Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound

Size: px
Start display at page:

Download "Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound"

Transcription

1 Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic Yu Kataoka, Kathy Wolski, Kiyoko Uno E. Murat Tuzcu, Steven E Nissen and Stephen J Nicholls ESC 2011 in Paris

2 Presenter Disclosure Information Yu Kataoka, MD Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis : Insights from Serial Intravascular Ultrasound FINANCIAL DISCLOSURE: None UNLABELED/UNAPPROVED USES DISCLOSURE: None

3 Nature of Calcified Atheroma Calcified atheroma has been considered as advanced and queiscent atherosclerotic stage. Serial intravascular ultrasound (IVUS) imaging demonstrated that calcified atheroma had more extensive disease which were resistant to undergoing changes in response to medical therapies.

4 Spotty Calcification A small amount of, spotty calcification is one of characteristics in vulnerable lesion and associated with plaque rupture and subsequent ischemic events. However, it remains to be elucidated about the natural history and response to medical therapies in patients with spotty calcification.

5 Objective To determine the atheroma progression in patients with spotty calcification in response to anti-atherosclerotic medical therapies

6 Study Population From 7 clinical trials which monitored atheroma progression by using IVUS, 1347 patients with/without spotty calcification were analyzed. Clinical characteristics and atheroma progression were compared between patients with spotty calcification (n=922) and without spotty calcification (n=425).

7 Definition of Spotty Calcification Spotty calcification was defined as 1-4 consecutive images containing with an arc < 90 entire through imaging segment. spotty calcification spotty calcification spotty calcification

8 IVUS measurements External Elastic Membrane (EEM) area Lumen area Percent Atheroma Volume (PAV) % = [Σ (EEM CSA - Lumen CSA ) / Σ EEM CSA ] 100 CSA = cross sectional area

9 Baseline Characteristics No (n=425) Spotty (n=922) p-value age (years) female (%) <0.001 BMI (kg/m 2 ) hypertension (%) diabetes (%) hyperlipidemia (%) smoker (%) previous myocardial infarction (%)

10 Use of Established Medical Therapies Concomitant Therapy No (n=425) Spotty (n=922) p-value Statins (%) Beta-blocker (%) ACE inhibitor (%) Calcium-channel blocker (%) Aspirin (%)

11 Lipid Profile Control LDL-C (mg/dl) HDL-C (mg/dl) total cholesterol (mg/dl) baseline follow-up absolute change baseline follow-up absolute change baseline follow-up absolute change No (n=425) p-value < Spotty (n=922)

12 Blood Pressure and CRP Control Systolic BP (mmhg) Diastolic BP (mmhg) hscrp (mg/dl) baseline follow-up absolute change baseline follow-up absolute change baseline follow-up absolute change No (n=425) Spotty (n=922) p-value

13 Serial Change in Atheroma Burden No (n=425) Spotty (n=922) p-value baseline PAV 29.0 ± ± 7.5 <0.001 Mean ± SD (mm 3 ) change in PAV 0.02 ± ± Least-square mean ± SE (%) Adjusted for baseline atheroma volume PAV = percent atheroma volume

14 percent Intensive LDL-C Lowering Therapy in Patients with Spotty Calcification change in PAV P<0.001 for trend Least-square mean no spotty no spotty LDL-C < 70mg/dL LDL-C 70mg/dL

15 percent Intensive Systolic BP, CRP Lowering Therapy in Patients with Spotty Calcification percent change in PAV Least-square mean P=0.008 for trend P<0.001 for trend no spotty no spotty no spotty no spotty Systolic BP < 130 mmhg Systolic BP 130 mmhg CRP < 2.0mg/dl CRP 2.0mg/dl

16 Summary Spotty calcification was associated with extensive atheroma burden and greater atheroma progression. Although intensive risk control was effective to slow atheroma progression, this efficacy was attenuated in patients with spotty calcification.

17 Conclusions Patients with spotty calcification harbored extensive and progressive atherosclerotic forms despite intensive medical therapies. These findings underscore more intensive global risk control for the prevention of plaque progression in patients with spotty calcification.

Methods. Background and Objectives STRADIVARIUS

Methods. Background and Objectives STRADIVARIUS STRADIVARIUS Effect of on Progression of Atherosclerosis in Patients with Abdominal Obesity and Coronary Artery Disease Steven E. Nissen MD Stephen J. Nicholls MBBS PhD, Kathy Wolski MPH, Josep Rodés-Cabau

More information

Cottrell Memorial Lecture. Has Reversing Atherosclerosis Become the New Gold Standard in the Treatment of Cardiovascular Disease?

