Document Detail

Spotty calcification as a marker of accelerated progression of coronary atherosclerosis: insights from serial intravascular ultrasound.
MedLine Citation:
PMID:  22538329     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: The purpose of this study was to determine atheroma progression in patients with spotty calcification.
BACKGROUND: Although extensively calcified atherosclerotic lesions have been proposed to be clinically quiescent, the presence of spotty calcification within plaque has been reported to be associated with an increased incidence of ischemic cardiovascular events. The relationship between spotty calcification and disease progression has not been investigated.
METHODS: A total of 1,347 stable patients with angiographic coronary artery disease underwent serial evaluation of atheroma burden with intravascular ultrasound imaging. Patients with spotty calcification were identified based on the presence of lesions (1 to 4 mm in length) containing an arc of calcification of <90°. Clinical characteristics and disease progression were compared between patients with spotty calcification (n = 922) and those with no calcification (n = 425).
RESULTS: Patients with spotty calcification were older (age 56 years vs. 54 years; p = 0.001), more likely to be male (68% vs. 54%; p = 0.01), and have a history of diabetes mellitus (30% vs. 24%; p = 0.01) and myocardial infarction (28% vs. 20%; p = 0.004), and have lower on-treatment high-density lipoprotein cholesterol levels (48 ± 16 mg/dl vs. 51 ± 17 mg/dl; p = 0.001). Patients with spotty calcification demonstrated a greater percent atheroma volume (PAV) (36.0 ± 7.6% vs. 29.0 ± 8.5%; p < 0.001) and total atheroma volume (174.6 ± 71.9 mm(3) vs. 133.9 ± 64.9 mm(3); p < 0.001). On serial evaluation, spotty calcification was associated with greater progression of PAV (+0.43 ± 0.07% vs. +0.02 ± 0.11%; p = 0.002). Although intensive low-density lipoprotein cholesterol and blood pressure lowering therapy slowed disease progression, these efficacies were attenuated in patients with spotty calcification.
CONCLUSIONS: The presence of spotty calcification is associated with more extensive and diffuse coronary atherosclerosis and accelerated disease progression despite use of medical therapies.
Yu Kataoka; Kathy Wolski; Kiyoko Uno; Rishi Puri; E Murat Tuzcu; Steven E Nissen; Stephen J Nicholls
Related Documents :
11051349 - Clinical analysis of autoimmune-related pancreatitis.
9088119 - The natural course of acute gallstone pancreatitis.
1383099 - Does the somatostatin analogue octreotide protect against ercp induced pancreatitis?
6206989 - Diagnostic and therapeutic applications of bentiromide screening test for exocrine panc...
21681509 - Multiparametric assessment of vascular function and atherosclerosis in patients with au...
10401949 - Severe accidental hypothermia: rewarming strategy using a veno-venous bypass system and...
10097779 - Vascular dementia versus dementia of alzheimer's type: do they have differential effect...
4013969 - Echocardiographic evaluation of patients with systemic sarcoidosis.
22033789 - Evaluation of right ventricular function in patients with a previous episode of pulmona...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  59     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1592-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Department of Cardiovascular Medicine, Heart & Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  New concepts in the assessment of syncope.
Next Document:  Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (Epl...