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Ciccarone Articles

Ciccarone Center Research

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Cardiac CT

Landmark Articles

Vitamin D deficiency is associated with coronary artery calcification in cardiovascularly asymptomatic African Americans with HIV infection.
By: Lai S, Fishman EK, Gerstenblith G, Brinker J, Tai H, Chen S, Li J, Tong W, Detrick B, Lai H.
These data suggest that, in order to reduce the risk for coronary artery disease in HIV-infected African-Americans, vitamin D levels should be closely monitored. These data also suggest that clinical trials should be conducted to examine whether vitamin D supplementations reduce the risk of CAD in this population.
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Comparative effectiveness of risk markers for cardiovascular risk assessment in intermediate-risk individuals: coronary artery calcium versus “the rest”?
By: Barth AS, Abd TT, Blumenthal RS, Blaha MJ.
We evaluated four large population-based cohort studies regarding the net reclassification index (NRI) among intermediate risk patients. We concluded that the coronary artery calcium score was the strongest marker for clinical risk prediction and is the most likely to influence future clinical outcomes.
Low-risk lifestyle, coronary calcium, cardiovascular events, and mortality: Results from MESA.
By: Ahmed HM, Blaha MJ, Nasir K, Jones SR, Rivera JJ, Agatston A, Blankstein R, Wong ND, Lakoski S, Budoff MJ, Burke GL, Sibley CT, Ouyang P, Blumenthal RS.
Unhealthy lifestyle habits are a major contributor to coronary artery disease (CAD). The purpose of the study was to investigate the associations of smoking, weight maintenance, physical activity, and Mediterranean-style diet with coronary calcium, cardiovascular events, and mortality. We discovered that, over the course of nearly 8 years, a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance contributed to lower coronary calcium incidence, slower calcium progression, and lower all-cause mortality.
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Family history of coronary heart disease (CHD) and markers of subclinical cardiovascular disease: Where do we stand?
By: Pandey AK, Pandey S, Blaha MJ, Agatston A, Feldman T, Ozner M, Santos RD, Budoff MJ, Blumenthal RS, Nasir K.
Family history of coronary artery disease is associated with markers of subclinical atherosclerosis, and this relationship remains statistically significant after adjusting for traditional risk factors. Our data suggest these individuals should be considered strongly as candidates for assessment of subclinical CVD to further refine risk and treatment goals.
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Establishing a successful coronary CT angiography program in the emergency department: Official writing of the Fellow and Resident Leaders of the Society of Cardiovascular Computed Tomography (FiRST).
By: Maroules CD, Blaha MJ, El-Haddad MA, Ferencik M, Cury RC.
Recent multicenter trials have reported that coronary CT angiography is safe, reduces time to diagnosis, facilitates discharge, and may lower overall cost compared with routine care. This study provides a 10-step approach for establishing a successful coronary CT angiography program in the emergency department.
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Use of cardiac CT angiography imaging in an epidemiology study: the Methodology of the Multicenter AIDS Cohort Study cardiovascular disease substudy.
By: Hac?o?lu Y, Gupta M, Choi TY, George RT, Deible CR, Jacobson LP, Witt MD, Palella FJ, Post WS, Budoff MJ.
This study concluded that cardiac CT angiography may serve as a reference for use in future epidemiology studies aiming to assess coronary atherosclerosis and cardiac anatomy in low-risk populations while minimizing radiation exposure.
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Progression of coronary calcium and incident CHD events: MESA (Multi-Ethnic Study of Atherosclerosis).
By: Budoff MJ, Young R, Lopez VA, Kronmal RA, Nasir K, Blumenthal RS, Detrano RC, Bild DE, Guerci AD, Liu K, Shea S, Szklo M, Post W, Lima J, Bertoni A, Wong ND.
This study concluded that progression of coronary artery calcium (CAC) is associated with an increased risk for future heart disease events, even after controlling for other potentially confounding factors.
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Genetic associations with valvular calcification and aortic stenosis.
By: Thanassoulis G, Campbell CY, Owens DS, Smith JG, Smith AV, Peloso GM, Kerr KF, Pechlivanis S, Budoff MJ, Harris TB, Malhotra R, O’Brien KD, Kamstrup PR, Nordestgaard BG, Tybjaerg-Hansen A, Allison MA, Aspelund T, Criqui MH, Heckbert SR, Hwang SJ, Liu Y, Sjogren M, van der Pals J, Kälsch H, Mühleisen TW, Nöthen MM, Cupples LA, Caslake M, Di Angelantonio E, Danesh J, Rotter JI, Sigurdsson S, Wong Q, Erbel R, Kathiresan S, Melander O, Gudnason V, O’Donnell CJ, Post WS; CHARGE Extracoronary Calcium Working Group.
Genetic variation in the lipoprotein(a) locus, mediated by lipoprotein(a) levels, is associated with aortic valve calcification across multiple ethnic groups and with incident clinical aortic stenosis.
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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.
This study found that 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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What is the role of calcium scoring in the age of coronary computed tomographic angiography?
By: Joshi PH, Blaha MJ, Blumenthal RS, Blankstein R, Nasir K.

Available data suggest that in low-to-intermediate risk symptomatic patients, CAC scanning may serve as an appropriate gatekeeper to further testing with either coronary computed tomographic angiography, functional imaging, or invasive coronary angiography.

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