Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease

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

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Diagnosis of coronary artery disease and management strategies have relied solely on the presence of diameter stenosis ≥50%. We assessed whether direct quantification of plaque burden (PB) and plaque characteristics assessed by coronary computed tomography angiography could provide additional value in terms of predicting rapid plaque progression. METHODS AND RESULTS: From a 13-center, 7-country prospective observational registry, 1345 patients (60.4±9.4 years old; 57.1% male) who underwent repeated coronary computed tomography angiography >2 years apart were enrolled. For conventional angiographic analysis, the presence of stenosis ≥50%, number of vessel involved, segment involvement score, and the presence of high-risk plaque feature were determined. For quantitative analyses, PB and annual change in PB (△PB/y) in the entire coronary tree were assessed. Clinical outcomes (cardiac death, nonfatal myocardial infarction, and coronary revascularization) were recorded. Rapid progressors, defined as a patient with ≥median value of △PB/y (0.33%/y), were older, more frequently male, and had more clinical risk factors than nonrapid progressors (all P<0.05). After risk adjustment, addition of baseline PB improved prediction of rapid progression to each angiographic assessment of coronary artery disease, and the presence of high-risk plaque further improved the predictive performance (all P<0.001). For prediction of adverse outcomes, adding both baseline PB and △PB/y showed best predictive performance (C statistics, 0.763; P<0.001). CONCLUSIONS: Direct quantification of atherosclerotic PB in addition to conventional angiographic assessment of coronary artery disease might be beneficial for improving risk stratification of coronary artery disease. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02803411.

Original languageEnglish
Pages (from-to)e007562
JournalCirculation. Cardiovascular imaging
Volume11
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

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Coronary Artery Disease
Pathologic Constriction
Risk Adjustment
Atherosclerotic Plaques
Disease Management
Registries
Myocardial Infarction
Clinical Trials
Computed Tomography Angiography

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Sang Eun ; Sung, Ji Min ; Rizvi, Asim ; Lin, Fay Y. ; Kumar, Amit ; Hadamitzky, Martin ; Kim, Yong Jin ; Conte, Edoardo ; Andreini, Daniele ; Pontone, Gianluca ; Budoff, Matthew J. ; Gottlieb, Ilan ; Lee, Byoung Kwon ; Chun, Eun Ju ; Cademartiri, Filippo ; Maffei, Erica ; Marques, Hugo ; Leipsic, Jonathon A. ; Shin, Sanghoon ; Hyun Choi, Jung ; Chinnaiyan, Kavitha ; Raff, Gilbert ; Virmani, Renu ; Samady, Habib ; Stone, Peter H. ; Berman, Daniel S. ; Narula, Jagat ; Shaw, Leslee J. ; Bax, Jeroen J. ; Min, James K. ; Chang, Hyuk Jae. / Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease. In: Circulation. Cardiovascular imaging. 2018 ; Vol. 11, No. 7. pp. e007562.
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abstract = "BACKGROUND: Diagnosis of coronary artery disease and management strategies have relied solely on the presence of diameter stenosis ≥50{\%}. We assessed whether direct quantification of plaque burden (PB) and plaque characteristics assessed by coronary computed tomography angiography could provide additional value in terms of predicting rapid plaque progression. METHODS AND RESULTS: From a 13-center, 7-country prospective observational registry, 1345 patients (60.4±9.4 years old; 57.1{\%} male) who underwent repeated coronary computed tomography angiography >2 years apart were enrolled. For conventional angiographic analysis, the presence of stenosis ≥50{\%}, number of vessel involved, segment involvement score, and the presence of high-risk plaque feature were determined. For quantitative analyses, PB and annual change in PB (△PB/y) in the entire coronary tree were assessed. Clinical outcomes (cardiac death, nonfatal myocardial infarction, and coronary revascularization) were recorded. Rapid progressors, defined as a patient with ≥median value of △PB/y (0.33{\%}/y), were older, more frequently male, and had more clinical risk factors than nonrapid progressors (all P<0.05). After risk adjustment, addition of baseline PB improved prediction of rapid progression to each angiographic assessment of coronary artery disease, and the presence of high-risk plaque further improved the predictive performance (all P<0.001). For prediction of adverse outcomes, adding both baseline PB and △PB/y showed best predictive performance (C statistics, 0.763; P<0.001). CONCLUSIONS: Direct quantification of atherosclerotic PB in addition to conventional angiographic assessment of coronary artery disease might be beneficial for improving risk stratification of coronary artery disease. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02803411.",
author = "Lee, {Sang Eun} and Sung, {Ji Min} and Asim Rizvi and Lin, {Fay Y.} and Amit Kumar and Martin Hadamitzky and Kim, {Yong Jin} and Edoardo Conte and Daniele Andreini and Gianluca Pontone and Budoff, {Matthew J.} and Ilan Gottlieb and Lee, {Byoung Kwon} and Chun, {Eun Ju} and Filippo Cademartiri and Erica Maffei and Hugo Marques and Leipsic, {Jonathon A.} and Sanghoon Shin and {Hyun Choi}, Jung and Kavitha Chinnaiyan and Gilbert Raff and Renu Virmani and Habib Samady and Stone, {Peter H.} and Berman, {Daniel S.} and Jagat Narula and Shaw, {Leslee J.} and Bax, {Jeroen J.} and Min, {James K.} and Chang, {Hyuk Jae}",
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Lee, SE, Sung, JM, Rizvi, A, Lin, FY, Kumar, A, Hadamitzky, M, Kim, YJ, Conte, E, Andreini, D, Pontone, G, Budoff, MJ, Gottlieb, I, Lee, BK, Chun, EJ, Cademartiri, F, Maffei, E, Marques, H, Leipsic, JA, Shin, S, Hyun Choi, J, Chinnaiyan, K, Raff, G, Virmani, R, Samady, H, Stone, PH, Berman, DS, Narula, J, Shaw, LJ, Bax, JJ, Min, JK & Chang, HJ 2018, 'Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease', Circulation. Cardiovascular imaging, vol. 11, no. 7, pp. e007562. https://doi.org/10.1161/CIRCIMAGING.117.007562

