Noninvasive definition of anatomic coronary artery disease by ultrafast computed tomographic scanning: A quantitative pathologic comparison study

Simons, D.Brent; Schwartz, Robert S.; Edwards, William D.; Sheedy, Patrick F.; Breen, Jerome F.; Rumberger, John A.

doi:10.1016/0735-1097(92)90367-v

Cited by 296 publications

(114 citation statements)

References 14 publications

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“…The absence of calcification, however, did correlate with the absence of advanced luminal disease on a site-by-site basis. A previous study by Simons and coworkers 27 determined that coronary calcification demonstrated on EBCT was present in 97.5% of all coronary segments with "significant" histologic coronary disease (that is, 75% or greater area or approximately a 50% or greater diameter stenosis).…”

Section: Coronary Calcium and Luminal Disease Severitymentioning

confidence: 99%

Electron Beam Computed Tomographic Coronary Calcium Scanning: A Review and Guidelines for Use in Asymptomatic Persons

Rumberger

Brundage²,

Rader

et al. 1999

Mayo Clinic Proceedings

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742

449

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Section: Coronary Calcium and Luminal Disease Severitymentioning

confidence: 99%

Electron Beam Computed Tomographic Coronary Calcium Scanning: A Review and Guidelines for Use in Asymptomatic Persons

Rumberger

Brundage²,

Rader

et al. 1999

Mayo Clinic Proceedings

Self Cite

742

449

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“…Coronary artery calcification as presently imaged is not a reliable indicator of atherosclerosis. 81 Furthermore, this technique has limited capability in measuring extent of coronary artery atherosclerosis. These major issues limit the usefulness of this noninvasive technique for clinical trials.…”

Section: Noninvasive Imaging Of the Coronary Arteriesmentioning

confidence: 99%

George Lyman Duff Memorial Lecture. Arterial imaging and atherosclerosis reversal.

Blankenhorn

Hodis

1994

Arterioscler Thromb

202

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This review explores evidence for the reversibility of atherosclerosis and augmentation of angiography with noninvasive arterial wall imaging. Meta-analysis from coronary angiographic trials demonstrates that regression and stabilization are 1.5 to 2 times more common in treated than placebo subjects, and progression is reduced by half in treated subjects. Odds ratios for clinical coronary events are significantly reduced with treatment. Lesion improvement occurs more readily in women than men and more so in women receiving concomitant estrogen replacement therapy. Lesions with >50% diameter stenosis (%S) at baseline respond more readily to lipid lowering than those <50%S, whereas reduction in coronary events is related to stabilization of lesions <50%S. Lipoproteins have a differential effect on lesion progression according to lesion size, and triglyceride-rich lipoproteins play an important role in the progression of coronary artery lesions <50%S. Improved therapeutic regimens to alter progression of atherosclerosis may require adjunctive therapy, such as with antioxidants or hormone replacement therapy, in concert with low-density lipoprotein cholesterol reduction to prevent new lesion formation or early lesion progression. Sequential coronary angiographic determination of progression evaluated by both quantitative coronary angiography and global change score, a visual assessment of overall lesion change, predicts clinical coronary events. Only inferences about the state of the arterial wall can be made from angiography, because it delineates only the lumen. Therapy testing and study of atherosclerosis progression can be improved with noninvasive B-mode ultrasonographic imaging of the distal common carotid artery far-wall intima-media thickness (IMT), a reliable measure of early preintrusive atherosclerosis. Measurement of common carotid IMT is useful for the study of coronary artery risk factors and can augment studies of coronary artery intrusive lesions, because it is associated with coronary artery disease. B-mode measurement of common carotid IMT has the potential of serving as a noninvasive surrogate end point for clinical coronary events. Screening for peripheral vessel changes indicative of high risk for coronary artery disease is possible and cost-effective with the noninvasive procedures now available. (Arterioscler Thromb. 1994;14:177-192.) Key Words • atherosclerosis • angiography • ultrasound • regression • clinical trials • intima-media thickness • quantitative computerized angiography • common carotid artery • coronary arteries • meta-analysis E vidence that progression of atherosclerosis can be retarded and atherosclerotic lesions can regress derives from several sources. These sources include studies of arterial lesions obtained at autopsy from starved human populations, animal experimentation, and clinical trials using serial angiography. In the first half of this article, we review serial angiographic evidence for atherosclerotic lesion improvement induced by diverse modes of int...