Cottrell Memorial Lecture. Has Reversing Atherosclerosis Become the New Gold Standard in the Treatment of Cardiovascular Disease? Cottrell Memorial Lecture Has Reversing Atherosclerosis Become the New Gold Standard in the Treatment of Cardiovascular Disease? Stephen Nicholls MBBS PhD @SAHMRI_Heart Disclosures Research support: AstraZeneca,

More information

Results of the GLAGOV Trial

Results of the GLAGOV Trial Results of the GLAGOV Trial Global Assessment of Plaque Regression with a PCSK9 Antibody as Measured by Intravascular Ultrasound Steven E. Nissen MD Stephen J. Nicholls MBBS PhD Consulting: Many companies

More information

Relationship Between Cardiovascular Risk Factors and Atherosclerotic Disease Burden Measured by Intravascular Ultrasound

Relationship Between Cardiovascular Risk Factors and Atherosclerotic Disease Burden Measured by Intravascular Ultrasound Journal of the American College of Cardiology Vol. 47, No. 10, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.12.058

More information

Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography

Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography Cardiovascular Division, Faculty of Medicine, University of Tsukuba Akira

More information

John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam

John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Latest Insights from the JUPITER Study John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Inflammation, hscrp, and Vascular Prevention

More information

Coronary Artery Calcification and Changes in Atheroma Burden in Response to Established Medical Therapies

Coronary Artery Calcification and Changes in Atheroma Burden in Response to Established Medical Therapies Journal of the American College of Cardiology Vol. 49, No. 2, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.10.038

More information

Effect of Rimonabant on Progression of Atherosclerosis in Patients With Abdominal Obesity and Coronary Artery Disease

Effect of Rimonabant on Progression of Atherosclerosis in Patients With Abdominal Obesity and Coronary Artery Disease ORIGINAL CONTRIBUTION JAMA-EXPRESS Effect of on Progression of Atherosclerosis in Patients With Abdominal Obesity and Coronary Artery Disease The STRADIVARIUS Randomized Controlled Trial Steven E. Nissen,

More information

Data Alert. Vascular Biology Working Group. Blunting the atherosclerotic process in patients with coronary artery disease.

Data Alert. Vascular Biology Working Group. Blunting the atherosclerotic process in patients with coronary artery disease. 1994--4 Vascular Biology Working Group www.vbwg.org c/o Medical Education Consultants, LLC 25 Sylvan Road South, Westport, CT 688 Chairman: Carl J. Pepine, MD Eminent Scholar American Heart Association

More information

Attenuated Plaque at Nonculprit Lesions in Patients Enrolled in Intravascular Ultrasound Atherosclerosis Progression Trials

Attenuated Plaque at Nonculprit Lesions in Patients Enrolled in Intravascular Ultrasound Atherosclerosis Progression Trials JACC: CARDIOVASCULAR INTERVENTIONS VOL. 2, NO. 7, 2009 2009 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/09/$36.00 PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2009.05.007 Attenuated

More information

GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS

GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS GALECTIN-3 PREDICTS LONG TERM CARDIOVASCULAR DEATH IN HIGH-RISK CORONARY ARTERY DISEASE PATIENTS Table of Contents List of authors pag 2 Supplemental figure I pag 3 Supplemental figure II pag 4 Supplemental

More information

ZEUS Trial ezetimibe Ultrasound Study

ZEUS Trial ezetimibe Ultrasound Study Trial The lower, The better Is it True for Plaque Regression? Statin alone versus Combination of Ezetimibe and Statin Juntendo University, Department of Cardiology, Tokyo, Japan Katsumi Miyauchi, Naohisa

More information

Know Your Number Aggregate Report Single Analysis Compared to National Averages

Know Your Number Aggregate Report Single Analysis Compared to National Averages Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics

More information

Cardiovascular Research Foundation and Columbia University Medical Center, New York.

Cardiovascular Research Foundation and Columbia University Medical Center, New York. Virtual Histology Intravascular Ultrasound Analysis of Non-culprit Attenuated Plaques Detected by Grayscale Intravascular Ultrasound in Patients with Acute Coronary Syndromes Xiaofan Wu, Akiko Maehara,

More information

Title for Paragraph Format Slide

Title for Paragraph Format Slide Title for Paragraph Format Slide Presentation Title: Month Date, Year Atherosclerosis A Spectrum of Disease: February 12, 2015 Richard Cameron Padgett, MD Executive Medical Director, OHVI Pt RB Age 38

More information

대한심장학회춘계학술대회 Satellite Symposium

대한심장학회춘계학술대회 Satellite Symposium 대한심장학회춘계학술대회 Satellite Symposium Coronary Plaque Regression and Compositional Changes by Lipid-Lowering Therapy: IVUS Substudy in Livalo (Pitavastatin) in Acute Myocardial Infarction Study (LAMIS) Livalo

More information

Atherosclerosis Regression An Overview of Recent Findings & Issues

Atherosclerosis Regression An Overview of Recent Findings & Issues Atherosclerosis Regression An Overview of Recent Findings & Issues 13th Angioplasty Summit 2008 Cheol Whan Lee, MD University of Ulsan, Asan Medical Center, Seoul, Korea CardioVascular Research Foundation

