Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study

Edoardo Conte; Aeshita Dwivedi; Saima Mushtaq; Gianluca Pontone; Fay Y. Lin; Emma J. Hollenberg; Sang Eun Lee; Jeroen Bax; Filippo Cademartiri; Kavitha Chinnaiyan; Benjamin J.W. Chow; Ricardo C. Cury; Gudrun Feuchtner; Martin Hadamitzky; Yong Jin Kim; Andrea Baggiano; Jonathon Leipsic; Erica Maffei; Hugo Marques; Fabian Plank; Gilbert L. Raff; Alexander R. Van Rosendael; Todd C. Villines; Harald G. Weirich; Subhi J. Al'Aref; Lohendran Baskaran; Iksung Cho; Ibrahim Danad; Donghee Han; Ran Heo; Ji Hyun Lee; Wijnand J. Stuijfzand; Heidi Gransar; Yao Lu; Ji Min Sung; Hyung Bok Park; Mouaz H. Al-Mallah; Pedro De Araújo Gonçalves; Daniel S. Berman; Matthew J. Budoff; Habib Samady; Leslee J. Shaw; Peter H. Stone; Renu Virmani; Jagat Narula; James K. Min; Hyuk Jae Chang; Daniele Andreini

doi:10.1093/ehjci/jeaa210

Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study

Edoardo Conte, Aeshita Dwivedi, Saima Mushtaq, Gianluca Pontone, Fay Y. Lin, Emma J. Hollenberg, Sang Eun Lee, Jeroen Bax, Filippo Cademartiri, Kavitha Chinnaiyan, Benjamin J.W. Chow, Ricardo C. Cury, Gudrun Feuchtner, Martin Hadamitzky, Yong Jin Kim, Andrea Baggiano, Jonathon Leipsic, Erica Maffei, Hugo Marques, Fabian PlankGilbert L. Raff, Alexander R. Van Rosendael, Todd C. Villines, Harald G. Weirich, Subhi J. Al'Aref, Lohendran Baskaran, Iksung Cho, Ibrahim Danad, Donghee Han, Ran Heo, Ji Hyun Lee, Wijnand J. Stuijfzand, Heidi Gransar, Yao Lu, Ji Min Sung, Hyung Bok Park, Mouaz H. Al-Mallah, Pedro De Araújo Gonçalves, Daniel S. Berman, Matthew J. Budoff, Habib Samady, Leslee J. Shaw, Peter H. Stone, Renu Virmani, Jagat Narula, James K. Min, Hyuk Jae Chang, Daniele Andreini

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

AIMS: Although there is increasing evidence supporting coronary atherosclerosis evaluation by coronary computed tomography angiography (CCTA), no data are available on age and sex differences for quantitative plaque features. The aim of this study was to investigate sex and age differences in both qualitative and quantitative atherosclerotic features from CCTA prior to acute coronary syndrome (ACS).

METHODS AND RESULTS: Within the ICONIC study, in which 234 patients with subsequent ACS were propensity matched 1:1 with 234 non-event controls, our current subanalysis included only the ACS cases. Both qualitative and quantitative advance plaque analysis by CCTA were performed by a core laboratory. In 129 cases, culprit lesions identified by invasive coronary angiography at the time of ACS were co-registered to baseline CCTA precursor lesions. The study population was then divided into subgroups according to sex and age (<65 vs. ≥ 65 years old) for analysis. Older patients had higher total plaque volume than younger patients. Within specific subtypes of plaque volume, however, only calcified plaque volume was higher in older patients (135.9 ± 163.7 vs. 63.8 ± 94.2 mm3, P < 0.0001, respectively). Although no sex-related differences were recorded for calcified plaque volume, females had lower fibrous and fibrofatty plaque volume than males (Fibrofatty volume 29.6 ± 44.1 vs. 75.3 ± 98.6 mm3, P = 0.0001, respectively). No sex-related differences in the prevalence of qualitative high-risk plaque features were found, even after separate analyses considering age were performed.

CONCLUSION: Our data underline the importance of age- and sex-related differences in coronary atherosclerosis presentation, which should be considered during CCTA-based atherosclerosis quantification.

