Yuka Otaki1, Balaji Tamarappoo2, Sebastien J Cadet3, Mhairi Doris1, Yoav Arnson1, Phi T Huynh1, Heidi Gransar1, Frances Wang1, Sean W Hayes1, John D Friedman1, Louise Thomson1, Piotr Slomka4, Damini Dey4, Daniel S Berman5. 1. Departments of Imaging, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. 2. Departments of Imaging, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Medicine, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Biomedical Sciences, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. 3. Biomedical Sciences, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. 4. Departments of Imaging, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Medicine, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. 5. Departments of Imaging, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Medicine, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Biomedical Sciences, Cedars-Sinai Medical Center, and Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. Electronic address: Daniel.berman@cshs.org.
Abstract
BACKGROUND AND AIMS: LDL-C reduction has been associated with a decrease in noncalcified plaque (NCP) by serial quantitative coronary CT angiography (CTA). We evaluated the effect of LDL-C reduction on specific components of noncalcified plaque (NCP). METHODS: We analyzed 154 patients undergoing serial CTAs (118 men, 60 ± 10 years, interval 4 ± 2 years) with baseline LDL-C≥70 mg/dl. Semi-automated software was used for quantifying plaque components based on CT attenuation in Hounsfield units (HU): 30-75, low attenuation plaque (LAP); 76-130, medium-low attenuation plaque (MLAP); 131-350, medium attenuation plaque (MAP); >350, calcified plaque (CP). Decrease in LDL-C was defined as a reduction >10% of baseline LDL-C. Plaque volume changes were compared between patients with (n = 85) and without (n = 69) LDL-C decrease. RESULTS: There was interval reduction in total plaque, LAP, MLAP, and MAP volumes in patients with LDL-C decrease vs. patients without LDL-C decrease before and after adjusting for differences between the two groups (all p ≤ 0.001). An increase in CP volume occurred in both groups (p = 0.42). CONCLUSIONS: Decrease in LDL-C was associated with reduction in all components of NCP measured by quantitative CTA. Change in total NCP volume may be the optimal measurement for assessing changes over time of coronary plaque on CTA.
BACKGROUND AND AIMS: LDL-C reduction has been associated with a decrease in noncalcified plaque (NCP) by serial quantitative coronary CT angiography (CTA). We evaluated the effect of LDL-C reduction on specific components of noncalcified plaque (NCP). METHODS: We analyzed 154 patients undergoing serial CTAs (118 men, 60 ± 10 years, interval 4 ± 2 years) with baseline LDL-C≥70 mg/dl. Semi-automated software was used for quantifying plaque components based on CT attenuation in Hounsfield units (HU): 30-75, low attenuation plaque (LAP); 76-130, medium-low attenuation plaque (MLAP); 131-350, medium attenuation plaque (MAP); >350, calcified plaque (CP). Decrease in LDL-C was defined as a reduction >10% of baseline LDL-C. Plaque volume changes were compared between patients with (n = 85) and without (n = 69) LDL-C decrease. RESULTS: There was interval reduction in total plaque, LAP, MLAP, and MAP volumes in patients with LDL-C decrease vs. patients without LDL-C decrease before and after adjusting for differences between the two groups (all p ≤ 0.001). An increase in CP volume occurred in both groups (p = 0.42). CONCLUSIONS: Decrease in LDL-C was associated with reduction in all components of NCP measured by quantitative CTA. Change in total NCP volume may be the optimal measurement for assessing changes over time of coronary plaque on CTA.