More information

Imaging Biomarkers: utilisation for the purposes of registration. EMEA-EFPIA Workshop on Biomarkers 15 December 2006

Imaging Biomarkers: utilisation for the purposes of registration. EMEA-EFPIA Workshop on Biomarkers 15 December 2006 Imaging Biomarkers: utilisation for the purposes of registration EMEA-EFPIA Workshop on Biomarkers 15 December 2006 Vascular Imaging Technologies Carotid Ultrasound-IMT IVUS-PAV QCA-% stenosis 2 ICH E

More information

Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging

Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging Gary S. Mintz,, MD Cardiovascular Research Foundation New York, NY Today, in reality, almost everything

More information

The ACCELERATE Trial

The ACCELERATE Trial The ACCELERATE Trial Impact of the Cholesteryl Ester Transfer Protein Inhibitor Evacetrapib on Cardiovascular Outcome Stephen J Nicholls for the ACCELERATE investigators Disclosure Research support: AstraZeneca,

More information

Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors

Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors Autonomic nervous system, inflammation and preclinical carotid atherosclerosis in depressed subjects with coronary risk factors Carmine Pizzi 1 ; Lamberto Manzoli 2, Stefano Mancini 3 ; Gigliola Bedetti

More information

Arterial Wall Remodeling in Response to Atheroma Regression with Very Intensive Lipid Lowering

Arterial Wall Remodeling in Response to Atheroma Regression with Very Intensive Lipid Lowering Arterial Wall Remodeling in Response to Atheroma Regression with Very Intensive Lipid Lowering Matthew I. Worthley MB BS, PhD, FRACP, FCSANZ, FACC Senior Lecturer/ Interventional Cardiologist University

More information

DECLARATION OF CONFLICT OF INTEREST. Nothing to disclose

DECLARATION OF CONFLICT OF INTEREST. Nothing to disclose DECLARATION OF CONFLICT OF INTEREST Nothing to disclose Four-Year Clinical Outcomes of the OLIVUS (Impact of OLmesartan on progression of coronary atherosclerosis; evaluation by IntraVascular UltraSound

More information

Relationship Between Atheroma Regression and Change in Lumen Size After Infusion of Apolipoprotein A-I Milano

Relationship Between Atheroma Regression and Change in Lumen Size After Infusion of Apolipoprotein A-I Milano Journal of the American College of Cardiology Vol. 47, No. 5, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.11.040

More information

Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion

Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion Assessment of Coronary Plaque Rupture and Erosion Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion Yukio Ozaki, MD, PhD, FACC, FESC Cardiology Dept., Fujita Health Univ. Toyoake,

More information

The Effects of Rosuvastatin on Plaque Regression in Patients Who Have a Mild to Moderate Degree of Coronary Stenosis With Vulnerable Plaque

The Effects of Rosuvastatin on Plaque Regression in Patients Who Have a Mild to Moderate Degree of Coronary Stenosis With Vulnerable Plaque ORIGINAL ARTICLE Korean Circ J 28;38:366-373 Print ISSN 1738-552 / On-line ISSN 1738-5555 Copyright c 28 The Korean Society of Cardiology The Effects of Rosuvastatin on Plaque Regression in Patients Who

More information

STABILITY Stabilization of Atherosclerotic plaque By Initiation of darapladib TherapY. Harvey D White on behalf of The STABILITY Investigators

STABILITY Stabilization of Atherosclerotic plaque By Initiation of darapladib TherapY. Harvey D White on behalf of The STABILITY Investigators STABILITY Stabilization of Atherosclerotic plaque By Initiation of darapladib TherapY Harvey D White on behalf of The STABILITY Investigators Lipoprotein- associated Phospholipase A 2 (Lp-PLA 2 ) activity:

More information

Intravascular Ultrasound-Derived Measures of Coronary Atherosclerotic Plaque Burden and Clinical Outcome

Intravascular Ultrasound-Derived Measures of Coronary Atherosclerotic Plaque Burden and Clinical Outcome Journal of the American College of Cardiology Vol. 55, No. 21, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2010.02.026

More information

Guidelines on cardiovascular risk assessment and management

Guidelines on cardiovascular risk assessment and management European Heart Journal Supplements (2005) 7 (Supplement L), L5 L10 doi:10.1093/eurheartj/sui079 Guidelines on cardiovascular risk assessment and management David A. Wood 1,2 * 1 Cardiovascular Medicine

More information

Methods Study population: From the Asan Medical Center (Seoul, Korea) clinical and IVUS core laboratory database,

Methods Study population: From the Asan Medical Center (Seoul, Korea) clinical and IVUS core laboratory database, Usefulness of Follow-Up Low-Density Lipoprotein Cholesterol Level as an Independent Predictor of Changes of Coronary Atherosclerotic Plaque Size as Determined by Intravascular Ultrasound Analysis After

