Publications by authors named "James K Min"
Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.
Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.
Aims: To investigate the location-specific prognostic significance of plaque burden, diameter stenosis, and plaque morphology.
Methods And Results: Patients without a documented cardiac history that underwent coronary computed tomography angiography (CCTA) for suspected coronary artery disease were included. Percentage atheroma volume (PAV), maximum diameter stenosis, and plaque morphology were assessed and classified into proximal, mid, or distal segments of the coronary tree.
Article Synopsis
- The study examines the long-term effects of coronary artery disease (CAD) polygenic risk scores (PRS) on plaque progression and high-risk plaque features over time.
- It found that patients with higher CAD PRS experienced significantly greater plaque volume at baseline and continued to show increased plaque progression over a decade.
- Results indicate that CAD PRS is a valuable tool for predicting future plaque progression and risk of high-risk plaque in patients with suspected CAD.
Article Synopsis
- The study aimed to evaluate the effectiveness of coronary computed tomography angiography (CCTA) in assessing the risk of cardiovascular events through atherosclerotic plaque analysis in patients with ischemia.
- Using quantitative computed tomography (AI-QCT), researchers analyzed plaque characteristics and examined their relationship to cardiovascular death or myocardial infarction over an average follow-up of 3.3 years.
- Results showed that total plaque volume was the strongest predictor of adverse outcomes, and incorporating AI-QCT data improved predictive models beyond traditional risk factors.
Importance: Lipoprotein(a) (Lp[a]) is a causal risk factor for cardiovascular disease; however, long-term effects on coronary atherosclerotic plaque phenotype, high-risk plaque formation, and pericoronary adipose tissue inflammation remain unknown.
Objective: To investigate the association of Lp(a) levels with long-term coronary artery plaque progression, high-risk plaque, and pericoronary adipose tissue inflammation.
Design, Setting, And Participants: This single-center prospective cohort study included 299 patients with suspected coronary artery disease (CAD) who underwent per-protocol repeated coronary computed tomography angiography (CCTA) imaging with an interscan interval of 10 years.
Article Synopsis
- - The study evaluated how various cardiometabolic risk factors, such as metabolic syndrome and individual factors like high fasting glucose and low HDL cholesterol, impact the progression of coronary plaque and the likelihood of major cardiovascular events in patients with stable coronary artery disease.
- - In a cohort of 1,200 patients followed over several years, 28% experienced rapid coronary plaque progression, identified primarily through increased atheroma volume, which indicates worsening arterial health.
- - The findings suggest that a combination of risk factors, particularly high blood sugar and blood pressure, significantly forecast both plaque progression and serious cardiovascular incidents, highlighting the importance of monitoring these factors in at-risk patients.
Article Synopsis
- The AI-QCT algorithm predicts ischemia directly from coronary CTA images in patients with obstructive coronary artery disease.
- Among 768 patients, 86% received conclusive AI-QCT results, with abnormal results linked to higher rates of significant health events (death, myocardial infarction, unstable angina) in those with normal PET perfusion.
- AI-QCT provided additional predictive value for patient outcomes compared to traditional PET imaging, particularly in cases where PET results were normal.
Article Synopsis
- - Traditional clinical risk scores for atherosclerosis do not reliably predict major adverse cardiovascular events (MACE) due to individual complexities in disease predisposition.
- - Advances in coronary computed tomography angiography (CCTA) have enhanced the ability to accurately quantify and characterize atherosclerotic plaques, showing improved prognostic value for MACE across diverse populations.
- - Serial studies using CCTA may deepen our understanding of atherosclerosis progression and could be combined with other risk markers to improve MACE prevention, though more extensive randomized trials are needed.
Background: Noninvasive stress testing is commonly used for detection of coronary ischemia but possesses variable accuracy and may result in excessive health care costs.
Objectives: This study aimed to derive and validate an artificial intelligence-guided quantitative coronary computed tomography angiography (AI-QCT) model for the diagnosis of coronary ischemia that integrates atherosclerosis and vascular morphology measures (AI-QCT) and to evaluate its prognostic utility for major adverse cardiovascular events (MACE).
Methods: A post hoc analysis of the CREDENCE (Computed Tomographic Evaluation of Atherosclerotic Determinants of Myocardial Ischemia) and PACIFIC-1 (Comparison of Coronary Computed Tomography Angiography, Single Photon Emission Computed Tomography [SPECT], Positron Emission Tomography [PET], and Hybrid Imaging for Diagnosis of Ischemic Heart Disease Determined by Fractional Flow Reserve) studies was performed.
Article Synopsis
- * In the ISCHEMIA trial, women had similar catheterization rates but significantly lower revascularization rates than men (73.4% vs. 81.2%, respectively).
- * Despite these differences, there were no significant disparities in primary outcomes like cardiovascular death and myocardial infarction between women and men, indicating that both sexes responded similarly to treatment.
Prediction of the development of new coronary atherosclerotic plaques with radiomics.
J Cardiovasc Comput Tomogr
April 2024
Background: Radiomics is expected to identify imaging features beyond the human eye. We investigated whether radiomics can identify coronary segments that will develop new atherosclerotic plaques on coronary computed tomography angiography (CCTA).
Methods: From a prospective multinational registry of patients with serial CCTA studies at ≥ 2-year intervals, segments without identifiable coronary plaque at baseline were selected and radiomic features were extracted.
