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Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Related Experiment Video

Updated: Sep 14, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Identifying High-Risk Obese Individuals Without Diabetes for GLP-1RA Therapy Using Coronary CTA.

Camila V Blair1, Daniel Huck1, Stephanie A Besser1

  • 1Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

JACC. Advances
|July 19, 2025
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Summary

Coronary artery disease (CAD) detected by coronary computed tomography angiography (CCTA) identifies overweight individuals without diabetes at high cardiovascular risk. This suggests potential benefits from GLP-1 receptor agonist therapies, similar to those seen in the SELECT trial.

Keywords:
coronary CTAcoronary artery diseaseobesitysemaglutide

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Pharmacology

Background:

  • The SELECT trial showed semaglutide reduced cardiovascular events in patients with existing cardiovascular disease (CVD) and obesity, excluding those with diabetes.
  • Coronary artery disease (CAD) is a major component of CVD.
  • Coronary computed tomography angiography (CCTA) is a non-invasive imaging technique used to visualize CAD.

Purpose of the Study:

  • To assess the association between CAD severity, identified via CCTA, and cardiovascular outcomes.
  • To evaluate if individuals without prior CVD but with overweight/obesity and CAD share similar cardiovascular risk profiles as observed in the SELECT trial population.

Main Methods:

  • Included 5,173 individuals aged ≥45 years with a body mass index ≥27 kg/m² who underwent CCTA.
  • Excluded individuals with prior myocardial infarction, revascularization, stroke, diabetes, end-stage kidney disease, or malignancy.
  • Categorized CAD severity as absent, nonobstructive (1-49%), or obstructive (≥50%), with extensive nonobstructive CAD defined as plaque in all coronary arteries. Used Cox modeling to analyze associations.

Main Results:

  • Individuals with obstructive CAD showed a 71% higher risk of major adverse cardiovascular events (MACE) compared to those without CAD (adjusted HR: 1.71).
  • At 4 years, event rates were 7.8% for obstructive CAD and 7.7% for extensive nonobstructive CAD.
  • The number needed to treat with a hypothetical 20% relative risk reduction was comparable to the SELECT trial (66-67 vs. 56).

Conclusions:

  • Obstructive or extensive nonobstructive CAD detected by CCTA identifies individuals without diabetes and prior CVD who are at elevated cardiovascular risk.
  • These findings suggest that glucagon-like peptide-1 receptor agonist therapy may benefit this population, mirroring SELECT trial outcomes.