Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque

Inge J. van den Hoogen; Wijnand J. Stuijfzand; Umberto Gianni; Alexander R. van Rosendael; A. Maxim Bax; Yao Lu; Sara W. Tantawy; Emma J. Hollenberg; Daniele Andreini; Mouaz H. Al-Mallah; Filippo Cademartiri; Kavitha Chinnaiyan; Benjamin J.W. Chow; Edoardo Conte; Ricardo C. Cury; Gudrun Feuchtner; Pedro de Araújo Gonçalves; Martin Hadamitzky; Yong Jin Kim; Jonathon Leipsic; Erica Maffei; Hugo Marques; Fabian Plank; Gianluca Pontone; Todd C. Villines; Sang Eun Lee; Subhi J. Al’Aref; Lohendran Baskaran; Ibrahim Danad; Heidi Gransar; Matthew J. Budoff; Habib Samady; Renu Virmani; Daniel S. Berman; Hyuk Jae Chang; Jagat Narula; James K. Min; Jeroen J. Bax; Fay Y. Lin; Leslee J. Shaw

doi:10.1093/ehjci/jeac114

Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque

Inge J. van den Hoogen, Wijnand J. Stuijfzand, Umberto Gianni, Alexander R. van Rosendael, A. Maxim Bax, Yao Lu, Sara W. Tantawy, Emma J. Hollenberg, Daniele Andreini, Mouaz H. Al-Mallah, Filippo Cademartiri, Kavitha Chinnaiyan, Benjamin J.W. Chow, Edoardo Conte, Ricardo C. Cury, Gudrun Feuchtner, Pedro de Araújo Gonçalves, Martin Hadamitzky, Yong Jin Kim, Jonathon LeipsicErica Maffei, Hugo Marques, Fabian Plank, Gianluca Pontone, Todd C. Villines, Sang Eun Lee, Subhi J. Al’Aref, Lohendran Baskaran, Ibrahim Danad, Heidi Gransar, Matthew J. Budoff, Habib Samady, Renu Virmani, Daniel S. Berman, Hyuk Jae Chang, Jagat Narula, James K. Min, Jeroen J. Bax, Fay Y. Lin, Leslee J. Shaw

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

4 Scopus citations

Abstract

Aims The temporal instability of coronary atherosclerotic plaque preceding an incident acute coronary syndrome (ACS) is not well defined. We sought to examine differences in the volume and composition of coronary atherosclerosis between patients experiencing an early (≤90 days) versus late ACS (.90 days) after baseline coronary computed tomography angiography (CCTA). Methods From a multicenter study, we enrolled patients who underwent a clinically indicated baseline CCTA and experienced and results ACS during follow-up. Separate core laboratories performed blinded adjudication of ACS events and quantification of CCTA including compositional plaque volumes by Hounsfield units (HU): calcified plaque .350 HU, fibrous plaque 131–350 HU, fibrofatty plaque 31–130 HU and necrotic core,30 HU. In 234 patients (mean age 62 + 12 years, 36% women), early and late ACS occurred in 129 and 105 patients after a mean of 395 + 622 days, respectively. Patients with early ACS had a greater maximal diameter stenosis and maximal cross-sectional plaque burden as compared to patients with late ACS (P, 0.05). Larger total, fibrous, fibrofatty, and necrotic core volumes were observed in the early ACS group (P, 0.05). Findings for total, fibrous, fibrofatty, and necrotic core volumes were reproduced in an external validation cohort (P, 0.05). Conclusions Volumetric differences in composition of coronary atherosclerosis exist between ACS patients according to their timing antecedent to the acute event. These data support that a large burden of non-calcified plaque on CCTA is strongly associated with near-term plaque instability and ACS risk.

Original language	English (US)
Pages (from-to)	1314-1323
Number of pages	10
Journal	European Heart Journal Cardiovascular Imaging
Volume	23
Issue number	10
DOIs	https://doi.org/10.1093/ehjci/jeac114
State	Published - Oct 1 2022

Keywords

acute coronary syndrome
atherosclerosis
coronary artery disease
coronary computed tomography angiography

