Coronary CT Angiography for Suspected ACS in the Era of High-Sensitivity Troponins

Dedic, Admir; Lubbers, Marisa; Schaap, Jeroen; Lammers, Jeronymus; Lamfers, E. J. P.; Rensing, Benno J.; Braam, Richard L.; Nathoe, Hendrik M.; Post, Johannes C.; Nielen, Tim Mj; Beelen, Driek; d’Armandville, Marie-Claire le Cocq; Rood, Pleunie P.M.; Schultz, Carl; Moelker, Adriaan; Ouhlous, Mohamed; Boersma, Eric; Nieman, Koen

doi:10.1016/j.jacc.2015.10.045

Cited by 139 publications

(81 citation statements)

References 39 publications

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“…The study was approved by the ethics committee of FuWai Hospital. Inclusion criteria of CAD were defined as having ≥50% narrowing of the lumina of at least 1 of the major coronary arteries by coronary angiography 15. The controls were selected from the subjects admitted to FuWai hospital for excluding coronary heart disease, with ≤20% stenosis of major coronary artery and without any vascular disease.…”

Section: Methodsmentioning

confidence: 99%

MicroRNA‐216a induces endothelial senescence and inflammation via Smad3/IκBα pathway

Yang

Chen

et al. 2018

J Cellular Molecular Medi

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Vascular endothelial senescence contributes to atherosclerosis and coronary artery disease (CAD), but the mechanisms are yet to be clarified. We identified that microRNA‐216a (miR‐216a) significantly increased in senescent endothelial cells. The replicative senescence model of human umbilical vein endothelial cells (HUVECs) was established to explore the role of miR‐216a in endothelial ageing and dysfunction. Luciferase assay indicated that Smad3 was a direct target of miR‐216a. Stable expression of miR‐216a induced a premature senescence‐like phenotype in HUVECs with an impairment in proliferation and migration and led to an increased adhesion to monocytes by inhibiting Smad3 expression and thereafter modulating the degradation of NF‐κB inhibitor alpha (IκBα) and activation of adhesion molecules. Conversely, inhibition of endogenous miR‐216a in senescent HUVECs rescued Smad3 and IκBα expression and inhibited monocytes attachment. Plasma miR‐216a was significantly higher in old CAD patients (>50 years) and associated with increased 31% risk for CAD (odds ratio 1.31, 95% confidence interval 1.03‐1.66; P = .03) compared with the matched healthy controls (>50 years). Taken together, our data suggested that miR‐216a promotes endothelial senescence and inflammation as an endogenous inhibitor of Smad3/IκBα pathway, which might serve as a novel target for ageing‐related atherosclerotic diseases.

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Section: Methodsmentioning

confidence: 99%

MicroRNA‐216a induces endothelial senescence and inflammation via Smad3/IκBα pathway

Yang

Chen

et al. 2018

J Cellular Molecular Medi

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“…In clinical practice, early detection of culprit plaque in advance with coronary computed tomographic angiography (CCTA), coronary angiography (CAG), or intravascular ultrasound (IVUS) may enable early intervention to prevent acute coronary syndrome (ACS) or other plaque-related diseases, decrease morbidity and mortality rates, and improve the quality of life for patients with CAD (3)(4)(5)(6)(7)(8). While CAG is an invasive method and more accurate in evaluating the degree of coronary artery stenosis, and although IVUS is the gold standard for the diagnosis of plaque characteristics, it is limited by high cost and invasive nature of the test.…”

Section: Introductionmentioning

confidence: 99%

The diagnosis of coronary plaque stability by multi-slice computed tomography coronary angiography

Song

Zhou

et al. 2018

J. Thorac. Dis.

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Background: Coronary computed tomographic angiography is a robust non-invasive method to assess coronary artery disease (CAD) and analyze coronary plaque stability, especially for the non-calcified plaques.The aim of this study was to investigate the differential characteristics between the unstable coronary plaques and the stable coronary plaques using multi-slice computed tomography (MSCT). Methods: Sixty patients with coronary heart disease (37 unstable plaques and 31 stable plaques) were included. The napkin ring thickness, napkin-ring sign, plaque CT attenuation and degree of lumen stenosis were retrospectively analyzed. The diagnostic performances of MSCT were determined to predict the unstable plaques. The difference was statistically significant if P<0.05. Results:The napkin ring thickness of the unstable plaques was thinner than that of the stable plaques (P<0.05). The napkin-ring sign was more frequently observed in the unstable group (89.2%) than the stable group (22.6%, P<0.05). The average CT value of the unstable plaques (26.8±17.8 HU) was lower than that of the stable plaques (68.5±25.5 HU, P<0.05). The unstable plaques had more severe lumen stenosis or occlusion (70.3%) than the stable plaques (41.9%, P<0.05). The measurable napkin ring thickness of the plaques with a cutoff value of 0.8 mm and an accuracy of 89.5% was one independent factor to predict unstable plaques. The optimal combined threshold of the napkin-ring sign and/or the plaque CT value of 53 HU with an accuracy of 80.9% was to predict unstable plaques. Conclusions:The optimal combined threshold of the napkin-ring sign and/or the plaque CT value ≤53 HU may be a good indicator to predict the unstable plaques in patients with CAD. The subgroup of measurable napkin ring thickness of the non-calcified plaques may also be an independent factor to predict the unstable plaques in patients with CAD.

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“…18 The coronary CTA group had lower direct medical costs (€337 vs. €511, P < 0.01) and less outpatient testing after the index emergency department visit (4% vs. 10%, P < 0.01). However, (in contrast to previously published American trials with standard troponin assays) there were no differences in the number of revascularizations, the emergency department discharge rates, or the length of stay.…”

Section: The Better Evaluation Of Acute Chest Pain With Computedmentioning

confidence: 87%

The year in cardiology 2016: imaging

Delgado¹,

Gaemperli²,

Lombardi³

et al. 2017

Cardiologia Croatica

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Coronary CT Angiography for Suspected ACS in the Era of High-Sensitivity Troponins

Cited by 139 publications

References 39 publications

MicroRNA‐216a induces endothelial senescence and inflammation via Smad3/IκBα pathway

MicroRNA‐216a induces endothelial senescence and inflammation via Smad3/IκBα pathway

The diagnosis of coronary plaque stability by multi-slice computed tomography coronary angiography

The year in cardiology 2016: imaging

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