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Coronary plaque volume and predictors for fast plaque progression assessed by serial coronary CT angiography-A single-center observational study.
Eur J Radiol. 2020 Feb; 123:108805.EJ

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.

Authors+Show Affiliations

Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany. Electronic address: Cynthia.Weber@med.uni-muenchen.de.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.Medizinische Klinik und Poliklinik I der Ludwig-Maximilians-Universität München, Munich, Germany. Electronic address: gulzerin.b@live.de.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.Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: A.Broersen@lumc.nl.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.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.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.Division of Radiology, Deutsches Herzzentrum München, Munich, Germany. Electronic address: mhy@dhm.mhn.de.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.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

31896023

Citation

Weber, C, et al. "Coronary Plaque Volume and Predictors for Fast Plaque Progression Assessed By Serial Coronary CT angiography-A Single-center Observational Study." European Journal of Radiology, vol. 123, 2020, p. 108805.
Weber C, Deseive S, Brim G, et al. Coronary plaque volume and predictors for fast plaque progression assessed by serial coronary CT angiography-A single-center observational study. Eur J Radiol. 2020;123:108805.
Weber, C., Deseive, S., Brim, G., Stocker, T. J., Broersen, A., Kitslaar, P., Martinoff, S., Massberg, S., Hadamitzky, M., & Hausleiter, J. (2020). Coronary plaque volume and predictors for fast plaque progression assessed by serial coronary CT angiography-A single-center observational study. European Journal of Radiology, 123, 108805. https://doi.org/10.1016/j.ejrad.2019.108805
Weber C, et al. Coronary Plaque Volume and Predictors for Fast Plaque Progression Assessed By Serial Coronary CT angiography-A Single-center Observational Study. Eur J Radiol. 2020;123:108805. PubMed PMID: 31896023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary plaque volume and predictors for fast plaque progression assessed by serial coronary CT angiography-A single-center observational study. AU - Weber,C, AU - Deseive,S, AU - Brim,G, AU - Stocker,T J, AU - Broersen,A, AU - Kitslaar,P, AU - Martinoff,S, AU - Massberg,S, AU - Hadamitzky,M, AU - Hausleiter,J, Y1 - 2019/12/24/ PY - 2019/09/05/received PY - 2019/12/18/revised PY - 2019/12/20/accepted PY - 2020/1/3/pubmed PY - 2021/2/2/medline PY - 2020/1/3/entrez KW - Changes in coronary plaques KW - Coronary artery disease KW - Coronary artery disease progression KW - Coronary plaque volume KW - Serial coronary computed tomography angiography SP - 108805 EP - 108805 JF - European journal of radiology JO - Eur J Radiol VL - 123 N2 - 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. SN - 1872-7727 UR - https://www.unboundmedicine.com/medline/citation/31896023/Coronary_plaque_volume_and_predictors_for_fast_plaque_progression_assessed_by_serial_coronary_CT_angiography_A_single_center_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(19)30455-3 DB - PRIME DP - Unbound Medicine ER -