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Prognostic Significance of Subtle Coronary Calcification in Patients with Zero Coronary Artery Calcium Score: From the CONFIRM Registry

2020Journal article Open access
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dc.contributor.authorHan, D
dc.contributor.authorKlein, E
dc.contributor.authorFriedman, J
dc.contributor.authorGransar, H
dc.contributor.authorAchenbach, S
dc.contributor.authorAl-Mallah, M
dc.contributor.authorBudoff, M
dc.contributor.authorCademartiri, F
dc.contributor.authorMaffei, E
dc.contributor.authorCallister, T
dc.contributor.authorChinnaiyan, K
dc.contributor.authorChow, B
dc.contributor.authorDeLago, A
dc.contributor.authorHadamitzky, M
dc.contributor.authorHausleiter, J
dc.contributor.authorKaufmann, P
dc.contributor.authorVillines, T
dc.contributor.authorKim, YJ
dc.contributor.authorLeipsic, J
dc.contributor.authorFeuchtner, G
dc.contributor.authorCury, R
dc.contributor.authorPontone, G
dc.contributor.authorAndreini, D
dc.contributor.authorPinto Marques, H
dc.contributor.authorRubinshtein, R
dc.contributor.authorChang, HJ
dc.contributor.authorLin, F
dc.contributor.authorShaw, L
dc.contributor.authorMin, J
dc.contributor.authorBerman, D
dc.date.accessioned2024-05-22T14:59:43Z
dc.date.available2024-05-22T14:59:43Z
dc.date.issued2020
dc.description.abstractBackground and aims: The Agatston coronary artery calcium score (CACS) may fail to identify small or less dense coronary calcification that can be detected on coronary CT angiography (CCTA). We investigated the prevalence and prognostic importance of subtle calcified plaques on CCTA among individuals with CACS 0. Methods: From the prospective multicenter CONFIRM registry, we evaluated patients without known CAD who underwent CAC scan and CCTA. CACS was categorized as 0, 1-10, 11-100, 101-400, and >400. Patients with CACS 0 were stratified according to the visual presence of coronary plaques on CCTA. Plaque composition was categorized as non-calcified (NCP), mixed (MP) and calcified (CP). The primary outcome was a major adverse cardiac event (MACE) which was defined as death and myocardial infarction. Results: Of 4049 patients, 1741 (43%) had a CACS 0. NCP and plaques that contained calcium (MP or CP) were detected by CCTA in 110 patients (6% of CACS 0) and 64 patients (4% of CACS 0), respectively. During a 5.6 years median follow-up (IQR 5.1-6.2 years), 413 MACE events occurred (13%). Patients with CACS 0 and MP/CP detected by CCTA had similar MACE risk compared to patients with CACS 1-10 (p = 0.868). In patients with CACS 0, after adjustment for risk factors and symptom, MP/CP was associated with an increased MACE risk compared to those with entirely normal CCTA (HR 2.39, 95% CI [1.09-5.24], p = 0.030). Conclusions: A small but non-negligible proportion of patients with CACS 0 had identifiable coronary calcification, which was associated with increased MACE risk. Modifying CAC image acquisition and/or scoring methods could improve the detection of subtle coronary calcification.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAtherosclerosis . 2020 Sep:309:33-38.pt_PT
dc.identifier.doi10.1016/j.atherosclerosis.2020.07.011pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4917
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectCalciumpt_PT
dc.subjectRisk Factorspt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectHumanspt_PT
dc.subjectCoronary Artery Disease* / diagnostic imagingpt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectRegistriespt_PT
dc.subjectVascular Calcification* / diagnostic imagingpt_PT
dc.subjectVascular Calcification* / epidemiologypt_PT
dc.titlePrognostic Significance of Subtle Coronary Calcification in Patients with Zero Coronary Artery Calcium Score: From the CONFIRM Registrypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage38pt_PT
oaire.citation.startPage33pt_PT
oaire.citation.titleAtherosclerosispt_PT
oaire.citation.volume309pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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