Coronary plaque volume and predictors for fast plaque progression assessed by serial coronary CT angiography-A single-center observational study.

Weber, C; Deseive, S; Brim, G; Stocker, T J; Broersen, A; Kitslaar, P; Martinoff, S; Massberg, S; Hadamitzky, M; Hausleiter, J

doi:10.1016/j.ejrad.2019.108805

2020

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Dokumenttyp:: Journal Article
Autor(en):: Weber, C; Deseive, S; Brim, G; Stocker, T J; Broersen, A; Kitslaar, P; Martinoff, S; Massberg, S; Hadamitzky, M; Hausleiter, J
Titel:: Coronary plaque volume and predictors for fast plaque progression assessed by serial coronary CT angiography-A single-center observational study.
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.
Zeitschriftentitel:: Eur J Radiol
Jahr:: 2020
Band / Volume:: 123
Volltext / DOI:: doi:10.1016/j.ejrad.2019.108805
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/31896023
Print-ISSN:: 0720-048X
TUM Einrichtung:: Institut für Radiologie und Nuklearmedizin
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