When Does a Calcium Score Equate to Secondary Prevention?

JACC. Cardiovascular imaging, Journal Year: 2023, Volume and Issue: 16(9), P. 1181 - 1189

Published: May 24, 2023

Language: Английский

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Effects of Combining Coronary Calcium Score With Treatment on Plaque Progression in Familial Coronary Artery Disease

JAMA, Journal Year: 2025, Volume and Issue: unknown

Published: March 5, 2025

Coronary artery calcium (CAC) scoring provides prognostic information, especially in patients at intermediate risk for coronary disease (CAD). However, the benefit of combining CAC score with a primary prevention strategy has not been tested randomized trial. To assess whether can be used to limit plaque progression intermediate-risk family history premature CAD. Prospective, randomized, open-blinded end point clinical trial 7 hospitals across Australia (between 2013 and 2020; last date follow-up was June 5, 2021). Asymptomatic people aged 40 70 years first-degree relative CAD onset younger than 60 old or second-degree 50 were recruited from community. Intermediate-risk participants underwent scoring. Those greater 0 but less 400 computed tomography angiography (CCTA) score-informed usual care. Follow-up CCTA obtained 3 years, volume measured by an independent core laboratory. The outcome total volume, further analysis calcified noncalcified volume. This study included 365 (mean [SD] age, 58 [6] years; 57.5% male); 179 186 care groups. Compared care, group showed sustained reduction [SD], -3 [31] mg/dL vs -56 [38] mg/dL; P < .001) LDL -2 -51 [36] cholesterol levels which associated pooled cohort equation calculation 2.1% [2.9%] 0.5% [2.9%]; .001). Plaque 24.9 [37.7] mm3 15.4 [30.9] mm3; = .009), 15.7 [32.2] 5.6 [28.5] .002), fibrofatty necrotic 4.5 [25.8] -0.8 [12.6] .02). These changes other factors including baseline blood pressure, lipid profile. combination atherogenic lipids slower compared data support use assist intensive preventive strategies patients. anzctr.org.au Identifier: ACTRN12614001294640.

Language: Английский

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Insights from Autopsy-initiated Pathological Studies of the Pathogenesis and Clinical Manifestations of Atherosclerosis and Ischemic Heart Disease: Part II. Ischemic Heart Disease

Cardiovascular Pathology, Journal Year: 2025, Volume and Issue: unknown, P. 107727 - 107727

Published: Feb. 1, 2025

Language: Английский

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Novel Insights into the Molecular Mechanisms of Atherosclerosis

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(17), P. 13434 - 13434

Published: Aug. 30, 2023

Atherosclerosis is one of the most fatal diseases in world. The associated thickening arterial wall and its background consequences make it a very composite disease entity with many mechanisms that lead to creation. It an active process, scientists from various branches are engaged research, including molecular biologists, cardiologists, immunologists. This review summarizes available information on pathophysiological implications atherosclerosis, focusing endothelium dysfunction, inflammatory factors, aging, uric acid, vitamin D, miRNA expression as recent evidence interactions cellular elements. Analyzing new discoveries for underlying causes this condition assists general research improve understanding mechanism pathophysiology thus prevention cardiovascular diseases.

Language: Английский

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A framework of biomarkers for vascular aging: a consensus statement by the Aging Biomarker Consortium

Life Medicine, Journal Year: 2023, Volume and Issue: 2(4)

Published: Aug. 30, 2023

Aging of the vasculature, which is integral to functioning literally all human organs, serves as a fundamental physiological basis for age-related alterations well shared etiological mechanism various chronic diseases prevalent in elderly population. China, home world's largest aging population, faces an escalating challenge addressing prevention and management these conditions. To meet this challenge, Biomarker Consortium China has developed expert consensus on biomarkers vascular (VA) by synthesizing literature insights from scientists clinicians. This provides comprehensive assessment associated with VA presents systemic framework classify them into three dimensions: functional, structural, humoral. Within each dimension, panel recommends most clinically relevant biomarkers. For functional domain, reflecting stiffness endothelial function are highlighted. The structural dimension encompasses metrics structure, microvascular distribution. Additionally, proinflammatory factors emphasized humoral dimension. aim establish foundation assessing extent conducting research related VA, ultimate goal improving health globally.

Language: Английский

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Enhancing cardiovascular risk prediction through AI-enabled calcium-omics

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: May 15, 2024

Abstract Whole-heart coronary calcium Agatston score is a well-established predictor of major adverse cardiovascular events (MACE), but it does not account for individual calcification features related to the pathophysiology disease (e.g., multiple-vessel disease, spread along vessel, stable calcifications, numbers lesions, and density). We used novel, hand-crafted (calcium-omics); Cox time-to-event modeling; elastic net; up down synthetic sampling methods imbalanced data, assess MACE risk. 2457 CT (CTCS) images enriched from our large no-cost CLARIFY program (ClinicalTrials.gov Identifier: NCT04075162). Among calcium-omics features, LAD mass, diffusivity (a measure spatial distribution) were especially important determinants increased risk, with dense (> 1000HU, calcifications) associated reduced risk Our model (training/testing, 80/20) gave C-index (80.5%/71.6%) 2-year AUC (82.4%/74.8%). Although notoriously impervious improvements, compared favorably significant difference ( P < 0.001). The identified 73.5% cases in high-risk group, 13.2% improvement as Agatston, suggesting that could be better identity candidates intensive follow-up therapies. categorical net-reclassification index was NRI = 0.153. findings this exploratory study suggest utility improved prediction. These promising results will pave way more extensive, multi-institutional studies calcium-omics.

