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Neither endothelial function nor carotid artery intima-media thickness predicts coronary computed tomography angiography plaque burden in clinically healthy subjects: a cross-sectional study.

Brolin EB, Agewall S, Brismar TB, Caidahl K, Tornvall P, Cederlund K - BMC Cardiovasc Disord (2015)

Bottom Line: Coronary CTA was analyzed with respect to any atheromatous plaques, stenotic as well as non-stenotic.There was no association between presence or extent of CAD and RH-PAT index (Spearman correlation coefficient rs = 0.13) or IMT (rs = 0.098).As expected, CAC was strongly correlated to presence and extent of CAD by coronary CTA (rs =0.86; p < 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. elin.bacsovics.brolin@ki.se.

ABSTRACT

Background: Cardiovascular risk assessment is usually based on traditional risk factors and risk assessment algorithms. However, a number of risk markers that might provide additional predictive power have been identified. Endothelial function determined by digital reactive hyperemia peripheral arterial tonometry (RH-PAT) and carotid artery intima-media thickness (IMT) have both been proposed as surrogate markers for coronary artery disease (CAD). We aimed to examine the ability of RH-PAT and IMT to predict coronary computed tomography angiography (CTA) plaque burden in clinically healthy subjects.

Methods: Fifty-eight clinically healthy volunteers (50-73 years old) underwent testing for RH-PAT and IMT as well as coronary CTA, including coronary artery calcium (CAC) scoring. Coronary CTA was analyzed with respect to any atheromatous plaques, stenotic as well as non-stenotic. The Mann-Whitney U-test was used to compare the groups with and without CAD and the Spearman test was used to test for correlation between variables.

Results: Twenty-five (43 %) subjects had normal coronary arteries, without any signs of atherosclerosis. The median (range) number of diseased segments was 1 (0-10), RH-PAT index 2.2 (1.4-4.9), IMT 0.70 (0.49-0.99) mm and CAC 4 (0-1882). There was no association between presence or extent of CAD and RH-PAT index (Spearman correlation coefficient rs = 0.13) or IMT (rs = 0.098). As expected, CAC was strongly correlated to presence and extent of CAD by coronary CTA (rs =0.86; p < 0.0001).

Conclusions: Neither evaluation of endothelial function by RH-PAT nor assessment of carotid artery IMT can reliably be used to predict coronary CTA plaque burden in clinically healthy subjects.

No MeSH data available.


Related in: MedlinePlus

Correlation between number of diseased segments, as determined by coronary CTA, and RHI (a), IMT (b) and CAC (c). The larger point (0, 0) in (c) corresponds to 23 subjects. Abbreviations: CTA, computed tomography angiography; RHI, reactive hyperemia index; IMT, intima-media thickness; CAC, coronary artery calcium
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Fig1: Correlation between number of diseased segments, as determined by coronary CTA, and RHI (a), IMT (b) and CAC (c). The larger point (0, 0) in (c) corresponds to 23 subjects. Abbreviations: CTA, computed tomography angiography; RHI, reactive hyperemia index; IMT, intima-media thickness; CAC, coronary artery calcium

Mentions: When comparing the groups with and without evidence of CAD by coronary CTA, no statistically significant differences were found concerning RHI or IMT. Nor was there any correlation between the number of diseased segments on coronary CTA and RHI (Spearman correlation coefficient 0.13) or IMT (Spearman correlation coefficient 0.098). Not surprisingly, there was a statistically significant difference in CAC scores when comparing the groups with and without CAD demonstrated by coronary CTA (p < 0.0001). Similarly, there was a strong correlation between the CAC score and the number of diseased coronary segments (Spearman correlation coefficient 0.86, p < 0.0001). Results are shown in Table 2 and Fig. 1. Still, among persons with a 0 CAC score 3 (14 %) had evidence of CAD by coronary CTA.Table 2


Neither endothelial function nor carotid artery intima-media thickness predicts coronary computed tomography angiography plaque burden in clinically healthy subjects: a cross-sectional study.

Brolin EB, Agewall S, Brismar TB, Caidahl K, Tornvall P, Cederlund K - BMC Cardiovasc Disord (2015)

Correlation between number of diseased segments, as determined by coronary CTA, and RHI (a), IMT (b) and CAC (c). The larger point (0, 0) in (c) corresponds to 23 subjects. Abbreviations: CTA, computed tomography angiography; RHI, reactive hyperemia index; IMT, intima-media thickness; CAC, coronary artery calcium
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4494716&req=5

Fig1: Correlation between number of diseased segments, as determined by coronary CTA, and RHI (a), IMT (b) and CAC (c). The larger point (0, 0) in (c) corresponds to 23 subjects. Abbreviations: CTA, computed tomography angiography; RHI, reactive hyperemia index; IMT, intima-media thickness; CAC, coronary artery calcium
Mentions: When comparing the groups with and without evidence of CAD by coronary CTA, no statistically significant differences were found concerning RHI or IMT. Nor was there any correlation between the number of diseased segments on coronary CTA and RHI (Spearman correlation coefficient 0.13) or IMT (Spearman correlation coefficient 0.098). Not surprisingly, there was a statistically significant difference in CAC scores when comparing the groups with and without CAD demonstrated by coronary CTA (p < 0.0001). Similarly, there was a strong correlation between the CAC score and the number of diseased coronary segments (Spearman correlation coefficient 0.86, p < 0.0001). Results are shown in Table 2 and Fig. 1. Still, among persons with a 0 CAC score 3 (14 %) had evidence of CAD by coronary CTA.Table 2

Bottom Line: Coronary CTA was analyzed with respect to any atheromatous plaques, stenotic as well as non-stenotic.There was no association between presence or extent of CAD and RH-PAT index (Spearman correlation coefficient rs = 0.13) or IMT (rs = 0.098).As expected, CAC was strongly correlated to presence and extent of CAD by coronary CTA (rs =0.86; p < 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. elin.bacsovics.brolin@ki.se.

ABSTRACT

Background: Cardiovascular risk assessment is usually based on traditional risk factors and risk assessment algorithms. However, a number of risk markers that might provide additional predictive power have been identified. Endothelial function determined by digital reactive hyperemia peripheral arterial tonometry (RH-PAT) and carotid artery intima-media thickness (IMT) have both been proposed as surrogate markers for coronary artery disease (CAD). We aimed to examine the ability of RH-PAT and IMT to predict coronary computed tomography angiography (CTA) plaque burden in clinically healthy subjects.

Methods: Fifty-eight clinically healthy volunteers (50-73 years old) underwent testing for RH-PAT and IMT as well as coronary CTA, including coronary artery calcium (CAC) scoring. Coronary CTA was analyzed with respect to any atheromatous plaques, stenotic as well as non-stenotic. The Mann-Whitney U-test was used to compare the groups with and without CAD and the Spearman test was used to test for correlation between variables.

Results: Twenty-five (43 %) subjects had normal coronary arteries, without any signs of atherosclerosis. The median (range) number of diseased segments was 1 (0-10), RH-PAT index 2.2 (1.4-4.9), IMT 0.70 (0.49-0.99) mm and CAC 4 (0-1882). There was no association between presence or extent of CAD and RH-PAT index (Spearman correlation coefficient rs = 0.13) or IMT (rs = 0.098). As expected, CAC was strongly correlated to presence and extent of CAD by coronary CTA (rs =0.86; p < 0.0001).

Conclusions: Neither evaluation of endothelial function by RH-PAT nor assessment of carotid artery IMT can reliably be used to predict coronary CTA plaque burden in clinically healthy subjects.

No MeSH data available.


Related in: MedlinePlus