The goal of this observational study is to determine the diagnostic accuracy of peripheral whole blood transcriptomes analyzed by an artificial intelligence algorithm to detect the presence and extent of coronary calcification in individuals without a history of known cardiovascular disease. The main question it aims to answer is: 1\. Will the proposed method predict the presence and extent of coronary artery calcification from the peripheral whole-blood transcriptomes?
This study will be a prospective observational single-site study. A convenience sample will be carried out to include 800 patients who attend the Clinic, to undergo a cardiac CT without contrast (coronary calcium score), either for a medical indication or volunteers for an assessment of cardiovascular risk. The study will have a baseline stage in which a clinical evaluation will be performed, blood samples will be drawn for transcriptome analysis and laboratory analysis. Then, a DNA sample obtained by swabbing the buccal mucosa will be taken. Subsequently, a non-contrast gated cardiac CT will be performed to assess the presence and extent of coronary calcification and other outcomes of interest. At the end of patient enrollment, biological samples will be sequenced for in silico evaluation of the results. Finally, a 5-year clinical (telephone) follow-up will be carried out to collect data on the incidence of fatal and non-fatal cardiovascular events.
Study Type
OBSERVATIONAL
Enrollment
800
Clinica Sagrada Familia
Buenos Aires, Argentina
Coronary artery calcium score
Coronary artery calcium (CAC) score (Agatston units) stratified with increasing risk according to the Society of Cardiovascular Computed Tomography Guidelines as CAC=0; CAC 1-99; CAC 100-299; and CAC≥300.
Time frame: At baseline (cross-sectional assessment)
Coronary artery calcium score
Percentile Agatston score: according to age and sex with a increasing risk ranging from 1 to 99 th percentile.
Time frame: At baseline (cross-sectional assessment)
Coronary artery calcium score (number of segments)
Number of segments with coronary calcifications ranging from 0 to 17 segments.
Time frame: At baseline (cross-sectional assessment)
Aortic valve calcium
Aortic valve calcification score (Agatston units) as a continuous variable with increasing risk and without preestablished thresholds
Time frame: At baseline (cross-sectional assessment)
Thoracic aorta calcium
Thoracic aorta calcification score (Agatston units) as a continuous variable with increasing risk and without preestablished thresholds
Time frame: At baseline (cross-sectional assessment)
Epicardial adipose tissue (volume)
cm2/m2
Time frame: At baseline (cross-sectional assessment)
Epicardial adipose tissue (density)
density, Q1-Q4: quartiles percentage
Time frame: At baseline (cross-sectional assessment)
Fatty liver
liver attenuation \<48 Hounsfield units
Time frame: At baseline (cross-sectional assessment)
Neutrophil to lymphocyte ratio
hematological parameter for systemic inflammation and stress
Time frame: At baseline (cross-sectional assessment)
High-sensitive C reactive protein (CRP)
mg/dl
Time frame: At baseline (cross-sectional assessment)
Repolarization abnormalities
Number of participants with repolarization abnormalities on a 12-lead ECG, defined as ST segment depression or pathological T wave inversion.
Time frame: At baseline (cross-sectional assessment)
Left ventricular hypertrophy
Number of participants with left ventricular hypertrophy on a 12-lead ECG, defined by positive Sokolow-Lyon or Cornell criteria.
Time frame: At baseline (cross-sectional assessment)
Intraventricular conduction abnormalities
Number of participants with intraventricular conduction abnormalities on a 12-lead ECG, stratified by the presence of left bundle branch block; right bundle branch block and left posterior fascicular block; right bundle branch block and left anterior fascicular block or right bundle branch block; or left anterior fascicular block.
Time frame: At baseline (cross-sectional assessment)
Percent electron density relative to water (%EDW)
percent electron density relative to water, available for direct evaluation with dedicated software in all scans acquired using a dual-layer spectral CT scanner).
Time frame: At baseline (cross-sectional assessment)
Death
Number of participants with report of death from any cause
Time frame: year 1 through 5
Acute ischemic syndrome
Number of participants with non fatal diagnosis of acute myocardial infarction or unstable angina
Time frame: year 1 through 5
Heart failure
Number of participants with non fatal new diagnosis of heart failure with preserved or impaired ventricular function
Time frame: year 1 through 5
Vascular revascularization
Number of participants with performance of myocardial revascularization surgery, coronary angioplasty or peripheral vascular angioplasty
Time frame: year 1 through 5
cerebrovascular event
Number of participants with non fatal diagnosis of cerebrovascular accident ("stroke") or transient ischemic attack
Time frame: year 1 through 5
Cancer
Number of participants with new diagnosis of any type of cancer
Time frame: year 1 through 5
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.