Outcomes of cardiovascular screening in men aged 60-64 years: the DANCAVAS II trial.

Background And Aims: Limited data suggest a benefit of population-based screening for cardiovascular disease (CVD) with respect to mortality.

Methods: A population-based, parallel-randomized controlled trial of Danish men aged 60-64 years randomized 1:4 to invitation to screening for subclinical CVD or no invitation (control group) were performed. Allocation was based on computer-generated random numbers and stratified on municipality.

Low-density lipoprotein cholesterol and cardiovascular risk in the absence of calcifications on computed tomography: the Western Denmark Heart Registry.

Aims: Coronary atherosclerosis tends to be non-calcified at early stages, questioning the implications of a coronary artery calcification score of zero (CAC = 0) at younger ages. This study investigates whether elevated low-density lipoprotein cholesterol (LDL-C) is associated with the presence of non-calcified plaques and future cardiovascular events in individuals with CAC = 0 across different ages.

Methods And Results: This cohort study from the Western Denmark Heart Registry included symptomatic individuals undergoing coronary computed tomography angiography (CCTA) from 2008-2021, with a 7.

Association of Statin Treatment and Dose With the Clinical Course of Small Abdominal Aortic Aneurysms in Men: A 5-Year Prospective Cohort Study From 2 Population-Based Screening Trials.

Background: Abdominal aortic aneurysms (AAA) present with high morbidity and mortality when they occasionally rupture. No medical therapy has successfully been proven to reduce AAA growth, though both metformin and statins have been identified as potential treatments in multiple meta-analysis. This study aimed to investigate a potential relationship between statin use and AAA growth rates and risk of undergoing repair, rupture, or death.

Aortic Aneurysm Risk and the Somatic Mutation: Insights From a Multicenter, Population-Based Cardiovascular Screening Study.

Background: The somatic sequence variation, a key driver of myeloproliferative neoplasms, has been associated with increased risk of aortic aneurysms. This study aimed to explore associations between the variant allele frequency (VAF) and ascending, descending, and abdominal aortic aneurysms.

Methods: In the DANCAVAS I and II trials (Danish Cardiovascular Screening), 15 000 individuals underwent cardiovascular risk assessments including blood samples and noncontrast ECG-gated computed tomography scans.

Primary prevention of cardiotoxicity in cancer patients treated with fluoropyrimidines: a randomized controlled trial.

Background: Fluoropyrimidines (FP) are the third most used chemotherapeutic drugs administered in solid tumors but have cardiotoxic side effects. We aimed to determine whether pre-chemotherapeutic cardiological assessment and management of cardiovascular risk factors could prevent FP-induced cardiotoxicity and if the coronary artery calcium (CAC) score was predictive of chest pain.

Methods: This was a randomized, controlled, single center trial of patients with various cancer types who were treated with FP and had no known ischemic heart disease.

Rationale and design of VICAD-RISK study: Visualization of coronary artery disease for modification of risk factors.

Background: With the increasing use of coronary computed tomography angiography (CTA), the prevalence of patients with nonobstructive atherosclerotic coronary artery disease (NOCAD) is growing. Presence of NOCAD is associated with an increased risk of an unfavorable clinical outcome. Therefore, guideline-directed preventive strategies such as lipid-lowering therapy with statins are important.

Sex-specific associations between total cholesterol and non-high-density lipoprotein cholesterol and the presence and extent of coronary artery calcifications.

Aims: Investigate sex-specific associations between total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C) and the burden of atherosclerosis assessed by coronary artery calcium (CAC) score.

Methods: A total of 10,049 participants (women: 958, men: 9,091) aged 49-75 years, without known cardiovascular disease (CVD) or current use of lipid-lowering medication, were included from the Danish Risk Score study and the Danish Cardiovascular Screening Trial cohorts. Logistic regression models and zero-inflated negative binomial regression models were used to estimate odds ratio (OR), the incidence rate ratio (IRR), and 95% confidence intervals (CI) for the association between total cholesterol, non-HDL-C, and CAC presence (CAC > 0) and extent.

The Nonsyndromic Ascending Thoracic Aorta in a Population-Based Setting: A 5-Year Prospective Cohort Study.

Background: Prospective data on the clinical course of the ascending thoracic aorta are lacking.

Objectives: This study sought to estimate growth rates of the ascending aorta and to evaluate occurrences of adverse aortic events (AAEs)-that is, thoracic aortic ruptures, type A aortic dissections, and thoracic aortic-related deaths.

Methods: In this prospective cohort study from the population-based, multicenter, randomized DANCAVAS (Danish Cardiovascular Screening trials) I and II, participants underwent cardiovascular risk assessments including electrocardiogram-gated, noncontrast computed tomography (CT) scans.

Selective FFR testing in suspected stable angina in clinical practice - initial experiences.

Coronary CT angiography (CTA) derived fractional flow reserve (FFR) is recommended for physiological assessment in intermediate coronary stenosis for guiding referral to invasive coronary angiography (ICA). In this study, we report real-world data on the feasibility of implementing a CTA/FFR test algorithm as a gatekeeper to ICA at referral hospitals. Retrospective all-comer study of patients with new onset stable symptoms and suspected coronary stenosis (30-89%) by CTA.

Association of Autoimmune Diseases With Coronary Atherosclerosis Severity and Ischemic Events.

Background: Some autoimmune diseases carry elevated risk for atherosclerotic cardiovascular disease (ASCVD), yet the underlying mechanism and the influence of traditional risk factors remain unclear.

Objectives: This study sought to determine whether autoimmune diseases independently correlate with coronary atherosclerosis and ASCVD risk and whether traditional cardiovascular risk factors modulate the risk.

Methods: The study included 85,512 patients from the Western Denmark Heart Registry undergoing coronary computed tomography angiography.

