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    Association between family history of premature coronary artery disease and coronary atherosclerotic plaques shown by multidetector computed tomography coronary angiography
    (Elsevier Ireland Ltd, 2013) Sunman, Hamza; Yorgun, Hikmet; Canpolat, Ugur; Hazirolan, Tuncay; Kaya, Ergun Baris; Ates, Ahmet Hakan; Dural, Muhammed
    Background: There is controversy regarding the role of family history (FH) of premature coronary artery disease (CAD) as an independent risk factor for CAD. Herein, we aimed to assess the role of FH of premature CAD in prediction of coronary atherosclerosis shown by multidetector computed tomography (MDCT) coronary angiography. Methods: We analyzed consecutive subset of 349 patients in whom MDCT coronary angiography was performed for suspected CAD. All patients underwent coronary MDCT imaging using dual-source MDCT scanner. Coronary arteries were evaluated on 16-segment basis, critical CAP was described as luminal narrowing >50%, whereas plaque morphology was assessed on per segment basis. Results: Study population consisted of 202 (57.9%) male and 147 (42.1%) female patients with mean age of 57.8 +/- 10.8 years. The presence of CAP was higher in patients with FH of premature CAD in LAD and Cx compared to patients without FH of premature CAD (70.8% vs 58.0%, p=0.013 for LAD; 42.3% vs 30.4%, p=0.021 for Cx; 34.5% vs 29.8%, p=0.348 for RCA). In multinominal logistic regression analysis age, male gender, dyslipidemia and FH of premature CAD seemed significant predictors of primarily noncalcified CAP(OR:1.17, 95% CI:1.07-1.15, p<0.001; OR:0.19, 95% CI:0.09-0.38, p<0.001; OR:2.26, 95% CI:1.21-4.24, p=0.01; OR:3.32, 95% CI:1.74-6.34, p<0.001 respectively) after adjustment for other risk factors. Conclusion: Our study results indicate that FH of premature CAD is associated with severity, extent and noncalcified CAP shown by MDCT. Further investigation is needed to clarify the exact diagnostic and prognostic role of MDCT coronary angiography in subjects with positive FH and suspected CAD. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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    Cardiovascular risk and coronary atherosclerotic plaques detected by multidetector computed tomography: Framingham and SCORE risk models underestimate coronary atherosclerosis in the symptomatic low-risk Turkish population
    (Lippincott Williams & Wilkins, 2012) Canpolat, Ugur; Yorgun, Hikmet; Aytemir, Kudret; Hazirolan, Tuncay; Kaya, Ergun Baris; Ates, Ahmet Hakan; Dural, Muhammed
    Objective In this study, we investigated the association between cardiovascular (CV) risk factors and coronary atherosclerotic plaque (CAP) burden/subtypes shown by multidetector computed tomography in symptomatic patients free of known coronary artery disease (CAD). Methods In 662 consecutive outpatients (56.9 +/- 10.7 years, 50.8% men) without known CAD, 64-slice multidetector computed tomography coronary angiography was performed for detection of CAD. Risk estimation for CV outcomes was assessed using the Systematic Coronary Risk Evaluation (SCORE) and the Framingham Risk Score (FRS). Logistic regression analysis was used to evaluate the association of CV risk factors with the prevalence/extent of CAP. Results CAP was detected in 318 (48.0%) individuals. Male sex, older age, hypertension, diabetes mellitus, smoking, and dyslipidemia all increased the likelihood of the presence of CAP in univariate analysis (P < 0.001). Older age, male sex, dyslipidemia, and diabetes mellitus independently increased the likelihood of the presence of CAP in multivariate analysis (P < 0.005). Multinominal logistic regression analysis showed an association with older age, male sex, dyslipidemia, and smoking for noncalcified plaques; with older age, male sex, diabetes, and dyslipidemia for mixed plaques; and with older age and male sex for calcified plaque. Patients with low FRS and SCORE showed a large number of CAPs (33.8 and 40.4%), although CAP was more prevalent in the high-risk groups (67 and 78%, respectively). Conclusion CV risk stratification using only risk factor-based scores is a weak discriminator of the overall CAP burden in individual patients. Many patients with low FRS or SCORE with substantial CAP might be undertreated or not treated at all. Coron Artery Dis 23:195-200 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.