Language: Английский

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SEA 2024 Standards for Global Control of Vascular Risk

Clínica e Investigación en Arteriosclerosis (English Edition), Journal Year: 2024, Volume and Issue: 36(3), P. 133 - 194

Published: May 1, 2024

One of the objectives Spanish Society Arteriosclerosis is to contribute knowledge, prevention and treatment vascular diseases, which are leading cause death in Spain entail a high degree disability health expenditure. Atherosclerosis multifactorial disease its requires global approach that takes into account associated risk factors. This document summarises current evidence includes recommendations for patients with established or at risk: it reviews symptoms signs evaluate, laboratory imaging procedures request routinely special situations, estimation risk, diagnostic criteria entities factors, general specific their treatment. Finally, presents aspects not usually referenced literature, such as organisation consultation. La Sociedad Española de (SEA) tiene entre sus objetivos contribuir al conocimiento, prevención y tratamiento las enfermedades vasculares, que son la primera causa muerte en España conllevan un elevado grado discapacidad gasto sanitario. arteriosclerosis es una enfermedad su exige abordaje contemple los factores riesgo asociados. Este documento resume evidencia actual e incluye recomendaciones seguir ante el paciente con establecida o (RV): se revisan síntomas signos evaluar, procedimientos laboratorio imagen solicitar rutinariamente situaciones especiales, estimación del RV, criterios diagnósticos entidades (FRV), plantea generales específicas para tratamiento. Por último, presentan aspectos poco referenciados literatura, como son, por ejemplo, organización consulta RV.

Language: Английский

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Guideline-Directed Application of Coronary Artery Calcium Scores for Primary Prevention of Atherosclerotic Cardiovascular Disease

JACC. Cardiovascular imaging, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

The 2018 ACC (American College of Cardiology)/AHA Heart Association) and 2021 ESC (European Society Cardiology)/EAS Atherosclerosis Society) guidelines recommend coronary artery calcium (CAC) score for risk refinement in primary prevention atherosclerotic cardiovascular disease (ASCVD). study sought to compare CAC utility as a risk-refining tool following the ACC/AHA guideline using pooled cohort equations (PCE) or PREVENT (Predicting Risk EVENTs) ESC/EAS SCORE2 (Systematic COronary Evaluation 2). A total 1,903 statin-naive participants 55 75 years age, free ASCVD diabetes, with low-density lipoprotein cholesterol <190 mg/dL from prospective population-based Rotterdam Study were included. Per guidelines, we determined proportions scan-eligible reclassified men women, incidence rates, numbers needed treat 10 (NNT10y). By (PCE), 18.3% 11.9% by (PREVENT), 13.4% 3.4% women eligible scan. ESC/EAS, 46.6% 44.9% eligible. Proportions uprisked derisked individuals varied per guideline. Among CAC-eligible individuals, rates ranged 9.3 23.8 1,000 person-years, estimated NNT10y prevent 1 event, based on high-intensity statin use, 11 26. differ selection application ASCVD. Guideline-directed middle-aged apparently healthy population improved stratification at an acceptable both guidelines.

Language: Английский

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Assessment of Subclinical Atherosclerosis in Asymptomatic People In Vivo: Measurements Suitable for Biomarker and Mendelian Randomization Studies

Arteriosclerosis Thrombosis and Vascular Biology, Journal Year: 2023, Volume and Issue: 44(1), P. 24 - 47

Published: Nov. 21, 2023

One strategy to reduce the burden of cardiovascular disease is early detection and treatment atherosclerosis. This has led significant interest in studies subclinical atherosclerosis, using different phenotypes, not all which are accurate reflections presence asymptomatic atherosclerotic plaques. The aim part 2 this series provide a review existing literature on purported measures recommendations concerning tests may be appropriate prevention incident disease.

Language: Английский

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Small dense low-density lipoprotein cholesterol and coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis

European Journal of Preventive Cardiology, Journal Year: 2024, Volume and Issue: 31(8), P. 1048 - 1054

Published: Feb. 7, 2024

Abstract Aims Elevated small dense LDL cholesterol (sd-LDL-C) increases atherosclerotic cardiovascular disease (CVD) risk. Although coronary artery calcification (CAC) is widely used for predicting CVD events, few studies have examined the relationship between sd-LDL-C and CAC. Methods results This study included 4672 individuals with directly measured baseline CAC from Multi-Ethnic Study of Atherosclerosis [mean (standard deviation) age: 61.9 (10.4) years; 52.5% women; 47.3% (mean score &gt;0)]. We multi-variable general linear models restricted cubic splines goodness fit testing to evaluate association presence Odds ratios [OR (95% confidence interval)] were adjusted demographics risk factors, including estimated total LDL-C. Higher quartiles associated CAC, even after accounting Compared lowest quartile sd-LDL-C, participants in Quartiles 2, 3, 4 had higher odds [Quartile 2 OR: 1.24 (1.00, 1.53); Quartile 3 1.51 (1.19, 1.93); OR 1.59 (1.17, 2.16)]. Splines suggested a quadratic curvilinear continuous adjustment factors (quadratic vs. first-order terms likelihood ratio test: P = 0.015), but not LDL-C terms: 0.156). Conclusion In large, multi-ethnic sample without known CVD, was above beyond Whether selective direct measurement indicated refine assessment primary prevention warrants further investigation.

Language: Английский

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