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Quantification of Coronary Atherosclerosis in the Assessment of Coronary Artery Disease

Authors
 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 Choi  ;  Kavitha 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 
Citation
 CIRCULATION-CARDIOVASCULAR IMAGING, Vol.11(7) : e007562, 2018 
Journal Title
 CIRCULATION-CARDIOVASCULAR IMAGING 
ISSN
 1941-9651 
Issue Date
2018
Keywords
angiography ; atherosclerosis ; coronary artery disease ; myocardial infarction ; risk factors
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.
Full Text
https://www.ahajournals.org/doi/full/10.1161/CIRCIMAGING.117.007562
DOI
10.1161/CIRCIMAGING.117.007562
Appears in Collections:
5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Sung, Ji Min(성지민)
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166776
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