The Coronary Angiogram and Its Seminal Contributions to Cardiovascular Medicine Over Five Decades

Ryan, Thomas J.

doi:10.1161/01.cir.0000024109.12658.d4

Cited by 81 publications

(58 citation statements)

References 45 publications

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“…Invasive contrast X-ray angiography has been the gold standard for imaging of coronary atherosclerosis over the past 50 years since Dr. F. Mason Sones Jr performed the first selective coronary angiogram by accident in 1958 (6). While remaining the imaging standard and the most studied in regards to patient outcomes, coronary angiography does not provide imaging of atherosclerosis itself, but rather its end result.…”

Section: Review Articlementioning

confidence: 99%

Future imaging of atherosclerosis: molecular imaging of coronary atherosclerosis with 18F positron emission tomography

Scherer

Psaltis

2016

Cardiovasc. Diagn. Ther.

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Atherosclerosis is characterized by the formation of complex atheroma lesions (plaques) in arteries that pose risk by their flow-limiting nature and propensity for rupture and thrombotic occlusion.It develops in the context of disturbances to lipid metabolism and immune response, with inflammation underpinning all stages of plaque formation, progression and rupture. As the primary disease process responsible for myocardial infarction, stroke and peripheral vascular disease, atherosclerosis is a leading cause of morbidity and mortality on a global scale. A precise understanding of its pathogenic mechanisms is therefore critically important. Integral to this is the role of vascular wall imaging. Over recent years, the rapidly evolving field of molecular imaging has begun to revolutionize our ability to image beyond just the anatomical substrate of vascular disease, and more dynamically assess its pathobiology. Nuclear imaging by positron emission tomography (PET) can target specific molecular and biological pathways involved in atherosclerosis, with the application of 18 Fluoride PET imaging being widely studied for its potential to identify plaques that are vulnerable or high risk. In this review, we discuss the emergence of 18 Fluoride PET as a promising modality for the assessment of coronary atherosclerosis, focusing on the strengths and limitations of the two main radionuclide tracers that have been investigated to date: 2-deoxy-2-(

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Section: Review Articlementioning

confidence: 99%

Future imaging of atherosclerosis: molecular imaging of coronary atherosclerosis with 18F positron emission tomography

Scherer

Psaltis

2016

Cardiovasc. Diagn. Ther.

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“…Invasive angiography offers superior spatial resolution (0.1–0.2 mm) and temporal resolution (10 ms) and has been the criterion standard for coronary atherosclerosis imaging for more than 50 years 128. It generates a 2‐dimensional silhouette of the arterial lumen and does not image the vessel wall; thus, it does not provide direct imaging of calcification or the atherosclerotic plaque itself.…”

Section: Intravascular Imagingmentioning

confidence: 99%

Imaging Cardiovascular Calcification

Wang

Osborne

Tung

et al. 2018

JAHA

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“…Patients with abnormal MPI results proceeded to ICA, the gold standard for obstructive CAD diagnosis. 34 The study team assumed that all patients with obstructive CAD at ICA received revascularization, either coronary artery bypass graft surgery or percutaneous coronary intervention, based on rates of revascularization from New York State's Cardiac Diagnostic Catheterization Database. 35 All patients who proceeded to ICA, regardless of the procedure's findings, were assumed to receive 1 year of optimal medical therapy comprising a statin, beta-blocker, angiotensin-converting enzyme (ACE) inhibitor, and aspirin, based on the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial regimen.…”

Section: Diagnostic Strategies and Test Performancementioning

confidence: 99%

Economic Utility of a Blood-Based Genomic Test for the Assessment of Patients with Symptoms Suggestive of Obstructive Coronary Artery Disease

Hochheiser

Juusola²,

Monane³

et al. 2014

Population Health Management

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Approximately 3 million patients with symptoms suggestive of obstructive coronary artery disease (CAD) present to primary care offices in the United States annually, resulting in approximately $6.7 billion in cardiac workup costs. Despite wide application of existing diagnostic technologies, yield of obstructive CAD at invasive coronary angiography (ICA) is low. This study used a decision analysis model to assess the economic utility of a novel gene expression score (GES) for the diagnosis of obstructive CAD. Within a representative commercial health plan's adult membership, current practice for obstructive CAD diagnosis (usual care) was compared to a strategy that incorporates the GES test (GES-directed care). The model projected the number of diagnostic tests and procedures performed, the number of patients receiving medical therapy, type I and type II errors for each strategy of obstructive CAD diagnosis, and the associated costs over a 1-year time horizon. Results demonstrate that GES-directed care to exclude the diagnosis of obstructive CAD prior to myocardial perfusion imaging may yield savings to health plans relative to usual care by reducing utilization of noninvasive and invasive cardiac imaging procedures and increasing diagnostic yield at ICA. At a 50% capture rate of eligible patients in GES-directed care, it is projected that a commercial health plan will realize savings of $0.77 per member per month; savings increase proportionally to the GES capture rate. These findings illustrate the potential value of this new blood-based, molecular diagnostic test for health plans and patients in an age of greater emphasis on personalized medicine. (Population Health Management 2014;17:287-296)

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The Coronary Angiogram and Its Seminal Contributions to Cardiovascular Medicine Over Five Decades

Cited by 81 publications

References 45 publications

Future imaging of atherosclerosis: molecular imaging of coronary atherosclerosis with 18F positron emission tomography

Future imaging of atherosclerosis: molecular imaging of coronary atherosclerosis with 18F positron emission tomography

Imaging Cardiovascular Calcification

Economic Utility of a Blood-Based Genomic Test for the Assessment of Patients with Symptoms Suggestive of Obstructive Coronary Artery Disease

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