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Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.

ABSTRACT: Purpose To assess the relationship between total, calcified, and noncalcified coronary plaque burdens throughout the entire coronary vasculature at coronary computed tomographic (CT) angiography in relationship to cardiovascular risk factors in asymptomatic individuals with low-to-moderate risk. Materials and Methods This HIPAA-compliant study had institutional review board approval, and written informed consent was obtained. Two hundred two subjects were recruited to an ongoing prospective study designed to evaluate the effect of HMG-CoA reductase inhibitors on atherosclerosis. Eligible subjects were asymptomatic individuals older than 55 years who were eligible for statin therapy. Coronary CT angiography was performed by using a 320-detector row scanner. Coronary wall thickness and plaque were evaluated in all epicardial coronary arteries greater than 2 mm in diameter. Images were analyzed by using dedicated software involving an adaptive lumen attenuation algorithm. Total plaque index (calcified plus noncalcified plaque) was defined as plaque volume divided by vessel length. Multivariable regression analysis was performed to determine the relationship between risk factors and plaque indexes. Results The mean age of the subjects was 65.5 years ± 6.9 (standard deviation) (36% women), and the median coronary artery calcium (CAC) score was 73 (interquartile range, 1-434). The total coronary plaque index was higher in men than in women (42.06 mm(2) ± 9.22 vs 34.33 mm(2) ± 8.35; P < .001). In multivariable analysis controlling for all risk factors, total plaque index remained higher in men than in women (by 5.01 mm(2); P = .03) and in those with higher simvastatin doses (by 0.44 mm(2)/10 mg simvastatin dose equivalent; P = .02). Noncalcified plaque index was positively correlated with systolic blood pressure (? = 0.80 mm(2)/10 mm Hg; P = .03), diabetes (? = 4.47 mm(2); P = .03), and low-density lipoprotein (LDL) cholesterol level (? = 0.04 mm(2)/mg/dL; P = .02); the association with LDL cholesterol level remained significant (P = .02) after additional adjustment for the CAC score. Conclusion LDL cholesterol level, systolic blood pressure, and diabetes were associated with noncalcified plaque burden at coronary CT angiography in asymptomatic individuals with low-to-moderate risk. (©) RSNA, 2015 Online supplemental material is available for this article.

SUBMITTER: Rodriguez K

PROVIDER: S-EPMC4613877 | biostudies-literature | 2015 Oct

REPOSITORIES: biostudies-literature

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Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.

Rodriguez Karen K Kwan Alan C AC Lai Shenghan S Lima João A C JA Vigneault Davis D Sandfort Veit V Pattanayak Puskar P Ahlman Mark A MA Mallek Marissa M Sibley Christopher T CT Bluemke David A DA

Radiology 20150602 1

Purpose To assess the relationship between total, calcified, and noncalcified coronary plaque burdens throughout the entire coronary vasculature at coronary computed tomographic (CT) angiography in relationship to cardiovascular risk factors in asymptomatic individuals with low-to-moderate risk. Materials and Methods This HIPAA-compliant study had institutional review board approval, and written informed consent was obtained. Two hundred two subjects were recruited to an ongoing prospective stud ...[more]

PMID: 26035436

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Project description:PurposeTo assess the effect of ultra-high-resolution coronary CT angiography (CCTA) with photon-counting detector (PCD) CT on quantitative coronary plaque characterization.Materials and methodsIn this IRB-approved study, 22 plaques of 20 patients (7 women; mean age 77 ± 8 years, mean body mass index 26.1 ± 3.6 kg/m2) undergoing electrocardiography (ECG)-gated ultra-high-resolution CCTA with PCD-CT were included. Images were reconstructed with a smooth (Bv40) and a sharp (Bv64) vascular kernel, with quantum iterative reconstruction (strength level 4), and using a slice thickness of 0.6, 0.4, and 0.2 mm, respectively (field-of-view 200 mm × 200 mm, matrix size 512 × 512 pixels). Reconstructions with the Bv40 kernel and slice thickness of 0.6 mm served as the reference standard. After identification of a plaque in coronary arteries with a vessel diameter ≥2 mm, plaque composition was determined using a dedicated, semi-automated plaque quantification software. Total plaque, calcified, fibrotic, and lipid-rich plaque components were quantified in all datasets.ResultsMedian plaque volume was highest (23.5 mm3, interquartiles 17.9-34.3 mm3) for reconstructions with the reference standard and lowest for ultra-high-resolution reconstructions with a slice thickness of 0.2 mm and the Bv64 kernel (18.1 mm3, interquartiles 14.1-25.8 mm3, p < 0.001). Reconstructions with the reference standard showed largest calcified (85.1%, interquartiles 76.4-91.1%) and smallest lipid-rich plaque components (0.5%, interquartiles 0.0-1.5%). Smallest calcified plaque components (75.2%, interquartiles 69.9-80.8%) and largest lipid-rich components (6.7%, interquartiles 5.1-8.4%) were found for ultra-high-resolution reconstructions with a slice thickness of 0.2 mm and the Bv64 kernel. At an identical slice thickness, volume of calcified components was always lower, and volume of lipid-rich components was always higher for reconstructions with the Bv64 kernel compared with reconstructions with the Bv40 kernel (all, p < 0.001).ConclusionThis patient study indicates significant differences of ultra-high-resolution scanning with PCD-CT on quantitative coronary plaque characterization. Reduced blooming artifacts may allow improved visualization of fibrotic and lipid-rich plaque components with the ultra-high-resolution mode of PCD-CT.

Dataset Information

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.

Publications

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.

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