Indre Ceponiene1, Rine Nakanishi2, Kazuhiro Osawa3, Mitsuru Kanisawa3, Negin Nezarat3, Sina Rahmani3, Kendall Kissel3, Michael Kim3, Eranthi Jayawardena3, Alexander Broersen4, Pieter Kitslaar5, Matthew J Budoff3. 1. Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California; Departments of Cardiology and Radiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. 2. Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California. Electronic address: rnakanishi@labiomed.org. 3. Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California. 4. Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. 5. Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging Systems, Leiden, the Netherlands.
Abstract
OBJECTIVES: The aim of this study was to determine whether coronary artery calcium (CAC) progression was associated with coronary plaque progression on coronary computed tomographic angiography. BACKGROUND: CAC progression and coronary plaque characteristics are associated with incident coronary heart disease. However, natural history of coronary atherosclerosis has not been well described to date, and the understanding of the association between CAC progression and coronary plaque subtypes such as noncalcified plaque progression remains unclear. METHODS: Consecutive patients who were referred to our clinic for evaluation and had serial coronary computed tomography angiography scans performed were included in the study. Coronary artery plaque (total, fibrous, fibrous-fatty, low-attenuation, densely calcified) volumes were calculated using semiautomated plaque analysis software. RESULTS: A total of 211 patients (61.3 ± 12.7 years of age, 75.4% men) were included in the analysis. The mean interval between baseline and follow-up scans was 3.3 ± 1.7 years. CAC progression was associated with a significant linear increase in all types of coronary plaque and no plaque progression was observed in subjects without CAC progression. In multivariate analysis, annualized and normalized total plaque (β = 0.38; p < 0.001), noncalcified plaque (β = 0.35; p = 0.001), fibrous plaque (β = 0.56; p < 0.001), and calcified plaque (β = 0.63; p = 0.001) volume progression, but not fibrous-fatty (β = 0.03; p = 0.28) or low-attenuation plaque (β = 0.11; p = 0.1) progression, were independently associated with CAC progression. Plaque progression did not differ between the sexes. A significantly increased total and calcified plaque progression was observed in statin users. CONCLUSIONS: In a clinical practice setting, progression of CAC was significantly associated with an increase in both calcified and noncalcified plaque volume, except fibrous-fatty and low-attenuation plaque. Serial CAC measurements may be helpful in determining the need for intensification of preventive treatment.
OBJECTIVES: The aim of this study was to determine whether coronary artery calcium (CAC) progression was associated with coronary plaque progression on coronary computed tomographic angiography. BACKGROUND: CAC progression and coronary plaque characteristics are associated with incident coronary heart disease. However, natural history of coronary atherosclerosis has not been well described to date, and the understanding of the association between CAC progression and coronary plaque subtypes such as noncalcified plaque progression remains unclear. METHODS: Consecutive patients who were referred to our clinic for evaluation and had serial coronary computed tomography angiography scans performed were included in the study. Coronary artery plaque (total, fibrous, fibrous-fatty, low-attenuation, densely calcified) volumes were calculated using semiautomated plaque analysis software. RESULTS: A total of 211 patients (61.3 ± 12.7 years of age, 75.4% men) were included in the analysis. The mean interval between baseline and follow-up scans was 3.3 ± 1.7 years. CAC progression was associated with a significant linear increase in all types of coronary plaque and no plaque progression was observed in subjects without CAC progression. In multivariate analysis, annualized and normalized total plaque (β = 0.38; p < 0.001), noncalcified plaque (β = 0.35; p = 0.001), fibrous plaque (β = 0.56; p < 0.001), and calcified plaque (β = 0.63; p = 0.001) volume progression, but not fibrous-fatty (β = 0.03; p = 0.28) or low-attenuation plaque (β = 0.11; p = 0.1) progression, were independently associated with CAC progression. Plaque progression did not differ between the sexes. A significantly increased total and calcified plaque progression was observed in statin users. CONCLUSIONS: In a clinical practice setting, progression of CAC was significantly associated with an increase in both calcified and noncalcified plaque volume, except fibrous-fatty and low-attenuation plaque. Serial CAC measurements may be helpful in determining the need for intensification of preventive treatment.
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Authors: Riemer H J A Slart; Michelle C Williams; Luis Eduardo Juarez-Orozco; Christoph Rischpler; Marc R Dweck; Andor W J M Glaudemans; Alessia Gimelli; Panagiotis Georgoulias; Olivier Gheysens; Oliver Gaemperli; Gilbert Habib; Roland Hustinx; Bernard Cosyns; Hein J Verberne; Fabien Hyafil; Paola A Erba; Mark Lubberink; Piotr Slomka; Ivana Išgum; Dimitris Visvikis; Márton Kolossváry; Antti Saraste Journal: Eur J Nucl Med Mol Imaging Date: 2021-04-17 Impact factor: 9.236
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