More information

Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome

Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Hiroyuki Okura*, MD; Nobuya Matsushita**,MD Kenji Shimeno**, MD; Hiroyuki Yamaghishi**, MD Iku Toda**,

More information

Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions in hs-crp

Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions in hs-crp Página 1 de 5 Return to Medscape coverage of: American Society of Hypertension 21st Annual Scientific Meeting and Exposition Val-MARC: Valsartan-Managing Blood Pressure Aggressively and Evaluating Reductions

More information

Inflammation, plaque progression and vulnerability: evidence from intravascular ultrasound imaging

Inflammation, plaque progression and vulnerability: evidence from intravascular ultrasound imaging Review Article Inflammation, plaque progression and vulnerability: evidence from intravascular ultrasound imaging Yu Kataoka, Rishi Puri, Stephen J. Nicholls South Australian Health & Medical Research

More information

Disclosures. Diabetes and Cardiovascular Risk Management. Learning Objectives. Atherosclerotic Cardiovascular Disease

Disclosures. Diabetes and Cardiovascular Risk Management. Learning Objectives. Atherosclerotic Cardiovascular Disease Disclosures Diabetes and Cardiovascular Risk Management Tony Hampton, MD, MBA Medical Director Advocate Aurora Operating System Advocate Aurora Healthcare Downers Grove, IL No conflicts or disclosures

More information

Supplemental Table S2: Subgroup analysis for IL-6 with BMI in 3 groups

Supplemental Table S2: Subgroup analysis for IL-6 with BMI in 3 groups Supplemental Table S1: Unadjusted and Adjusted Hazard Ratios for Diabetes Associated with Baseline Factors Considered in Model 3 SMART Participants Only Unadjusted Adjusted* Baseline p-value p-value Covariate

More information

Intercommunale de Santé Publique du Pays de Charleroi, Charleroi, Belgium 2

Intercommunale de Santé Publique du Pays de Charleroi, Charleroi, Belgium 2 Lipid Abnormalities Remain High among Treated Hypertensive Patients with Stable CHD: Results of the Dyslipidemia International Study (DYSIS) II Belgium Michel Guillaume 1, Eric Weber 2, Johan De Sutter

More information

Statin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography

Statin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography Statin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography Hyo Eun Park 1, Eun-Ju Chun 2, Sang-Il Choi 2, Soyeon Ahn 2, Hyung-Kwan Kim 3,

More information

Cardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003

Cardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003 Authorized By: Medical Management Guideline Committee Approval Date: 12/13/01 Revision Date: 12/11/03 Beta-Blockers Nitrates Calcium Channel Blockers MEDICATIONS Indicated in post-mi, unstable angina,

More information

Serum levels of galectin-1, galectin-3, and galectin-9 are associated with large artery atherosclerotic

Serum levels of galectin-1, galectin-3, and galectin-9 are associated with large artery atherosclerotic Supplementary Information The title of the manuscript Serum levels of galectin-1, galectin-3, and galectin-9 are associated with large artery atherosclerotic stroke Xin-Wei He 1, Wei-Ling Li 1, Cai Li

More information

Imaging the Vulnerable Plaque. David A. Dowe, MD Atlantic Medical Imaging

Imaging the Vulnerable Plaque. David A. Dowe, MD Atlantic Medical Imaging Imaging the Vulnerable Plaque David A. Dowe, MD Atlantic Medical Imaging Why is this so important? The Acute Situation Coronary disease-important Diagnosis of cardiovascular disease cost $148 billion in

More information

IVUS Analysis. Myeong-Ki. Hong, MD, PhD. Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea

IVUS Analysis. Myeong-Ki. Hong, MD, PhD. Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea IVUS Analysis Myeong-Ki Hong, MD, PhD Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea Intimal disease (plaque) is dense and will appear white Media is made of

More information

Protecting the heart and kidney: implications from the SHARP trial

Protecting the heart and kidney: implications from the SHARP trial Cardiology Update, Davos, 2013: Satellite Symposium Protecting the heart and kidney: implications from the SHARP trial Colin Baigent Professor of Epidemiology CTSU, University of Oxford S1 First CTT cycle:

More information

egfr > 50 (n = 13,916)

egfr > 50 (n = 13,916) Saxagliptin and Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus and Moderate or Severe Renal Impairment: Observations from the SAVOR-TIMI 53 Trial Supplementary Table 1. Characteristics according

More information

(n=6279). Continuous variables are reported as mean with 95% confidence interval and T1 T2 T3. Number of subjects

(n=6279). Continuous variables are reported as mean with 95% confidence interval and T1 T2 T3. Number of subjects Table 1. Distribution of baseline characteristics across tertiles of OPG adjusted for age and sex (n=6279). Continuous variables are reported as mean with 95% confidence interval and categorical values