Aims: The incremental impact of atherosclerosis imaging-quantitative computed tomography (AI-QCT) on diagnostic certainty and downstream patient management is not yet known. The aim of this study was to compare the clinical utility of the routine implementation of AI-QCT versus conventional visual coronary CT angiography (CCTA) interpretation.
Methods And Results: In this multi-centre cross-over study in 5 expert CCTA sites, 750 consecutive adult patients referred for CCTA were prospectively recruited.
Article Synopsis
- This study investigates familial hypercholesterolaemia (FH) patients, focusing on their lifetime exposure to low density lipoprotein cholesterol (LDL-C) and its impact on subclinical atherosclerosis and coronary health.
- Researchers compared genetically diagnosed FH patients to a control group using coronary CT angiography and found that FH patients had significantly higher LDL-C exposure and more coronary plaque.
- The findings suggest that early and aggressive lipid-lowering therapy is essential in reducing coronary plaque burden in FH patients, highlighting the value of periodic monitoring to tailor treatment strategies.
Article Synopsis
- Doctors use a special scan called coronary CTA to check for heart problems, and there's a new AI tool that helps figure out if a patient has low blood flow to the heart muscle.
- This study looked at how well this AI tool can predict serious health problems, like death or heart attacks, in patients who might have heart disease.
- The results showed that if the AI tool finds something wrong, those patients may have a higher chance of serious issues, especially if they have non-obstructive heart disease.
Background: In the last 15 years, large registries and several randomized clinical trials have demonstrated the diagnostic and prognostic value of coronary computed tomography angiography (CCTA). Advances in CT scanner technology and developments of analytic tools now enable accurate quantification of coronary artery disease (CAD), including total coronary plaque volume and low attenuation plaque volume. The primary aim of CONFIRM2, (Quantitative COroNary CT Angiography Evaluation For Evaluation of Clinical Outcomes: An InteRnational, Multicenter Registry) is to perform comprehensive quantification of CCTA findings, including coronary, non-coronary cardiac, non-cardiac vascular, non-cardiac findings, and relate them to clinical variables and cardiovascular clinical outcomes.
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- AI-QCT (Artificial Intelligence Quantitative CT) is effective for identifying coronary plaque morphology, specifically low-density noncalcified plaque (LD-NCP), utilizing NIRS-IVUS (near-infrared spectroscopy-intravascular ultrasound) as a benchmark.
- The study assessed 133 plaques from 47 patients, revealing AI-QCT's high accuracy (94%) and a strong correlation with IVUS metrics such as vessel area and plaque burden.
- Results suggest that AI-QCT is a reliable tool for detecting significant LD-NCP, with a notable optimal volume threshold identified for improved diagnostic performance.
Background: Non-obstructing small coronary plaques may not be well recognized by expert readers during coronary computed tomography angiography (CCTA) evaluation. Recent developments in atherosclerosis imaging quantitative computed tomography (AI-QCT) enabled by machine learning allow for whole-heart coronary phenotyping of atherosclerosis, but its diagnostic role for detection of small plaques on CCTA is unknown.
Methods: We performed AI-QCT in patients who underwent serial CCTA in the multinational PARADIGM study.
Objectives: No clear recommendations are endorsed by the different scientific societies on the clinical use of repeat coronary computed tomography angiography (CCTA) in patients with non-obstructive coronary artery disease (CAD). This study aimed to develop and validate a practical CCTA risk score to predict medium-term disease progression in patients at a low-to-intermediate probability of CAD.
Methods: Patients were part of the Progression of AtheRosclerotic PlAque Determined by Computed Tomographic Angiography Imaging (PARADIGM) registry.
Rationale and design of the INVICTUS Registry: (Multicenter Registry of Invasive and Non-Invasive imaging modalities to compare Coronary Computed Tomography Angiography, Intravascular Ultrasound and Optical Coherence Tomography for the determination of Severity, Volume and Type of coronary atherosclerosiS).
J Cardiovasc Comput Tomogr
December 2023
Background: Coronary CT angiography (CCTA) is a first-line noninvasive imaging modality for evaluating coronary artery disease (CAD). Recent advances in CCTA technology enabled semi-automated detection of coronary arteries and atherosclerosis. However, there have been to date no large-scale validation studies of automated assessment of coronary atherosclerosis phenotype and coronary artery dimensions by artificial intelligence (AI) compared to current standard invasive imaging.
View Article and Find Full Text PDFIt is unknown whether gender influences the atherosclerotic plaque characteristics (APCs) of lesions of varying angiographic stenosis severity. This study evaluated the imaging data of 303 symptomatic patients from the derivation arm of the CREDENCE (Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia) trial, all of whom underwent coronary computed tomographic angiography and clinically indicated nonemergent invasive coronary angiography upon study enrollment. Index tests were interpreted by 2 blinded core laboratories, one of which performed quantitative coronary computed tomographic angiography using an artificial intelligence application to characterize and quantify APCs, including percent atheroma volume (PAV), low-density noncalcified plaque (LD-NCP), noncalcified plaque (NCP), calcified plaque (CP), lesion length, positive arterial remodeling, and high-risk plaque (a combination of LD-NCP and positive remodeling ≥1.
View Article and Find Full Text PDFObjective: Obesity is associated with all-cause mortality and cardiovascular disease (CVD). Visceral fat (VF) is an important CVD risk metric given its independent correlation with myocardial infarction and stroke. This study aims to clarify the relationship between the presence and severity of VF with the presence and severity of coronary artery plaque.
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