Major Global Coronary Artery Calcium Guidelines

Golub, Ilana; Termeie, Orly G.; Kristo, Stephanie; Schroeder, Lucia P.; Lakshmanan, Suvasini; Shafter, Ahmed M; Hussein, Luay; Verghese, Dhiran; Aldana-Bitar, Jairo; Manubolu, Venkat Sanjay; Budoff, Matthew J.

doi:10.1016/j.jcmg.2022.06.018

Cited by 58 publications

(26 citation statements)

References 59 publications

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“…SREBP-1c, the main transcription regulator of fatty acid and TG synthesis, is mainly regulated by LXRα is in liver. As previously reviewed, LXRβ knockout has no effect on the expression of SREBP-1c (Golub et al, 2023). As a cholesterol sensor, LXRα activates SREBP1c to enhance synthesis of fatty acids which are substrates for CE synthesis, thereby alleviating intracellular cholesterol accumulation (WHO, 2023).…”

Section: Mechanisms Of Action Of Lxr Signaling Pathwaymentioning

confidence: 99%

Targeting macrophages in atherosclerosis using nanocarriers loaded with liver X receptor agonists: A narrow review

Yang

Miao²,

Yu³

et al. 2023

Front. Mol. Biosci.

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Macrophages are involved in the whole process of atherosclerosis, which is characterized by accumulation of lipid and inflammation. Presently, clinically used lipid-lowering drugs cannot completely retard the progress of atherosclerosis. Liver X receptor (LXR) plays a key role in regulation of lipid metabolism and inflammation. Accumulating evidence have demonstrated that synthetic LXR agonists can significantly retard the development of atherosclerosis. However, these agonists induce sever hypertriglyceridemia and liver steatosis. These side effects have greatly limited their potential application for therapy of atherosclerosis. The rapid development of drug delivery system makes it possible to delivery interested drugs to special organs or cells using nanocarriers. Macrophages express various receptors which can recognize and ingest specially modified nanocarriers loaded with LXR agonists. In the past decades, a great progress has been made in this field. These macrophage-targeted nanocarriers loaded with LXR agonists are found to decrease atherosclerosis by reducing cholesterol accumulation and inflammatory reactions. Of important, these nanocarriers can alleviate side effects of LXR agonists. In this article, we briefly review the roles of macrophages in atherosclerosis, mechanisms of action of LXR agonists, and focus on the advances of macrophage-targeted nanocarriers loaded with LXR agonists. This work may promote the potential clinical application of these nanocarriers.

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Section: Mechanisms Of Action Of Lxr Signaling Pathwaymentioning

confidence: 99%

Targeting macrophages in atherosclerosis using nanocarriers loaded with liver X receptor agonists: A narrow review

Yang

Miao²,

Yu³

et al. 2023

Front. Mol. Biosci.

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show abstract

“…Coronary artery calcium (CAC) and the quantitative measure of atherosclerosis with a CAC score, has become a commonly used screening test for cardiovascular disease [2], with a negative predictive value to rule out coronary artery disease (CAD) in asymptomatic patients of over 99% [3]. CAC score is wildly available and highly reproducible and is included in multiple national [4,5] and international [6][7][8] guidelines and scientific statements [9,10]. Utilization of artificial intelligence (AI) and deep learning are being studied in many fields of medicine, including cardiac imaging.…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence using a deep learning versus expert computed tomography human reading in calcium score and coronary artery calcium data and reporting system classification

Aldana-Bitar

Cho

Anderson

et al. 2023

Coronary Artery Disease

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Background Artificial intelligence (AI) applied to cardiac imaging may provide improved processing, reading precision and advantages of automation. Coronary artery calcium (CAC) score testing is a standard stratification tool that is rapid and highly reproducible. We analyzed CAC results of 100 studies in order to determine the accuracy and correlation between the AI software (Coreline AVIEW, Seoul, South Korea) and expert level-3 computed tomography (CT) human CAC interpretation and its performance when coronary artery disease data and reporting system (coronary artery calcium data and reporting system) classification is applied. Methods A total of 100 non-contrast calcium score images were selected by blinded randomization and processed with the AI software versus human level-3 CT reading. The results were compared and the Pearson correlation index was calculated. The CAC-DRS classification system was applied, and the cause of category reclassification was determined using an anatomical qualitative description by the readers. Results The mean age was age 64.5 years, with 48% female. The absolute CAC scores between AI versus human reading demonstrated a highly significant correlation (Pearson coefficient R = 0.996); however, despite these minimal CAC score differences, 14% of the patients had their CAC-DRS category reclassified. The main source of reclassification was observed in CAC-DRS 0–1, where 13 were recategorized, particularly between studies having a CAC Agatston score of 0 versus 1. Qualitative description of the errors showed that the main cause of misclassification was AI underestimation of right coronary calcium, AI overestimation of right ventricle densities and human underestimation of right coronary artery calcium. Conclusion Correlation between AI and human values is excellent with absolute numbers. When the CAC-DRS classification system was adopted, there was a strong correlation in the respective categories. Misclassified were predominantly in the category of CAC = 0, most often with minimal values of calcium volume. Additional algorithm optimization with enhanced sensitivity and specificity for low values of calcium volume will be required to enhance AI CAC score utilization for minimal disease. Over a broad range of calcium scores, AI software for calcium scoring had an excellent correlation compared to human expert reading and in rare cases determined calcium missed by human interpretation.

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“…CT coronary artery calcium scoring (CACS) is a high-yield screening and risk-stratification tool for coronary artery disease (CAD) with a large body of evidence now spanning several decades and across diverse populations. [1][2][3][4][5] One of the most compelling summations of CACS utility, borne out of multiple large population registry studies, has been the 'power of zero' mantra-a score of zero conveys a very low 10-year cardiovascular risk. 3,4 Small print is important though, and the study by Allio et al in this month's JNC reminds us that CACS is no exception to this-the details of acquisition do really matter and may influence 'power of zero' validity.…”

mentioning

confidence: 99%

“…The latter is based on adherence to CACS protocols in the original derivation studies, legacy evidence-base, and the intent for results to be universally standardised and comparable. [1][2][3][4][5]7 Using a standardised acquisition protocol and score methodology, has permitted an ease of understanding among physicians and patients without fiddly conversion factors between results; and facilitated global registries to underpin the prognostic impact of results. 3,4 However, times move on and innovations in the field of cardiac CT often emphasise dose-reduction strategies attempting to achieve the same information at a lower dose through hardware improvements or novel image reconstruction methods.…”

mentioning

confidence: 99%

Low-dose coronary calcium scoring tarnishes power of zero

Motwani

2023

Journal of Nuclear Cardiology

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Major Global Coronary Artery Calcium Guidelines

Cited by 58 publications

References 59 publications

Targeting macrophages in atherosclerosis using nanocarriers loaded with liver X receptor agonists: A narrow review

Targeting macrophages in atherosclerosis using nanocarriers loaded with liver X receptor agonists: A narrow review

Artificial intelligence using a deep learning versus expert computed tomography human reading in calcium score and coronary artery calcium data and reporting system classification

Low-dose coronary calcium scoring tarnishes power of zero

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