Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events

Alexander R. van Rosendael; Fay Y. Lin; Inge J. van den Hoogen; Xiaoyue Ma; Umberto Gianni; Omar Al Hussein Alawamlh; Subhi J. Al'Aref; Jessica M. Peña; Daniele Andreini; Matthew J. Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Edoardo Conte; Hugo Marques; Pedro de Araújo Gonçalves; Ilan Gottlieb; Martin Hadamitzky; Jonathon Leipsic; Erica Maffei; Gianluca Pontone; Gilbert L. Raff; Sanghoon Shin; Yong Jin Kim; Byoung Kwon Lee; Eun Ju Chun; Ji Min Sung; Sang Eun Lee; Donghee Han; Daniel S. Berman; Renu Virmani; Habib Samady; Peter Stone; Jagat Narula; Jeroen J. Bax; Leslee J. Shaw; James K. Min; Hyuk Jae Chang

doi:10.1016/j.jcct.2020.12.007

Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events

Alexander R. van Rosendael, Fay Y. Lin, Inge J. van den Hoogen, Xiaoyue Ma, Umberto Gianni, Omar Al Hussein Alawamlh, Subhi J. Al'Aref, Jessica M. Peña, Daniele Andreini, Matthew J. Budoff, Filippo Cademartiri, Kavitha Chinnaiyan, Jung Hyun Choi, Edoardo Conte, Hugo Marques, Pedro de Araújo Gonçalves, Ilan Gottlieb, Martin Hadamitzky, Jonathon Leipsic, Erica MaffeiGianluca Pontone, Gilbert L. Raff, Sanghoon Shin, Yong Jin Kim, Byoung Kwon Lee, Eun Ju Chun, Ji Min Sung, Sang Eun Lee, Donghee Han, Daniel S. Berman, Renu Virmani, Habib Samady, Peter 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

8 Citations (Scopus)

Abstract

Background: The current study aimed to examine the independent prognostic value of whole-heart atherosclerosis progression by serial coronary computed tomography angiography (CCTA) for major adverse cardiovascular events (MACE). Methods: The multi-center PARADIGM study includes patients undergoing serial CCTA for symptomatic reasons, ≥2 years apart. Whole-heart atherosclerosis was characterized on a segmental level, with co-registration of baseline and follow-up CCTA, and summed to per-patient level. The independent prognostic significance of atherosclerosis progression for MACE (non-fatal myocardial infarction [MI], death, unplanned coronary revascularization) was examined. Patients experiencing interval MACE were not omitted. Results: The study population comprised 1166 patients (age 60.5 ± 9.5 years, 54.7% male) who experienced 139 MACE events during 8.2 (IQR 6.2, 9.5) years of follow up (15 death, 5 non-fatal MI, 119 unplanned revascularizations). Whole-heart percent atheroma volume (PAV) increased from 2.32% at baseline to 4.04% at follow-up. Adjusted for baseline PAV, the annualized increase in PAV was independently associated with MACE: OR 1.23 (95% CI 1.08, 1.39) per 1 standard deviation increase, which was consistent in multiple subpopulations. When categorized by composition, only non-calcified plaque progression associated independently with MACE, while calcified plaque did not. Restricting to patients without events before follow-up CCTA, those with future MACE showed an annualized increase in PAV of 0.93% (IQR 0.34, 1.96) vs 0.32% (IQR 0.02, 0.90), P < 0.001. Conclusions: Whole-heart atherosclerosis progression examined by serial CCTA is independently associated with MACE, with a prognostic threshold of 1.0% increase in PAV per year.

Original language	English
Pages (from-to)	322-330
Number of pages	9
Journal	Journal of Cardiovascular Computed Tomography
Volume	15
Issue number	4
DOIs	https://doi.org/10.1016/j.jcct.2020.12.007
Publication status	Published - 2021 Jul 1

Bibliographical note

Funding Information:
This work was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT ( MSIT ) (Grant No. 2012027176 ). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging (New York, NY) and the Michael Wolk Foundation (New York, NY).

Funding Information:
Dr. James K. Min receives funding from the Dalio Foundation , National Institutes of Health , and GE Healthcare . Dr. Min serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Cleerly. Dr. Habib Samady serves on the medical advisory board of Philips and has equity holding in Covanos. The remaining authors have no relevant disclosures.

