Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers

Abstract

Chronic inflammatory mechanisms in the arterial wall lead to atherosclerosis, and include endothelial cell damage, inflammation, apoptosis, lipoprotein deposition, calcification and fibrosis. Cardiac computed tomography angiography (CCTA) has been shown to be a promising tool for non-invasive assessment of theses specific compositional and structural changes in coronary arteries. This review focuses on the technical background of CCTA-based quantitative plaque characterization. Furthermore, we discuss the available evidence for CCTA-based plaque characterization and the potential role of CCTA for risk stratification of patients with coronary artery disease.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Atherosclerotic plaque composition; Quantification analysis; Multi-slice cardiac computed tomography; Biomarkers Core tip: This review gives an overview of the current status of noninvasive assessment of coronary artery disease (CAD) and the ability of cardiac computed tomography angiography (CCTA) and cardiac biomarkers for the diagnostic classification and risk stratification of patients with suspected and known CAD. Since all techniques described herein are available in the clinical routine and are associated with an acceptable time spent the translation to the clinical realm appears promising. Focusing on CCTA-based quantitative plaque characterization we herein present the (1) available evidence; (2) comparison with other techniques of plaque characterization; and (3) the value of "bio-imaging" for the risk stratification of patients with CAD.Gitsioudis G, Katus HA, Korosoglou G. Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers.

Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study

“…Of interest, we also identified an association with small increases of hs-TnT, which is an established biomarker for myocardial micro-injury [ 17 , 35 ]. As with other prior investigations, we identified a significant association of minor increases of cardiac troponin T with vulnerable plaque characteristic as assessed by CCTA in patients with presumably stable CAD, which is possibly caused by silent plaque rupture, micro-embolization and microvascular obstruction, which may precede the clinical manifestation of myocardial infarction [ 15 , 17 , 35 , 36 ]. The present results affirm that hs-TnT correlates with coronary plaque burden as assessed by total plaque volume and calcium scoring.…”

AhR expression and polymorphisms are associated with risk of coronary arterial disease in Chinese population

“…The sensitivity and specificity of circulating AhR were notably superior to those of clinical biomarkers such as hs-TnI, MYO, CK, and CK-MB ( Figure 2 ). These biomarkers reflect myocardial damage, while AhR is closely related to multiple pathogenic factors of CAD, although it remains unclear whether AhR is directly responsible for CAD development, and no studies have previously examined the role of AhR variants in CAD risk 3 24 25 .…”

Validation of Coronary Artery Disease Reporting and Data System (CAD-RADS) and Application of Coronary Artery Calcium Data and Reporting System (CAC-DRS) as New Standardized Tools in the Management of Coronary Artery Disease Patients

“…CCTA is a non-invasive technique that is beneficial in assessing the early stages of CAD. 10 The need for a standardized CCTA report terminology to facilitate information exchange between interpreting and referring doctors resulted in creating a novel report system. 6 By providing physicians with a direct link between objective radiological information and evidence-based treatment recommendations, structured reporting systems have become more popular.…”