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2. Combination of computed tomography angiography with coronary artery calcium score for improved diagnosis of coronary artery disease: a collaborative meta-analysis of stable chest pain patients referred for invasive coronary angiography.

Author

Mohamed, Mahmoud, Bosserdt, Maria, Wieske, Viktoria, Dubourg, Benjamin, Alkadhi, Hatem, Garcia, Mario, Leschka, Sebastian, Zimmermann, Elke, Shabestari, Abbas, Nørgaard, Bjarne, Meijs, Matthijs, Øvrehus, Kristian, Diederichsen, Axel, Knuuti, Juhani, Halvorsen, Bjørn, Mendoza-Rodriguez, Vladymir, Wan, Yung-Liang, Bettencourt, Nuno, Martuscelli, Eugenio, Buechel, Ronny, Mickley, Hans, Sun, Kai, Muraglia, Simone, Kaufmann, Philipp, Herzog, Bernhard, Tardif, Jean-Claude, Schütz, Georg, Laule, Michael, Newby, David, Achenbach, Stephan, Haase, Robert, Biavati, Federico, Mézquita, Aldo, Schlattmann, Peter, Dewey, Marc, and Budoff, Matthew

Subjects
Computed tomography angiography, Coronary angiography, Coronary artery disease, Humans, Female, Male, Coronary Artery Disease, Coronary Angiography, Computed Tomography Angiography, Calcium, Predictive Value of Tests, Tomography, X-Ray Computed, Coronary Stenosis, Chest Pain
Abstract

OBJECTIVES: Coronary computed tomography angiography (CCTA) has higher diagnostic accuracy than coronary artery calcium (CAC) score for detecting obstructive coronary artery disease (CAD) in patients with stable chest pain, while the added diagnostic value of combining CCTA with CAC is unknown. We investigated whether combining coronary CCTA with CAC score can improve the diagnosis of obstructive CAD compared with CCTA alone. METHODS: A total of 2315 patients (858 women, 37%) aged 61.1 ± 10.2 from 29 original studies were included to build two CAD prediction models based on either CCTA alone or CCTA combined with the CAC score. CAD was defined as at least 50% coronary diameter stenosis on invasive coronary angiography. Models were built by using generalized linear mixed-effects models with a random intercept set for the original study. The two CAD prediction models were compared by the likelihood ratio test, while their diagnostic performance was compared using the area under the receiver-operating-characteristic curve (AUC). Net benefit (benefit of true positive versus harm of false positive) was assessed by decision curve analysis. RESULTS: CAD prevalence was 43.5% (1007/2315). Combining CCTA with CAC improved CAD diagnosis compared with CCTA alone (AUC: 87% [95% CI: 86 to 89%] vs. 80% [95% CI: 78 to 82%]; p

Published
2024

5. Computed tomographic angiography in coronary artery disease.

Author

Serruys, Patrick, Kotoku, Nozomi, Nørgaard, Bjarne, Garg, Scot, Nieman, Koen, Dweck, Marc, Bax, Jeroen, Knuuti, Juhani, Narula, Jagat, Perera, Divaka, Taylor, Charles, Leipsic, Jonathon, Nicol, Edward, Piazza, Nicolo, Schultz, Carl, Kitagawa, Kakuya, Bruyne, Bernard, Collet, Carlos, Tanaka, Kaoru, Mushtaq, Saima, Belmonte, Marta, Dudek, Darius, Zlahoda-Huzior, Adriana, Tu, Shengxian, Wijns, William, Sharif, Faisal, Mey, Johan, Andreini, Daniele, Onuma, Yoshinobu, and Budoff, Matthew

Subjects
Humans, Coronary Artery Disease, Fractional Flow Reserve, Myocardial, Coronary Angiography, Predictive Value of Tests, Tomography, X-Ray Computed, Computed Tomography Angiography, Plaque, Atherosclerotic, Coronary Vessels, Coronary Stenosis
Abstract

Coronary computed tomographic angiography (CCTA) is becoming the first-line investigation for establishing the presence of coronary artery disease and, with fractional flow reserve (FFRCT), its haemodynamic significance. In patients without significant epicardial obstruction, its role is either to rule out atherosclerosis or to detect subclinical plaque that should be monitored for plaque progression/regression following prevention therapy and provide risk classification. Ischaemic non-obstructive coronary arteries are also expected to be assessed by non-invasive imaging, including CCTA. In patients with significant epicardial obstruction, CCTA can assist in planning revascularisation by determining the disease complexity, vessel size, lesion length and tissue composition of the atherosclerotic plaque, as well as the best fluoroscopic viewing angle; it may also help in selecting adjunctive percutaneous devices (e.g., rotational atherectomy) and in determining the best landing zone for stents or bypass grafts.

