Radiomics shows cocaine fuels coronary artery disease risk

February 16, 2021

OAK BROOK, Ill. - Radiomics--the extraction of very detailed quantitative features from medical images--provides a refined understanding of how cocaine use and other risk factors affect the course of coronary artery disease, according to a study published in Radiology. Researchers said the study shows the power of radiomics to improve understanding of not just cardiovascular disease, but cancer and other conditions as well.

Coronary artery disease typically develops over time as plaque builds up inside the arteries. This process, known as atherosclerosis, can eventually lead to life-threatening events like heart attack and stroke.

Historically, imaging techniques like coronary CT angiography provided information on atherosclerosis by describing the degree of stenosis, or narrowing, in the coronary arteries. While measures of stenosis are useful, they are not always the most precise way to assess the risk of an adverse event like a heart attack.

"Some people have very bad stenosis where the vessels are 90% blocked and do fine, while others with only 40% to 50% stenosis die suddenly without warning," said study lead author Shenghan Lai, M.D., M.P.H., professor of epidemiology and public health at the Institute of Human Virology at the University of Maryland School of Medicine and adjunct professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, both in Baltimore. "This shows that not just stenosis but the nature of the plaque itself may play a very important role in risk assessment."

Radiomics is a tool that goes beyond plaque volume to examine a multitude of features apparent in the image but not visible to the naked eye. To perform radiomics analysis, images are run through software that can analyze thousands of features for a more comprehensive risk assessment.

In the new study, Dr. Lai, Márton Kolossváry, M.D., Ph.D., a pioneer in the use of radiomics in cardiovascular imaging, and colleagues assessed whether different cardiovascular risk factors have distinctive contributions to the changes in plaque over time. Risk factors assessed included cocaine use and HIV infection.

The study group included 300 individuals with subclinical coronary artery disease, or disease not yet severe enough to present any symptoms, as confirmed via coronary CT angiography. Changes in 1,276 radiomic features were analyzed over an average of four years follow-up. The data were derived from the Heart Study, a longitudinal investigation of the effects of HIV and cocaine use on subclinical coronary artery disease, which has been funded by the National Institute on Drug Abuse for 21 consecutive years.

Radiomics-based analysis indicated that conventional risk factors, cocaine use, and HIV-infection each have different effects on changes in coronary atherosclerosis over time. Cocaine use was significantly associated with almost a quarter of the radiomics features. HIV infection, in contrast, was linked to only slightly more than 1% of radiomics features. The study also revealed that HIV infection had a more profound effect on coronary artery disease in younger individuals.

"Cocaine use plays an important role in the pathogenesis of coronary artery disease," Dr. Lai said. "Cocaine users with HIV should abstain from cocaine use to lower the risk of coronary artery disease."

The results suggest that rather than having a complex interconnected network of factors contributing to the development of atherosclerosis, the effects of different risk factors may correspond to specific known or unknown pathways of disease progression. This information will likely provide a more complete picture of the state of cardiac health.

"We want to figure out why some people die early, why some die suddenly, and why some people go on and on even if they have very significant fixed disease," Dr. Lai said. "With radiomics, we can use a CT image or an MR image, because these images have more data than just stenosis."

Dr. Lai said the radiomics technology used in the study could have applications beyond cardiovascular assessment, such as cancer and diseases of the lungs.

"The technology is there, that's not the key obstacle," he said. "The key obstacle is that not enough physician-researchers have access to this information."
-end-
"Contribution of Risk Factors to the Development of Coronary Atherosclerosis as Confirmed via Coronary CT Angiography: A Longitudinal Radiomics-based Study."
Collaborating with Drs. Lai and Kolossváry were Gary Gerstenblith, M.D., David A. Bluemke, M.D., Ph.D., Elliot K. Fishman, M.D., Raul N. Mandler, M.D., Thomas S. Kickler, M.D., Shaoguang Chen, M.S., Sandeepan Bhatia, M.D., and Hong Lai, Ph.D., M.P.H.

Radiology is edited by David A. Bluemke, M.D., Ph.D., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, and owned and published by the Radiological Society of North America, Inc.
(https://pubs.rsna.org/journal/radiology)

RSNA is an association of radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Illinois. (RSNA.org)

For patient-friendly information on cardiovascular imaging, visit RadiologyInfo.org.

Radiological Society of North America

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.