Do conventional risk factors predict subclinical coronary artery disease? Results from the Prospective Army Coronary Calcium Project

Taylor, Allen J.; Feuerstein, Irwin M.; Wong, Henry; Barko, William F.; Brazaitis, Michael; O’Malley, Patrick G.

doi:10.1067/mhj.2001.113069

Cited by 124 publications

(75 citation statements)

References 27 publications

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“…[18][19][20][21] At the same time, these studies have also highlighted a discrepancy between the presence of traditional risk factors and the presence of subclinical atherosclerosis: substantial atherosclerosis was frequently observed in patients at low to intermediate risk, while being absent in patients deemed at high risk. Also in the current study, atherosclerosis was identified across all FRS categories.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of coronary artery disease across the Framingham risk categories: coronary artery calcium scoring and MSCT coronary angiography

Nucifora

Schuijf

Werkhoven

et al. 2009

Journal of Nuclear Cardiology

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Background. Non-invasive assessment of subclinical atherosclerosis by means of coronary artery calcium scoring (CACS) and multi-slice computed tomography (MSCT) coronary angiography could improve patients' risk stratification. However, data relating observations on CACS and MSCT coronary angiography to traditional risk assessment are scarce.Methods and Results. In 314 consecutive outpatients (54 ± 13 years, 56% males) without known CAD, CACS and 64-slice MSCT coronary angiography were performed. According to the Framingham risk score (FRS), 51% of patients were at low, 24% at intermediate and 25% at high risk, respectively. MSCT angiograms showing atherosclerosis were classified as showing obstructive ( ‡50% luminal narrowing) CAD or not. Both CACS and MSCT coronary angiography showed a high prevalence of normal coronary arteries in low FRS patients (70% and 61%, respectively). An increase in the prevalence of CACS >400 (4% low vs 19% intermediate vs 36% high), CAD (39% low vs 79% intermediate vs 91% high), and obstructive CAD (15% low vs 43% intermediate vs 58% high) was observed across the FRS categories (P < .0001 for all comparisons).Conclusions. A strong positive relationship exists between FRS and the prevalence and extent of atherosclerosis. Especially in intermediate FRS patients, CACS and MSCT coronary angiography provide useful information on the presence of subclinical atherosclerosis. (J Nucl Cardiol 2009;16:368-75.)

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Section: Discussionmentioning

confidence: 99%

Prevalence of coronary artery disease across the Framingham risk categories: coronary artery calcium scoring and MSCT coronary angiography

Nucifora

Schuijf

Werkhoven

et al. 2009

Journal of Nuclear Cardiology

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“…Therefore, it is necessary that other tests be used for a better stratification of the risks for coronary events. Data from the literature have shown that the presence of coronary artery calcification is associated with a greater risk for coronary events [11][12][13][14] , and its absence is associated with an almost-zero risk for coronary events in studies of 3-to-5 year follow-up 25 . Coronary artery calcium scores have their major usefulness in stratifying the risk for clinical events.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrafast computed tomography is a noninvasive and very sensitive method to detect calcification in coronary arteries 7 . Evidence exists that the presence of coronary artery calcification on ultrafast computed tomography may be a risk marker of clinical events in coronary artery disease, independent of the risk factors for atherosclerosis [11][12][13][14] . Up to now, coronary artery calcium scores in the Brazilian population have not been reported.…”

Section: Distribution Of Coronary Artery Calcium Scores Determined Bymentioning

confidence: 99%

Distribuição dos escores de cálcio coronariano determinados pela tomografia ultra-rápida em 2.253 homens brancos assintomáticos

Meneghelo¹,

Santos

Almeida

et al. 2003

Arq. Bras. Cardiol.

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Meneghelo et al Ultrafast computer tomography in assymptomatic white menCoronary atherosclerosis is one of the major causes of death among us 1 . Atherosclerosis is a multifactorial disease, and the identification of individuals at high risk for coronary events is extremely important, because preventive therapies, such as change in lifestyle and use of drugs, such as statins and acetylsalicylic acid, significantly reduce clinical events and mortality 2 . Classically, the risk stratification of coronary events has been performed through the analysis of a set of risk factors. However, epidemiological data have shown that approximately 25% of the individuals who died suddenly due to cardiac causes had no previous symptoms, and even the classical tools for assessing the risk of coronary events, such as the Framingham scores, have limitations in identifying high-risk individuals 3,4 . Approximately 50% of the coronary deaths and most myocardial infarctions occur in individuals considered at low to intermediate risk, according to clinical and laboratory parameters 3 . Therefore, assessment of subclinical atherosclerosis through imaging techniques may be useful for risk stratification, because evidence exists that the load of the atherosclerotic plaque correlates with the risk of coronary events [5][6] .Coronary artery calcification ( fig. 1), detected on ultrafast computed tomography or electron beam computed tomography, correlates with the load of the atherosclerotic plaque in histological, angiographic, and intravascular ultrasound studies [7][8][9][10] . Ultrafast computed tomography is a noninvasive and very sensitive method to detect calcification in coronary arteries 7 . Evidence exists that the presence of coronary artery calcification on ultrafast computed tomography may be a risk marker of clinical events in coronary artery disease, independent of the risk factors for atherosclerosis [11][12][13][14] . Up to now, coronary artery calcium scores in the Brazilian population have not been reported.This study aimed at describing the distribution of coronary artery calcium scores in a population sample of asymptomatic white Brazilian men undergoing assessment on ultrafast computed tomography. 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, and >65 years. Objective -To describe the distribution of coronary artery calcium scores in a population of asymptomatic white Brazilian men undergoing assessment with ultrafast computed tomography. Methods - Results -

