Coronary Computed Tomography Angiography-Based Coronary Risk Stratification in Subjects Presenting With No or Atypical Symptoms
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- Fujimoto Shinichiro
- Department of Cardiology, Takase Clinic Department of Cardiovascular Medicine, Toho University Omori Medical Center
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- Kondo Takeshi
- Department of Cardiology, Takase Clinic
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- Kodama Takahide
- Department of Cardiology, Takase Clinic
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- Orihara Tadaaki
- Department of Cardiology, Takase Clinic
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- Sugiyama Junichi
- Department of Cardiology, Takase Clinic
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- Kondo Makoto
- Department of Cardiology, Takase Clinic
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- Endo Akira
- Department of Cardiology, Takase Clinic
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- Fukazawa Hiroshi
- Department of Cardiology, Takase Clinic
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- Nagaoka Hideki
- Department of Cardiology, Takase Clinic
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- Oida Akitsugu
- Department of Cardiology, Takase Clinic
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- Ikeda Takanori
- Department of Cardiovascular Medicine, Toho University Omori Medical Center
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- Yamazaki Junichi
- Department of Cardiovascular Medicine, Toho University Omori Medical Center
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- Takase Shinichi
- Department of Cardiology, Takase Clinic
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- Narula Jagat
- Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josee and Henry R. Kravis Cardiovascular Health Center, Mount Sinai School of Medicine
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Background: Coronary computed tomography angiography (CTA) findings of positive vessel remodeling and low-attenuation plaque, referred to as computed tomography-verified high-risk plaque (CT-HRP), have been reported to be associated with the development of subsequent acute coronary syndromes. The aim of this study was to examine the usefulness of coronary CTA for coronary risk re-stratification of patients with asymptomatic and atypical chest symptoms. Methods and Results: A total of 1,139 subjects (M/F 602/537; mean age, 61.5±9.3 years) who were either asymptomatic or presented with atypical chest symptoms underwent coronary 64- or 320-slice multidetector computed tomography angiography and Agatston score. Age, sex, coronary risk factors, including hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were investigated as predictors for CT-HRP on multivariate analysis using logistic regression analysis. CT-HRP was observed in 72 patients (6.3%). Based on Framingham risk scores (FRS), CT-HRP was observed in 0/94 subjects (0.0%) in the low-risk group, 35/806 (4.3%) in the intermediate-risk group, and 37/239 (15.5%) in the high-risk group. On logistic regression analysis significant predictors for CT-HRP in intermediate- and high-risk subjects were male sex (odds ratio [OR] 2.829; 95% confidence interval [CI] 1.460–5.479, P=0.0021), DM (OR 2.418; 95% CI 1.420–4.116, P=0.0011), and current smoking (OR 1.922; 95% CI 1.096–3.371, P=0.0160). CT-HRP prevalence for Agatston scores >500 and >250 was lower in the intermediate- and high-risk groups, respectively. Conclusions: In asymptomatic subjects and those presenting with atypical chest pain who have a more than an intermediate risk, coronary CTA is contributory to FRS. Male sex, DM and smoking were independent predictors of vulnerable plaque in the more than intermediate-risk group. (Circ J 2012; 76: 2419–2425)<br>
収録刊行物
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- Circulation Journal
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Circulation Journal 76 (10), 2419-2425, 2012
一般社団法人 日本循環器学会
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詳細情報
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- CRID
- 1390001205104364416
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- NII論文ID
- 10030874953
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- NII書誌ID
- AA11591968
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- COI
- 1:STN:280:DC%2BC38flsFKmsg%3D%3D
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- ISSN
- 13474820
- 13469843
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- PubMed
- 22864230
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
- PubMed
- CiNii Articles
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- 使用不可