TY - JOUR
T1 - Coronary atherosclerosis in outlier subjects at the opposite extremes of traditional risk factors
T2 - Rationale and preliminary results of the Coronary Atherosclerosis in outlier subjects: Protective and novel Individual Risk factors Evaluation (CAPIRE) study
AU - Magnoni, Marco
AU - Andreini, Daniele
AU - Gorini, Marco
AU - Moccetti, Tiziano
AU - Modena, Maria Grazia
AU - Canestrari, Mauro
AU - Berti, Sergio
AU - Casolo, Giancarlo
AU - Gabrielli, Domenico
AU - Marraccini, Paolo
AU - Pontone, Gianluca
AU - Masson, Serge
AU - Latini, Roberto
AU - Maggioni, Aldo Pietro
AU - Maseri, Attilio
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Although it is generally accepted that cardiac ischemic events develop when coronary atherosclerosis (coronary artery disease [CAD]) has reached a critical threshold, this is true only to a first approximation. Indeed, there are patients with severe CAD who do not develop ischemic events; conversely, at the other extreme, individuals with minimal CAD may do. Similar exceptions to this paradigm include patients with diffuse CAD with a low risk factor (RF) profile and others with multiple RFs who develop only mild or no CAD. Therefore, the CAPIRE project was designed to investigate whether the specific study of these extreme outlier populations could provide clues for identification of yet unknown risk or protective factors for CAD and ischemic events. In the CAPIRE study, 481 subjects without previous symptoms or history of ischemic heart disease and normal left ventricular systolic function undergoing coronary computed tomography angiography have been selected based on coronary computed tomography angiography findings and cardiovascular RF profile. Therefore, in the whole population, 2 extreme outlier populations have been identified: (1) subjects with no CAD despite multiple RFs, and (2) at the opposite extreme, subjects with diffuse CAD despite a low-risk profile. Each subject has been characterized by clinical, anatomical imaging variables of CAD and baseline circulating biomarkers. Blood samples were collected and stored in a biological bank for further advanced investigations. The project is designed as a prospective, observational, international multicenter study with an initial cross-sectional analysis of clinical, imaging, and biomolecular variables in the selected groups and a longitudinal 5-year follow-up.
AB - Although it is generally accepted that cardiac ischemic events develop when coronary atherosclerosis (coronary artery disease [CAD]) has reached a critical threshold, this is true only to a first approximation. Indeed, there are patients with severe CAD who do not develop ischemic events; conversely, at the other extreme, individuals with minimal CAD may do. Similar exceptions to this paradigm include patients with diffuse CAD with a low risk factor (RF) profile and others with multiple RFs who develop only mild or no CAD. Therefore, the CAPIRE project was designed to investigate whether the specific study of these extreme outlier populations could provide clues for identification of yet unknown risk or protective factors for CAD and ischemic events. In the CAPIRE study, 481 subjects without previous symptoms or history of ischemic heart disease and normal left ventricular systolic function undergoing coronary computed tomography angiography have been selected based on coronary computed tomography angiography findings and cardiovascular RF profile. Therefore, in the whole population, 2 extreme outlier populations have been identified: (1) subjects with no CAD despite multiple RFs, and (2) at the opposite extreme, subjects with diffuse CAD despite a low-risk profile. Each subject has been characterized by clinical, anatomical imaging variables of CAD and baseline circulating biomarkers. Blood samples were collected and stored in a biological bank for further advanced investigations. The project is designed as a prospective, observational, international multicenter study with an initial cross-sectional analysis of clinical, imaging, and biomolecular variables in the selected groups and a longitudinal 5-year follow-up.
UR - http://www.scopus.com/inward/record.url?scp=84960416570&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84960416570&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2015.11.017
DO - 10.1016/j.ahj.2015.11.017
M3 - Article
C2 - 26920592
AN - SCOPUS:84960416570
VL - 173
SP - 18
EP - 26
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
ER -