Original language	English (US)
Pages (from-to)	24-33
Number of pages	10
Journal	European Heart Journal Cardiovascular Imaging
Volume	22
Issue number	1
DOIs	https://doi.org/10.1093/ehjci/jeaa210
State	Published - Jan 1 2021

Keywords

CCTA
atherosclerosis
cardiac CT
gender medicine
high-risk plaque features
Plaque, Atherosclerotic/diagnostic imaging
Humans
Male
Computed Tomography Angiography
Coronary Artery Disease/diagnostic imaging
Coronary Angiography
Atherosclerosis
Female
Acute Coronary Syndrome/diagnostic imaging
Aged

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Radiology Nuclear Medicine and imaging

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10.1093/ehjci/jeaa210

Cite this

Conte, E., Dwivedi, A., Mushtaq, S., Pontone, G., Lin, F. Y., Hollenberg, E. J., Lee, S. E., Bax, J., Cademartiri, F., Chinnaiyan, K., Chow, B. J. W., Cury, R. C., Feuchtner, G., Hadamitzky, M., Kim, Y. J., Baggiano, A., Leipsic, J., Maffei, E., Marques, H., ... Andreini, D. (2021). Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study. European Heart Journal Cardiovascular Imaging, 22(1), 24-33. https://doi.org/10.1093/ehjci/jeaa210

Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study. / Conte, Edoardo; Dwivedi, Aeshita; Mushtaq, Saima et al.
In: European Heart Journal Cardiovascular Imaging, Vol. 22, No. 1, 01.01.2021, p. 24-33.

Research output: Contribution to journal › Article › peer-review

Conte, E, Dwivedi, A, Mushtaq, S, Pontone, G, Lin, FY, Hollenberg, EJ, Lee, SE, Bax, J, Cademartiri, F, Chinnaiyan, K, Chow, BJW, Cury, RC, Feuchtner, G, Hadamitzky, M, Kim, YJ, Baggiano, A, Leipsic, J, Maffei, E, Marques, H, Plank, F, Raff, GL, Van Rosendael, AR, Villines, TC, Weirich, HG, Al'Aref, SJ, Baskaran, L, Cho, I, Danad, I, Han, D, Heo, R, Lee, JH, Stuijfzand, WJ, Gransar, H, Lu, Y, Sung, JM, Park, HB, Al-Mallah, MH, De Araújo Gonçalves, P, Berman, DS, Budoff, MJ, Samady, H, Shaw, LJ, Stone, PH, Virmani, R, Narula, J, Min, JK, Chang, HJ & Andreini, D 2021, 'Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study', European Heart Journal Cardiovascular Imaging, vol. 22, no. 1, pp. 24-33. https://doi.org/10.1093/ehjci/jeaa210

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title = "Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study",

abstract = "AIMS: Although there is increasing evidence supporting coronary atherosclerosis evaluation by coronary computed tomography angiography (CCTA), no data are available on age and sex differences for quantitative plaque features. The aim of this study was to investigate sex and age differences in both qualitative and quantitative atherosclerotic features from CCTA prior to acute coronary syndrome (ACS).METHODS AND RESULTS: Within the ICONIC study, in which 234 patients with subsequent ACS were propensity matched 1:1 with 234 non-event controls, our current subanalysis included only the ACS cases. Both qualitative and quantitative advance plaque analysis by CCTA were performed by a core laboratory. In 129 cases, culprit lesions identified by invasive coronary angiography at the time of ACS were co-registered to baseline CCTA precursor lesions. The study population was then divided into subgroups according to sex and age (<65 vs. ≥ 65 years old) for analysis. Older patients had higher total plaque volume than younger patients. Within specific subtypes of plaque volume, however, only calcified plaque volume was higher in older patients (135.9 ± 163.7 vs. 63.8 ± 94.2 mm3, P < 0.0001, respectively). Although no sex-related differences were recorded for calcified plaque volume, females had lower fibrous and fibrofatty plaque volume than males (Fibrofatty volume 29.6 ± 44.1 vs. 75.3 ± 98.6 mm3, P = 0.0001, respectively). No sex-related differences in the prevalence of qualitative high-risk plaque features were found, even after separate analyses considering age were performed.CONCLUSION: Our data underline the importance of age- and sex-related differences in coronary atherosclerosis presentation, which should be considered during CCTA-based atherosclerosis quantification.",