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.2020.12.007

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van Rosendael, A. R., Lin, F. Y., van den Hoogen, I. J., Ma, X., Gianni, U., Al Hussein Alawamlh, O., Al'Aref, S. J., Peña, J. M., Andreini, D., Budoff, M. J., Cademartiri, F., Chinnaiyan, K., Choi, J. H., Conte, E., Marques, H., de Araújo Gonçalves, P., Gottlieb, I., Hadamitzky, M., Leipsic, J., ... Chang, H. J. (2021). Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events. Journal of Cardiovascular Computed Tomography, 15(4), 322-330. https://doi.org/10.1016/j.jcct.2020.12.007

@article{4a216ea9de474fd1badf55c41f1ca4bc,

title = "Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events",

abstract = "Background: The current study aimed to examine the independent prognostic value of whole-heart atherosclerosis progression by serial coronary computed tomography angiography (CCTA) for major adverse cardiovascular events (MACE). Methods: The multi-center PARADIGM study includes patients undergoing serial CCTA for symptomatic reasons, ≥2 years apart. Whole-heart atherosclerosis was characterized on a segmental level, with co-registration of baseline and follow-up CCTA, and summed to per-patient level. The independent prognostic significance of atherosclerosis progression for MACE (non-fatal myocardial infarction [MI], death, unplanned coronary revascularization) was examined. Patients experiencing interval MACE were not omitted. Results: The study population comprised 1166 patients (age 60.5 ± 9.5 years, 54.7% male) who experienced 139 MACE events during 8.2 (IQR 6.2, 9.5) years of follow up (15 death, 5 non-fatal MI, 119 unplanned revascularizations). Whole-heart percent atheroma volume (PAV) increased from 2.32% at baseline to 4.04% at follow-up. Adjusted for baseline PAV, the annualized increase in PAV was independently associated with MACE: OR 1.23 (95% CI 1.08, 1.39) per 1 standard deviation increase, which was consistent in multiple subpopulations. When categorized by composition, only non-calcified plaque progression associated independently with MACE, while calcified plaque did not. Restricting to patients without events before follow-up CCTA, those with future MACE showed an annualized increase in PAV of 0.93% (IQR 0.34, 1.96) vs 0.32% (IQR 0.02, 0.90), P < 0.001. Conclusions: Whole-heart atherosclerosis progression examined by serial CCTA is independently associated with MACE, with a prognostic threshold of 1.0% increase in PAV per year.",

author = "{van Rosendael}, {Alexander R.} and Lin, {Fay Y.} and {van den Hoogen}, {Inge J.} and Xiaoyue Ma and Umberto Gianni and {Al Hussein Alawamlh}, Omar and Al'Aref, {Subhi J.} and Pe{\~n}a, {Jessica M.} and Daniele Andreini 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 Jonathon Leipsic and Erica Maffei and Gianluca Pontone and Raff, {Gilbert L.} and Sanghoon Shin and Kim, {Yong Jin} and Lee, {Byoung Kwon} and Chun, {Eun Ju} and Sung, {Ji Min} and Lee, {Sang Eun} and Donghee Han and Berman, {Daniel S.} and Renu Virmani and Habib Samady and Peter Stone 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 the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT ( MSIT ) (Grant No. 2012027176 ). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging (New York, NY) and the Michael Wolk Foundation (New York, NY). Funding Information: Dr. James K. Min receives funding from the Dalio Foundation , National Institutes of Health , and GE Healthcare . Dr. Min serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Cleerly. Dr. Habib Samady serves on the medical advisory board of Philips and has equity holding in Covanos. The remaining authors have no relevant disclosures. Publisher Copyright: {\textcopyright} 2020 Society of Cardiovascular Computed Tomography",

year = "2021",

month = jul,

day = "1",

doi = "10.1016/j.jcct.2020.12.007",

language = "English",

volume = "15",

pages = "322--330",

journal = "Journal of Cardiovascular Computed Tomography",

issn = "1934-5925",

publisher = "Elsevier Inc.",

number = "4",

}

van Rosendael, AR, Lin, FY, van den Hoogen, IJ, Ma, X, Gianni, U, Al Hussein Alawamlh, O, Al'Aref, SJ, Peña, JM, Andreini, D, Budoff, MJ, Cademartiri, F, Chinnaiyan, K, Choi, JH, Conte, E, Marques, H, de Araújo Gonçalves, P, Gottlieb, I, Hadamitzky, M, Leipsic, J, Maffei, E, Pontone, G, Raff, GL, Shin, S, Kim, YJ, Lee, BK, Chun, EJ, Sung, JM, Lee, SE, Han, D, Berman, DS, Virmani, R, Samady, H, Stone, P, Narula, J, Bax, JJ, Shaw, LJ, Min, JK & Chang, HJ 2021, 'Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events', Journal of Cardiovascular Computed Tomography, vol. 15, no. 4, pp. 322-330. https://doi.org/10.1016/j.jcct.2020.12.007

TY - JOUR

T1 - Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events

AU - van Rosendael, Alexander R.

AU - Lin, Fay Y.

AU - van den Hoogen, Inge J.

AU - Ma, Xiaoyue

AU - Gianni, Umberto

AU - Al Hussein Alawamlh, Omar

AU - Al'Aref, Subhi J.

AU - Peña, Jessica M.

AU - Andreini, Daniele

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

AU - Maffei, Erica

AU - Pontone, Gianluca

AU - Raff, Gilbert L.

