Prevalence of computed tomographic angiography-verified high-risk plaques and significant luminal stenosis in patients with zero coronary calcium score

Morita, Hitomi; Fujimoto, Shinichiro; Kondo, Takeshi; Arai, T.; Sekine, Takako; Matsutani, Hideyuki; Sano, Tomonari; Kondō, Makoto; Kodama, Takahide; Takase, Sachiko; Narula, Jagat

doi:10.1016/j.ijcard.2011.02.052

Cited by 32 publications

(19 citation statements)

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“…In the study with Japanese patients, Ueda et al identified hypercholesterolemia and DM as independent predictors of NCP or mixed coronary plaque [11]. Morita et al also identified age and male gender as significant predictors of 2 feature-positive plaque having positive remodeling and low attenuation, which is associated with the subsequent development of ACS [19]. We similarly found that advanced age, male gender, DM and current smoking were independent predictors of the presence of NCPs in patients with zero CACS.…”

Section: Discussionsupporting

confidence: 65%

“…The reported prevalence of NCP and obstructive coronary lesions in patients with zero CACS is 7% ~ 51% and < 1% ~ 24%, respectively [8][9][10][11][12][13][14][15][16][17][18][19][20]. The variation is thought to be due to differences in patients' characteristics, such as clinical pre- 117 sentation, race, gender and risk factors [9,19], and generally, reviewing the above recent reports, NCP or obstructive coronary lesions appear more frequent in study populations at higher risk for CAD. On the other hand, there are not many studies with Asian, especially Japanese patients, which reveal that the prevalence of NCP and obstructive coronary lesions in patients with zero CACS is 12% and 2.4% ~ 3.1%, respectively [11,17,19].…”

Section: Discussionmentioning

confidence: 94%

“…The variation is thought to be due to differences in patients' characteristics, such as clinical pre- 117 sentation, race, gender and risk factors [9,19], and generally, reviewing the above recent reports, NCP or obstructive coronary lesions appear more frequent in study populations at higher risk for CAD. On the other hand, there are not many studies with Asian, especially Japanese patients, which reveal that the prevalence of NCP and obstructive coronary lesions in patients with zero CACS is 12% and 2.4% ~ 3.1%, respectively [11,17,19]. The present study found that 11% of the patients without CAC had significant stenosis, 32% of them had NCP, and 7% of them had NCP with both PR and LP.…”

Section: Discussionmentioning

confidence: 99%

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Predictive Factors of the Presence and Number of Noncalcified Coronary Plaque in Japanese Patients with Zero Coronary Artery Calcium Score Using 64-Slice Multi-Detector Computed Tomography

Noda¹,

Matsutera²,

Yasuoka³

et al. 2013

ACT

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Background: Factors that can predict the presence and number of noncalcified coronary plaques (NCP) in Japanese patients with zero coronary artery calcium scores (CACS) essentially remain undefined. Methods and Results: We assessed independent predictors of the presence and number of segments with NCP in 111 Japanese patients with zero CACS who underwent 64-slice multi-detector computed tomography at our hospital. Thirty five patients (32%) had NCP, and 24 patients (22%) had ≥ 2 NCPs. Multiple logistic regression analysis revealed that significant predictors for the presence of NCP were age (odds ratio [OR]: 1.06, 95% confidence interval [CI] 1.01 -1.11, p = 0.021), male (OR: 3.61, 95% CI 1.40 -9.35, p = 0.008) and diabetes mellitus (OR: 3.10, 95% CI 1.02 -9.45, p = 0.046), and those for the presence of ≥ 2 NCPs were age (OR: 1.08, 95% CI 1.02 -1.15, p = 0.007) and a current smoking habit (OR: 5.09, 95% CI 1.00 -25.74, p = 0.049). Multiple linear regression analysis identified advanced age, male gender and diabetes mellitus as independent predictors of the number of NCPs. A novel score calculated from the above four predictors showed moderate accuracy for a diagnosis of NCP and ≥ 2 NCPs, with areas under receiver operating curves of 0.738 and 0.736, respectively. Conclusions: Male Japanese patients with zero CACS, advanced age, diabetes mellitus and a current smoking habit might have NCPs.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Predictive Factors of the Presence and Number of Noncalcified Coronary Plaque in Japanese Patients with Zero Coronary Artery Calcium Score Using 64-Slice Multi-Detector Computed Tomography

