Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study

Sang Eun Lee; Ji Min Sung; Daniele Andreini; Matthew J. Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Eun Ju Chun; Edoardo Conte; Ilan Gottlieb; Martin Hadamitzky; Yong Jin Kim; Amit Kumar; Byoung Kwon Lee; Jonathon A. Leipsic; Erica Maffei; Hugo Marques; Gianluca Pontone; Gilbert Raff; Sanghoon Shin; Peter H. Stone; Habib Samady; Renu Virmani; Jagat Narula; Daniel S. Berman; Leslee J. Shaw; Jeroen J. Bax; Fay Y. Lin; James K. Min; Hyuk Jae Chang

doi:10.1093/ehjci/jez022

Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study

Sang Eun Lee, Ji Min Sung, Daniele Andreini, Matthew J. Budoff, Filippo Cademartiri, Kavitha Chinnaiyan, Jung Hyun Choi, Eun Ju Chun, Edoardo Conte, Ilan Gottlieb, Martin Hadamitzky, Yong Jin Kim, Amit Kumar, Byoung Kwon Lee, Jonathon A. Leipsic, Erica Maffei, Hugo Marques, Gianluca Pontone, Gilbert Raff, Sanghoon ShinPeter H. Stone, Habib Samady, Renu Virmani, Jagat Narula, Daniel S. Berman, Leslee J. Shaw, Jeroen J. Bax, Fay Y. Lin, James K. Min, Hyuk Jae Chang

Department of Internal Medicine

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

43 Citations (Scopus)

Abstract

Aims: Coronary artery calcium score (CACS) is a strong predictor of major adverse cardiac events (MACE). Conversely, statins, which markedly reduce MACE risk, increase CACS. We explored whether CACS progression represents compositional plaque volume (PV) progression differently according to statin use. Methods and results: From a prospective multinational registry of consecutive patients (n = 2252) who underwent serial coronary computed tomography angiography (CCTA) at a ≥ 2-year interval, 654 patients (61 ± 10 years, 56% men, inter-scan interval 3.9 ± 1.5 years) with information regarding the use of statins and having a serial CACS were included. Patients were divided into non-statin (n = 246) and statin-taking (n = 408) groups. Coronary PVs (total, calcified, and non-calcified; sum of fibrous, fibro-fatty, and lipid-rich) were quantitatively analysed, and CACS was measured from both CCTAs. Multivariate linear regression models were constructed for both statin-taking and non-statin group to assess the association between compositional PV change and change in CACS. In multivariate linear regression analysis, in the non-statin group, CACS increase was positively associated with both non-calcified (β = 0.369, P = 0.004) and calcified PV increase (β = 1.579, P < 0.001). However, in the statin-taking group, CACS increase was positively associated with calcified PV change (β = 0.756, P < 0.001) but was negatively associated with non-calcified PV change (β =-0.194, P = 0.026). Conclusion: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins.

Original language	English
Pages (from-to)	1307-1314
Number of pages	8
Journal	European heart journal cardiovascular Imaging
Volume	20
Issue number	11
DOIs	https://doi.org/10.1093/ehjci/jez022
Publication status	Published - 2019 Nov 1

Bibliographical note

Funding Information:
In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins. coronary artery atherosclerosis statins coronary computed tomography angiography coronary artery calcium score coronary artery calcification Agatston score Leading Foreign Research Institute Recruitment National Research Foundation of Korea 10.13039/501100003725 Ministry of Science and ICT 2012027176 Dalio Institute of Cardiovascular Imaging Michael Wolk Foundation National Research Foundation of Korea 10.13039/501100003725 NRF 10.13039/100007431 Ministry of Science and ICT 2012027176 National Institutes of Health 10.13039/100000002 R01 HL111141 R01 HL115150 R01 118019 U01 HL 105907 Qatar National Priorities Research Program 09-370-3-089 GE Healthcare 10.13039/100006775 National Research Foundation 10.13039/100011512 Korean Government Ministry of Education, Science and Technology 10.13039/501100004085 NRF-2015R1D1A1A01059717 National Institutes of Health 10.13039/100000002 Phillips/Volcano

Publisher Copyright:
© 2019 Published on behalf of the European Society of Cardiology. All rights reserved.

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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Lee, S. E., Sung, J. M., Andreini, D., Budoff, M. J., Cademartiri, F., Chinnaiyan, K., Choi, J. H., Chun, E. J., Conte, E., Gottlieb, I., Hadamitzky, M., Kim, Y. J., Kumar, A., Lee, B. K., Leipsic, J. A., Maffei, E., Marques, H., Pontone, G., Raff, G., ... Chang, H. J. (2019). Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study. European heart journal cardiovascular Imaging, 20(11), 1307-1314. https://doi.org/10.1093/ehjci/jez022

Lee, Sang Eun ; Sung, Ji Min ; Andreini, Daniele et al. / Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins : The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study. In: European heart journal cardiovascular Imaging. 2019 ; Vol. 20, No. 11. pp. 1307-1314.

