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RISS 인기검색어
- 검색키워드
- 저자 : Lohendran Baskaran (검색결과 3 건)
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Han, Donghee,Hartaigh, Brí,ain Ó,Gransar, Heidi,Lee, Ji Hyun,Rizvi, Asim,Baskaran, Lohendran,Schulman-Marcus, Joshua,Dunning, Allison,Achenbach, Stephan,Al-Mallah, Mouaz H,Berman, Daniel S Oxford University Press 2018 European heart journal cardiovascular Imaging Vol.19 No.6
<P><B>Abstract</B></P><P><B>Aims</B></P><P>Coronary computed tomography angiography (CCTA) and coronary artery calcium score (CACS) have prognostic value for coronary artery disease (CAD) events beyond traditional risk assessment. Age is a risk factor with very high weight and little is known regarding the incremental value of CCTA over CAC for predicting cardiac events in older adults.</P><P><B>Methods and results</B></P><P>Of 27 125 individuals undergoing CCTA, a total of 3145 asymptomatic adults were identified. This study sample was categorized according to tertiles of age (cut-off points: 52 and 62 years). CAD severity was classified as 0, 1–49, and ≥50% maximal stenosis in CCTA, and further categorized according to number of vessels ≥50% stenosis. The Framingham 10-year risk score (FRS) and CACS were employed as major covariates. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death or non-fatal MI. During a median follow-up of 26 months (interquartile range: 18–41 months), 59 (1.9%) MACE occurred. For patients in the top age tertile, CCTA improved discrimination beyond a model included FRS and CACS (C-statistic: 0.75 vs. 0.70, <I>P</I>-value = 0.015). Likewise, the addition of CCTA improved category-free net reclassification (cNRI) of MACE in patients within the highest age tertile (e.g. cNRI = 0.75; proportion of events/non-events reclassified were 50 and 25%, respectively; <I>P</I>-value <0.05, all). CCTA displayed no incremental benefit beyond FRS and CACS for prediction of MACE in the lower age tertiles.</P><P><B>Conclusion</B></P><P>CCTA provides added prognostic value beyond cardiac risk factors and CACS for the prediction of MACE in asymptomatic older adults.</P>
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Prognostic Value of Coronary Artery Calcium in a Multi-Ethnic Asian Cohort
Shu Yun Heng,Jien Sze Ho,Seyed Ehsan Saffari,Zijuan Huang,Foong Koon Cheah,Siang Jin Terrance Chua,Yung Jih Felix Keng,Lohendran Baskaran,Swee Yaw Tan 아시아심장혈관영상의학회 2021 Cardiovascular Imaging Asia Vol.5 No.3
Objective: Coronary artery calcium (CAC) is associated with the presence of coronary atherosclerotic plaque and is a prognostic factor of cardiovascular events. CAC varies among ethnic groups in patients of the same age and gender. Studies on the prognostic value of CAC in a multi-ethnic Asian population have yet to be performed. We aim to study the association of CAC and ethnicity, all-cause mortality, and acute myocardial infarction (AMI). Materials and Methods: This is a retrospective study with a multi-ethnic cohort aged 35–84 years from a single tertiary institution between 2007–2017. The individuals were all clinically referred for cardiac CT calcium scanning. CAC was determined by Toshiba Aquilion One 320 Multi-detector Row CT (Toshiba Medical System). Results: This study had 65% males at an average age of 55 years. In our multivariable analysis of 16561 individuals, CAC is generally higher in the Malay than Chinese ethnic group [odds ratio (OR)=1.30, 95% confidence interval (CI)=1.10–1.55] and did not differ among Indians and Chinese (p=0.400). Increasing CAC was associated with higher all-cause mortality (OR=1.27, 95% CI=1.17–1.36) and AMI (OR=1.50, 95% CI=1.35–1.66) after adjusting for known cardiovascular risk factors. Incorporation of CAC into a model with known cardiovascular risk variables enhanced prediction of all-cause mortality [area under the curve (AUC)=0.78] and AMI (AUC=0.85). Conclusion: This study is the largest performed in a multi-ethnic Asian cohort. Malay ethnicity seems to confer a higher likelihood of coronary calcification compared to the Chinese and Indians. CAC was associated with higher all-cause mortality and AMI and complemented traditional cardiovascular risk factors in risk prediction, confirming its applicability in a multi-ethnic Asian population.
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Han, Donghee,Torii, Sho,Yahagi, Kazuyuki,Lin, Fay Y.,Lee, Ji Hyun,Rizvi, Asim,Gransar, Heidi,Park, Mahn-Won,Roudsari, Hadi Mirhedayati,Stuijfzand, Wijnand J.,Baskaran, Lohendran,ó,Hartaigh, Br&i Elsevier Scientific Publ. Co 2018 Atherosclerosis Vol. No.
<P><B>Abstract</B></P> <P><B>Background and aims</B></P> <P>Recent advancements in coronary computed tomography angiography (CCTA) have allowed for the quantitative measurement of high-risk lipid rich plaque. Determination of the optimal threshold for Hounsfield units (HU) by CCTA for identifying lipid rich plaque remains unknown. We aimed to validate reliable cut-points of HU for quantitative assessment of lipid rich plaque.</P> <P><B>Methods</B></P> <P>8 post-mortem sudden coronary death hearts were evaluated with CCTA and histologic analysis. Quantitative plaque analysis was performed in histopathology images and lipid rich plaque area was defined as intra-plaque necrotic core area. CCTA images were analyzed for quantitative plaque measurement. Low attenuation plaque (LAP) was defined as any pixel < 30, 45, 60, 75, and 90 HU cut-offs within a coronary plaque. The area of LAP was calculated in each cross-section.</P> <P><B>Results</B></P> <P>Among 105 cross-sections<B>,</B> 37 (35.2%) cross-sectional histology images contained lipid rich plaque. Although the highest specificity for identifying lipid rich plaque was shown with <30 HU cut-off (88.2%), sensitivity (e.g. 55.6% for <75 HU, 16.2% for <30 HU) and negative predictive value (e.g. 75.9% for <75 HU, 65.9% for <30 HU) tended to increase with higher HU cut-offs. For quantitative measurement, <75 HU showed the highest correlation coefficient (0.292, <I>p</I> = 0.003) and no significant differences were observed between lipid rich plaque area and LAP area between histology and CT analysis (Histology: 0.34 ± 0.73 mm<SUP>2</SUP>, QCT: 0.37 ± 0.71 mm<SUP>2</SUP>, <I>p</I> = 0.701).</P> <P><B>Conclusions</B></P> <P>LAP area by CCTA using a <75 HU cut-off value demonstrated high sensitivity and quantitative agreement with lipid rich plaque area by histology analysis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Lipid rich plaques are related to future risk of acute coronary syndrome. </LI> <LI> Quantitative coronary plaque (QCT) analysis enables to quantify lipid rich plaques. </LI> <LI> 75 HU is a reliable cut-off for quantification of lipid rich plaque in QCT analysis. </LI> </UL> </P>
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