User-defined outcomes of the Danish cardiovascular screening (DANCAVAS) trial: A post hoc analyses of a population-based, randomised controlled trial.

Background: The Danish cardiovascular screening (DANCAVAS) trial, a nationwide trial designed to investigate the impact of cardiovascular screening in men, did not decrease all-cause mortality, an outcome decided by the investigators. However, the target group may have varied preferences. In this study, we aimed to evaluate whether men aged 65 to 74 years requested a CT-based cardiovascular screening examination and to assess its impact on outcomes determined by their preferences.

The association between diabetes and abdominal aortic aneurysms in men: results of two Danish screening studies, a systematic review, and a meta-analysis of population-based screening studies.

Background: A paradoxical protective effect of diabetes on the development and progression of abdominal aortic aneurysms (AAA) has been known for years. This study aimed to investigate whether the protective role of diabetes on AAAs has evolved over the years.

Methods: A cross-sectional study, a systematic review and meta-analysis.

Influence of intensive lipid-lowering on CT derived fractional flow reserve in patients with stable chest pain: Rationale and design of the FLOWPROMOTE study.

Introduction: Coronary CT angiography (CTA) derived fractional flow reserve (FFR ) shows high diagnostic performance when compared to invasively measured FFR. Presence and extent of low attenuation plaque density have been shown to be associated with abnormal physiology by measured FFR. Moreover, it is well established that statin therapy reduces the rate of plaque progression and results in morphology alterations underlying atherosclerosis.

Cost effectiveness of population screening vs. no screening for cardiovascular disease: the Danish Cardiovascular Screening trial (DANCAVAS).

Aims: A recent trial has shown that screening of men for cardiovascular disease (CVD) may reduce all-cause mortality. This study assesses the cost effectiveness of such screening vs. no screening from the perspective of European healthcare systems.

Diagnostic and Clinical Value of FFR in Stable Chest Pain Patients With Extensive Coronary Calcification: The FACC Study.

Background: The influence of extensive coronary calcifications on the diagnostic and prognostic value of coronary computed tomography angiography-derived fractional flow reserve (FFR) has been scantily investigated.

Objectives: The purpose of this study was to investigate the diagnostic and short-term role of FFR in chest pain patients with Agatston score (AS) >399.

Methods: This was a prospective multicenter study of 260 stable patients with suspected coronary artery disease (CAD) and AS >399.

Association of Left Atrial Size Measured by Non-Contrast Computed Tomography with Cardiovascular Risk Factors-The Danish Cardiovascular Screening Trial (DANCAVAS).

Left atrium (LA) size is associated with adverse cardiovascular events. The purpose of this study was to investigate the association of LA enlargement measured by non-contrast CT (NCCT) with traditional cardiovascular risk factors. Individuals aged 60-75 years from the population-based multicentre Danish Cardiovascular Screening (DANCAVAS) trial were included in this cross-sectional study.

Mitral Annulus Calcification and Cardiac Conduction Disturbances: A DANCAVAS Sub-study.

Background: Due to its location very close to the bundle of His, mitral annulus calcification (MAC) might be associated with the development of atrioventricular (AV) conduction disturbances. This study assessed the association between MAC and AV conduction disturbances identified by cardiac implantable electronic device (CIED) use and electrocardiographic parameters. The association between MAC and traditional cardiovascular risk factors was also assessed.

Cross-sectional study of aortic valve calcification and cardiovascular risk factors in older Danish men.

Objective: Aortic valve calcification (AVC) and coronary artery calcification (CAC) are predictors of cardiovascular disease (CVD), presumably sharing risk factors. Our objectives were to determine the prevalence and extent of AVC in a large population of men aged 60-74 years and to assess the association between AVC and cardiovascular risk factors including CAC and biomarkers.

Methods: Participants from the DANish CArdioVAscular Screening and intervention trial (DANCAVAS) with AVC and CAC scores and without previous valve replacement were included in the study.

Reduction of Myocardial Infarction and All-Cause Mortality Associated to Statins in Patients Without Obstructive CAD.

Objectives: The aim of this work was to evaluate the prognostic impact of statin therapy in symptomatic patients without obstructive CAD.

Background: Information on the prognostic impact of post-coronary computed tomographic angiography (CTA) statin use in patients with no or nonobstructive coronary artery disease (CAD) is sparse.

Methods: Patients undergoing CTA with suspected CAD in western Denmark from 2008 to 2017 with <50% coronary stenoses were identified.

Population-Based Risk Factors for Ascending, Arch, Descending, and Abdominal Aortic Dilations for 60-74-Year-Old Individuals.

Background: Aortic dilations (ectasias and aneurysms) may occur on any segment of the aorta. Pathogenesis varies between locations, suggesting that etiology and risk factors may differ. Despite this discrepancy, guidelines recommend screening of the whole aorta if 1 segmental dilation is discovered.

Prevalence and extent of coronary artery calcification in the middle-aged and elderly population.

Aims: Coronary artery calcification (CAC) measured on cardiac computed tomography (CT) is an important risk marker for cardiovascular disease (CVD) and has been included in the prevention guidelines. The aim of this study was to describe CAC score reference values in the middle-aged and elderly population and to develop a freely available CAC calculator.

Methods And Results: All participants from two population-based cardiac CT screening cohorts (DanRisk and DANCAVAS) were included.

Prognostic importance of left atrial size measured by non-contrast cardiac computed tomography - A DANCAVAS study.

Background: Enlargement of left atrium (LA) is a valuable marker of cardiovascular events, and LA size is readily available while performing non-contrast cardiac computed tomography (NCCT) for preventive purposes. We aimed to evaluate the predictive value of a single LA area from NCCT in a population-based cohort.

Method: Mainly men aged 60-75 years from DANCAVAS were included.