Mortality rates in smokers and nonsmokers in the presence or absence of coronary artery calcification.
By: McEvoy JW, Blaha MJ, Rivera JJ, Budoff MJ, Khan AN, Shaw LJ, Berman DS, Raggi P, Min JK, Rumberger JA, Callister TQ, Blumenthal RS, Nasir K.
The aim of this study was to further explore the interplay between smoking status, coronary artery calcium (CAC), and all-cause mortality. Smoking is a risk factor for death across the entire spectrum of subclinical coronary atherosclerosis. Smokers with any CAC had significantly higher mortality than smokers without CAC, a finding with implications for smokers undergoing lung cancer CT-based screening. However, the absence of CAC might not be as useful a "negative risk factor" in active smokers, because this group has mortality rates similar to nonsmokers with mild-to-moderate atherosclerosis.
- Journal:
Journal of the American College of Cardiology
- Year: 2012
- Topics:
ASCVD (Atherosclerotic Cardiovascular Disease),
Cardiac CT,
Cigarette Smoking
- Read more articles by:
Roger S. Blumenthal, MD,
Michael Blaha, MD, MPH,
Khurram Nasir, MD, MPH,
J. Bill McEvoy, MB BCh, MHS
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Herpes simplex virus type 2 (HSV-2) as a coronary atherosclerosis risk factor in HIV-infected men: Multicenter AIDS Cohort Study.
By: Hechter RC, Budoff M, Hodis HN, Rinaldo CR, Jenkins FJ, Jacobson LP, Kingsley LA, Taiwo B, Post WS, Margolick JB, Detels R.
We assessed associations of herpes simplex virus types 1 and 2 (HSV-1 and -2), cytomegalovirus (CMV), and human herpesvirus 8 (HHV-8) infection with subclinical coronary atherosclerosis in 291 HIV-infected men in the Multicenter AIDS Cohort Study. Coronary artery calcium (CAC) was measured by non-contrast coronary CT imaging. Markers for herpesviruses infection were measured in frozen specimens collected 10-12 years prior to case identification. Multivariable logistic regression models and ordinal logistic regression models were performed. HSV-2 seropositivity was associated with coronary atherosclerosis (adjusted odds ratio [AOR]=4.12, 95% confidence interval [CI]=1.58-10.85) after adjustment for age, race/ethnicity, cardiovascular risk factors, and HIV infection related factors. Infection with a greater number of herpesviruses was associated with elevated CAC levels (AOR=1.58, 95% CI=1.06-2.36). Our findings suggest HSV-2 may be a risk factor for subclinical coronary atherosclerosis in HIV-infected men. Infection with multiple herpesviruses may contribute to the increased burden of atherosclerosis.
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Coronary artery calcium for the prediction of mortality in young adults <45 years old and elderly adults >75 years old.
By: Tota-Maharaj R, Blaha MJ, McEvoy JW, Blumenthal RS, Muse ED, Budoff MJ, Shaw LJ, Berman DS, Rana JS, Rumberger J, Callister T, Rivera J, Agatston A, Nasir K.
The value of coronary artery calcium for predicting mortality extends to both elderly patients and those <45 years old. Elderly persons with no CAC have a lower mortality rate than younger persons with high CAC.
- Journal:
European Heart Journal
- Year: 2012
- Topics:
ASCVD (Atherosclerotic Cardiovascular Disease),
Cardiac CT,
Cardiovascular Risk Assessment
- Read more articles by:
Roger S. Blumenthal, MD,
Michael Blaha, MD, MPH,
Khurram Nasir, MD, MPH,
J. Bill McEvoy, MB BCh, MHS
Read on Pubmed
Gender differences in coronary plaque composition and burden detected in symptomatic patients referred for coronary computed tomographic angiography.
By: Qureshi W, Blaha MJ, Nasir K, Al-Mallah MH.
Symptomatic women have a lower prevalence of obstructive coronary artery disease and are less likely to have mixed coronary plaque compared to symptomatic men. Future studies are needed to determine the prognostic implications of these findings.
