Your browser doesn't support javascript.
loading
Advances in Coronary Computed Tomographic Angiographic Imaging of Atherosclerosis for Risk Stratification and Preventive Care.
Bienstock, Solomon; Lin, Fay; Blankstein, Ron; Leipsic, Jonathon; Cardoso, Rhanderson; Ahmadi, Amir; Gelijns, Annetine; Patel, Krishna; Baldassarre, Lauren A; Hadley, Michael; LaRocca, Gina; Sanz, Javier; Narula, Jagat; Chandrashekhar, Y S; Shaw, Leslee J; Fuster, Valentin.
Afiliación
  • Bienstock S; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Lin F; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Blankstein R; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Leipsic J; University of British Columbia, Vancouver, British Columbia, Canada.
  • Cardoso R; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Ahmadi A; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Gelijns A; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Patel K; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Baldassarre LA; Department of Cardiovascular Medicine and Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA.
  • Hadley M; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • LaRocca G; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Sanz J; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Narula J; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Chandrashekhar YS; University of Minnesota, Minneapolis, Minnesota, USA.
  • Shaw LJ; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: leslee.shaw@mountsinai.org.
  • Fuster V; Division of Cardiology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
JACC Cardiovasc Imaging ; 16(8): 1099-1115, 2023 08.
Article en En | MEDLINE | ID: mdl-37178070
ABSTRACT
The diagnostic evaluation of coronary artery disease is undergoing a dramatic transformation with a new focus on atherosclerotic plaque. This review details the evidence needed for effective risk stratification and targeted preventive care based on recent advances in automated measurement of atherosclerosis from coronary computed tomography angiography (CTA). To date, research findings support that automated stenosis measurement is reasonably accurate, but evidence on variability by location, artery size, or image quality is unknown. The evidence for quantification of atherosclerotic plaque is unfolding, with strong concordance reported between coronary CTA and intravascular ultrasound measurement of total plaque volume (r >0.90). Statistical variance is higher for smaller plaque volumes. Limited data are available on how technical or patient-specific factors result in measurement variability by compositional subgroups. Coronary artery dimensions vary by age, sex, heart size, coronary dominance, and race and ethnicity. Accordingly, quantification programs excluding smaller arteries affect accuracy for women, patients with diabetes, and other patient subsets. Evidence is unfolding that quantification of atherosclerotic plaque is useful to enhance risk prediction, yet more evidence is required to define high-risk patients across varied populations and to determine whether such information is incremental to risk factors or currently used coronary computed tomography techniques (eg, coronary artery calcium scoring or visual assessment of plaque burden or stenosis). In summary, there is promise for the utility of coronary CTA quantification of atherosclerosis, especially if it can lead to targeted and more intensive cardiovascular prevention, notably for those patients with nonobstructive coronary artery disease and high-risk plaque features. The new quantification techniques available to imagers must not only provide sufficient added value to improve patient care, but also add minimal and reasonable cost to alleviate the financial burden on our patients and the health care system.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 / 2_ODS3 Problema de salud: 1_doencas_nao_transmissiveis / 2_muertes_prematuras_enfermedades_notrasmisibles Asunto principal: Enfermedad de la Arteria Coronaria / Aterosclerosis / Placa Aterosclerótica Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: JACC Cardiovasc Imaging Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 1_ASSA2030 / 2_ODS3 Problema de salud: 1_doencas_nao_transmissiveis / 2_muertes_prematuras_enfermedades_notrasmisibles Asunto principal: Enfermedad de la Arteria Coronaria / Aterosclerosis / Placa Aterosclerótica Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: JACC Cardiovasc Imaging Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos
...