TY - JOUR
T1 - Relationship between patient presentation and morphology of coronary atherosclerosis by quantitative multidetector computed tomography
AU - de Knegt, Martina C
AU - Linde, Jesper J
AU - Fuchs, Andreas
AU - Pham, Michael H C
AU - Jensen, Andreas K
AU - Nordestgaard, Børge G
AU - Kelbæk, Henning
AU - Køber, Lars V
AU - Heitmann, Merete
AU - Fornitz, Gitte
AU - Hove, Jens D
AU - Kofoed, Klaus F
AU - CGPS, the CATCH, and the VERDICT Investigators
A2 - Steffensen, Rolf
A2 - Jurlander, Birgit
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: [email protected].
PY - 2019/11/1
Y1 - 2019/11/1
N2 - AIMS: Quantitative computed tomography (QCT) allows assessment of morphological features of coronary atherosclerosis. We aimed to test the hypothesis that clinical patient presentation is associated with distinct morphological features of coronary atherosclerosis.METHODS AND RESULTS: A total of 1652 participants, representing a spectrum of clinical risk profiles [787 asymptomatic individuals from the general population, 468 patients with acute chest pain without acute coronary syndrome (ACS), and 397 patients with acute chest pain and ACS], underwent multidetector computed tomography. Of these, 274 asymptomatic individuals, 254 patients with acute chest pain without ACS, and 327 patients with acute chest pain and ACS underwent QCT to assess coronary plaque volumes and proportions of dense calcium (DC), fibrous, fibro fatty (FF), and necrotic core (NC) tissue. Furthermore, the presence of vulnerable plaques, defined by plaque volume and tissue composition, was examined. Coronary plaque volume increased significantly with worsening clinical risk profile [geometric mean (95% confidence interval): 148 (129-166) mm3, 257 (224-295) mm3, and 407 (363-457) mm3, respectively, P < 0.001]. Plaque composition differed significantly across cohorts, P < 0.0001. The proportion of DC decreased, whereas FF and NC increased with worsening clinical risk profile (mean proportions DC: 33%, 23%, 23%; FF: 50%, 61%, 57%; and NC: 17%, 17%, 20%, respectively). Significant differences in plaque composition persisted after multivariable adjustment for age, gender, body surface area, hypertension, statin use at baseline, diabetes, smoking, family history of ischaemic heart disease, total plaque volume, and tube voltage, P < 0.01.CONCLUSION: Coronary atherosclerotic plaque volume and composition are strongly associated to clinical presentation.
AB - AIMS: Quantitative computed tomography (QCT) allows assessment of morphological features of coronary atherosclerosis. We aimed to test the hypothesis that clinical patient presentation is associated with distinct morphological features of coronary atherosclerosis.METHODS AND RESULTS: A total of 1652 participants, representing a spectrum of clinical risk profiles [787 asymptomatic individuals from the general population, 468 patients with acute chest pain without acute coronary syndrome (ACS), and 397 patients with acute chest pain and ACS], underwent multidetector computed tomography. Of these, 274 asymptomatic individuals, 254 patients with acute chest pain without ACS, and 327 patients with acute chest pain and ACS underwent QCT to assess coronary plaque volumes and proportions of dense calcium (DC), fibrous, fibro fatty (FF), and necrotic core (NC) tissue. Furthermore, the presence of vulnerable plaques, defined by plaque volume and tissue composition, was examined. Coronary plaque volume increased significantly with worsening clinical risk profile [geometric mean (95% confidence interval): 148 (129-166) mm3, 257 (224-295) mm3, and 407 (363-457) mm3, respectively, P < 0.001]. Plaque composition differed significantly across cohorts, P < 0.0001. The proportion of DC decreased, whereas FF and NC increased with worsening clinical risk profile (mean proportions DC: 33%, 23%, 23%; FF: 50%, 61%, 57%; and NC: 17%, 17%, 20%, respectively). Significant differences in plaque composition persisted after multivariable adjustment for age, gender, body surface area, hypertension, statin use at baseline, diabetes, smoking, family history of ischaemic heart disease, total plaque volume, and tube voltage, P < 0.01.CONCLUSION: Coronary atherosclerotic plaque volume and composition are strongly associated to clinical presentation.
KW - atherosclerosis
KW - cardiac computed tomography angiography
KW - plaque composition
KW - plaque quantification
KW - plaque volume
KW - quantitative computed tomography
U2 - 10.1093/ehjci/jey146
DO - 10.1093/ehjci/jey146
M3 - Journal article
C2 - 30325406
SN - 1525-2167
VL - 20
SP - 1221
EP - 1230
JO - European heart journal cardiovascular Imaging
JF - European heart journal cardiovascular Imaging
IS - 11
ER -