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Coronary computed tomographic angiography and risk of all-cause mortality and nonfatal myocardial infarction in subjects without chest pain syndrome from the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International...
By: Cho I, Chang HJ, Sung JM, Pencina MJ, Lin FY, Dunning AM, Achenbach S, Al-Mallah M, Berman DS, Budoff MJ, Callister TQ, Chow BJ, Delago A, Hadamitzky M, Hausleiter J, Maffei E, Cademartiri F, Kaufmann P, Shaw LJ, Raff GL, Chinnaiyan KM, Villines TC, Cheng V, Nasir K, Gomez M, Min JK; on behalf of the CONFIRM Investigators.
Although the prognosis for individuals without chest pain is stratified by coronary computed tomographic angiography (cCTA), the additional risk-predictive advantage by cCTA is not clinically meaningful compared with a risk model based on coronary artery calcium scoring. Therefore, at present, the application of cCTA for risk assessment of individuals without coronary artery calcium scoring should not be justified.
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Niacin and statin combination therapy for atherosclerosis regression and prevention of cardiovascular disease events: Reconciling the AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Heal
By: Michos ED, Sibley CT, Baer JT, Blaha MJ, Blumenthal RS.
Despite substantial risk reductions targeting low-density lipoprotein cholesterol with statins, there remains significant residual risk as evidenced by incident and recurrent CVD events among statin-treated patients. Observational studies have shown that low levels of high-density lipoprotein cholesterol (HDL-C) are associated with increased CVD risk. It remains unclear whether strategies aimed at increasing HDL-C in addition to background statin therapy will further reduce risk.
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Regional coronary endothelial function is closely related to local early coronary atherosclerosis in patients with mild coronary artery disease: pilot study.
By: Hays AG, Kelle S, Hirsch GA, Soleimanifard S, Yu J, Agarwal HK, Gerstenblith G, Schär M, Stuber M, Weiss RG.
There is an inverse relationship between coronary endothelial function and local coronary wall thickness in patients with coronary artery disease but not in healthy adults. These findings demonstrate that local endothelial-dependent functional changes are related to the extent of early anatomic atherosclerosis in mildly diseased arteries. This combined MRI approach enables the anatomic and functional investigation of early coronary disease.
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Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: the Multi-Ethnic Study of Atherosclerosis study.
By: Wong ND, Nelson JC, Granston T, Bertoni AG, Blumenthal RS, Carr JJ, Guerci A, Jacobs DR Jr, Kronmal R, Liu K, Saad M, Selvin E, Tracy R, Detrano R.
This study examines and compares the incidence and progression of CAC among persons with metabolic syndrome and diabetes mellitus (DM) versus those with neither condition. Individuals with metabolic syndrome and DM have a greater incidence and absolute progression of CAC compared with individuals without these conditions, with progression also predicting coronary heart disease events in those with metabolic syndrome and DM.
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Comparison of the Diamond-Forrester method and Duke Clinical Score to predict obstructive coronary artery disease by computed tomographic angiography.
By: Wasfy MM, Brady TJ, Abbara S, Nasir K, Ghoshhajra BB, Truong QA, Hoffmann U, Di Carli MF, Blankstein R.
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Intracoronary cardiosphere-derived cells for heart regeneration after myocardial infarction (CADUCEUS): a prospective, randomized phase 1 trial.
By: Makkar RR, Smith RR, Cheng K, Malliaras K, Thomson LE, Berman D, Czer LS, Marbán L, Mendizabal A, Johnston PV, Russell SD, Schuleri KH, Lardo AC, Gerstenblith G, Marbán E.
Cardiosphere-derived cells (CDCs) reduce scarring after myocardial infarction, increase viable myocardium, and boost cardiac function in preclinical models. We show that intracoronary infusion of autologous CDCs in patients within six weeks of a MI is safe and decreased infarct size and increased viable myocardium. These findings are consistent with regeneration of myocardium and merit additional assessment in further clinical trials.
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