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1093/ehjci/jeac114

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van den Hoogen, I. J., Stuijfzand, W. J., Gianni, U., van Rosendael, A. R., Bax, A. M., Lu, Y., Tantawy, S. W., Hollenberg, E. J., Andreini, D., Al-Mallah, M. H., Cademartiri, F., Chinnaiyan, K., Chow, B. J. W., Conte, E., Cury, R. C., Feuchtner, G., de Araújo Gonçalves, P., Hadamitzky, M., Kim, Y. J., ... Shaw, L. J. (2022). Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque. European Heart Journal Cardiovascular Imaging, 23(10), 1314-1323. https://doi.org/10.1093/ehjci/jeac114

van den Hoogen, IJ, Stuijfzand, WJ, Gianni, U, van Rosendael, AR, Bax, AM, Lu, Y, Tantawy, SW, Hollenberg, EJ, Andreini, D, Al-Mallah, MH, Cademartiri, F, Chinnaiyan, K, Chow, BJW, Conte, E, Cury, RC, Feuchtner, G, de Araújo Gonçalves, P, Hadamitzky, M, Kim, YJ, Leipsic, J, Maffei, E, Marques, H, Plank, F, Pontone, G, Villines, TC, Lee, SE, Al’Aref, SJ, Baskaran, L, Danad, I, Gransar, H, Budoff, MJ, Samady, H, Virmani, R, Berman, DS, Chang, HJ, Narula, J, Min, JK, Bax, JJ, Lin, FY & Shaw, LJ 2022, 'Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque', European Heart Journal Cardiovascular Imaging, vol. 23, no. 10, pp. 1314-1323. https://doi.org/10.1093/ehjci/jeac114

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title = "Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque",

abstract = "Aims The temporal instability of coronary atherosclerotic plaque preceding an incident acute coronary syndrome (ACS) is not well defined. We sought to examine differences in the volume and composition of coronary atherosclerosis between patients experiencing an early (≤90 days) versus late ACS (.90 days) after baseline coronary computed tomography angiography (CCTA). Methods From a multicenter study, we enrolled patients who underwent a clinically indicated baseline CCTA and experienced and results ACS during follow-up. Separate core laboratories performed blinded adjudication of ACS events and quantification of CCTA including compositional plaque volumes by Hounsfield units (HU): calcified plaque .350 HU, fibrous plaque 131–350 HU, fibrofatty plaque 31–130 HU and necrotic core,30 HU. In 234 patients (mean age 62 + 12 years, 36% women), early and late ACS occurred in 129 and 105 patients after a mean of 395 + 622 days, respectively. Patients with early ACS had a greater maximal diameter stenosis and maximal cross-sectional plaque burden as compared to patients with late ACS (P, 0.05). Larger total, fibrous, fibrofatty, and necrotic core volumes were observed in the early ACS group (P, 0.05). Findings for total, fibrous, fibrofatty, and necrotic core volumes were reproduced in an external validation cohort (P, 0.05). Conclusions Volumetric differences in composition of coronary atherosclerosis exist between ACS patients according to their timing antecedent to the acute event. These data support that a large burden of non-calcified plaque on CCTA is strongly associated with near-term plaque instability and ACS risk.",

keywords = "acute coronary syndrome, atherosclerosis, coronary artery disease, coronary computed tomography angiography",

author = "{van den Hoogen}, {Inge J.} and Stuijfzand, {Wijnand J.} and Umberto Gianni and {van Rosendael}, {Alexander R.} and Bax, {A. Maxim} and Yao Lu and Tantawy, {Sara W.} and Hollenberg, {Emma J.} and Daniele Andreini and Al-Mallah, {Mouaz H.} and Filippo Cademartiri and Kavitha Chinnaiyan and Chow, {Benjamin J.W.} and Edoardo Conte and Cury, {Ricardo C.} and Gudrun Feuchtner and {de Ara{\'u}jo Gon{\c c}alves}, Pedro and Martin Hadamitzky and Kim, {Yong Jin} and Jonathon Leipsic and Erica Maffei and Hugo Marques and Fabian Plank and Gianluca Pontone and Villines, {Todd C.} and Lee, {Sang Eun} and Al{\textquoteright}Aref, {Subhi J.} and Lohendran Baskaran and Ibrahim Danad and Heidi Gransar and Budoff, {Matthew J.} and Habib Samady and Renu Virmani and Berman, {Daniel S.} and Chang, {Hyuk Jae} and Jagat Narula and Min, {James K.} and Bax, {Jeroen J.} and Lin, {Fay Y.} and Shaw, {Leslee J.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2022.",

year = "2022",

month = oct,

day = "1",

doi = "10.1093/ehjci/jeac114",

language = "English (US)",

volume = "23",

pages = "1314--1323",

journal = "European Heart Journal Cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

number = "10",

}

TY - JOUR

T1 - Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque

AU - van den Hoogen, Inge J.

AU - Stuijfzand, Wijnand J.

