS This study was performed on 601 people (320 males and 281 females), who underwent coronary computed tomography angiography (CCTA), among health checkup examinees from January 2, 2015 to December 31, 2016. Those with any prior history of cardiovascular diseases, underwent coronary artery bypass grafting or coronary artery stenting in the past, those with atrial fibrillation, those suspected of contrast agent side effects, and those whose creatinine levels deviated from the normal range were excluded. RESULTS The mean age was 58.7 ± 8.0 years. Coronary artery stenosis was detected in 173 people (28.8%), and the mean coronary artery stenosis rate was 25.8 ± 12.8%. Regression analysis showed that coronary artery stenosis was influenced significantly by age, gender, glycated hemoglobin (HbA1c), past smoking duration, current smoking duration, and number of glasses of alcohol consumed (p < 0.05). In terms of the relationship between the presence of coronary artery stenosis and lifestyle habits, amount of alcohol consumed per day (p = 0.03), and patients with a longer period of past (p < 0.001) and current smoking duration (p = 0.01) had a significant effect on coronary artery stenosis. CONCLUSION These results suggest that men aged 60 years or older, who have consumed large amounts of alcohol and cigarettes for a long time, require continuous management through tests such as a health checkup, because of the high probability of coronary artery stenosis, even in those without specific symptoms.
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Affiliation(s)
- D-W Noh
- Department of Radiology, Korea Association of Health Promotion Medicheck, 500 Dokbae-ro, Michuhol-gu, 22172, Incheon, Republic of Korea; Department of Radiological Science, Gachon University Medical Campus, Incheon, Republic of Korea.
| | - S Kim
- Department of Radiological Science, Gachon University Medical Campus, Incheon, Republic of Korea.
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