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“…Coronary artery calcification (CAC) is highly correlated with the presence of coronary atherosclerotic plaque. [13][14][15] However, information on the association between CAC scores and UAE is currently limited.This study examined the association between UAE and several measures of subclinical CVD, including CAC scores, in a large multi-ethnic population without clinical CVD. We hypothesized that increased UAE is associated with subclinical CVD reflecting kidney damage caused by exposure to CVD risk factors, particularly diabetes mellitus (DM) and hypertension, and that these associations exist at UAE cutpoints below thresholds currently used to define microalbuminuria.…”

mentioning

confidence: 99%

Urine Albumin Excretion and Subclinical Cardiovascular Disease

et al. 2005

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Abstract-We examined the association between urine albumin excretion (UAE) and common and internal carotid artery intima-media thickness (IMT), end-diastolic left ventricular (LV) mass, and coronary artery calcification (CAC) scores using data from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study of 6814 adults aged 45 to 85 years without clinical cardiovascular disease (CVD). The mean age of the MESA participants was 62.7 years, 47% were male, and 15% had diabetes mellitus (DM). Sex-specific spot urine albumin/creatinine ratios were used to define 4 UAE categories: normal, high normal, microalbuminuria, and macroalbuminuria. CAC scores were log-transformed after adding 1 to all scores. Key Words: cardiovascular diseases Ⅲ urine M icroalbuminuria, increased urine albumin excretion (UAE) below the detection of urinary dipstick measurement, strongly predicts cardiovascular disease (CVD) mortality in nondiabetic patients with established CVD. 1 Moreover, the association between UAE and increased CVD mortality in high-risk groups begins at levels of UAE below clinically defined thresholds for microalbuminuria. 1 Subclinical CVD, such as left ventricular (LV) hypertrophy 2-6 and increased carotid artery intima-media thickness (IMT), [7][8][9][10][11][12] has been associated with microalbuminuria among individuals at high risk for CVD. Whether the presence of increased UAE provides any additional predictive value for the presence of subclinical CVD in groups not at high risk aside from established, independent CVD risk factors remains unestablished. Coronary artery calcification (CAC) is highly correlated with the presence of coronary atherosclerotic plaque. [13][14][15] However, information on the association between CAC scores and UAE is currently limited.This study examined the association between UAE and several measures of subclinical CVD, including CAC scores, in a large multi-ethnic population without clinical CVD. We hypothesized that increased UAE is associated with subclinical CVD reflecting kidney damage caused by exposure to CVD risk factors, particularly diabetes mellitus (DM) and hypertension, and that these associations exist at UAE cutpoints below thresholds currently used to define microalbuminuria. An association between increased UAE and subclinical CVD in adults without clinical CVD may give further credence to using UAE to identify individuals who may benefit from aggressive risk factor intervention for the primary prevention of CV events.

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Noninvasive definition of anatomic coronary artery disease by ultrafast computed tomographic scanning: A quantitative pathologic comparison study

Cited by 296 publications

References 14 publications

Electron Beam Computed Tomographic Coronary Calcium Scanning: A Review and Guidelines for Use in Asymptomatic Persons

Electron Beam Computed Tomographic Coronary Calcium Scanning: A Review and Guidelines for Use in Asymptomatic Persons

George Lyman Duff Memorial Lecture. Arterial imaging and atherosclerosis reversal.

Urine Albumin Excretion and Subclinical Cardiovascular Disease

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