keywords = "CCTA, atherosclerosis, cardiac CT, gender medicine, high-risk plaque features, Plaque, Atherosclerotic/diagnostic imaging, Humans, Male, Computed Tomography Angiography, Coronary Artery Disease/diagnostic imaging, Coronary Angiography, Atherosclerosis, Female, Acute Coronary Syndrome/diagnostic imaging, Aged",

author = "Edoardo Conte and Aeshita Dwivedi and Saima Mushtaq and Gianluca Pontone and Lin, {Fay Y.} and Hollenberg, {Emma J.} and Lee, {Sang Eun} and Jeroen Bax and Filippo Cademartiri and Kavitha Chinnaiyan and Chow, {Benjamin J.W.} and Cury, {Ricardo C.} and Gudrun Feuchtner and Martin Hadamitzky and Kim, {Yong Jin} and Andrea Baggiano and Jonathon Leipsic and Erica Maffei and Hugo Marques and Fabian Plank and Raff, {Gilbert L.} and {Van Rosendael}, {Alexander R.} and Villines, {Todd C.} and Weirich, {Harald G.} and Al'Aref, {Subhi J.} and Lohendran Baskaran and Iksung Cho and Ibrahim Danad and Donghee Han and Ran Heo and Lee, {Ji Hyun} and Stuijfzand, {Wijnand J.} and Heidi Gransar and Yao Lu and Sung, {Ji Min} and Park, {Hyung Bok} and Al-Mallah, {Mouaz H.} and {De Ara{\'u}jo Gon{\c c}alves}, Pedro and Berman, {Daniel S.} and Budoff, {Matthew J.} and Habib Samady and Shaw, {Leslee J.} and Stone, {Peter H.} and Renu Virmani and Jagat Narula and Min, {James K.} and Chang, {Hyuk Jae} and Daniele Andreini",

year = "2021",

month = jan,

day = "1",

doi = "10.1093/ehjci/jeaa210",

language = "English (US)",

volume = "22",

pages = "24--33",

journal = "European Heart Journal Cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

number = "1",

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TY - JOUR

T1 - Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome

T2 - Results from the ICONIC study

AU - Conte, Edoardo

AU - Dwivedi, Aeshita

AU - Mushtaq, Saima

AU - Pontone, Gianluca

AU - Lin, Fay Y.

AU - Hollenberg, Emma J.

AU - Lee, Sang Eun

AU - Bax, Jeroen

AU - Cademartiri, Filippo

AU - Chinnaiyan, Kavitha

AU - Chow, Benjamin J.W.

AU - Cury, Ricardo C.

AU - Feuchtner, Gudrun

AU - Hadamitzky, Martin

AU - Kim, Yong Jin

AU - Baggiano, Andrea

AU - Leipsic, Jonathon

AU - Maffei, Erica

AU - Marques, Hugo

AU - Plank, Fabian

AU - Raff, Gilbert L.

AU - Van Rosendael, Alexander R.

AU - Villines, Todd C.

AU - Weirich, Harald G.

AU - Al'Aref, Subhi J.

AU - Baskaran, Lohendran

AU - Cho, Iksung

AU - Danad, Ibrahim

AU - Han, Donghee

AU - Heo, Ran

AU - Lee, Ji Hyun

AU - Stuijfzand, Wijnand J.

AU - Gransar, Heidi

AU - Lu, Yao

AU - Sung, Ji Min

AU - Park, Hyung Bok

AU - Al-Mallah, Mouaz H.

AU - De Araújo Gonçalves, Pedro

AU - Berman, Daniel S.

AU - Budoff, Matthew J.

AU - Samady, Habib

AU - Shaw, Leslee J.

AU - Stone, Peter H.

AU - Virmani, Renu

AU - Narula, Jagat

AU - Min, James K.

