Progression of calcified coronary atherosclerosis: Relationship to coronary risk factors and carotid intima-media thickness

Taylor, Allen J.; Bindeman, Jody; Le, Toan; Bauer, Kelly; Byrd, Carole; Wu, Hongyan; O’Malley, Patrick G.

doi:10.1016/j.atherosclerosis.2007.05.027

Cited by 44 publications

(25 citation statements)

References 24 publications

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“…Similar findings have been recently observed by Rodrigues et al [16], who found high fibrinogen independently associated with progression of coronary calcification among 1,186 patients with Type 1 Diabetes. Opposite findings were observed by Taylor et al [17] who did not find an association between fibrinogen and progression of CAC in a smaller population of 180 patients and a window of observation of only 4.2 years. This is one of the largest study so far conducted to investigate the relationship between fibrinogen levels and CAD as evaluated by coronary angiography.…”

Section: Discussionmentioning

confidence: 55%

High fibrinogen level is an independent predictor of presence and extent of coronary artery disease among Italian population

Luca

Verdoia

Cassetti

et al. 2010

J Thromb Thrombolysis

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Few reports have so far investigated the relationship between fibrinogen levels and the extent of coronary artery disease (CAD) as evaluated by coronary angiography, that is therefore the aim of the current study. We measured fibrinogen in 2,121 consecutive patients undergoing coronary angiography. Patients were divided in 5 groups based on quintiles of fibrinogen levels. Significant CAD was defined as stenosis >50% in at least 1 coronary vessel. We additionally measured carotid intima-media thickness (CIMT) in a subgroup of 359 patients. Patients with elevated fibrinogen were older (P = 0.038), with larger prevalence of diabetes (P = 0.027), female gender (P < 0.0001), hypertension (P < 0.001), chronic renal failure (P < 0.0001), previous CVA (P = 0.036), less often with family history of CAD (P = 0.019) and previous PCI (P < 0.0001), more often presenting with ACS (P < 0.0001), more often on nitrates (P < 0.0001), clopidogrel (P = 0.009) and diuretics (P < 0.0001). Fibrinogen levels were linearly associated with baseline glycaemia (P < 0.017), WBC count (P < 0.0001), creatinine (P < 0.0001), and Platelet count (P < 0.0001) but inversely associated with RBC count (P < 0.0001). Fibrinogen levels were associated with CAD (P = 0.001), especially for extremely high levels (5th percentile, P < 0.0001). At multivariate analysis, after correction for baseline confounding factors, high fibrinogen level (5th percentile) was still associated with the prevalence of CAD (P = 0.034). Furthermore, fibrinogen levels were related with maximal CIMT (r = 0.12; P = 0.01), with larger prevalence of carotid plaques in patients with higher fibrinogen levels (5th quintile) as compared to remaining patients (P = 0.046). This study showed that high fibrinogen level is significantly associated with CAD and carotid atherosclerosis.

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Section: Discussionmentioning

confidence: 55%

High fibrinogen level is an independent predictor of presence and extent of coronary artery disease among Italian population

Luca

Verdoia

Cassetti

et al. 2010

J Thromb Thrombolysis

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“…Non-invasively, repeated measurements of coronary artery calcium (CAC) by electron-beam or multi-detector computed tomography (CT) have been employed to assess changes in CAC burden. However, CAC represents only one component of atherosclerotic plaque and follow-up studies of CAC assessing the role of both medical therapies and cardiovascular risk factors have led to contradictory results (2,9–12). More recently, contrast-enhanced coronary multidetector CT has been established as a robust and reliable modality to non-invasively detect the presence, extent, and composition of coronary plaque (13,14).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Coronary Plaque Progression in Coronary Computed Tomography Angiography Using a Semiquantitative Score