More information

CVD Risk Assessment. Michal Vrablík Charles University, Prague Czech Republic

CVD Risk Assessment. Michal Vrablík Charles University, Prague Czech Republic CVD Risk Assessment Michal Vrablík Charles University, Prague Czech Republic What is Risk? A cumulative probability of an event, usually expressed as percentage e.g.: 5 CV events in 00 pts = 5% risk This

More information

Lessons from Recent Atherosclerosis Trials

Lessons from Recent Atherosclerosis Trials Lessons from Recent Atherosclerosis Trials Han, Ki Hoon MD PhD Asan Medical Center Seoul, Korea Change of concept Primary vs. secondary prevention Low risk vs. High risk High Risk CHD and equivalents CHD

More information

Spotty calcification and plaque vulnerability in vivo: frequencydomain optical coherence tomography analysis

Spotty calcification and plaque vulnerability in vivo: frequencydomain optical coherence tomography analysis Original Article Spotty calcification and plaque vulnerability in vivo: frequencydomain optical coherence tomography analysis Yu Kataoka 1, Rishi Puri 2,3, Muhammad Hammadah 3, Bhanu Duggal 3, Kiyoko Uno

More information

2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension.

2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension. 2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension Writing Group: Background Hypertension worldwide causes 7.1 million premature

More information

2010 Korean Society of Cardiology Spring Scientific Session Korea Japan Joint Symposium. Seoul National University Hospital Cardiovascular Center

2010 Korean Society of Cardiology Spring Scientific Session Korea Japan Joint Symposium. Seoul National University Hospital Cardiovascular Center 2010 Korean Society of Cardiology Spring Scientific Session Korea Japan Joint Symposium Does Lt Late Cth Catch up Exist Eiti in DES? : Quantitative Coronary Angiography Analysis Kyung Woo Park, MD Cardiovascular

More information

Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up

Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up... Study Population: 340... Total Population: 500... Time Window of Baseline: 09/01/13 to 12/20/13... Time Window of Follow-up:

More information

Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden

Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Cardiovascular Disease Prevention (CVD) Three Strategies for CVD

More information

Appendix This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors.

Appendix This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors. Appendix This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors. Appendix to: Banks E, Crouch SR, Korda RJ, et al. Absolute risk of cardiovascular

More information

JUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study

JUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study Panel Discussion: Literature that Should Have an Impact on our Practice: The Study Kaiser COAST 11 th Annual Conference Maui, August 2009 Robert Blumberg, MD, FACC Ralph Brindis, MD, MPH, FACC Primary

More information

Term-End Examination December, 2009 MCC-006 : CARDIOVASCULAR EPIDEMIOLOGY

Term-End Examination December, 2009 MCC-006 : CARDIOVASCULAR EPIDEMIOLOGY MCC-006 POST GRADUATE DIPLOMA IN CLINICAL CARDIOLOGY (PGDCC) 00269 Term-End Examination December, 2009 MCC-006 : CARDIOVASCULAR EPIDEMIOLOGY Time : 2 hours Maximum Marks : 60 Note : There will be multiple

More information

Effects of Obesity on Lipid-Lowering, Anti-Inflammatory, and Antiatherosclerotic Benefits of Atorvastatin

Effects of Obesity on Lipid-Lowering, Anti-Inflammatory, and Antiatherosclerotic Benefits of Atorvastatin Effects of Obesity on Lipid-Lowering, Anti-Inflammatory, and Antiatherosclerotic Benefits of Atorvastatin or Pravastatin in Patients With Coronary Artery Disease (from the REVERSAL Study) Stephen J. Nicholls,

More information

pissn: , eissn: Yonsei Med J 54(2): , 2013

pissn: , eissn: Yonsei Med J 54(2): , 2013 Original Article http://dx.doi.org/10.3349/ymj.2013.54.2.336 pissn: 0513-5796, eissn: 1976-2437 Yonsei Med J 54(2):336-344, 2013 Early Differential Changes in Coronary Plaque Composition According to Plaque

More information

Trial to Reduce. Aranesp* Therapy. Cardiovascular Events with

Trial to Reduce. Aranesp* Therapy. Cardiovascular Events with Trial to Reduce Cardiovascular Events with Aranesp* Therapy John J.V. McMurray, Hajime Uno, Petr Jarolim, Akshay S. Desai, Dick de Zeeuw, Kai-Uwe Eckardt, Peter Ivanovich, Andrew S. Levey, Eldrin F. Lewis,

More information

Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution

Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution of A: total cholesterol (TC); B: low-density lipoprotein

More information

Epicardial fat volume as a predictor of coronary vulnerable plaques using cardiac computed tomography in the patients with zero calcium score

Epicardial fat volume as a predictor of coronary vulnerable plaques using cardiac computed tomography in the patients with zero calcium score ESC Congress 2011 Epicardial fat volume as a predictor of coronary vulnerable plaques using cardiac computed tomography in the patients with zero calcium score K. Harada, N. Terada, A. Okada, M. Shigekiyo,

