Determinants of Coronary Calcium Conversion Among Patients With a Normal Coronary Calcium Scan

Min, James K.; Lin, Fay Y.; Gidseg, David S.; Weinsaft, Jonathan W.; Berman, Daniel S.; Shaw, Leslee J.; Rozanski, Alan; Callister, Tracy Q.

doi:10.1016/j.jacc.2009.08.088

Cited by 179 publications

(103 citation statements)

References 28 publications

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“…First, we used appropriate methods to minimize the interscan variability. Second, it has been shown that CAC does not increase at a constant rate and usually progression is detected following a ‘lag period' of 4 years [16]. In our study, all patients had the second scan at least 4 years after the first one.…”

Section: Discussionmentioning

confidence: 62%

“…For instance, according to a multi-ethnic study of atherosclerosis in younger age patients (closer to our study population's age range) the yearly rate of CAC incidence was <5%. However, because of the non-linear nature of CAC progression and the ‘lag period' before the detection of the new CAC, using an annual incidence rate of CAC might not be a good measure to assess CAC progression [16]. Moreover, the analysis of raw CAC data does not take the high interscan variability into account.…”

Section: Discussionmentioning

confidence: 99%

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Progression of Coronary Artery Calcification in Living Kidney Donors: A Follow-Up Study

Alagöz¹,

Cebi

Akman

et al. 2014

Nephron Clin Pract

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Background: Data on the long-term mortality and morbidity of living kidney donors are scarce. In the general population, coronary artery calcification (CAC) and progression of CAC are predictors of future cardiac risk. We conducted a study to determine the progression of CAC in renal transplant donors. Methods: We used multidetector computed tomography to examine CAC in 75 former renal transplant donors. A baseline and a follow-up scan were performed and changes in CAC scores were evaluated in each subject individually to calculate the incidence of CAC progression. Results: Baseline CAC prevalence was 16% and the mean CAC score was 5.3 ± 25.8. At the follow-up scan that was performed after an average of 4.8 ± 0.3 years, CAC prevalence increased to 72% and the mean CAC score to 12.5 ± 23.4. Progression of the individual CAC score was found between 18.7 and 26.7%, depending on the method used to define progression. In patients with baseline CAC, the mean annualized rate of CAC progression was 2.1. Presence of hypertension, high systolic blood pressure and an increase in BMI were the determinants of CAC progression. Conclusions: The rate of CAC progression does not seem to be high in carefully selected donors.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Progression of Coronary Artery Calcification in Living Kidney Donors: A Follow-Up Study

Alagöz¹,

Cebi

Akman

et al. 2014

Nephron Clin Pract

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“…These discrepancies in CAC progression on KTRs could be partially related to demographic and clinical differences of the study populations, but there are some other variables that should be considered in CAC progression studies: (1) interscan variability of CAC scoring; (2) a CAC score reflects the aggregate of medial and intimal wall calcification: a different progression pattern can be expected for each type of calcification, and (3) the optimal time interval for measuring CAC progression is not defined. For the purpose of interventional trials, intervals of at least 3 years were proposed [20]. The time interval for measuring CAC progression is critical in transplantation where the risk factors relating to it start at the time of surgery.…”

Section: Vascular Calcification Progression and Cardiovascular Outcomesmentioning

confidence: 99%

Importance of Vascular Calcification in Kidney Transplant Recipients

Cianciolo¹,

Capelli²,

Angelini³

et al. 2014

Am J Nephrol

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Background: Kidney transplantation is the treatment of choice for chronic kidney disease (CKD), but in kidney transplant recipients (KTRs) cardiovascular events are the first cause of death with a functioning graft, ranging from 36 to 55%. The impact of vascular calcification (VC) on morbidity and mortality of KTRs is not appreciated enough nowadays. Summary: This review summarizes 13 important studies on VC in KTRs, comparing the results with CKD and dialysis populations. We focused on VC evaluation and use of coronary artery calcification (CAC) and aorta calcification (AoC) scores. We also evaluated the influence of traditional and non-traditional progression risk factors. Key Messages: VC strongly predicts cardiovascular events and all-cause mortality in KTRs. VC assessment is important in KTRs and based essentially on multislice computed tomography or electron beam computed tomography recognition of lesions. Quantitative measurement of CAC and AoC scores is essential for a correct definition of the calcium burden before and after kidney transplant. Progression of CAC slows down but does not halt after kidney transplant. A variable association of both traditional and non-traditional risk factors is shown. There is a strong association between baseline CAC score and CAC progression. A significant improvement in secondary hyperparathyroidism after transplantation favorably affects the progression of CAC. Low 25(OH)D₃ levels are an independent determinant of CAC progression. Diabetes is a risk factor for the presence of CAC in KTRs, but has not been independently associated with CAC progression. The data published on the use of immunosuppressive drugs as progression factors are few and inconclusive.

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“…Currently, coronary calcium scan as well as coronary angiography scan has become an important methodology for screening or monitoring patients with suspected CAD or coronary revascularization [37]. The optimal followup interval using CAC scan, QCT and DXA for patients with osteoporosis and atherosclerosis has been still ambiguous [102,103]. A study by Lenora et al [104] displayed the follow-up intervals (least significant change/median rate of a BMD change) in both women and men as 8 years and 13 years, respectively, by using a DXA scanner, 3 and 32 years by using a lunar Prodigy scanner for total hip and lumbar spine respectively.…”

Section: Follow-up Time Using the Qctmentioning

confidence: 99%

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

et al. 2016

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a b s t r a c t a r t i c l e i n f oOsteoporosis is a common metabolic bone disease, causing increased skeletal fragility characterized by a low bone mass and trabecular microarchitectural deterioration. Assessment of the bone mineral density (BMD) is the primary determinant of skeletal fragility. Computed tomography (CT)-based trabecular microarchitectural and mechanical assessments are important methods to evaluate the skeletal strength. In this review, we focus the feasibility of QCT BMD measurement using a calibration phantom or phantomless. The application of QCT could extend the bone mineral density assessment to all patients who underwent a heart, lung, whole-body, and as well as all routine clinical implications of CT scan.

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Determinants of Coronary Calcium Conversion Among Patients With a Normal Coronary Calcium Scan

Abstract: Among individuals with CAC = 0, conversion to CAC >0 is nonlinear and occurs at low frequency before 4 years. No clinical factor seems to mandate earlier repeat CAC scanning.

Cited by 179 publications

References 28 publications

Progression of Coronary Artery Calcification in Living Kidney Donors: A Follow-Up Study

Progression of Coronary Artery Calcification in Living Kidney Donors: A Follow-Up Study

Importance of Vascular Calcification in Kidney Transplant Recipients

Application of quantitative computed tomography for assessment of trabecular bone mineral density, microarchitecture and mechanical property

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