Among individuals suspected of having coronary artery disease (CAD) without modifiable risk factors, CAD is common with significantly increased hazards for major adverse cardiovascular events (MACEs) and mortality, according to new research.
From an international multicenter cohort study of 27,125 subjects undergoing coronary CT angiography (CCTA) at 12 centers, Jonathon Leipsic, M.D., of St. Paul’s Hospital, University of British Columbia, Vancouver, and colleagues identified 5,262 patients without known CAD and without modifiable risk factors.
In patients without medically modifiable risk factors, the presence of increasing burden of CAD was predictive of MACEs at the per-patient, per-vessel, and per-segment level across varying symptom and family history status. A relationship of increased CAD burden to all individual “hard” end-point components of MACE, including death, myocardial infarction and late target vessel revascularization is present.
“Coronary CT angiography allows for the identification of those at risk among patients without medically modifiable risk factors in a fashion not previously possible with traditional risk stratification tools alone,” the authors write.
A single concussion may cause lasting structural damage to the brain one year after the injury, according to new research.
Yongxia Zhou, Ph.D., of New York University School of Medicine, and colleagues investigated changes in global and regional brain volume in patients one year after mild traumatic brain injury (MTBI). The study comprised 28 MTBI patients (19 followed at one year) with post-traumatic symptoms after injury and 22 matched controls (12 followed at one year). Researchers used 3D MR imaging to determine regional gray matter and white matter volumes and correlated these findings with other clinical and cognitive measurements.
One year after MTBI, global brain atrophy was measurably larger than that in control subjects. The anterior cingulate white matter bilaterally and the left cingulate gyrus isthmus white matter—as well as the right precuneal gray matter—showed significant decreases in regional volume in patients with MTBI over the first year after injury. These findings were confirmed by a cross-sectional comparison with data in control subjects.
“Regional brain atrophy is not exclusive to moderate and severe traumatic brain injury but may be seen after mild injury,” the authors write. “In particular, the anterior part of the cingulum and the cingulate gyrus isthmus, as well as the precuneal gray matter, may be distinctively vulnerable one year after MTBI.”
Cortical abnormalities occur in patients with migraine and may represent the results of a balance between an intrinsic predisposition—as suggested by cortical surface area abnormalities—and disease-related processes, as indicated by cortical thickness abnormalities, according to new research.
Roberta Messina, M.D., of the Institute of Experimental Neurology, Vita-Salute San Raffaele University, Milan, Italy, and colleagues acquired T2-weighted and 3D T1-weighted MR images of the brain in 63 patients with migraine and 18 matched healthy control subjects. Using a general linear model approach, researchers conducted a vertex-by-vertex statistical analysis (P , .01) to assess between-group comparisons (migraine patients vs. control subjects, the aura effect, the effect of white matter hyperintensities) and the correlations between cortical thickness and surface area measurements and patients’ clinical and radiologic characteristics.
Compared with control subjects, patients with migraine showed reduced cortical thickness (P , .01) and cortical surface area (P , .01) in regions subserving pain processing; conversely, cortical thickness and cortical surface area were increased in patients with migraine in regions involved in executive functions and visual motion processing (P , .01), results showed.
“Accurate measurements of cortical gray matter abnormalities might be useful in better characterizing patients with migraine and in understanding the pathophysiologic processes underlying this condition,” the authors write.
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In recognition of American Stroke Month in May, RSNA is distributing public service announcements (PSAs) focusing on stroke imaging, interventional treatments for stroke and the importance of receiving stroke treatment quickly.
In addition to the PSAs, RSNA is also distributing the “60-Second Checkup” audio program to radio stations. This month, the program focuses on how brain angioplasty and stents have been found safe and effective for stroke patients.
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