More information

Using the New Hypertension Guidelines

Using the New Hypertension Guidelines Using the New Hypertension Guidelines Kamal Henderson, MD Department of Cardiology, Preventive Medicine, University of North Carolina School of Medicine Kotchen TA. Historical trends and milestones in

More information

Beyond Framingham. Prediction of cardiovascular risk. Niels van Pelt Cardiologist, Middlemore Hospital

Beyond Framingham. Prediction of cardiovascular risk. Niels van Pelt Cardiologist, Middlemore Hospital Beyond Framingham Prediction of cardiovascular risk Niels van Pelt Cardiologist, Middlemore Hospital Niels Bohr (Danish Physicist)1885-1962 Prediction is very difficult, especially if it's about the future

More information

Module 2. Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension

Module 2. Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension Module 2 Global Cardiovascular Risk Assessment and Reduction in Women with Hypertension 1 Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored,

More information

Physical Activity and Coronary calcification ADJ ASSOCIATE PROFESSOR TAN SWEE YAW NATIONAL HEART CENTRE SINGAPORE

Physical Activity and Coronary calcification ADJ ASSOCIATE PROFESSOR TAN SWEE YAW NATIONAL HEART CENTRE SINGAPORE Physical Activity and Coronary calcification ADJ ASSOCIATE PROFESSOR TAN SWEE YAW NATIONAL HEART CENTRE SINGAPORE Calcium Scores (CACS) Calcium Scores (CACS) Calcium Scores are indicative of the presence

More information

Heart disease in Women

Heart disease in Women Heart disease in Women Extent and risk assessment Charles McCreery MB FACC St Vincent's Hospital Dublin St Columcille s Hospital Dublin Natural Progression of Atherosclerosis Heart disease risk differs

More information

How would you manage Ms. Gold

How would you manage Ms. Gold How would you manage Ms. Gold 32 yo Asian woman with dyslipidemia Current medications: Simvastatin 20mg QD Most recent lipid profile: TC = 246, TG = 100, LDL = 176, HDL = 50 What about Mr. Williams? 56

More information

Low-density lipoproteins cause atherosclerotic cardiovascular disease (ASCVD) 1. Evidence from genetic, epidemiologic and clinical studies

Low-density lipoproteins cause atherosclerotic cardiovascular disease (ASCVD) 1. Evidence from genetic, epidemiologic and clinical studies Low-density lipoproteins cause atherosclerotic cardiovascular disease (ASCVD) 1. Evidence from genetic, epidemiologic and clinical studies A Consensus Statement from the European Atherosclerosis Society

More information

Which CVS risk reduction strategy fits better to carotid US findings?

Which CVS risk reduction strategy fits better to carotid US findings? Which CVS risk reduction strategy fits better to carotid US findings? Dougalis A, Soulaidopoulos S, Cholongitas E, Chalevas P, Vettas Ch, Doumtsis P, Vaitsi K, Diavasti M, Mandala E, Garyfallos A 4th Department

More information

Cardiovascular Division, Saitama Citizens Medical Center, Shimane, Nishi-ku, Saitama , Japan 2

Cardiovascular Division, Saitama Citizens Medical Center, Shimane, Nishi-ku, Saitama , Japan 2 International Vascular Medicine Volume 2010, Article ID 134692, 5 pages doi:10.1155/2010/134692 Clinical Study Gender Differences of Plaque Characteristics in Elderly Patients with Stable Angina Pectoris:

More information

Quality Payment Program: Cardiology Specialty Measure Set

Quality Payment Program: Cardiology Specialty Measure Set Quality Payment Program: Cardiology Specialty Set Title Number CMS Reporting Method(s) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for

More information

4/7/ The stats on heart disease. + Deaths & Age-Adjusted Death Rates for

4/7/ The stats on heart disease. + Deaths & Age-Adjusted Death Rates for + Update on Lipid Management Stacey Gardiner, MD Assistant Professor Division of Cardiovascular Medicine Medical College of Wisconsin + The stats on heart disease Over the past 10 years for which statistics

More information

CLINICAL OUTCOME Vs SURROGATE MARKER

CLINICAL OUTCOME Vs SURROGATE MARKER CLINICAL OUTCOME Vs SURROGATE MARKER Statin Real Experience Dr. Mostafa Sherif Senior Medical Manager Pfizer Egypt & Sudan Objective Difference between Clinical outcome and surrogate marker Proper Clinical

More information

40% minimum reduction from

40% minimum reduction from 160 Circulatory Disease Mortality Target: Death rates in England 1993-2006 Persons under 75 Death / 100,000 population A fall of 44% over 10 years 140 120 100 80 60 40 20 141.0 84.2 Immortality guaranteed

