Parham Eshtehardi MD Profile picture
Preventive + Imaging Cardiologist & Scientist β€’ Dad β€’ Husband of A Stroke Survivor Hero β€’ @EinsteinMed @EmoryHeart Trained β€’ @CardioOB #CardioObstetrics #cvCMD

Sep 21, 2021, 7 tweets

Prevalence of Subclinical Coronary Atherosclerosis in General Population
@CircAHA

1/x
πŸ‡ΈπŸ‡ͺ 25K randomly invited individuals w/o known CAD underwent CCTA
πŸ‡ΈπŸ‡ͺ 51% women
πŸ‡ΈπŸ‡ͺ 50 to 64 yrs
πŸ‡ΈπŸ‡ͺ #SCAPIS (the Swedish Cardiopulmonary Bioimage Study)

ahajournals.org/doi/10.1161/CI…

2/x
πŸ‡ΈπŸ‡ͺ 42.1% any CCTA-detected atherosclerosis

πŸ‡ΈπŸ‡ͺ 5.2% any significant stenosis (β‰₯50%)

πŸ‡ΈπŸ‡ͺ 1.9% LM, prox LAD or 3VCAD

πŸ‡ΈπŸ‡ͺ 8.3% any non-calcified plaque

πŸ‡ΈπŸ‡ͺ plaques most common in prox LAD

πŸ‡ΈπŸ‡ͺ Participants with only non-Ca plaques were rare (2.4%)

ahajournals.org/doi/10.1161/CI…

3/x
πŸ‡ΈπŸ‡ͺ Prevalence of CCTA-detected atherosclerosis ⬆ w/ ⬆ #CAC scores

πŸ‡ΈπŸ‡ͺ#CAC-positive participants:
- Most w/ low (11 - 100) or ultralow (1 - 10) scores
- median score 35 (IQR 8 - 126)

πŸ‡ΈπŸ‡ͺ participants w/ #CAC zero & interm 10-yr risk, 9.2% had CCTA-verified atherosclerosis

4/x
πŸ‡ΈπŸ‡ͺ #CAC >400:
100% (any CCTA-detected) atherosclerosis
45.7% significant stenosis

πŸ‡ΈπŸ‡ͺ #CAC 101-400:
100% atherosclerosis
24% significant stenosis

πŸ‡ΈπŸ‡ͺ #CAC 11-100:
98.7% atherosclerosis
7.0% significant stenosis
14.9% non-Ca plaques

ahajournals.org/doi/10.1161/CI…

5/x
πŸ‡ΈπŸ‡ͺ #CAC 1-10:
81.9% atherosclerosis
2.0% significant stenosis
0.5% LM, prox LAD or 3VCAD
10.5% non-Ca plaques

πŸ‡ΈπŸ‡ͺ #CAC zero:
5.5% atherosclerosis
0.4% significant stenosis
0.2% LM, prox LAD or 3VCAD
4.0% non-Ca plaques

#PowerOfZero
ahajournals.org/doi/10.1161/CI…

6/x
πŸ‡ΈπŸ‡ͺ Prevalence of atherosclerosis 1.9 X ⬆ in men vs women + ⬆ sharply w/ age in both sexes

πŸ‡ΈπŸ‡ͺ onset of atherosclerosis was delayed on average by 10 yrs in women

πŸ‡ΈπŸ‡ͺ Prevalence of atherosclerosis ⬆ w/ RF burden, 2 & 3X ⬆ in high vs low risk

ahajournals.org/doi/10.1161/CI…

7/x
πŸ”‘ βœ‰
πŸ‡ΈπŸ‡ͺ silent coronary atherosclerosis common in population w/o known CAD

πŸ‡ΈπŸ‡ͺ CCTA-detected atherosclerosis associated w/ #CAC score

πŸ‡ΈπŸ‡ͺ subgroups IDed whose atherosclerosis was not accurately represented by CAC showing CCTA potential additive value

ahajournals.org/doi/10.1161/CI…

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