@article{48024b1f6efd4fd88085cb3625eb2b32,

title = "Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study",

abstract = "Aims: Coronary artery calcium score (CACS) is a strong predictor of major adverse cardiac events (MACE). Conversely, statins, which markedly reduce MACE risk, increase CACS. We explored whether CACS progression represents compositional plaque volume (PV) progression differently according to statin use. Methods and results: From a prospective multinational registry of consecutive patients (n = 2252) who underwent serial coronary computed tomography angiography (CCTA) at a ≥ 2-year interval, 654 patients (61 ± 10 years, 56% men, inter-scan interval 3.9 ± 1.5 years) with information regarding the use of statins and having a serial CACS were included. Patients were divided into non-statin (n = 246) and statin-taking (n = 408) groups. Coronary PVs (total, calcified, and non-calcified; sum of fibrous, fibro-fatty, and lipid-rich) were quantitatively analysed, and CACS was measured from both CCTAs. Multivariate linear regression models were constructed for both statin-taking and non-statin group to assess the association between compositional PV change and change in CACS. In multivariate linear regression analysis, in the non-statin group, CACS increase was positively associated with both non-calcified (β = 0.369, P = 0.004) and calcified PV increase (β = 1.579, P < 0.001). However, in the statin-taking group, CACS increase was positively associated with calcified PV change (β = 0.756, P < 0.001) but was negatively associated with non-calcified PV change (β =-0.194, P = 0.026). Conclusion: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins.",

author = "Lee, {Sang Eun} and Sung, {Ji Min} and Daniele Andreini and Budoff, {Matthew J.} and Filippo Cademartiri and Kavitha Chinnaiyan and Choi, {Jung Hyun} and Chun, {Eun Ju} and Edoardo Conte and Ilan Gottlieb and Martin Hadamitzky and Kim, {Yong Jin} and Amit Kumar and Lee, {Byoung Kwon} and Leipsic, {Jonathon A.} and Erica Maffei and Hugo Marques and Gianluca Pontone and Gilbert Raff and Sanghoon Shin and Stone, {Peter H.} and Habib Samady and Renu Virmani and Jagat Narula and Berman, {Daniel S.} and Shaw, {Leslee J.} and Bax, {Jeroen J.} and Lin, {Fay Y.} and Min, {James K.} and Chang, {Hyuk Jae}",

note = "Funding Information: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins. coronary artery atherosclerosis statins coronary computed tomography angiography coronary artery calcium score coronary artery calcification Agatston score Leading Foreign Research Institute Recruitment National Research Foundation of Korea 10.13039/501100003725 Ministry of Science and ICT 2012027176 Dalio Institute of Cardiovascular Imaging Michael Wolk Foundation National Research Foundation of Korea 10.13039/501100003725 NRF 10.13039/100007431 Ministry of Science and ICT 2012027176 National Institutes of Health 10.13039/100000002 R01 HL111141 R01 HL115150 R01 118019 U01 HL 105907 Qatar National Priorities Research Program 09-370-3-089 GE Healthcare 10.13039/100006775 National Research Foundation 10.13039/100011512 Korean Government Ministry of Education, Science and Technology 10.13039/501100004085 NRF-2015R1D1A1A01059717 National Institutes of Health 10.13039/100000002 Phillips/Volcano Publisher Copyright: {\textcopyright} 2019 Published on behalf of the European Society of Cardiology. All rights reserved.",

year = "2019",

month = nov,

day = "1",

doi = "10.1093/ehjci/jez022",

language = "English",

volume = "20",

pages = "1307--1314",

journal = "European Heart Journal Cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

number = "11",

}

Lee, SE, Sung, JM, Andreini, D, Budoff, MJ, Cademartiri, F, Chinnaiyan, K, Choi, JH, Chun, EJ, Conte, E, Gottlieb, I, Hadamitzky, M, Kim, YJ, Kumar, A, Lee, BK, Leipsic, JA, Maffei, E, Marques, H, Pontone, G, Raff, G, Shin, S, Stone, PH, Samady, H, Virmani, R, Narula, J, Berman, DS, Shaw, LJ, Bax, JJ, Lin, FY, Min, JK & Chang, HJ 2019, 'Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study', European heart journal cardiovascular Imaging, vol. 20, no. 11, pp. 1307-1314. https://doi.org/10.1093/ehjci/jez022

Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins : The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study. / Lee, Sang Eun; Sung, Ji Min; Andreini, Daniele et al.

In: European heart journal cardiovascular Imaging, Vol. 20, No. 11, 01.11.2019, p. 1307-1314.

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

TY - JOUR

T1 - Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins

T2 - The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study

AU - Lee, Sang Eun

AU - Sung, Ji Min

AU - Andreini, Daniele

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Chinnaiyan, Kavitha

AU - Choi, Jung Hyun

AU - Chun, Eun Ju

AU - Conte, Edoardo

AU - Gottlieb, Ilan

AU - Hadamitzky, Martin

AU - Kim, Yong Jin

AU - Kumar, Amit

AU - Lee, Byoung Kwon

AU - Leipsic, Jonathon A.