AU - Gianni, Umberto

AU - van Rosendael, Alexander R.

AU - Bax, A. Maxim

AU - Lu, Yao

AU - Tantawy, Sara W.

AU - Hollenberg, Emma J.

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

AU - Maffei, Erica

AU - Marques, Hugo

AU - Plank, Fabian

AU - Pontone, Gianluca

AU - Villines, Todd C.

AU - Lee, Sang Eun

AU - Al’Aref, Subhi J.

AU - Baskaran, Lohendran

AU - Danad, Ibrahim

AU - Gransar, Heidi

AU - Budoff, Matthew J.

AU - Samady, Habib

AU - Virmani, Renu

AU - Berman, Daniel S.

AU - Chang, Hyuk Jae

AU - Narula, Jagat

AU - Min, James K.

AU - Bax, Jeroen J.

AU - Lin, Fay Y.

AU - Shaw, Leslee J.

PY - 2022/10/1

Y1 - 2022/10/1

N2 - Aims The temporal instability of coronary atherosclerotic plaque preceding an incident acute coronary syndrome (ACS) is not well defined. We sought to examine differences in the volume and composition of coronary atherosclerosis between patients experiencing an early (≤90 days) versus late ACS (.90 days) after baseline coronary computed tomography angiography (CCTA). Methods From a multicenter study, we enrolled patients who underwent a clinically indicated baseline CCTA and experienced and results ACS during follow-up. Separate core laboratories performed blinded adjudication of ACS events and quantification of CCTA including compositional plaque volumes by Hounsfield units (HU): calcified plaque .350 HU, fibrous plaque 131–350 HU, fibrofatty plaque 31–130 HU and necrotic core,30 HU. In 234 patients (mean age 62 + 12 years, 36% women), early and late ACS occurred in 129 and 105 patients after a mean of 395 + 622 days, respectively. Patients with early ACS had a greater maximal diameter stenosis and maximal cross-sectional plaque burden as compared to patients with late ACS (P, 0.05). Larger total, fibrous, fibrofatty, and necrotic core volumes were observed in the early ACS group (P, 0.05). Findings for total, fibrous, fibrofatty, and necrotic core volumes were reproduced in an external validation cohort (P, 0.05). Conclusions Volumetric differences in composition of coronary atherosclerosis exist between ACS patients according to their timing antecedent to the acute event. These data support that a large burden of non-calcified plaque on CCTA is strongly associated with near-term plaque instability and ACS risk.

AB - Aims The temporal instability of coronary atherosclerotic plaque preceding an incident acute coronary syndrome (ACS) is not well defined. We sought to examine differences in the volume and composition of coronary atherosclerosis between patients experiencing an early (≤90 days) versus late ACS (.90 days) after baseline coronary computed tomography angiography (CCTA). Methods From a multicenter study, we enrolled patients who underwent a clinically indicated baseline CCTA and experienced and results ACS during follow-up. Separate core laboratories performed blinded adjudication of ACS events and quantification of CCTA including compositional plaque volumes by Hounsfield units (HU): calcified plaque .350 HU, fibrous plaque 131–350 HU, fibrofatty plaque 31–130 HU and necrotic core,30 HU. In 234 patients (mean age 62 + 12 years, 36% women), early and late ACS occurred in 129 and 105 patients after a mean of 395 + 622 days, respectively. Patients with early ACS had a greater maximal diameter stenosis and maximal cross-sectional plaque burden as compared to patients with late ACS (P, 0.05). Larger total, fibrous, fibrofatty, and necrotic core volumes were observed in the early ACS group (P, 0.05). Findings for total, fibrous, fibrofatty, and necrotic core volumes were reproduced in an external validation cohort (P, 0.05). Conclusions Volumetric differences in composition of coronary atherosclerosis exist between ACS patients according to their timing antecedent to the acute event. These data support that a large burden of non-calcified plaque on CCTA is strongly associated with near-term plaque instability and ACS risk.

KW - acute coronary syndrome

KW - atherosclerosis

KW - coronary artery disease

KW - coronary computed tomography angiography

UR - http://www.scopus.com/inward/record.url?scp=85138128641&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85138128641&partnerID=8YFLogxK

U2 - 10.1093/ehjci/jeac114

DO - 10.1093/ehjci/jeac114

M3 - Article

C2 - 35904766

AN - SCOPUS:85138128641

SN - 2047-2404

VL - 23

SP - 1314

EP - 1323

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

IS - 10

ER -

Early versus late acute coronary syndrome risk patterns of coronary atherosclerotic plaque

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