All-cause mortality by age and gender based on coronary artery calcium scores

Nakanishi, Rine; Liu, Dong; Blaha, Michael J.; Whelton, Seamus P.; Darabian, Sirous; Flores, Ferdinand; Dailing, Christopher; Blumenthal, Roger S.; Nasir, Khurram; Berman, Daniel S.; Budoff, Matthew J.

doi:10.1093/ehjci/jev328

Cited by 62 publications

(48 citation statements)

References 36 publications

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“…These observations were also confirmed in a recent investigation by Valenti et al, demonstrating that a coronary artery calcium (CAC) score of zero could no longer predict all-cause death beyond 5 years among diabetes patients [10]. The data represents a much shorter warranty period of a "normal" CAC score than that of >10 years for a general asymptomatic population [11,12]. These findings potentially highlight the important fact that diabetes was likely to be associated with advanced coronary atherosclerosis, but which may not be functionally significant or visualized on non-contrast CT, yet much more accumulated overtime, active to rapid plaque progression or rapid progress of ischemia [13].…”

supporting

confidence: 55%

Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study

et al. 2016

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Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study Methods: We identified 142 study subjects undergoing serial coronary computed tomography angiography. The resulting propensity score was applied 1:1 to match diabetic patients to non-diabetic patients for clinical risk factors, prior coronary stenting, coronary artery calcium (CAC) score and the serial scan interval, resulting in the 71 diabetes and 71 non-diabetes patients. Coronary plaque (total, calcified, noncalcified including fibrous, fibrous-fatty and low attenuation plaque [LAP]) volume normalized by total coronary artery length was measured using semi-automated plaque software and its change overtime between diabetic and non-diabetic patients was evaluated.Results: The matching was successful without significant differences between the two groups in all matched variables. The baseline volumes in each plaque also did not differ. During a mean scan interval of 3.4 ± 1.8 years, diabetic patients showed a 2-fold greater progression in normalized total plaque volume (TPV) than non-diabetes patients (52.8 mm 3 vs. 118.3 mm 3 , p ¼ 0.005). Multivariable linear regression model revealed that diabetes was associated with normalized TPV progression (b 72.3, 95%CI 24.3e120.3). A similar trend was observed for the non-calcified components, but not calcified plaque (b 3.8, 95%CI À27.0e34.7). Higher baseline CAC score was found to be associated with total, non-calcified and calcified plaque progression. However, baseline non-calcified volume but not CAC score was associated with LAP progression. Conclusions: The current study among matched patients indicates diabetes is associated with a greater plaque progression. Our results show the need for strict adherence of diabetic patients to the current preventive guidelines.

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confidence: 55%

Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study

et al. 2016

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“…CAC has been shown to be the best predictor of future events in the general population, 13e15 the elderly, 13,17 and in persons with diabetes. 18 It provides more robust risk prediction than carotid IMT, C-reactive protein, ankle-brachial index, and family history of premature heart disease 19 Incorporating CAC into the Multi-Ethnic Study of Atherosclerosis (MESA) clearly improves risk stratification and discrimination over scores based on chronologic age.…”

Section: Evidence Supporting Cac For Risk Assessmentmentioning

confidence: 99%

2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology

Hecht

Cronin

Blaha

et al. 2017

Journal of Cardiovascular Computed Tomography

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“…Multiple studies have shown the prognostic value of coronary artery calcification and its additive value to traditional risk factors for predicting the presence of coronary artery disease or subsequent cardiac events. [15][16][17][18][19][20] In the PROMISE study, a cut-off of 400 Agatston units identified patients with increased risk of cardiovascular death or myocardial infarction with an adjusted hazard ratio of 1.92 (95% CI 0.84, 4.39). 21 Similarly in the SCOT-HEART study, increased coronary artery calcium score was associated with an increased risk of coronary heart disease death or non-fatal myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Standardized reporting systems for computed tomography coronary angiography and calcium scoring: A real-world validation of CAD-RADS and CAC-DRS in patients with stable chest pain

Williams

Moss

Dweck

et al. 2020

Journal of Cardiovascular Computed Tomography

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A B S T R A C TObjectives: To assess the prognostic implications of standardized reporting systems for coronary computed tomography angiography (CCTA) and coronary artery calcium scores (CACS) in patients with stable chest pain. Background: The Coronary Artery Disease Reporting And Data System (CAD-RADS) and Coronary Artery Calcium -Data and Reporting System (CAC-DRS) aim to improve communication of CACS and CCTA results, but its influence on prognostication is unknown. Methods: Images from 1769 patients who underwent CCTA as part of the Scottish Computed Tomography of the HEART (SCOT-HEART) multi-center randomized controlled trial were assessed. CACS were classified as CAC-DRS 0 to 3 based on Agatston scores. CCTA were classified as CAD-RADS 0 to 5 based on the most clinically relevant finding per patient. The primary outcome was the five-year events of fatal and non-fatal myocardial infarction. Results: Patients had a mean age of 58 ± 10 years and 56% were male. CAC-DRS 0, 1, 2 and 3 occurred in 642 (36%), 510 (29%), 239 (14%) and 379 (21%) patients respectively. CAD-RADS 0, 1, 2, 3, 4A, 4B and 5 occurred in 622 (35%), 327 (18%), 211 (12%), 165 (9%), 221 (12%), 42 (2%) and 181 (10%) patients respectively. Patients classified as CAC-DRS 3 were at an increased risk of fatal or non-fatal myocardial infarction compared to CAC-DRS 0 patients (hazard ratio (HR) 9.41; 95% confidence interval (CI) 3.24, 27.31; p < 0.001). Patients with higher CAD-RADS categories were at an increased risk of fatal or non-fatal myocardial infarction, with patients classified as CAD-RADS 4B at the highest risk compared to CAD-RADS 0 patients (HR 19.14; 95% CI 4.28, 85.53; p < 0.001). Conclusion: Patients with higher CAC-DRS and CAD-RADS scores were at increased risk of subsequent fatal and non-fatal myocardial infarction. This confirms that the classification provides additional prognostic discrimination for future coronary heart disease events.

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All-cause mortality by age and gender based on coronary artery calcium scores

Cited by 62 publications

References 36 publications

Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study

Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study

2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology

Standardized reporting systems for computed tomography coronary angiography and calcium scoring: A real-world validation of CAD-RADS and CAC-DRS in patients with stable chest pain

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