Published
2023

12. Computed tomography angiography versus Agatston score for diagnosis of coronary artery disease in patients with stable chest pain: individual patient data meta-analysis of the international COME-CCT Consortium

Author

Wieske, Viktoria, Walther, Mario, Dubourg, Benjamin, Alkadhi, Hatem, Nørgaard, Bjarne L, Meijs, Matthijs FL, Diederichsen, Axel CP, Wan, Yung-Liang, Mickley, Hans, Nikolaou, Konstantin, Shabestari, Abbas A, Halvorsen, Bjørn A, Martuscelli, Eugenio, Sun, Kai, Herzog, Bernhard A, Marcus, Roy P, Leschka, Sebastian, Garcia, Mario J, Ovrehus, Kristian A, Knuuti, Juhani, Mendoza-Rodriguez, Vladymir, Bettencourt, Nuno, Muraglia, Simone, Buechel, Ronny R, Kaufmann, Philipp A, Zimmermann, Elke, Tardif, Jean-Claude, Budoff, Matthew J, Schlattmann, Peter, and Dewey, Marc

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Heart Disease - Coronary Heart Disease, Atherosclerosis, Cardiovascular, Heart Disease, Biomedical Imaging, Clinical Research, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Calcium, Chest Pain, Computed Tomography Angiography, Coronary Angiography, Coronary Artery Disease, Coronary Stenosis, Humans, Predictive Value of Tests, Tomography, X-Ray Computed, Computed tomography angiography, Coronary angiography, Coronary artery disease, COME-CCT Consortium, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

ObjectivesThere is conflicting evidence about the comparative diagnostic accuracy of the Agatston score versus computed tomography angiography (CTA) in patients with suspected obstructive coronary artery disease (CAD).PurposeTo determine whether CTA is superior to the Agatston score in the diagnosis of CAD.MethodsIn total 2452 patients with stable chest pain and a clinical indication for invasive coronary angiography (ICA) for suspected CAD were included by the Collaborative Meta-analysis of Cardiac CT (COME-CCT) Consortium. An Agatston score of > 400 was considered positive, and obstructive CAD defined as at least 50% coronary diameter stenosis on ICA was used as the reference standard.ResultsObstructive CAD was diagnosed in 44.9% of patients (1100/2452). The median Agatston score was 74. Diagnostic accuracy of CTA for the detection of obstructive CAD (81.1%, 95% confidence interval [CI]: 77.5 to 84.1%) was significantly higher than that of the Agatston score (68.8%, 95% CI: 64.2 to 73.1%, p < 0.001). Among patients with an Agatston score of zero, 17% (101/600) had obstructive CAD. Diagnostic accuracy of CTA was not significantly different in patients with low to intermediate (1 to < 100, 100-400) versus moderate to high Agatston scores (401-1000, > 1000).ConclusionsResults in our international cohort show CTA to have significantly higher diagnostic accuracy than the Agatston score in patients with stable chest pain, suspected CAD, and a clinical indication for ICA. Diagnostic performance of CTA is not affected by a higher Agatston score while an Agatston score of zero does not reliably exclude obstructive CAD.Key points• CTA showed significantly higher diagnostic accuracy (81.1%, 95% confidence interval [CI]: 77.5 to 84.1%) for diagnosis of coronary artery disease when compared to the Agatston score (68.8%, 95% CI: 64.2 to 73.1%, p < 0.001). • Diagnostic performance of CTA was not affected by increased amount of calcium and was not significantly different in patients with low to intermediate (1 to 1000). • Seventeen percent of patients with an Agatston score of zero showed obstructive coronary artery disease by invasive angiography showing absence of coronary artery calcium cannot reliably exclude coronary artery disease.

