Cited 305 times in
Coronary Atherosclerotic Precursors of Acute Coronary Syndromes
DC Field | Value | Language |
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dc.contributor.author | 장혁재 | - |
dc.contributor.author | 이상은 | - |
dc.date.accessioned | 2018-08-28T17:25:55Z | - |
dc.date.available | 2018-08-28T17:25:55Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 0735-1097 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/162599 | - |
dc.description.abstract | BACKGROUND: The association of atherosclerotic features with first acute coronary syndromes (ACS) has not accounted for plaque burden. OBJECTIVES: The purpose of this study was to identify atherosclerotic features associated with precursors of ACS. METHODS: We performed a nested case-control study within a cohort of 25,251 patients undergoing coronary computed tomographic angiography (CTA) with follow-up over 3.4 +/- 2.1 years. Patients with ACS and nonevent patients with no prior coronary artery disease (CAD) were propensity matched 1:1 for risk factors and coronary CTA-evaluated obstructive (>/=50%) CAD. Separate core laboratories performed blinded adjudication of ACS and culprit lesions and quantification of baseline coronary CTA for percent diameter stenosis (%DS), percent cross-sectional plaque burden (PB), plaque volumes (PVs) by composition (calcified, fibrous, fibrofatty, and necrotic core), and presence of high-risk plaques (HRPs). RESULTS: We identified 234 ACS and control pairs (age 62 years, 63% male). More than 65% of patients with ACS had nonobstructive CAD at baseline, and 52% had HRP. The %DS, cross-sectional PB, fibrofatty and necrotic core volume, and HRP increased the adjusted hazard ratio (HR) of ACS (1.010 per %DS, 95% confidence interval [CI]: 1.005 to 1.015; 1.008 per percent cross-sectional PB, 95% CI: 1.003 to 1.013; 1.002 per mm(3) fibrofatty plaque, 95% CI: 1.000 to 1.003; 1.593 per mm(3) necrotic core, 95% CI: 1.219 to 2.082; all p < 0.05). Of the 129 culprit lesion precursors identified by coronary CTA, three-fourths exhibited <50% stenosis and 31.0% exhibited HRP. CONCLUSIONS: Although ACS increases with %DS, most precursors of ACS cases and culprit lesions are nonobstructive. Plaque evaluation, including HRP, PB, and plaque composition, identifies high-risk patients above and beyond stenosis severity and aggregate plaque burden. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Elsevier Biomedical | - |
dc.relation.isPartOf | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.title | Coronary Atherosclerotic Precursors of Acute Coronary Syndromes | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | Hyuk-Jae Chang | - |
dc.contributor.googleauthor | Fay Y Lin | - |
dc.contributor.googleauthor | Sang-Eun Lee | - |
dc.contributor.googleauthor | Daniele Andreini | - |
dc.contributor.googleauthor | Jeroen Bax | - |
dc.contributor.googleauthor | Filippo Cademartiri | - |
dc.contributor.googleauthor | Kavitha Chinnaiyan | - |
dc.contributor.googleauthor | Benjamin J W Chow | - |
dc.contributor.googleauthor | Edoardo Conte | - |
dc.contributor.googleauthor | Ricardo C Cury | - |
dc.contributor.googleauthor | Gudrun Feuchtner | - |
dc.contributor.googleauthor | Martin Hadamitzky | - |
dc.contributor.googleauthor | Yong-Jin Kim | - |
dc.contributor.googleauthor | Jonathon Leipsic | - |
dc.contributor.googleauthor | Erica Maffei | - |
dc.contributor.googleauthor | Hugo Marques | - |
dc.contributor.googleauthor | Fabian Plank | - |
dc.contributor.googleauthor | Gianluca Pontone | - |
dc.contributor.googleauthor | Gilbert L Raff | - |
dc.contributor.googleauthor | Alexander R van Rosendael | - |
dc.contributor.googleauthor | Todd C Villines | - |
dc.contributor.googleauthor | Harald G Weirich | - |
dc.contributor.googleauthor | Subhi J Al'Aref | - |
dc.contributor.googleauthor | Lohendran Baskaran | - |
dc.contributor.googleauthor | Iksung Cho | - |
dc.contributor.googleauthor | Ibrahim Danad | - |
dc.contributor.googleauthor | Donghee Han | - |
dc.contributor.googleauthor | Ran Heo | - |
dc.contributor.googleauthor | Ji Hyun Lee | - |
dc.contributor.googleauthor | Asim Rivzi | - |
dc.contributor.googleauthor | Wijnand J Stuijfzand | - |
dc.contributor.googleauthor | Heidi Gransar | - |
dc.contributor.googleauthor | Yao Lu | - |
dc.contributor.googleauthor | Ji Min Sung | - |
dc.contributor.googleauthor | Hyung-Bok Park | - |
dc.contributor.googleauthor | Daniel S Berman | - |
dc.contributor.googleauthor | Matthew J Budoff | - |
dc.contributor.googleauthor | Habib Samady | - |
dc.contributor.googleauthor | Leslee J Shaw | - |
dc.contributor.googleauthor | Peter H Stone | - |
dc.contributor.googleauthor | Renu Virmani | - |
dc.contributor.googleauthor | Jagat Narula | - |
dc.contributor.googleauthor | James K Min | - |
dc.identifier.doi | 10.1016/j.jacc.2018.02.079 | - |
dc.contributor.localId | A03490 | - |
dc.relation.journalcode | J01770 | - |
dc.identifier.eissn | 1558-3597 | - |
dc.identifier.pmid | 29852975 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S0735109718343717 | - |
dc.subject.keyword | acute coronary syndrome | - |
dc.subject.keyword | atherosclerosis | - |
dc.subject.keyword | clinical outcome | - |
dc.subject.keyword | coronary artery disease | - |
dc.subject.keyword | coronary computed tomography angiography | - |
dc.contributor.alternativeName | Chang, Hyuck Jae | - |
dc.contributor.affiliatedAuthor | Chang, Hyuck Jae | - |
dc.citation.volume | 71 | - |
dc.citation.number | 22 | - |
dc.citation.startPage | 2511 | - |
dc.citation.endPage | 2522 | - |
dc.identifier.bibliographicCitation | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol.71(22) : 2511-2522, 2018 | - |
dc.identifier.rimsid | 60179 | - |
dc.type.rims | ART | - |
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