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Ren L, Han Y, Long M, Yan L, Wang Q, Fei X, Luo Y. Association with carotid plaque parameters detected on contrast-enhanced ultrasound and coronary artery plaque progression in non-culprit lesions: A retrospective study. Int J Cardiol 2023; 377:115-122. [PMID: 36682688 DOI: 10.1016/j.ijcard.2023.01.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
AIM To investigate the correlation between carotid plaque parameters detected on contrast-enhanced ultrasound(CEUS) and the plaque progression in non-culprit coronary lesions (NCCLs) after percutaneous coronary intervention (PCI). METHODS In this retrospective cross-sectional study, we analyzed 173 patients who underwent PCI. Patients were stratified into two groups (progression and non-progression groups) by comparing the coronary angiography (CAG) results at baseline and follow-up. The correlation between carotid plaque parameters and plaque progression in NCCLs was analyzed by multivariate logistic regression analysis. A logistic regression model was established to predict NCCLs progression. RESULTS Overall, 55 of 173 patients exhibited NCCLs progression (31.79%). Univariate comparisons showed that plaque thickness, plaque length, and IPN score were significantly higher in the progressive group than in the non-progressive group (P < 0.01). Multivariate logistic regression analysis revealed that carotid plaque length (OR = 3.418, 95% CI =1.101-10.610) and IPN score (OR = 7.395, 95% CI =3.154-17.342) were strongly associated with plaque progression in NCCLs. After adjusting for confounders, the history of previous PCI, plaque length, and IPN score were independent predictors of the NCCLs progression (P < 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the logistic regression model in predicting the NCCLs progression were 62.50%, 90.53%, 81.12%, 76.92%, and 82.69%, respectively, and the area under the receiver operating characteristic (ROC) curve was 0.882 (95% CI: 0.826-0.939). CONCLUSIONS Carotid plaque length and IPN score were strongly correlated with plaque progression in NCCLs. Combining the history of previous PCI can reasonably predict the NCCLs progression.
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Affiliation(s)
- Ling Ren
- The Second Medical College of Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou, Gansu 730030, China; Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Yanyan Han
- Cardiology Department, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China; Medical School of PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Mei Long
- Department of Cardiology, Zibo Central Hospital, No. 54 Gongqingtuanxi Road, Zhangdian District, Zibo, Shandong 255000, China
| | - Lin Yan
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Qi Wang
- Cardiology Department, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China; Medical School of PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Xiang Fei
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
| | - Yukun Luo
- The Second Medical College of Lanzhou University, No. 222 Tianshui South Road, Chengguan District, Lanzhou, Gansu 730030, China; Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
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López-Candales A, Sawalha K. Improving diagnostic assessments in the ever-changing landscape of atherosclerosis. J Cardiovasc Med (Hagerstown) 2023; 24:221-229. [PMID: 36952387 DOI: 10.2459/jcm.0000000000001451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
As our understanding of atherosclerotic vascular injury continues to evolve, so should our diagnostic approaches. Emerging data have recently challenged our basic understanding in linking ischemia to its adverse outcomes as well as the need for invasive testing for both diagnosis and treatment. The advent of coronary computed tomography in providing improved visualization of coronary arteries has led to the identification of both subclinical atherosclerosis and high-risk coronary lesions. Recognition of asymptomatic coronary artery disease (CAD) with objective localization of subclinical coronary atherosclerosis improves atherosclerotic cardiovascular risk assessment and allows healthcare providers to take effective primary prevention measures. Therefore, reshaping the diagnostic landscape in proposing new testing modalities would be highly dependent on local resource availability and the reading expertise of each clinical practice and medical institution. The main objective of this Review is to propose a potentially new diagnostic approach of simply using noninvasive stress testing or coronary angiography in the routine assessment of CAD.
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Affiliation(s)
| | - Khalid Sawalha
- Nutrition and Metabolism Fellowship, University of Missouri-Kansas City, Kansas City, Missouri, USA
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Low attenuation plaque volume on coronary computed tomography angiography is associated with plaque progression. Coron Artery Dis 2021; 33:176-181. [PMID: 34618752 DOI: 10.1097/mca.0000000000001103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patient-related clinical factors, laboratory factors, and some imaging factors may lead to statistical bias when investigating coronary plaque progression. In this study, we avoided patient characteristics by comparing morphological characteristics of plaque progression and nonprogression within the same patient with multiple plaques. METHODS From August 2011 to December 2018, 177 consecutive patients with 424 plaques who were followed with coronary computed tomography angiography (CTA) were reviewed retrospectively. Follow-up images of the plaques were used to determine whether the plaque volume or stenosis grade increased. The plaques were divided into progressive and nonprogressive groups. Logistic regression analysis was used to identify the factors associated with plaque progression. Through clinical follow-up, we analyzed whether the factors associated with plaque progression were related to major adverse cardiac events (MACEs). RESULTS There were 223 plaques that progressed during a mean follow-up period of 27.6 ± 15.9 months. The univariate logistic regression model revealed that only low attenuation plaque (LAP) volume (P = 0.02) was associated with plaque progression. After a mean post-CTA follow-up period of 36.7 ± 18.4 months, 37 patients experienced MACEs, and LAP volume was significantly related to future MACEs. CONCLUSION Only a high baseline LAP volume was associated with plaque progression, and patients with progressive plaques and a high LAP volume were more likely to have future MACEs. More attention should be given to plaques with LAP volumes larger than 2.4 mm3.
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Kang JH, Kim DH, Park SH, Baek JH. Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals. Korean J Radiol 2018; 19:1172-1178. [PMID: 30386148 PMCID: PMC6201984 DOI: 10.3348/kjr.2018.19.6.1172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/01/2018] [Indexed: 12/13/2022] Open
Abstract
Objective To analyze and compare the age of data in contemporary research articles published in representative general radiology journals. Materials and Methods We searched for articles reporting original research studies analyzing patient data that were published in the print issues of the Korean Journal of Radiology (KJR), European Radiology (ER), and Radiology in 2017. Eligible articles were reviewed to extract data collection period (time from first patient recruitment to last patient follow-up) and age of data (time between data collection end and publication). The journals were compared in terms of the proportion of articles reporting the data collection period to the level of calendar month and regarding the age of data. Results There were 50, 492, and 254 eligible articles in KJR, ER, and Radiology, respectively. Of these, 44 (88%; 95% confidence interval [CI]: 75.8-94.8%), 359 (73%; 95% CI: 68.9-76.7%), and 211 (83.1%; 95% CI: 78-87.2%) articles, respectively, provided enough details of data collection period, revealing a significant difference between ER and Radiology (p = 0.002). The age of data was significantly greater in KJR (median age: 826 days; range: 299-2843 days) than in ER (median age: 570 days; range: 56-4742 days; p < 0.001) and Radiology (median age: 618; range: 75-4271 days; p < 0.001). Conclusion Korean Journal of Radiology did not fall behind ER or Radiology in reporting of data collection period, but showed a significantly greater age of data than ER and Radiology, suggesting that KJR should take measures to improve the timeliness of its data.
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Affiliation(s)
- Ji Hun Kang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Dong Hwan Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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