Differences in coronary plaque composition with aging measured by coronary computed tomography angiography

Rajesh Tota-Maharaj, Michael J. Blaha, Juan J. Rivera, Travis S. Henry, Eue Keun Choi, Sung A. Chang, Yeonyee E. Yoon, Eun Ju Chun, Sang Il Choi, Roger S. Blumenthal, Hyuk-Jae Chang, Khurram Nasir

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64% men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50% calcified tissue were classified as calcified (CAP), plaques with < 50% calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5%, 3rd tertile: 38.5% [p < 0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50% in the first tertile to approximately 20% in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.

Original languageEnglish
Pages (from-to)240-245
Number of pages6
JournalInternational Journal of Cardiology
Volume158
Issue number2
DOIs
Publication statusPublished - 2012 Jul 12

Fingerprint

Regression Analysis
Calcium
Health
Computed Tomography Angiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Tota-Maharaj, R., Blaha, M. J., Rivera, J. J., Henry, T. S., Choi, E. K., Chang, S. A., ... Nasir, K. (2012). Differences in coronary plaque composition with aging measured by coronary computed tomography angiography. International Journal of Cardiology, 158(2), 240-245. https://doi.org/10.1016/j.ijcard.2011.01.041
Tota-Maharaj, Rajesh ; Blaha, Michael J. ; Rivera, Juan J. ; Henry, Travis S. ; Choi, Eue Keun ; Chang, Sung A. ; Yoon, Yeonyee E. ; Chun, Eun Ju ; Choi, Sang Il ; Blumenthal, Roger S. ; Chang, Hyuk-Jae ; Nasir, Khurram. / Differences in coronary plaque composition with aging measured by coronary computed tomography angiography. In: International Journal of Cardiology. 2012 ; Vol. 158, No. 2. pp. 240-245.
@article{60dbfb0fbf7d4266b443b047fc717984,
title = "Differences in coronary plaque composition with aging measured by coronary computed tomography angiography",
abstract = "Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64{\%} men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50{\%} calcified tissue were classified as calcified (CAP), plaques with < 50{\%} calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5{\%}, 3rd tertile: 38.5{\%} [p < 0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50{\%} in the first tertile to approximately 20{\%} in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.",
author = "Rajesh Tota-Maharaj and Blaha, {Michael J.} and Rivera, {Juan J.} and Henry, {Travis S.} and Choi, {Eue Keun} and Chang, {Sung A.} and Yoon, {Yeonyee E.} and Chun, {Eun Ju} and Choi, {Sang Il} and Blumenthal, {Roger S.} and Hyuk-Jae Chang and Khurram Nasir",
year = "2012",
month = "7",
day = "12",
doi = "10.1016/j.ijcard.2011.01.041",
language = "English",
volume = "158",
pages = "240--245",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

Tota-Maharaj, R, Blaha, MJ, Rivera, JJ, Henry, TS, Choi, EK, Chang, SA, Yoon, YE, Chun, EJ, Choi, SI, Blumenthal, RS, Chang, H-J & Nasir, K 2012, 'Differences in coronary plaque composition with aging measured by coronary computed tomography angiography', International Journal of Cardiology, vol. 158, no. 2, pp. 240-245. https://doi.org/10.1016/j.ijcard.2011.01.041

Differences in coronary plaque composition with aging measured by coronary computed tomography angiography. / Tota-Maharaj, Rajesh; Blaha, Michael J.; Rivera, Juan J.; Henry, Travis S.; Choi, Eue Keun; Chang, Sung A.; Yoon, Yeonyee E.; Chun, Eun Ju; Choi, Sang Il; Blumenthal, Roger S.; Chang, Hyuk-Jae; Nasir, Khurram.

In: International Journal of Cardiology, Vol. 158, No. 2, 12.07.2012, p. 240-245.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Differences in coronary plaque composition with aging measured by coronary computed tomography angiography

AU - Tota-Maharaj, Rajesh

AU - Blaha, Michael J.

AU - Rivera, Juan J.

AU - Henry, Travis S.

AU - Choi, Eue Keun

AU - Chang, Sung A.

AU - Yoon, Yeonyee E.

AU - Chun, Eun Ju

AU - Choi, Sang Il

AU - Blumenthal, Roger S.

AU - Chang, Hyuk-Jae

AU - Nasir, Khurram

PY - 2012/7/12

Y1 - 2012/7/12

N2 - Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64% men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50% calcified tissue were classified as calcified (CAP), plaques with < 50% calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5%, 3rd tertile: 38.5% [p < 0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50% in the first tertile to approximately 20% in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.

AB - Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64% men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50% calcified tissue were classified as calcified (CAP), plaques with < 50% calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5%, 3rd tertile: 38.5% [p < 0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50% in the first tertile to approximately 20% in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.

UR - http://www.scopus.com/inward/record.url?scp=84859803894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859803894&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2011.01.041

DO - 10.1016/j.ijcard.2011.01.041

M3 - Article

C2 - 21316114

AN - SCOPUS:84859803894

VL - 158

SP - 240

EP - 245

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 2

ER -