Additional value of the coronary artery calcium score in patients for whom myocardial perfusion imaging is challenging

Havel, Martin; Koranda, Pavel; Kincl, Vladimír; Quinn, Libuse; Kamínek, Milan

doi:10.5603/kp.a2019.0037

Cited by 6 publications

(3 citation statements)

References 22 publications

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“… 1 , 4–6 The growing body of literature behind CAC is demonstrating other applications including periprocedural risk assessment, augmentation of functional stress testing, and prediction of atrial fibrillation. 7–9 Nonetheless, with limitations including radiation exposure, lack of widespread availability, and concern for misinterpretation, CAC has yet to be universally embraced. 10–12 …”

Section: Introductionmentioning

confidence: 99%

Prediction of coronary artery calcium scoring from surface electrocardiogram in atherosclerotic cardiovascular disease: a pilot study

Farjo

Yanamala

Kagiyama

et al. 2020

European Heart Journal - Digital Health

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Aims Coronary artery calcium (CAC) scoring is an established tool for cardiovascular risk stratification. However, the lack of widespread availability and concerns about radiation exposure have limited the universal clinical utilization of CAC. In this study, we sought to explore whether machine learning (ML) approaches can aid cardiovascular risk stratification by predicting guideline recommended CAC score categories from clinical features and surface electrocardiograms. Methods and results In this substudy of a prospective, multicentre trial, a total of 534 subjects referred for CAC scores and electrocardiographic data were split into 80% training and 20% testing sets. Two binary outcome ML logistic regression models were developed for prediction of CAC scores equal to 0 and ≥400. Both CAC = 0 and CAC ≥400 models yielded values for the area under the curve, sensitivity, specificity, and accuracy of 84%, 92%, 70%, and 75%, and 87%, 91%, 75%, and 81%, respectively. We further tested the CAC ≥400 model to risk stratify a cohort of 87 subjects referred for invasive coronary angiography. Using an intermediate or higher pretest probability (≥15%) to predict CAC ≥400, the model predicted the presence of significant coronary artery stenosis (P = 0.025), the need for revascularization (P < 0.001), notably bypass surgery (P = 0.021), and major adverse cardiovascular events (P = 0.023) during a median follow-up period of 2 years. Conclusion ML techniques can extract information from electrocardiographic data and clinical variables to predict CAC score categories and similarly risk-stratify patients with suspected coronary artery disease.

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Section: Introductionmentioning

confidence: 99%

Prediction of coronary artery calcium scoring from surface electrocardiogram in atherosclerotic cardiovascular disease: a pilot study

Farjo

Yanamala

Kagiyama

et al. 2020

European Heart Journal - Digital Health

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“…По данным Havel M, et al [35] у пациентов без стресс-индуцированных ДП частота развития MACE в течение 21 мес. наблюдения была достоверно выше при с КИ >530 ед.…”

Section: совмещенная офэкт/кт сердцаunclassified

Combined myocardial perfusion scintigraphy and computed tomography: diagnostic and prognostic value in coronary artery disease

et al. 2022

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Modern imaging techniques occupy an important place in the diagnosis, selection of treatment and prognosis of patients with coronary artery disease. Hybrid imaging is a combination of two sets of diagnostic data that complement and enhance each other by comparing anatomical and functional characteristics. As a rule, hybrid imaging is synergistic, that is, more powerful, since the addition of new information leads to an increase in the sensitivity and specificity of each of the modalities separately.The review provides brief information on the diagnostic efficacy of myocardial perfusion scintigraphy (MPS), computerized tomography (CT) coronary angiography in comparison with invasive coronary angiography with fractional flow reserve. The diagnostic and prognostic significance of assessing calcium index with MPS, as well as CT coronary angiography combined with MPS in the diagnosis, risk stratification and prognosis of patients with coronary artery disease, is characterized in detail. A separate section is devoted to the importance of hybrid imaging in making decisions about myocardial revascularization.

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“…Computed tomography allows visualization of coronary artery plaque distribution and assessment of a coronary calcium score. Coronary artery calcium (CAC) score is an independent and powerful predictor of coronary artery diseases [5]. It has been shown that a wider bifurcation angle between the left anterior descending (LAD) and left circumflex branch (LCx) is associated with the development of coronary atherosclerosis [6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Relationship between left main trifurcation angulation, calcium score, and the onset of plaque formation

2023

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Background: It has been suggested that a wider left main (LM) bifurcation angle is associated with the development of atherosclerosis. However, the relationship between LM trifurcation angulation and atherosclerosis has not been investigated. Aims:We aimed to investigate the relationship between LM trifurcation angulation and the presence of calcifications in the left coronary artery (LCA) using coronary computed tomography angiography (CCTA). Furthermore, we assessed the relationship between LM trifurcation angulation and the age at which calcification originated. Methods:The LM trifurcation angle and coronary artery calcium (CAC) score in the LCA were measured. Based on observational studies, we assumed that CAC progression is 25% per year on average. Then, we calculated the age at which LCA CAC scores were lower than 0.1 Agatston units.Results: Of 266 patients, 52 patients (mean age of [standard deviation, SD] 61 [6] years; 28 men) with LM trifurcation were included in the study. Calcified plaques occurred in the LCA in 36 patients (69.2%). The mean LM trifurcation angle in patients with a diseased LCA was wider than that in patients with a normal LCA (108° [33°] vs. 91° [28°]; P = 0.04). Pearson correlation coefficient showed that the wider the LM trifurcation angle was, the earlier the calcification in the LCA may be expected (r = -0.34; P = 0.04 with outliers; r = -0.43; P = 0.009 without outliers). Conclusions:A wider LM trifurcation angle is associated with a higher LCA CAC score. Moreover, the LM trifurcation angle has a significant impact on the earlier onset of atherosclerosis.

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Additional value of the coronary artery calcium score in patients for whom myocardial perfusion imaging is challenging

Cited by 6 publications

References 22 publications

Prediction of coronary artery calcium scoring from surface electrocardiogram in atherosclerotic cardiovascular disease: a pilot study

Prediction of coronary artery calcium scoring from surface electrocardiogram in atherosclerotic cardiovascular disease: a pilot study

Combined myocardial perfusion scintigraphy and computed tomography: diagnostic and prognostic value in coronary artery disease

Relationship between left main trifurcation angulation, calcium score, and the onset of plaque formation

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