AU - Chang, Hyuk Jae

AU - Andreini, Daniele

PY - 2021/1/1

Y1 - 2021/1/1

N2 - AIMS: Although there is increasing evidence supporting coronary atherosclerosis evaluation by coronary computed tomography angiography (CCTA), no data are available on age and sex differences for quantitative plaque features. The aim of this study was to investigate sex and age differences in both qualitative and quantitative atherosclerotic features from CCTA prior to acute coronary syndrome (ACS).METHODS AND RESULTS: Within the ICONIC study, in which 234 patients with subsequent ACS were propensity matched 1:1 with 234 non-event controls, our current subanalysis included only the ACS cases. Both qualitative and quantitative advance plaque analysis by CCTA were performed by a core laboratory. In 129 cases, culprit lesions identified by invasive coronary angiography at the time of ACS were co-registered to baseline CCTA precursor lesions. The study population was then divided into subgroups according to sex and age (<65 vs. ≥ 65 years old) for analysis. Older patients had higher total plaque volume than younger patients. Within specific subtypes of plaque volume, however, only calcified plaque volume was higher in older patients (135.9 ± 163.7 vs. 63.8 ± 94.2 mm3, P < 0.0001, respectively). Although no sex-related differences were recorded for calcified plaque volume, females had lower fibrous and fibrofatty plaque volume than males (Fibrofatty volume 29.6 ± 44.1 vs. 75.3 ± 98.6 mm3, P = 0.0001, respectively). No sex-related differences in the prevalence of qualitative high-risk plaque features were found, even after separate analyses considering age were performed.CONCLUSION: Our data underline the importance of age- and sex-related differences in coronary atherosclerosis presentation, which should be considered during CCTA-based atherosclerosis quantification.

AB - AIMS: Although there is increasing evidence supporting coronary atherosclerosis evaluation by coronary computed tomography angiography (CCTA), no data are available on age and sex differences for quantitative plaque features. The aim of this study was to investigate sex and age differences in both qualitative and quantitative atherosclerotic features from CCTA prior to acute coronary syndrome (ACS).METHODS AND RESULTS: Within the ICONIC study, in which 234 patients with subsequent ACS were propensity matched 1:1 with 234 non-event controls, our current subanalysis included only the ACS cases. Both qualitative and quantitative advance plaque analysis by CCTA were performed by a core laboratory. In 129 cases, culprit lesions identified by invasive coronary angiography at the time of ACS were co-registered to baseline CCTA precursor lesions. The study population was then divided into subgroups according to sex and age (<65 vs. ≥ 65 years old) for analysis. Older patients had higher total plaque volume than younger patients. Within specific subtypes of plaque volume, however, only calcified plaque volume was higher in older patients (135.9 ± 163.7 vs. 63.8 ± 94.2 mm3, P < 0.0001, respectively). Although no sex-related differences were recorded for calcified plaque volume, females had lower fibrous and fibrofatty plaque volume than males (Fibrofatty volume 29.6 ± 44.1 vs. 75.3 ± 98.6 mm3, P = 0.0001, respectively). No sex-related differences in the prevalence of qualitative high-risk plaque features were found, even after separate analyses considering age were performed.CONCLUSION: Our data underline the importance of age- and sex-related differences in coronary atherosclerosis presentation, which should be considered during CCTA-based atherosclerosis quantification.

KW - CCTA

KW - atherosclerosis

KW - cardiac CT

KW - gender medicine

KW - high-risk plaque features

KW - Plaque, Atherosclerotic/diagnostic imaging

KW - Humans

KW - Male

KW - Computed Tomography Angiography

KW - Coronary Artery Disease/diagnostic imaging

KW - Coronary Angiography

KW - Atherosclerosis

KW - Female

KW - Acute Coronary Syndrome/diagnostic imaging

KW - Aged

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U2 - 10.1093/ehjci/jeaa210

DO - 10.1093/ehjci/jeaa210

M3 - Article

C2 - 32793985

AN - SCOPUS:85099073514

SN - 2047-2404

VL - 22

SP - 24

EP - 33

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

IS - 1

ER -

Age- And sex-related features of atherosclerosis from coronary computed tomography angiography in patients prior to acute coronary syndrome: Results from the ICONIC study

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