Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy

Minkwan Kim; Seung Pyo Lee; Soongu Kwak; Seokhun Yang; Yong Jin Kim; Daniele Andreini; Mouaz H. Al-Mallah; Matthew J. Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Edoardo Conte; Hugo Marques; Pedro de Araújo Gonçalves; Ilan Gottlieb; Martin Hadamitzky; Jonathon A. Leipsic; Erica Maffei; Gianluca Pontone; Gilbert L. Raff; Sanghoon Shin; Byoung Kwon Lee; Eun Ju Chun; Ji Min Sung; Sang Eun Lee; Daniel S. Berman; Fay Y. Lin; Renu Virmani; Habib Samady; Peter H. Stone; Jagat Narula; Jeroen J. Bax; Leslee J. Shaw; James K. Min; Hyuk Jae Chang

doi:10.1016/j.jcct.2020.09.009

Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy

Minkwan Kim, Seung Pyo Lee, Soongu Kwak, Seokhun Yang, Yong Jin Kim, Daniele Andreini, Mouaz H. Al-Mallah, Matthew J. Budoff, Filippo Cademartiri, Kavitha Chinnaiyan, Jung Hyun Choi, Edoardo Conte, Hugo Marques, Pedro de Araújo Gonçalves, Ilan Gottlieb, Martin Hadamitzky, Jonathon A. Leipsic, Erica Maffei, Gianluca Pontone, Gilbert L. RaffSanghoon Shin, Byoung Kwon Lee, Eun Ju Chun, Ji Min Sung, Sang Eun Lee, Daniel S. Berman, Fay Y. Lin, Renu Virmani, Habib Samady, Peter H. Stone, Jagat Narula, Jeroen J. Bax, Leslee J. Shaw, James K. Min, Hyuk Jae Chang

Department of Internal Medicine

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

4 Citations (Scopus)

Abstract

Background: The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA). Methods: From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression. Results: With a 3.3-years’ median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm³/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm³/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and < 0.001, respectively). However, this tendency was not observed in any other plaque components. The annual volume changes of total plaque and dense calcification were also significantly different in the propensity score-matched lowest age quartile group versus the other age groups as was the composite clinical event (log-rank p = 0.003). In random forest analysis, age had comparable importance in the total plaque volume progression as other traditional factors. Conclusions: The rate of whole-heart plaque progression and dense calcification increases depending on age. Age is a significant factor in plaque growth, the importance of which is comparable to other traditional risk factors. Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02803411.

Original language	English
Pages (from-to)	232-239
Number of pages	8
Journal	Journal of Cardiovascular Computed Tomography
Volume	15
Issue number	3
DOIs	https://doi.org/10.1016/j.jcct.2020.09.009
Publication status	Published - 2021 May 1

Bibliographical note

Funding Information:
This work was supported by grants through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176 & No. 2019R1A2C2084099). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.Dr. Min receives funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare and serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Clearly. Dr. Samady serves on the scientific advisory board of Philips, has equity interest in Covanos Inc., and has a research grant from Medtronic. The remaining authors have no relevant disclosures.

Funding Information:
This work was supported by grants through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176 & No. 2019R1A2C2084099 ). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Publisher Copyright:
© 2020 Society of Cardiovascular Computed Tomography

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.jcct.2020.09.009

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Kim, M., Lee, S. P., Kwak, S., Yang, S., Kim, Y. J., Andreini, D., Al-Mallah, M. H., Budoff, M. J., Cademartiri, F., Chinnaiyan, K., Choi, J. H., Conte, E., Marques, H., de Araújo Gonçalves, P., Gottlieb, I., Hadamitzky, M., Leipsic, J. A., Maffei, E., Pontone, G., ... Chang, H. J. (2021). Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy. Journal of Cardiovascular Computed Tomography, 15(3), 232-239. https://doi.org/10.1016/j.jcct.2020.09.009

@article{c0dcac5d7254488b87d47a8c000bcc23,

title = "Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy",

abstract = "Background: The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA). Methods: From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression. Results: With a 3.3-years{\textquoteright} median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm3/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm3/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and < 0.001, respectively). However, this tendency was not observed in any other plaque components. The annual volume changes of total plaque and dense calcification were also significantly different in the propensity score-matched lowest age quartile group versus the other age groups as was the composite clinical event (log-rank p = 0.003). In random forest analysis, age had comparable importance in the total plaque volume progression as other traditional factors. Conclusions: The rate of whole-heart plaque progression and dense calcification increases depending on age. Age is a significant factor in plaque growth, the importance of which is comparable to other traditional risk factors. Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02803411.",

author = "Minkwan Kim and Lee, {Seung Pyo} and Soongu Kwak and Seokhun Yang and Kim, {Yong Jin} and Daniele Andreini and Al-Mallah, {Mouaz H.} and Budoff, {Matthew J.} and Filippo Cademartiri and Kavitha Chinnaiyan and Choi, {Jung Hyun} and Edoardo Conte and Hugo Marques and {de Ara{\'u}jo Gon{\c c}alves}, Pedro and Ilan Gottlieb and Martin Hadamitzky and Leipsic, {Jonathon A.} and Erica Maffei and Gianluca Pontone and Raff, {Gilbert L.} and Sanghoon Shin and Lee, {Byoung Kwon} and Chun, {Eun Ju} and Sung, {Ji Min} and Lee, {Sang Eun} and Berman, {Daniel S.} and Lin, {Fay Y.} and Renu Virmani and Habib Samady and Stone, {Peter H.} and Jagat Narula and Bax, {Jeroen J.} and Shaw, {Leslee J.} and Min, {James K.} and Chang, {Hyuk Jae}",

