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- 저자 : Swee Yaw Tan (검색결과 2 건)
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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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ASCI Practice Guideline Working Group,백경민,김정아,최연현,Sim Kui Hian,John Hoe,홍유진,김성목,김태훈,김영진,김윤현,Sachio Kuribayashi,이종민,Lilian Leong,임태환,Bin Lu,박재형,Hajime Sakuma,양동현,Tan Swee Yaw,Yung-Liang Wan,Zhaoqi Zhan 대한영상의학회 2017 Korean Journal of Radiology Vol.18 No.6
In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios. Ninety-five clinical scenarios were developed from eight selected pre-existing guidelines and classified into four sections as follows: 1) detection of coronary artery disease, symptomatic or asymptomatic; 2) cardiac evaluation in various clinical scenarios; 3) use of imaging modality according to prior testing; and 4) evaluation of cardiac structure and function. The clinical scenarios were scored by a separate rating committee on a scale of 1–9 to designate appropriate use, uncertain use, or inappropriate use according to a modified Delphi method. Overall, the AUC ratings for CT were higher than those of previous guidelines. These new AUC provide guidance for clinicians choosing among available testing modalities for various cardiac diseases and are also unique, given that most previous AUC for noninvasive imaging include only one imaging technique. As cardiac imaging is multimodal in nature, we believe that these AUC will be more useful for clinical decision making.
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