Relationship Between Coronary Artery Calcium and Atherosclerosis Progression Among Patients With Suspected Coronary Artery Disease.

Atherosclerosis Calcium Computed Tomography Angiography / methods Constriction, Pathologic / complications Coronary Angiography / methods Coronary Artery Disease / complications Coronary Vessels / diagnostic imaging Disease Progression Humans Plaque, Atherosclerotic Predictive Value of Tests Risk Factors

atherosclerotic plaque coronary artery calcium coronary computed tomographic angiography plaque progression

Journal

JACC. Cardiovascular imaging

ISSN: 1876-7591

Titre abrégé: JACC Cardiovasc Imaging

Pays: United States

ID NLM: 101467978

Informations de publication

Date de publication:
06 2022

Historique:

received: 18 05 2021

revised: 16 12 2021

accepted: 21 12 2021

entrez: 9 6 2022

pubmed: 10 6 2022

medline: 14 6 2022

Statut: ppublish

Résumé

Among symptomatic patients, it remains unclear whether a coronary artery calcium (CAC) score alone is sufficient or misses a sizeable burden and progressive risk associated with obstructive and nonobstructive atherosclerotic plaque. Among patients with low to high CAC scores, our aims were to quantify co-occurring obstructive and nonobstructive noncalcified plaque and serial progression of atherosclerotic plaque volume. A total of 698 symptomatic patients with suspected coronary artery disease (CAD) underwent serial coronary computed tomographic angiography (CTA) performed 3.5 to 4.0 years apart. Atherosclerotic plaque was quantified, including by compositional subgroups. Obstructive CAD was defined as ≥50% stenosis. Multivariate linear regression models were used to measure atherosclerotic plaque progression by CAC scores. Cox proportional hazard models estimated CAD event risk (median of 10.7 years of follow-up). Across baseline CAC scores from 0 to ≥400, total plaque volume ranged from 30.4 to 522.4 mm CAC imperfectly characterizes atherosclerotic disease burden, but its subgroups exhibit pathogenic patterns of early to advanced disease progression and stratify long-term prognostic risk.

Sections du résumé

BACKGROUND

OBJECTIVES

Among patients with low to high CAC scores, our aims were to quantify co-occurring obstructive and nonobstructive noncalcified plaque and serial progression of atherosclerotic plaque volume.

METHODS

A total of 698 symptomatic patients with suspected coronary artery disease (CAD) underwent serial coronary computed tomographic angiography (CTA) performed 3.5 to 4.0 years apart. Atherosclerotic plaque was quantified, including by compositional subgroups. Obstructive CAD was defined as ≥50% stenosis. Multivariate linear regression models were used to measure atherosclerotic plaque progression by CAC scores. Cox proportional hazard models estimated CAD event risk (median of 10.7 years of follow-up).

RESULTS

Across baseline CAC scores from 0 to ≥400, total plaque volume ranged from 30.4 to 522.4 mm

CONCLUSIONS

CAC imperfectly characterizes atherosclerotic disease burden, but its subgroups exhibit pathogenic patterns of early to advanced disease progression and stratify long-term prognostic risk.

Identifiants

DOI: 10.1016/j.jcmg.2021.12.015 PMID: 35680215

pubmed: 35680215

pii: S1936-878X(22)00103-6

doi: 10.1016/j.jcmg.2021.12.015

pii:

doi:

Substances chimiques

Calcium SY7Q814VUP

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

1063-1074

Commentaires et corrections

Type : CommentIn

Informations de copyright

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures Partial funding was provided by a gift from the Dalio Foundation (New York, New York) and supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation funded by the Ministry of Science and Information and Communications Technology of Korea (Grant number 2012027176). Dr Chinnaiyan is a medical advisor (unpaid) for Heartflow, Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.