AU - Maffei, Erica

AU - Marques, Hugo

AU - Pontone, Gianluca

AU - Raff, Gilbert

AU - Shin, Sanghoon

AU - Stone, Peter H.

AU - Samady, Habib

AU - Virmani, Renu

AU - Narula, Jagat

AU - Berman, Daniel S.

AU - Shaw, Leslee J.

AU - Bax, Jeroen J.

AU - Lin, Fay Y.

AU - Min, James K.

AU - Chang, Hyuk Jae

N1 - Funding Information: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins. coronary artery atherosclerosis statins coronary computed tomography angiography coronary artery calcium score coronary artery calcification Agatston score Leading Foreign Research Institute Recruitment National Research Foundation of Korea 10.13039/501100003725 Ministry of Science and ICT 2012027176 Dalio Institute of Cardiovascular Imaging Michael Wolk Foundation National Research Foundation of Korea 10.13039/501100003725 NRF 10.13039/100007431 Ministry of Science and ICT 2012027176 National Institutes of Health 10.13039/100000002 R01 HL111141 R01 HL115150 R01 118019 U01 HL 105907 Qatar National Priorities Research Program 09-370-3-089 GE Healthcare 10.13039/100006775 National Research Foundation 10.13039/100011512 Korean Government Ministry of Education, Science and Technology 10.13039/501100004085 NRF-2015R1D1A1A01059717 National Institutes of Health 10.13039/100000002 Phillips/Volcano Publisher Copyright: © 2019 Published on behalf of the European Society of Cardiology. All rights reserved.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Aims: Coronary artery calcium score (CACS) is a strong predictor of major adverse cardiac events (MACE). Conversely, statins, which markedly reduce MACE risk, increase CACS. We explored whether CACS progression represents compositional plaque volume (PV) progression differently according to statin use. Methods and results: From a prospective multinational registry of consecutive patients (n = 2252) who underwent serial coronary computed tomography angiography (CCTA) at a ≥ 2-year interval, 654 patients (61 ± 10 years, 56% men, inter-scan interval 3.9 ± 1.5 years) with information regarding the use of statins and having a serial CACS were included. Patients were divided into non-statin (n = 246) and statin-taking (n = 408) groups. Coronary PVs (total, calcified, and non-calcified; sum of fibrous, fibro-fatty, and lipid-rich) were quantitatively analysed, and CACS was measured from both CCTAs. Multivariate linear regression models were constructed for both statin-taking and non-statin group to assess the association between compositional PV change and change in CACS. In multivariate linear regression analysis, in the non-statin group, CACS increase was positively associated with both non-calcified (β = 0.369, P = 0.004) and calcified PV increase (β = 1.579, P < 0.001). However, in the statin-taking group, CACS increase was positively associated with calcified PV change (β = 0.756, P < 0.001) but was negatively associated with non-calcified PV change (β =-0.194, P = 0.026). Conclusion: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins.

AB - Aims: Coronary artery calcium score (CACS) is a strong predictor of major adverse cardiac events (MACE). Conversely, statins, which markedly reduce MACE risk, increase CACS. We explored whether CACS progression represents compositional plaque volume (PV) progression differently according to statin use. Methods and results: From a prospective multinational registry of consecutive patients (n = 2252) who underwent serial coronary computed tomography angiography (CCTA) at a ≥ 2-year interval, 654 patients (61 ± 10 years, 56% men, inter-scan interval 3.9 ± 1.5 years) with information regarding the use of statins and having a serial CACS were included. Patients were divided into non-statin (n = 246) and statin-taking (n = 408) groups. Coronary PVs (total, calcified, and non-calcified; sum of fibrous, fibro-fatty, and lipid-rich) were quantitatively analysed, and CACS was measured from both CCTAs. Multivariate linear regression models were constructed for both statin-taking and non-statin group to assess the association between compositional PV change and change in CACS. In multivariate linear regression analysis, in the non-statin group, CACS increase was positively associated with both non-calcified (β = 0.369, P = 0.004) and calcified PV increase (β = 1.579, P < 0.001). However, in the statin-taking group, CACS increase was positively associated with calcified PV change (β = 0.756, P < 0.001) but was negatively associated with non-calcified PV change (β =-0.194, P = 0.026). Conclusion: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins.

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UR - http://www.scopus.com/inward/citedby.url?scp=85067204787&partnerID=8YFLogxK

U2 - 10.1093/ehjci/jez022

DO - 10.1093/ehjci/jez022

M3 - Article

C2 - 30789215

AN - SCOPUS:85067204787

SN - 2047-2404

VL - 20

SP - 1307

EP - 1314

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

IS - 11

ER -

Lee SE, Sung JM, Andreini D, Budoff MJ, Cademartiri F, Chinnaiyan K et al. Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study. European heart journal cardiovascular Imaging. 2019 Nov 1;20(11):1307-1314. doi: 10.1093/ehjci/jez022

Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: The Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study

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