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Ciccarone Articles

Ciccarone Center Research

Topic

Cardiac CT

Landmark Articles

Potential use of coronary artery calcium progression to guide therapy and management of patients at risk for coronary artery disease.
By: McEvoy JW, Blaha MJ, Blumenthal RS, Jones SR, Nasir K.
This review examines the strengths and limitations of the existing data purporting to show an incremental prognostic benefit of looking at progression of CAC.
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Genome-wide association study for coronary artery calcification with follow-up in myocardial infarction.
By: O’Donnell CJ, Kavousi M, Smith AV, Kardia SL, Feitosa MF, Hwang SJ, Sun YV, Province MA, Aspelund T, Dehghan A, Hoffmann U, Bielak LF, Zhang Q, Eiriksdottir G, van Duijn CM, Fox CS, de Andrade M, Kraja AT, Sigurdsson S, Elias-Smale SE, Murabito JM, Launer LJ, van der Lugt A, Kathiresan S; CARDIoGRAM Consortium, Krestin GP, Herrington DM, Howard TD, Liu Y, Post W, et al.

Coronary artery calcification (CAC) detected by computed tomography is a noninvasive measure of coronary atherosclerosis, which underlies most cases of myocardial infarction (MI). We sought to identify common genetic variants associated with CAC and further investigate their associations with MI. SNPs in the 9p21 and PHACTR1 gene loci were strongly associated with CAC and MI, and there are suggestive associations with both CAC and MI of SNPs in additional loci. Multiple genetic loci are associated with development of both underlying coronary atherosclerosis and clinical events.

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Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.
By: Coylewright M, Rice K, Budoff MJ, Blumenthal RS, Greenland P, Kronmal R, Barr RG, Burke GL, Tracy R, Post WS.
Both high and very high levels of coronary artery calcium are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, as compared to high CAC.
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Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.
By: Coylewright M, Rice K, Budoff MJ, Blumenthal RS, Greenland P, Kronmal R, Barr RG, Burke GL, Tracy R, Post WS.
Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC scores.
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No justification for coronary CT angiography in low- to intermediate-risk individuals with coronary artery calcium score of 0.
By: Nasir K, Blaha MJ.
We review the rationale for non-contrast CT to risk stratify low-risk patients with atypical chest discomfort who have normal cardiac biomarkers.
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No justification for coronary CT angiography among low-intermediate risk individuals with CAC=0.
By: Blaha MJ, Nasir K.
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The association of Framingham and Reynolds risk scores with incidence and progression of coronary artery calcification in MESA (Multi-Ethnic Study of Atherosclerosis).
By: DeFilippis AP, Blaha MJ, Ndumele CE, Budoff MJ, Lloyd-Jones DM, McClelland RL, Lakoski SG, Cushman M, Wong ND, Blumenthal RS, Lima J, Nasir K.
Both the Framingham and Reynolds risk scores predict onset and progression of subclinical atherosclerosis. However, the Reynolds risk score may provide additional predictive information when discordance between the scoring systems exists.
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The association of the Framingham and Reynolds risk scores with incidence and progression of coronary artery calcium in MESA.
By: DeFilippis AP, Blaha MJ, Ndumele C, Budoff MJ, Lloyd-Jones D, McClelland RL, Lakoski SG, Cushman M, Wong ND, Blumenthal RS, Lima J, Nasir K.
This innovative study found that the Reynolds Risk Score was modestly better than the traditional Framingham risk score in predicting the incidence of new coronary calcification and the progression of existing calcification. This observation also applied to clinical events.
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The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis.
By: Tison GH, Blaha MJ, Budoff MJ, Katz R, Rivera JJ, Bertoni AG, Wong ND, Blumenthal RS, Szklo M, Eng J, Tracy R, Nasir K.
The homeostasis model assessment of insulin resistance has a positive and graded association with extra-coronary calcification, but not independently of cardiovascular risk factors, particularly metabolic syndrome components.
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Impact of subclinical atherosclerosis on cardiovascular disease events in individuals with metabolic syndrome and diabetes: the multi-ethnic study of atherosclerosis.
By: Malik S, Budoff MJ, Katz R, Blumenthal RS, Bertoni AG, Nasir K, Szklo M, Barr RG, Wong ND.
Individuals with metabolic syndrome or diabetes have low risks for CHD when CAC or carotid intimal-medial thickness (CIMT) is not increased. Prediction of CHD and CVD events is improved by CAC more than by CIMT. Screening for CAC or CIMT can stratify risk in people with metabolic syndrome and diabetes and support the latest recommendations regarding CAC screening in those with diabetes.
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