Lehman

Schlett

Bamberg

et al. 2009

JACC: Cardiovascular Imaging

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Objectives To describe progression of coronary atherosclerotic plaque over time by computed tomography (CT) angiography stratified by plaque composition and its association with cardiovascular risk profiles. Background Data on the progression of atherosclerosis stratified by plaque composition using non-invasive assessment by CT are limited and hampered by high measurement variability. Methods This analysis included patients who presented with acute chest pain to the emergency room but had initially no evidence for acute coronary syndrome. All patients underwent contrast enhanced 64-slice CT at baseline and after 2-years using a similar protocol. CT datasets were co-registered and assessed for presence of calcified and non-calcified plaque at 1mm cross-sections of the proximal 40mm of each major coronary artery. Plaque progression over time and its association to risk factors were determined. Measurement reproducibility and correlation to plaque volume was performed in a subset of patients. Results We included 69 patients (mean age 55±12years, 59% male) and compared 8,311 co-registered cross-sections at baseline and follow-up. At baseline, any plaque, calcified plaque, and non-calcified were detected in 12.5%, 10.1%, and 2.4% of cross-sections per patient. There was significant progression in the mean number of cross-sections containing any plaque (16.5±25.3 versus 18.6±25.5, p=0.01) and non-calcified plaque (3.1±5.8 versus 4.4±7.0, p=0.04), but not calcified plaque (13.3±23.1 versus 14.2±22.0, p=0.2). In longitudinal regression analysis, the presence of baseline plaque, number of cardiovascular risk factors and smoking were independently associated with plaque progression after adjustment for age, gender and follow-up time interval. The semi-quantitative score based on cross-sections correlated close with plaque volume progression (r=0.75, p<0.0001) and demonstrated an excellent intra- and inter-observer agreement (κ=0.95 and κ=0.93, retrospectively). Conclusions Coronary plaque burden of patients with acute chest pain significantly increases over two years. Progression over time is dependent on plaque composition and cardiovascular risk profile. Larger studies are needed to confirm these results and to determine the effect of medical treatment on progression.

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“…49,50 Novel markers of risk for CHD were also investigated. While microalbuminuria, 51 carotid intima-media thickness, 52 white race 43 and polymorphisms of the reninangiotensinmsystem genes 53 predict progression of subclinical coronary atherosclerosis, the C-reactive protein did not. 54,55 Interestingly, although abdominal obesity, 56 body mass index 57 and metabolic syndrome 50 were associated with progression of CACS, the levels of low and high-density lipoproteins were related just with the incidence, and not with the progression of preclinical atherosclerosis disease.…”

Section: Coronary Calcium Scoring By Ctmentioning

confidence: 91%

Role of Computed Tomography for Diagnosis and Risk Stratification of Patients With Suspected or Known Coronary Artery Disease

Heo

Valenti

Nakazato

et al. 2014

ATVB

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Cardiac computed tomography angiography(CCTA) has emerged as a powerful imaging modality for the detection and prognostication of individuals with suspected coronary artery disease (CAD). Because calcification of coronary plaque occurs in proportion to the total atheroma volume, the initial diagnostic potential of CCT focused on identification and quantification of coronary calcium in low to intermediate risk individuals, a finding that tracks precisely with the risk of incident adverse clinical events. Beyond non-contrast detection of coronary calcium, CCT employing the use of iodinated contrast yields incremental information regarding the degree and distribution of coronary plaques and stenosis, as well as vessel wall morphology and atherosclerotic plaque features. This additive information offers the promise of CCT to provide a more comprehensive view of total atherosclerotic burden as it relates to myocardial ischemia and future adverse clinical events. Further, emerging data suggest the prognostic and diagnostic importance of stenosis severity detection and atherosclerotic plaque features described by CCT—including positive remodeling, low attenuation plaque and spotty calcification—which have been associated with the “vulnerability” of plaque. We report a summary of the evidence supporting the role of CCT in the detection of subclinical and clinical CAD in both asymptomatic and symptomatic patients, and discuss the potential of CCT to augment identification of at-risk individuals. CCTA and coronary artery calcium scoring offer the ability to improve risk stratification, discrimination and reclassification of the risk in patients with suspected CAD and to non-invasively determine the measures of stenosis severity and atherosclerotic plaque features.

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Progression of calcified coronary atherosclerosis: Relationship to coronary risk factors and carotid intima-media thickness

Cited by 44 publications

References 24 publications

High fibrinogen level is an independent predictor of presence and extent of coronary artery disease among Italian population

High fibrinogen level is an independent predictor of presence and extent of coronary artery disease among Italian population

Assessment of Coronary Plaque Progression in Coronary Computed Tomography Angiography Using a Semiquantitative Score

Role of Computed Tomography for Diagnosis and Risk Stratification of Patients With Suspected or Known Coronary Artery Disease

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