note = "Funding Information: This work was supported by grants through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176 & No. 2019R1A2C2084099). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.Dr. Min receives funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare and serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Clearly. Dr. Samady serves on the scientific advisory board of Philips, has equity interest in Covanos Inc., and has a research grant from Medtronic. The remaining authors have no relevant disclosures. Funding Information: This work was supported by grants through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176 & No. 2019R1A2C2084099 ). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Publisher Copyright: {\textcopyright} 2020 Society of Cardiovascular Computed Tomography",

year = "2021",

month = may,

day = "1",

doi = "10.1016/j.jcct.2020.09.009",

language = "English",

volume = "15",

pages = "232--239",

journal = "Journal of Cardiovascular Computed Tomography",

issn = "1934-5925",

publisher = "Elsevier Inc.",

number = "3",

}

Kim, M, Lee, SP, Kwak, S, Yang, S, Kim, YJ, Andreini, D, Al-Mallah, MH, Budoff, MJ, Cademartiri, F, Chinnaiyan, K, Choi, JH, Conte, E, Marques, H, de Araújo Gonçalves, P, Gottlieb, I, Hadamitzky, M, Leipsic, JA, Maffei, E, Pontone, G, Raff, GL, Shin, S, Lee, BK, Chun, EJ, Sung, JM, Lee, SE, Berman, DS, Lin, FY, Virmani, R, Samady, H, Stone, PH, Narula, J, Bax, JJ, Shaw, LJ, Min, JK & Chang, HJ 2021, 'Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy', Journal of Cardiovascular Computed Tomography, vol. 15, no. 3, pp. 232-239. https://doi.org/10.1016/j.jcct.2020.09.009

TY - JOUR

T1 - Impact of age on coronary artery plaque progression and clinical outcome

T2 - A PARADIGM substudy

AU - Kim, Minkwan

AU - Lee, Seung Pyo

AU - Kwak, Soongu

AU - Yang, Seokhun

AU - Kim, Yong Jin

AU - Andreini, Daniele

AU - Al-Mallah, Mouaz H.

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Chinnaiyan, Kavitha

AU - Choi, Jung Hyun

AU - Conte, Edoardo

AU - Marques, Hugo

AU - de Araújo Gonçalves, Pedro

AU - Gottlieb, Ilan

AU - Hadamitzky, Martin

AU - Leipsic, Jonathon A.

AU - Maffei, Erica

AU - Pontone, Gianluca

AU - Raff, Gilbert L.

AU - Shin, Sanghoon

AU - Lee, Byoung Kwon

AU - Chun, Eun Ju

AU - Sung, Ji Min

AU - Lee, Sang Eun

AU - Berman, Daniel S.

AU - Lin, Fay Y.

AU - Virmani, Renu

AU - Samady, Habib

AU - Stone, Peter H.

AU - Narula, Jagat

AU - Bax, Jeroen J.

AU - Shaw, Leslee J.

AU - Min, James K.

AU - Chang, Hyuk Jae

N1 - Funding Information: This work was supported by grants through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176 & No. 2019R1A2C2084099). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.Dr. Min receives funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare and serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Clearly. Dr. Samady serves on the scientific advisory board of Philips, has equity interest in Covanos Inc., and has a research grant from Medtronic. The remaining authors have no relevant disclosures. Funding Information: This work was supported by grants through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT (MSIT) (Grant No. 2012027176 & No. 2019R1A2C2084099 ). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Publisher Copyright: © 2020 Society of Cardiovascular Computed Tomography

PY - 2021/5/1

Y1 - 2021/5/1

N2 - Background: The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA). Methods: From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression. Results: With a 3.3-years’ median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm3/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm3/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and < 0.001, respectively). However, this tendency was not observed in any other plaque components. The annual volume changes of total plaque and dense calcification were also significantly different in the propensity score-matched lowest age quartile group versus the other age groups as was the composite clinical event (log-rank p = 0.003). In random forest analysis, age had comparable importance in the total plaque volume progression as other traditional factors. Conclusions: The rate of whole-heart plaque progression and dense calcification increases depending on age. Age is a significant factor in plaque growth, the importance of which is comparable to other traditional risk factors. Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02803411.

AB - Background: The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA). Methods: From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression. Results: With a 3.3-years’ median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm3/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm3/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and < 0.001, respectively). However, this tendency was not observed in any other plaque components. The annual volume changes of total plaque and dense calcification were also significantly different in the propensity score-matched lowest age quartile group versus the other age groups as was the composite clinical event (log-rank p = 0.003). In random forest analysis, age had comparable importance in the total plaque volume progression as other traditional factors. Conclusions: The rate of whole-heart plaque progression and dense calcification increases depending on age. Age is a significant factor in plaque growth, the importance of which is comparable to other traditional risk factors. Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02803411.

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U2 - 10.1016/j.jcct.2020.09.009

DO - 10.1016/j.jcct.2020.09.009

M3 - Article

C2 - 33032975

AN - SCOPUS:85092053588

SN - 1934-5925

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EP - 239

JO - Journal of Cardiovascular Computed Tomography

JF - Journal of Cardiovascular Computed Tomography

IS - 3

ER -

Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy

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