More information

Update on Lipid Management in Cardiovascular Disease: How to Understand and Implement the New ACC/AHA Guidelines

Update on Lipid Management in Cardiovascular Disease: How to Understand and Implement the New ACC/AHA Guidelines Update on Lipid Management in Cardiovascular Disease: How to Understand and Implement the New ACC/AHA Guidelines Paul Mahoney, MD Sentara Cardiology Specialists Lipid Management in Cardiovascular Disease

More information

2013 ACC/AHA Guidelines on the Assessment of Atherosclerotic Cardiovascular Risk: Overview and Commentary

2013 ACC/AHA Guidelines on the Assessment of Atherosclerotic Cardiovascular Risk: Overview and Commentary 2013 ACC/AHA Guidelines on the Assessment of Atherosclerotic Cardiovascular Risk: Overview and Commentary The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Becky McKibben, MPH; Seth

More information

Management of Hypertension

Management of Hypertension Clinical Practice Guidelines Management of Hypertension Definition and classification of blood pressure levels (mmhg) Category Systolic Diastolic Normal

More information

Understanding new international guidelines to tackle CV Risk: A practical model John Deanfield, MD UCL, London United Kingdom s

Understanding new international guidelines to tackle CV Risk: A practical model John Deanfield, MD UCL, London United Kingdom s Understanding new international guidelines to tackle CV Risk: A practical model John Deanfield, MD UCL, London United Kingdom s Ho Chi Minh City, Vietnam August 7, 2014 JBS 2 Risk Guidelines (2005) Based

More information

New evidences in heart failure: the GISSI-HF trial. Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy

New evidences in heart failure: the GISSI-HF trial. Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy New evidences in heart failure: the GISSI-HF trial Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy % Improving survival in chronic HF and LV systolic dysfunction: 1 year all-cause mortality 20

More information

MPS and Calcium Score in asymptomatic patient F. Mut, J. Vitola

MPS and Calcium Score in asymptomatic patient F. Mut, J. Vitola MPS and Calcium Score in asymptomatic patient F. Mut, J. Vitola Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Quanta Diagnostico Nuclear Curitiba, Brazil Clinical history Male 63 y.o.,

More information

Intravascular Ultrasound

Intravascular Ultrasound May 2008 Beth Israel Deaconess Medical Center Harvard Medical School Intravascular Ultrasound Matthew Altman, HMS III Gillian Lieberman, MD BIDMC Department of Radiology Presentation Overview 1. Patient

More information

Cardiovascular Disorders Lecture 3 Coronar Artery Diseases

Cardiovascular Disorders Lecture 3 Coronar Artery Diseases Cardiovascular Disorders Lecture 3 Coronar Artery Diseases By Prof. El Sayed Abdel Fattah Eid Lecturer of Internal Medicine Delta University Coronary Heart Diseases It is the leading cause of death in

More information

Assessment of Vulnerable Plaques Causing Acute Coronary Syndrome Using Integrated Backscatter Intravascular Ultrasound

Assessment of Vulnerable Plaques Causing Acute Coronary Syndrome Using Integrated Backscatter Intravascular Ultrasound Journal of the American College of Cardiology Vol. 47, No. 4, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.09.061

More information

Cardiac CT for Risk Assessment: Do we need to look beyond Coronary Artery Calcification

Cardiac CT for Risk Assessment: Do we need to look beyond Coronary Artery Calcification Cardiac CT for Risk Assessment: Do we need to look beyond Coronary Artery Calcification Matthew Budoff, MD, FACC, FAHA Professor of Medicine Director, Cardiac CT Harbor-UCLA Medical Center, Torrance, CA

More information

Metoprolol Succinate SelokenZOC

Metoprolol Succinate SelokenZOC Metoprolol Succinate SelokenZOC Blood Pressure Control and Far Beyond Mohamed Abdel Ghany World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2014. 1 Death Rates From Ischemic

More information

Current Cholesterol Guidelines and Treatment of Residual Risk COPYRIGHT. J. Peter Oettgen, MD

Current Cholesterol Guidelines and Treatment of Residual Risk COPYRIGHT. J. Peter Oettgen, MD Current Cholesterol Guidelines and Treatment of Residual Risk J. Peter Oettgen, MD Associate Professor of Medicine Harvard Medical School Director, Preventive Cardiology Beth Israel Deaconess Medical Center

More information

Quality Payment Program: Cardiology Specialty Measure Set

Quality Payment Program: Cardiology Specialty Measure Set Measure Title * Reportable via PINNACLE α Reportable via Diabetes Collaborative CQMC v1.0 Measure High Priority Measure Cross Cutting Measure Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor

More information

THE BLOOD VESSELS. Manar hajeer, MD University of Jordan Faculty of medicine, pathology department.