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“…Coronary artery calcification (CAC) has long been known to occur as a part of the atherosclerotic process and incremental prognostic value beyond traditional risk factors in various subsets of the population (4)(5)(6)(7)(8). Recently, Jung et al (9) demonstrated significant correlation between MPV and CAC in general population.…”

Section: Introductionmentioning

confidence: 99%

Association between mean platelet volume and coronary artery calcification in patients without overt cardiovascular disease: an observational study

Korkmaz¹,

Korkmaz²,

Akyüz³

et al. 2012

Anadolu Kardiyol Derg

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Objective: Platelets have an important role in the pathogenesis of atherothrombosis. It has been shown that platelet size measured by mean platelet volume (MPV), correlates with their reactivity and is still regarded as an easy, useful tool for indirect monitoring of platelet activity in different situations. Coronary artery calcification (CAC) has long been known to occur as a part of the atherosclerotic process. The aim of this study was to determine whether an association exists between MPV and CAC. Methods: In this observational study, we enrolled 259 participants with at least one cardiac risk factor but with unknown cardiovascular disease. Coronary calcification was assessed by multislice computerized tomography and MPV was measured in a blood sample collected in EDTA tubes. Statistical analysis was performed using Kruskal-Wallis, Chi-square, correlation tests and multiple regression analysis. Results: Calcium scores ranged from 0 to 735. There was a significant relation between CAC and MPV (r=0.24, p=0.02), age (r=0.32, p<0.001), hypertension (r=0.19, p=0.03), diabetes (r=0.16, p=0.005), smoking (r=0.17, p=0.001). In linear regression analysis, MPV (β=0.4,.1, p<0.001), age (β=0.13, 95%CI 0.23-2.4, p=0.01) and smoking (β=0.12, 95%CI 3.2-15.1, p=0.02) independently associated with CAC. In addition, there were significant differences in MPV between significant CAC group compared to the minimal and none (10.2±2.4 versus 8.1±0.9 and 7.6±1.3; p<0.001). Conclusion: We have found significant association between MPV and CAC. Although this study is purely correlative and no causative conclusions can be drawn, it may suggest that higher MPV may reflect increased atherosclerotic burden and cardiovascular risk. Yöntemler: Bu gözlemsel çalışmada, bilinen kardiyovasküler hastalığı olmayan ve en az bir kardiyovasküler riski olan 259 hasta çalışmaya alın-dı. KAK çok kesitli tomografi ile değerlendirildi. OTH ise etilen diamin tetra asetik asit (EDTA)'li tüplere alınan kanda ölçüldü. İstatistiksel analiz Kruskal-Wallis, Ki-kare, korelasyon testleri ve çoklu regresyon analiz ile yapıldı. Bulgular: Kalsiyum skoru 0 ile 735 arasında idi. Tek yönlü analizde KAK ile OTH (r=0.24, p=0.02), yaş (r=0.32, p<0.001), hipertansiyon (r=0.19, p=0.03), diyabet (r=0.16, p=0.005) ve sigara içimi (r=0.17, p=0.001) arasında anlamlı bir ilişki vardı. Çok yönlü analizde ise OTH (β=0.4, %95GA 19.8-31.1, p<0.001), yaş (β=0.13, %95GA 0.23-2.4 p=0.01) ve sigara içimi (β=0.12, %95GA 3.2-15.1, p=0.02) KAK'ın bağımsız belirleyicileri idi. Ayrıca anlamlı KAK'ı olanlarda minimal ya da KAK'ı olmayan hastalara göre OTH anlamlı olarak yüksek idi (10.2±2.4 karşı 8.1±0.9 ve 7.6±1.3; R 2 =52.7, p<0.001).

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Do conventional risk factors predict subclinical coronary artery disease? Results from the Prospective Army Coronary Calcium Project

Cited by 124 publications

References 27 publications

Prevalence of coronary artery disease across the Framingham risk categories: coronary artery calcium scoring and MSCT coronary angiography

Prevalence of coronary artery disease across the Framingham risk categories: coronary artery calcium scoring and MSCT coronary angiography

Distribuição dos escores de cálcio coronariano determinados pela tomografia ultra-rápida em 2.253 homens brancos assintomáticos

Association between mean platelet volume and coronary artery calcification in patients without overt cardiovascular disease: an observational study

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