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Titel:

Comparison of coronary atherosclerotic plaque progression in East Asians and Caucasians by serial coronary computed tomographic angiography: A PARADIGM substudy.

Dokumenttyp:
Journal Article
Autor(en):
Ben Zekry, Sagit; Sreedharan, Subhashaan; Han, Donghee; Sellers, Stephanie; Ahmadi, Amir A; Blanke, Philipp; Hadamitzky, Martin; Kim, Yong-Jin; Conte, Edoardo; Andreini, Daniele; Pontone, Gianluca; Budoff, Matthew J; Gottlieb, Ilan; Lee, Byoung Kwon; Chun, Eun Ju; Cademartiri, Filippo; Maffei, Erica; Marques, Hugo; Shin, Sanghoon; Choi, Jung Hyun; Virmani, Renu; Samady, Habib; Stone, Peter H; Berman, Daniel S; Narula, Jagat; Shaw, Leslee J; Bax, Jeroen J; Leipsic, Jonathon; Chang, Hyuk-Jae
Abstract:
OBJECTIVES: To investigate potential differences in plaque progression (PP) between in East Asians and Caucasians as well as to determine clinical predictors of PP in East Asians. BACKGROUND: Studies have demonstrated differences in cardiovascular risk factors as well as plaque burden and progression across different ethnic groups. METHODS: The study comprised 955 East Asians (age 60.4 ​± ​9.3 years, 50.9% males) and 279 Caucasians (age 60.4 ​± ​8.6 years, 74.5% males) who underwent two serial coronary computed tomography angiography (CCTA) studies over a period of at least 24 months. Patients were enrolled and analyzed from the PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging) registry. After propensity-score matching, plaque composition and progression were compared between East Asian and Caucasian patients. Within East Asians, the plaque progression group (defined as plaque volume at follow-up CCTA minus plaque volume at baseline CCTA> 0) was compared to the no PP group to determine clinical predictors for PP in East Asians. RESULTS: In the matched cohort, baseline volumes of total plaque as well as all plaque subtypes were comparable. There was a trend towards increased annualized plaque progression among East Asians compared to Caucasians (18.3 ​± ​24.7 ​mm3/year vs 16.6 ​mm3/year, p ​= ​0.054). Among East Asians, 736 (77%) had PP. East Asians with PP had more clinical risk factors and higher plaque burden at baseline (normalized total plaque volume of144.9 ​± ​233.3 ​mm3 vs 36.6 ​± ​84.2 ​mm3 for PP and no PP, respectively, p ​< ​0.001). Multivariate logistic regression analysis showed that baseline normalized plaque volume (OR: 1.10, CI: 1.10-1.30, p ​< ​0.001), age (OR: 1.02, CI: 1.00-1.04, p ​= ​0.023) and body mass index (OR: 2.24, CI: 1.01-1.13, p ​= ​0.024) were all predictors of PP in East Asians. Clinical events, driven mainly by percutaneous coronary intervention, were higher among the PP group with a total of 124 (16.8%) events compared to 22 (10.0%) in the no PP group (p ​= ​0.014). CONCLUSION: East Asians and Caucasians had comparable plaque composition and progression. Among East Asians, the PP group had a higher baseline plaque burden which was associated with greater PP and increased clinical events.
Zeitschriftentitel:
J Cardiovasc Comput Tomogr
Jahr:
2022
Band / Volume:
16
Heft / Issue:
3
Seitenangaben Beitrag:
222-229
Volltext / DOI:
doi:10.1016/j.jcct.2021.09.012
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/34736879
Print-ISSN:
1934-5925
TUM Einrichtung:
Institut für Radiologie und Nuklearmedizin
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