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

In: Circulation. Cardiovascular imaging, Vol. 11, No. 7, 01.07.2018, p. e007562.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease

AU - Lee, Sang Eun

AU - Sung, Ji Min

AU - Rizvi, Asim

AU - Lin, Fay Y.

AU - Kumar, Amit

AU - Hadamitzky, Martin

AU - Kim, Yong Jin

AU - Conte, Edoardo

AU - Andreini, Daniele

AU - Pontone, Gianluca

AU - Budoff, Matthew J.

AU - Gottlieb, Ilan

AU - Lee, Byoung Kwon

AU - Chun, Eun Ju

AU - Cademartiri, Filippo

AU - Maffei, Erica

AU - Marques, Hugo

AU - Leipsic, Jonathon A.

AU - Shin, Sanghoon

AU - Hyun Choi, Jung

AU - Chinnaiyan, Kavitha

AU - Raff, Gilbert

AU - Virmani, Renu

AU - Samady, Habib

AU - Stone, Peter H.

AU - Berman, Daniel S.

AU - Narula, Jagat

AU - Shaw, Leslee J.

AU - Bax, Jeroen J.

AU - Min, James K.

AU - Chang, Hyuk Jae

PY - 2018/7/1

Y1 - 2018/7/1

N2 - BACKGROUND: Diagnosis of coronary artery disease and management strategies have relied solely on the presence of diameter stenosis ≥50%. We assessed whether direct quantification of plaque burden (PB) and plaque characteristics assessed by coronary computed tomography angiography could provide additional value in terms of predicting rapid plaque progression. METHODS AND RESULTS: From a 13-center, 7-country prospective observational registry, 1345 patients (60.4±9.4 years old; 57.1% male) who underwent repeated coronary computed tomography angiography >2 years apart were enrolled. For conventional angiographic analysis, the presence of stenosis ≥50%, number of vessel involved, segment involvement score, and the presence of high-risk plaque feature were determined. For quantitative analyses, PB and annual change in PB (△PB/y) in the entire coronary tree were assessed. Clinical outcomes (cardiac death, nonfatal myocardial infarction, and coronary revascularization) were recorded. Rapid progressors, defined as a patient with ≥median value of △PB/y (0.33%/y), were older, more frequently male, and had more clinical risk factors than nonrapid progressors (all P<0.05). After risk adjustment, addition of baseline PB improved prediction of rapid progression to each angiographic assessment of coronary artery disease, and the presence of high-risk plaque further improved the predictive performance (all P<0.001). For prediction of adverse outcomes, adding both baseline PB and △PB/y showed best predictive performance (C statistics, 0.763; P<0.001). CONCLUSIONS: Direct quantification of atherosclerotic PB in addition to conventional angiographic assessment of coronary artery disease might be beneficial for improving risk stratification of coronary artery disease. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02803411.

AB - BACKGROUND: Diagnosis of coronary artery disease and management strategies have relied solely on the presence of diameter stenosis ≥50%. We assessed whether direct quantification of plaque burden (PB) and plaque characteristics assessed by coronary computed tomography angiography could provide additional value in terms of predicting rapid plaque progression. METHODS AND RESULTS: From a 13-center, 7-country prospective observational registry, 1345 patients (60.4±9.4 years old; 57.1% male) who underwent repeated coronary computed tomography angiography >2 years apart were enrolled. For conventional angiographic analysis, the presence of stenosis ≥50%, number of vessel involved, segment involvement score, and the presence of high-risk plaque feature were determined. For quantitative analyses, PB and annual change in PB (△PB/y) in the entire coronary tree were assessed. Clinical outcomes (cardiac death, nonfatal myocardial infarction, and coronary revascularization) were recorded. Rapid progressors, defined as a patient with ≥median value of △PB/y (0.33%/y), were older, more frequently male, and had more clinical risk factors than nonrapid progressors (all P<0.05). After risk adjustment, addition of baseline PB improved prediction of rapid progression to each angiographic assessment of coronary artery disease, and the presence of high-risk plaque further improved the predictive performance (all P<0.001). For prediction of adverse outcomes, adding both baseline PB and △PB/y showed best predictive performance (C statistics, 0.763; P<0.001). CONCLUSIONS: Direct quantification of atherosclerotic PB in addition to conventional angiographic assessment of coronary artery disease might be beneficial for improving risk stratification of coronary artery disease. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02803411.

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