C Weber1, S Deseive2, G Brim3, T J Stocker4, A Broersen5, P Kitslaar6, S Martinoff7, S Massberg8, M Hadamitzky9, J Hausleiter10. 1. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany. Electronic address: Cynthia.Weber@med.uni-muenchen.de. 2. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany. Electronic address: Simon.Deseive@med.uni-muenchen.de. 3. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany. Electronic address: gulzerin.b@live.de. 4. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany. Electronic address: Thomas.Stocker@med.uni-muenchen.de. 5. Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: A.Broersen@lumc.nl. 6. Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging Systems BV, Leiden, the Netherlands. Electronic address: kitslaar@gmail.com. 7. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; Medis Medical Imaging Systems BV, Leiden, the Netherlands; Division of Radiology, Deutsches Herzzentrum München, Munich, Germany. Electronic address: drmartinoff@dhm.mhn.de. 8. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany. Electronic address: Steffen.Massberg@med.uni-muenchen.de. 9. Division of Radiology, Deutsches Herzzentrum München, Munich, Germany. Electronic address: mhy@dhm.mhn.de. 10. Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance at DZHK, Munich, Germany. Electronic address: Joerg.Hausleiter@med.uni-muenchen.de.
Abstract
PURPOSE: The rationale of this study was to identify patients with fast progression of coronary plaque volume PV and characterize changes in PV and plaque components over time. METHOD: Total PV (TPV) was measured in 350 patients undergoing serial coronary computed tomography angiography (median scan interval 3.6 years) using semi-automated software. Plaque morphology was assessed based on attenuation values and stratified into calcified, fibrous, fibrous-fatty and low-attenuation PV for volumetric measurements. Every plaque was additionally classified as either calcified, partially calcified or non-calcified. RESULTS: In total, 812 and 955 plaques were detected in the first and second scan. Mean TPV increase was 20 % on a per-patient base (51.3 mm³ [interquartile range (IQR): 14.4, 126.7] vs. 61.6 mm³ [IQR: 16.7, 170.0]). TPV increase was driven by calcified PV (first scan: 7.6 mm³ [IQR: 0.2, 33.6] vs. second scan: 16.6 mm³ [IQR: 1.8, 62.1], p < 0.01). Forty-two patients showed fast progression of TPV, defined as >1.3 mm3 increase of TPV per month. Male sex (odds ratio 3.1, p = 0.02) and typical angina (odds ratio 3.95, p = 0.03) were identified as risk factors for fast TPV progression, while high-density lipoprotein cholesterol had a protective effect (odds ratio per 10 mg/dl increase of HDL cholesterol: 0.72, p < 0.01). Progression to >50 % stenosis at follow-up was observed in 34 of 327 (10.4 %) calcified plaques, in 13 of 401 (3.2 %) partially calcified plaques and 2 of 221 (0.9 %) non-calcified plaques (p < 0.01). CONCLUSION: Fast plaque progression was observed in male patients and patients with typical angina. High HDL cholesterol showed a protective effect.
PURPOSE: The rationale of this study was to identify patients with fast progression of coronary plaque volume PV and characterize changes in PV and plaque components over time. METHOD: Total PV (TPV) was measured in 350 patients undergoing serial coronary computed tomography angiography (median scan interval 3.6 years) using semi-automated software. Plaque morphology was assessed based on attenuation values and stratified into calcified, fibrous, fibrous-fatty and low-attenuation PV for volumetric measurements. Every plaque was additionally classified as either calcified, partially calcified or non-calcified. RESULTS: In total, 812 and 955 plaques were detected in the first and second scan. Mean TPV increase was 20 % on a per-patient base (51.3 mm³ [interquartile range (IQR): 14.4, 126.7] vs. 61.6 mm³ [IQR: 16.7, 170.0]). TPV increase was driven by calcified PV (first scan: 7.6 mm³ [IQR: 0.2, 33.6] vs. second scan: 16.6 mm³ [IQR: 1.8, 62.1], p < 0.01). Forty-two patients showed fast progression of TPV, defined as >1.3 mm3 increase of TPV per month. Male sex (odds ratio 3.1, p = 0.02) and typical angina (odds ratio 3.95, p = 0.03) were identified as risk factors for fast TPV progression, while high-density lipoprotein cholesterol had a protective effect (odds ratio per 10 mg/dl increase of HDL cholesterol: 0.72, p < 0.01). Progression to >50 % stenosis at follow-up was observed in 34 of 327 (10.4 %) calcified plaques, in 13 of 401 (3.2 %) partially calcified plaques and 2 of 221 (0.9 %) non-calcified plaques (p < 0.01). CONCLUSION: Fast plaque progression was observed in male patients and patients with typical angina. High HDL cholesterol showed a protective effect.
Authors: Ki-Bum Won; Byoung Kwon Lee; Hyung-Bok Park; Ran Heo; Sang-Eun Lee; Asim Rizvi; Fay Y Lin; Amit Kumar; Martin Hadamitzky; Yong-Jin Kim; Ji Min Sung; Edoardo Conte; Daniele Andreini; Gianluca Pontone; Matthew J Budoff; Ilan Gottlieb; Eun Ju Chun; Filippo Cademartiri; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Jonathon A Leipsic; Sanghoon Shin; Jung Hyun Choi; Renu Virmani; Habib Samady; Kavitha Chinnaiyan; Gilbert L Raff; Peter H Stone; Daniel S Berman; Jagat Narula; Leslee J Shaw; Jeroen J Bax; James K Min; Hyuk-Jae Chang Journal: Cardiovasc Diabetol Date: 2020-07-18 Impact factor: 9.951