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passages: document
passages: Spotty calcification as a marker of accelerated progression of coronary atherosclerosis : insights from serial intravascular ultrasound . OBJECTIVES The purpose of this study was to determine atheroma progression in patients with spotty calcification . BACKGROUND Although extensively calcified atherosclerotic lesions have been proposed to be clinically quiescent , the presence of spotty calcification within plaque has been reported to be associated with an increased incidence of ischemic cardiovascular events . The relationship between spotty calcification and disease progression has not been investigated . METHODS A total of 1,347 stable patients with angiographic coronary artery disease underwent serial evaluation of atheroma burden with intravascular ultrasound imaging . Patients with spotty calcification were identified based on the presence of lesions ( 1 to 4 mm in length ) containing an arc of calcification of < 90° . Clinical characteristics and disease progression were compared between patients with spotty calcification ( n = 922 ) and those with no calcification ( n = 425 ) . RESULTS Patients with spotty calcification were older ( age 56 years vs. 54 years ; p = 0.001 ) , more likely to be male ( 68 % vs. 54 % ; p = 0.01 ) , and have a history of diabetes mellitus ( 30 % vs. 24 % ; p = 0.01 ) and myocardial infarction ( 28 % vs. 20 % ; p = 0.004 ) , and have lower on-treatment high-density lipoprotein cholesterol levels ( 48 ± 16 mg/dl vs. 51 ± 17 mg/dl ; p = 0.001 ) . Patients with spotty calcification demonstrated a greater percent atheroma volume ( PAV ) ( 36.0 ± 7.6 % vs. 29.0 ± 8.5 % ; p < 0.001 ) and total atheroma volume ( 174.6 ± 71.9 mm ( 3 ) vs. 133.9 ± 64.9 mm ( 3 ) ; p < 0.001 ) . On serial evaluation , spotty calcification was associated with greater progression of PAV ( +0.43 ± 0.07 % vs. +0.02 ± 0.11 % ; p = 0.002 ) . Although intensive low-density lipoprotein cholesterol and blood pressure lowering therapy slowed disease progression , these efficacies were attenuated in patients with spotty calcification . CONCLUSIONS The presence of spotty calcification is associated with more extensive and diffuse coronary atherosclerosis and accelerated disease progression despite use of medical therapies .
entities: 2429
entities: Intervention_Other
entities: serial evaluation of atheroma burden with intravascular ultrasound imaging .
entities: 2430
entities: Outcome_Physical
entities: progression of coronary atherosclerosis :
entities: 2431
entities: Outcome_Physical
entities: atheroma progression
entities: 2432
entities: Outcome_Physical
entities: disease progression
entities: 2433
entities: Outcome_Physical
entities: atheroma burden
entities: 2434
entities: Outcome_Physical
entities: greater progression
entities: 2435
entities: Outcome_Physical
entities: coronary atherosclerosis
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entities: Participant_Condition
entities: patients with spotty calcification .
entities: 2437
entities: Participant_Sample-size
entities: 1,347
entities: 2438
entities: Participant_Condition
entities: stable patients with angiographic coronary artery disease