TY - JOUR
T1 - Age related compositional plaque burden by CT in patients with future ACS
AU - van Rosendael, Alexander R.
AU - van den Hoogen, Inge J.
AU - Lin, Fay Y.
AU - Gianni, Umberto
AU - Lu, Yao
AU - Andreini, Daniele
AU - Al-Mallah, Mouaz H.
AU - Cademartiri, Filippo
AU - Chinnaiyan, Kavitha
AU - Chow, Benjamin J.W.
AU - Conte, Edoardo
AU - Cury, Ricardo C.
AU - Feuchtner, Gudrun
AU - de Araújo Gonçalves, Pedro
AU - Hadamitzky, Martin
AU - Kim, Yong Jin
AU - Leipsic, Jonathon A.
AU - Maffei, Erica
AU - Marques, Hugo
AU - Plank, Fabian
AU - Pontone, Gianluca
AU - Raff, Gilbert L.
AU - Villines, Todd C.
AU - Lee, Sang Eun
AU - Al'Aref, Subhi J.
AU - Baskaran, Lohendran
AU - Cho, Iksung
AU - Danad, Ibrahim
AU - Gransar, Heidi
AU - Budoff, Matthew J.
AU - Samady, Habib
AU - Virmani, Renu
AU - Min, James K.
AU - Narula, Jagat
AU - Berman, Daniel S.
AU - Chang, Hyuk Jae
AU - Shaw, Leslee J.
AU - Bax, Jeroen J.
N1 - Publisher Copyright:
© 2022
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background: We examined age differences in whole-heart volumes of non-calcified and calcified atherosclerosis by coronary computed tomography angiography (CCTA) of patients with future ACS. Methods: A total of 234 patients with core-lab adjudicated ACS after baseline CCTA were enrolled. Atherosclerotic plaque was quantified and characterized from the main epicardial vessels and side branches on a 0.5 mm cross-sectional basis. Calcified plaque and non-calcified plaque were defined by above or below 350 Hounsfield units. Patients were categorized according to their age by deciles. Also, coronary artery calcium scores (CACS) were evaluated when available. Results: Patients were on average 62.2 ± 11.5 years old. On the pre-ACS CCTA, patients showed diffuse, multi-site, predominantly non-obstructive atherosclerosis across all age categories, with plaque being detected in 93.5% of all ACS cases. The proportion calcified plaque from the total plaque burden increased significantly with older presentation (10% calcification in those <50 years, and 50% calcification in those >80 years old). Patients with ACS <50 years had remarkably lower atherosclerotic burden compared with older patients, but a high proportion of high risk markers such as low-attenuation plaque. CACS was >0 in 85% of the patients older than 50 years, and in 57% of patients younger than 50 years. Conclusion: The proportion of calcified plaque varied depending on patient age at the time of ACS. Only a small proportion of plaque was calcified when ACS occurred at <50 years old, while this increased gradually with older age. Purely non-calcified atherosclerotic plaque was not uncommon in patients <50 years.
AB - Background: We examined age differences in whole-heart volumes of non-calcified and calcified atherosclerosis by coronary computed tomography angiography (CCTA) of patients with future ACS. Methods: A total of 234 patients with core-lab adjudicated ACS after baseline CCTA were enrolled. Atherosclerotic plaque was quantified and characterized from the main epicardial vessels and side branches on a 0.5 mm cross-sectional basis. Calcified plaque and non-calcified plaque were defined by above or below 350 Hounsfield units. Patients were categorized according to their age by deciles. Also, coronary artery calcium scores (CACS) were evaluated when available. Results: Patients were on average 62.2 ± 11.5 years old. On the pre-ACS CCTA, patients showed diffuse, multi-site, predominantly non-obstructive atherosclerosis across all age categories, with plaque being detected in 93.5% of all ACS cases. The proportion calcified plaque from the total plaque burden increased significantly with older presentation (10% calcification in those <50 years, and 50% calcification in those >80 years old). Patients with ACS <50 years had remarkably lower atherosclerotic burden compared with older patients, but a high proportion of high risk markers such as low-attenuation plaque. CACS was >0 in 85% of the patients older than 50 years, and in 57% of patients younger than 50 years. Conclusion: The proportion of calcified plaque varied depending on patient age at the time of ACS. Only a small proportion of plaque was calcified when ACS occurred at <50 years old, while this increased gradually with older age. Purely non-calcified atherosclerotic plaque was not uncommon in patients <50 years.
KW - Atherosclerosis
KW - Coronary cta
KW - Early detection of heart attack
KW - Predictive Value of Tests
KW - Cross-Sectional Studies
KW - Tomography, X-Ray Computed/methods
KW - Computed Tomography Angiography/methods
KW - Humans
KW - Middle Aged
KW - Plaque, Atherosclerotic
KW - Coronary Artery Disease/diagnostic imaging
KW - Aged, 80 and over
KW - Aged
KW - Coronary Angiography/methods
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UR - http://www.scopus.com/inward/citedby.url?scp=85132703545&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2022.05.005
DO - 10.1016/j.jcct.2022.05.005
M3 - Article
C2 - 35725722
AN - SCOPUS:85132703545
SN - 1934-5925
VL - 16
SP - 491
EP - 497
JO - Journal of cardiovascular computed tomography
JF - Journal of cardiovascular computed tomography
IS - 6
ER -