THE BLOOD VESSELS. Manar hajeer, MD University of Jordan Faculty of medicine, pathology department. THE BLOOD VESSELS Manar hajeer, MD University of Jordan Faculty of medicine, pathology department. Vascular pathology: 1- Narrowing or complete obstruction of vessel lumina, either progressively (e.g.,

More information

Disclosures No relationships (not even to an employer) No off-label uses. Cholesterol Lowering Guidelines: What now?

Disclosures No relationships (not even to an employer) No off-label uses. Cholesterol Lowering Guidelines: What now? Disclosures No relationships (not even to an employer) No off-label uses Cholesterol Lowering Guidelines: What now?, FACP 1 2 65-year-old white woman Total cholesterol 175mg/dL HDL 54 mg/dl LDL 96 mg/dl

More information

Diabetes and Cardiovascular Risk Management Denise M. Kolanczyk, PharmD, BCPS-AQ Cardiology

Diabetes and Cardiovascular Risk Management Denise M. Kolanczyk, PharmD, BCPS-AQ Cardiology Diabetes and Cardiovascular Risk Management Denise M. Kolanczyk, PharmD, BCPS-AQ Cardiology Disclosures In compliance with the accrediting board policies, the American Diabetes Association requires the

More information

Management of Stable Ischemic Heart Disease. Vinay Madan MD February 10, 2018

Management of Stable Ischemic Heart Disease. Vinay Madan MD February 10, 2018 Management of Stable Ischemic Heart Disease Vinay Madan MD February 10, 2018 1 Disclosure No financial disclosure. 2 Overview of SIHD Diagnosis Outline of talk Functional vs. Anatomic assessment Management

More information

Gary S. Mintz,, MD. IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function

Gary S. Mintz,, MD. IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function Gary S. Mintz,, MD IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function Important IVUS Observations: Remodeling Originally used (first by Glagov) ) to explain atherosclerosis

More information

Randomized comparison of single versus double mammary coronary artery bypass grafting: 5 year outcomes of the Arterial Revascularization Trial

Randomized comparison of single versus double mammary coronary artery bypass grafting: 5 year outcomes of the Arterial Revascularization Trial Randomized comparison of single versus double mammary coronary artery bypass grafting: 5 year outcomes of the Arterial Revascularization Trial Embargoed until 10:45 a.m. CT, Monday, Nov. 14, 2016 David

More information

OCT; Comparative Imaging Results with IVUS, VH and Angioscopy

OCT; Comparative Imaging Results with IVUS, VH and Angioscopy OCT; Comparative Imaging Results with IVUS, VH and Angioscopy Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Comparison among coronary imaging techniques OCT IVUS MRI CAG Angioscopy

More information

Professor Norman Sharpe. Heart Foundation West Coast

Professor Norman Sharpe. Heart Foundation West Coast Professor Norman Sharpe Heart Foundation West Coast Primary Care the Keystone to Heart Health Improvement Norman Sharpe June 2013 The heart health continuum and the keystone position The culprit disease

More information

Clinical Trial Synopsis TL-OPI-516, NCT#

Clinical Trial Synopsis TL-OPI-516, NCT# Clinical Trial Synopsis, NCT#00225277 Title of Study: A Double-Blind, Randomized, Comparator-Controlled Study in Subjects With Type 2 Diabetes Mellitus Comparing the Effects of Pioglitazone HCl Versus

More information

Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers

Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers International Inflammation Volume 2012, Article ID 124693, 5 pages doi:10.1155/2012/124693 Research Article Comparison of Different Anthropometric Measurements and Inflammatory Biomarkers Yaron Arbel,

More information

Cardiac CT Angiography

Cardiac CT Angiography Cardiac CT Angiography Dr James Chafey, Radiologist Why do we need a better test for C.A.D? 1. CAD is the leading cause of death in the US CAD 31% Cancer 23% Stroke 7% 2. The prevalence of atherosclerosis

More information

Preventing Myocardial Infarction in the Young Adult in the First Place: How Do the National Cholesterol Education Panel III Guidelines Perform?

Preventing Myocardial Infarction in the Young Adult in the First Place: How Do the National Cholesterol Education Panel III Guidelines Perform? Journal of the American College of Cardiology Vol. 41, No. 9, 2003 2003 by the American College of Cardiology Foundation ISSN 0735-1097/03/$30.00 Published by Elsevier Inc. doi:10.1016/s0735-1097(03)00187-6

More information

Cover Page. The handle holds various files of this Leiden University dissertation

Cover Page. The handle   holds various files of this Leiden University dissertation Cover Page The handle http://hdl.handle.net/1887/43967 holds various files of this Leiden University dissertation Author: Graaf, Michiel A. de Title: Computed tomography coronary angiography : from quantification

More information

Quinn Capers, IV, MD

Quinn Capers, IV, MD Heart Attacks Mended Hearts Presentation, January, 2017 Quinn Capers, IV, MD Associate Professor of Medicine (Cardiovascular Medicine) Director, Transradial Coronary Interventions Division of Cardiovascular

More information