Noda¹,

Matsutera²,

Yasuoka³

et al. 2013

ACT

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“…CCS is a marker for atherosclerotic plaque burden and has been shown to be a predictor for the occurrence of myocardial infarction and cardiovascular death [23]. On the other hand, in case of a CCS of zero, it is still possible to have a so called ‘vulnerable’ plaque, which may rupture and cause an acute coronary event [24]. By means of contrast enhanced CT-angiography, it is possible to visualize these non-calcified plaques.…”

Section: Discussionmentioning

confidence: 99%

Relation between Mild to Moderate Chronic Kidney Disease and Coronary Artery Disease Determined with Coronary CT Angiography

et al. 2012

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BackgroundBoth end-stage and milder stages of chronic kidney disease (CKD) are associated with an increased risk of adverse cardiovascular events. Several studies found an association between decreasing renal function and increasing coronary artery calcification, but it remains unclear if this association is independent from traditional cardiovascular risk factors. Therefore, the aim of this study was to investigate whether mild to moderate CKD is independently associated with coronary plaque burden beyond traditional cardiovascular risk factors.MethodsA total of 2,038 patients with symptoms of chest discomfort suspected for coronary artery disease underwent coronary CT-angiography. We assessed traditional risk factors, coronary calcium score and coronary plaque characteristics (morphology and degree of luminal stenosis). Patients were subdivided in three groups, based on their estimated glomerular filtration rate (eGFR) Normal renal function (eGFR ≥90 mL/min/1.73 m2); mild CKD (eGFR 60–89 mL/min/1.73 m2); and moderate CKD (eGFR 30–59 mL/min/1.73 m2).ResultsCoronary calcium score increased significantly with decreasing renal function (P<0.001). Coronary plaque prevalence was higher in patients with mild CKD (OR 1.83, 95%CI 1.52–2.21) and moderate CKD (OR 2.46, 95%CI 1.69–3.59), compared to patients with normal renal function (both P<0.001). Coronary plaques with >70% luminal stenosis were found significantly more often in patients with mild CKD (OR 1.67 (95%CI 1.16–2.40) and moderate CKD (OR2.36, 95%CI 1.35–4.13), compared to patients with normal renal function (both P<0.01). After adjustment for traditional cardiovascular risk factors, the association between renal function and the presence of any coronary plaque as well as the association between renal function and the presence of coronary plaques with >70% luminal stenosis becomes weaker and were no longer statistically significant.ConclusionAlthough decreasing renal function is associated with increasing extent and severity of coronary artery disease, mild to moderately CKD is not independently associated with coronary plaque burden after adjustment for traditional cardiovascular risk factors.

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“…It is interesting to investigate whether the evaluation of small calcifications by 0.5-mm slice reconstruction gives an incremental diagnostic value to identify such high risk plaques on CCTA. Previously, we found 4.6% high risk plaques on CCTA in the patients with a CACS of 0 and reported that when the subjects were limited to the patients having spotty calcification which could not be detected by CACS, the incidence increased to 9.6% 8) .…”

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confidence: 86%

Significance of Small Calcifications in Patients with a Zero Calcium Score

Fujimoto

2016

JAT

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Prevalence of computed tomographic angiography-verified high-risk plaques and significant luminal stenosis in patients with zero coronary calcium score

Cited by 32 publications

References 28 publications

Predictive Factors of the Presence and Number of Noncalcified Coronary Plaque in Japanese Patients with Zero Coronary Artery Calcium Score Using 64-Slice Multi-Detector Computed Tomography

Predictive Factors of the Presence and Number of Noncalcified Coronary Plaque in Japanese Patients with Zero Coronary Artery Calcium Score Using 64-Slice Multi-Detector Computed Tomography

Relation between Mild to Moderate Chronic Kidney Disease and Coronary Artery Disease Determined with Coronary CT Angiography

Significance of Small Calcifications in Patients with a Zero Calcium Score

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