Published
2022

27. Coronary computed tomography angiography-based endothelial wall shear stress in normal coronary arteries

Author

Schultz, Jussi, van den Hoogen, Inge J., Kuneman, Jurrien H., de Graaf, Michiel A., Kamperidis, Vasileios, Broersen, Alexander, Jukema, J. Wouter, Sakellarios, Antonis, Nikopoulos, Sotirios, Tsarapatsani, Konstantina, Naka, Katerina, Michalis, Lampros, Fotiadis, Dimitrios I., Maaniitty, Teemu, Saraste, Antti, Bax, Jeroen J., and Knuuti, Juhani

Published
2023
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29. Coronary Volume to Left Ventricular Mass Ratio in Patients With Hypertension

Author

van Rosendael, Sophie E., van Rosendael, Alexander R., Kuneman, Jurrien H., Patel, Manesh R., Nørgaard, Bjarne Linde, Fairbairn, Timothy A., Nieman, Koen, Akasaka, Takashi, Berman, Daniel S., Koweek, Lynne M. Hurwitz, Pontone, Gianluca, Kawasaki, Tomohiro, Sand, Niels Peter Rønnow, Jensen, Jesper M., Amano, Tetsuya, Poon, Michael, Øvrehus, Kristian A., Sonck, Jeroen, Rabbat, Mark G., Rogers, Campbell, Matsuo, Hitoshi, Leipsic, Jonathon A., Marsan, Nina Ajmone, Jukema, J. Wouter, Bax, Jeroen J., Saraste, Antti, and Knuuti, Juhani

Published
2023
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31. Myocardial Perfusion PET for the Detection and Reporting of Coronary Microvascular Dysfunction: A JACC: Cardiovascular Imaging Expert Panel Statement

Author

Schindler, Thomas H., Fearon, William F., Pelletier-Galarneau, Matthieu, Ambrosio, Giuseppe, Sechtem, Udo, Ruddy, Terrence D., Patel, Krishna K., Bhatt, Deepak L., Bateman, Timothy M., Gewirtz, Henry, Shirani, Jamshid, Knuuti, Juhani, Gropler, Robert J., Chareonthaitawee, Panithaya, Slart, Riemer H.J.A., Windecker, Stephan, Kaufmann, Philipp A., Abraham, Maria R., Taqueti, Viviany R., Ford, Thomas J., Camici, Paolo G., Schelbert, Heinrich R., and Dilsizian, Vasken

Published
2023
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41. Association of MMP9 with adverse features of plaque progression and residual inflammatory risk in patients with chronic coronary syndrome (CCS)

Author

Caselli, Chiara, Di Giorgi, Nicoletta, Ragusa, Rosetta, Lorenzoni, Valentina, Smit, Jeff, el Mahdiui, Mohammed, Buechel, Ronny R., Teresinska, Anna, Pizzi, Maria N., Roque, Albert, Poddighe, Rosa, Knuuti, Juhani, Schütte, Moritz, Parodi, Oberdan, Pelosi, Gualtiero, Scholte, Arthur, Rocchiccioli, Silvia, and Neglia, Danilo

Published
2022
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42. Coronary volume to left ventricular mass ratio in patients with diabetes mellitus

Author

Kuneman, Jurrien H., El Mahdiui, Mohammed, van Rosendael, Alexander R., van den Hoogen, Inge J., Patel, Manesh R., Nørgaard, Bjarne Linde, Fairbairn, Timothy A., Nieman, Koen, Akasaka, Takashi, Berman, Daniel S., Hurwitz Koweek, Lynne M., Pontone, Gianluca, Kawasaki, Tomohiro, Rønnow Sand, Niels Peter, Jensen, Jesper M., Amano, Tetsuya, Poon, Michael, Øvrehus, Kristian A., Sonck, Jeroen, Rabbat, Mark G., De Bruyne, Bernard, Rogers, Campbell, Matsuo, Hitoshi, Bax, Jeroen J., Leipsic, Jonathon A., and Knuuti, Juhani

Published
2022
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45. Subclinical leaflet thrombosis after transcatheter aortic valve implantation: no association with left ventricular reverse remodeling at 1-year follow-up

Author

Kuneman, Jurrien H., Singh, Gurpreet K., Hansson, Nicolaj C., Fusini, Laura, Poulsen, Steen H., Fortuni, Federico, Vollema, E. Mara, Pedersen, Anders L. D., Annoni, Andrea D., Nørgaard, Bjarne L., Pontone, Gianluca, Ajmone Marsan, Nina, Delgado, Victoria, Bax, Jeroen J., and Knuuti, Juhani

Published
2022
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49. Sedentary behavior reduction and blood lipids in adults with metabolic syndrome: a 6-month randomized controlled trial.