AU - Shin, Sanghoon

AU - Kim, Yong Jin

AU - Lee, Byoung Kwon

AU - Chun, Eun Ju

AU - Sung, Ji Min

AU - Lee, Sang Eun

AU - Han, Donghee

AU - Berman, Daniel S.

AU - Virmani, Renu

AU - Samady, Habib

AU - Stone, Peter

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 the Leading Foreign Research Institute Recruitment Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science and ICT ( MSIT ) (Grant No. 2012027176 ). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging (New York, NY) and the Michael Wolk Foundation (New York, NY). Funding Information: Dr. James K. Min receives funding from the Dalio Foundation , National Institutes of Health , and GE Healthcare . Dr. Min serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Cleerly. Dr. Habib Samady serves on the medical advisory board of Philips and has equity holding in Covanos. The remaining authors have no relevant disclosures. Publisher Copyright: © 2020 Society of Cardiovascular Computed Tomography

PY - 2021/7/1

Y1 - 2021/7/1

N2 - Background: The current study aimed to examine the independent prognostic value of whole-heart atherosclerosis progression by serial coronary computed tomography angiography (CCTA) for major adverse cardiovascular events (MACE). Methods: The multi-center PARADIGM study includes patients undergoing serial CCTA for symptomatic reasons, ≥2 years apart. Whole-heart atherosclerosis was characterized on a segmental level, with co-registration of baseline and follow-up CCTA, and summed to per-patient level. The independent prognostic significance of atherosclerosis progression for MACE (non-fatal myocardial infarction [MI], death, unplanned coronary revascularization) was examined. Patients experiencing interval MACE were not omitted. Results: The study population comprised 1166 patients (age 60.5 ± 9.5 years, 54.7% male) who experienced 139 MACE events during 8.2 (IQR 6.2, 9.5) years of follow up (15 death, 5 non-fatal MI, 119 unplanned revascularizations). Whole-heart percent atheroma volume (PAV) increased from 2.32% at baseline to 4.04% at follow-up. Adjusted for baseline PAV, the annualized increase in PAV was independently associated with MACE: OR 1.23 (95% CI 1.08, 1.39) per 1 standard deviation increase, which was consistent in multiple subpopulations. When categorized by composition, only non-calcified plaque progression associated independently with MACE, while calcified plaque did not. Restricting to patients without events before follow-up CCTA, those with future MACE showed an annualized increase in PAV of 0.93% (IQR 0.34, 1.96) vs 0.32% (IQR 0.02, 0.90), P < 0.001. Conclusions: Whole-heart atherosclerosis progression examined by serial CCTA is independently associated with MACE, with a prognostic threshold of 1.0% increase in PAV per year.

AB - Background: The current study aimed to examine the independent prognostic value of whole-heart atherosclerosis progression by serial coronary computed tomography angiography (CCTA) for major adverse cardiovascular events (MACE). Methods: The multi-center PARADIGM study includes patients undergoing serial CCTA for symptomatic reasons, ≥2 years apart. Whole-heart atherosclerosis was characterized on a segmental level, with co-registration of baseline and follow-up CCTA, and summed to per-patient level. The independent prognostic significance of atherosclerosis progression for MACE (non-fatal myocardial infarction [MI], death, unplanned coronary revascularization) was examined. Patients experiencing interval MACE were not omitted. Results: The study population comprised 1166 patients (age 60.5 ± 9.5 years, 54.7% male) who experienced 139 MACE events during 8.2 (IQR 6.2, 9.5) years of follow up (15 death, 5 non-fatal MI, 119 unplanned revascularizations). Whole-heart percent atheroma volume (PAV) increased from 2.32% at baseline to 4.04% at follow-up. Adjusted for baseline PAV, the annualized increase in PAV was independently associated with MACE: OR 1.23 (95% CI 1.08, 1.39) per 1 standard deviation increase, which was consistent in multiple subpopulations. When categorized by composition, only non-calcified plaque progression associated independently with MACE, while calcified plaque did not. Restricting to patients without events before follow-up CCTA, those with future MACE showed an annualized increase in PAV of 0.93% (IQR 0.34, 1.96) vs 0.32% (IQR 0.02, 0.90), P < 0.001. Conclusions: Whole-heart atherosclerosis progression examined by serial CCTA is independently associated with MACE, with a prognostic threshold of 1.0% increase in PAV per year.

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U2 - 10.1016/j.jcct.2020.12.007

DO - 10.1016/j.jcct.2020.12.007

M3 - Article

C2 - 33451974

AN - SCOPUS:85099478733

SN - 1934-5925

VL - 15

SP - 322

EP - 330

JO - Journal of Cardiovascular Computed Tomography

JF - Journal of Cardiovascular Computed Tomography

IS - 4

ER -

Progression of whole-heart Atherosclerosis by coronary CT and major adverse cardiovascular events

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