Author

Ylinen, Venla P., Sjöros, Tanja, Laine, Saara, Garthwaite, Taru, Norha, Jooa, Vähä-Ypyä, Henri, Löyttyniemi, Eliisa, Houttu, Noora, Laitinen, Kirsi, Kalliokoski, Kari K., Sievänen, Harri, Vasankari, Tommi, Knuuti, Juhani, and Heinonen, Ilkka HA

Subjects
BLOOD lipids, SATURATED fatty acids, FOOD diaries, SEDENTARY behavior, HIGH density lipoproteins
Abstract

The aim of this study was to investigate whether a reduction in accelerometer-measured sedentary behavior (SB) improves blood lipids in inactive adults with metabolic syndrome (MetS). Sixty-four participants were randomly assigned into intervention (INT, n = 33) and control (CONT, n = 31) groups. The INT group was instructed to reduce SB by 1 h/day without increasing formal exercise, whereas the CONT group was advised to maintain usual SB habits. SB and physical activity (PA) were measured with accelerometers throughout the intervention. Plasma lipid concentrations and dietary intake by food diaries were assessed at baseline and at the end of the intervention. High-density lipoprotein percentage of total cholesterol decreased during the intervention similarly in both groups (p = 0.047). Other blood lipids did not change from baseline to six months in either group. The CONT group had a statistically significant reduction in the intake of saturated fatty acids compared to the INT group (p = 0.03). Intervention resulting in a 40-minute reduction in daily SB and 20-minute increase in habitual MVPA seems to not be effective in improving blood lipids in adults with MetS. Reducing SB together with a higher volume and/or intensity of PA and proper nutrition may be needed to reduce the risk of cardiometabolic diseases. Trial registration. This study is registered at ClinicalTrials.gov (NCT03101228, 05/04/2017). https://www.clinicaltrials.gov/ct2/show/NCT03101228?term=NCT03101228&draw=2&rank=1. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Pericoronary adipose tissue for predicting long-term outcomes.

Author

Rosendael, Sophie E van, Kamperidis, Vasileios, Maaniitty, Teemu, Graaf, Michiel A de, Saraste, Antti, McKay-Goodall, George E, Jukema, J Wouter, Knuuti, Juhani, and Bax, Jeroen J

Subjects
RISK assessment, PREDICTIVE tests, BLOOD vessels, COMPUTED tomography, MAJOR adverse cardiovascular events, DESCRIPTIVE statistics, CORONARY artery disease, EPICARDIAL adipose tissue, CORONARY angiography, COMPARATIVE studies, CONFIDENCE intervals, PROPORTIONAL hazards models, DISEASE risk factors, SYMPTOMS
Abstract

Aims Pericoronary adipose tissue (PCAT) attenuation obtained by coronary computed tomography angiography (CCTA) has been associated with coronary inflammation and outcomes. Whether PCAT attenuation is predictive of major adverse cardiac events (MACE) during long-term follow-up is unknown. Methods and results Symptomatic patients with coronary artery disease (CAD) who underwent CCTA were included, and clinical outcomes were evaluated. PCAT was measured at all lesions for all three major coronary arteries using semi-automated software. A comparison between patients with and without MACE was made on both a per-lesion and a per-patient level. The predictive value of PCAT attenuation for MACE was assessed in Cox regression models. In 483 patients (63.3 ± 8.5 years, 54.9% men), 1561 lesions were analysed over a median follow-up duration of 9.5 years. The mean PCAT attenuation was not significantly different between patients with and without MACE. At a per-patient level, the adjusted hazard ratio (HR) and 95% confidence interval (CI) for MACE were 0.970 (95% CI: 0.933–1.008, P = 0.121) when the average of all lesions per patient was analysed, 0.992 (95% CI: 0.961–1.024, P = 0.622) when only the most obstructive lesion was evaluated, and 0.981 (95% CI: 0.946–1.016, P = 0.285) when only the lesion with the highest PCAT attenuation per individual was evaluated. Adjusted HRs for vessel-specific PCAT attenuation in the right coronary artery, left anterior descending artery, and left circumflex artery were 0.957 (95% CI: 0.830–1.104, P = 0.548), 0.989 (95% CI: 0.954–1.025, P = 0.550), and 0.739 (95% CI: 0.293–1.865, P = 0.522), respectively, in predicting long-term MACE. Conclusion In patients referred to CCTA for clinically suspected CAD, PCAT attenuation did not predict MACE during long-term follow-up. [ABSTRACT FROM AUTHOR]

Published
2024
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