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Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study

Authors
 Sang-Eun Lee  ;  Ji Min Sung  ;  Daniele Andreini  ;  Matthew J. Budoff  ;  Filippo Cademartiri  ;  Kavitha Chinnaiyan  ;  Jung Hyun Choi  ;  Eun Ju Chun  ;  Edoardo Conte  ;  Ilan Gottlieb  ;  Martin Hadamitzky  ;  Yong Jin Kim  ;  Amit Kumar  ;  Byoung Kwon Lee  ;  Jonathon A. Leipsic  ;  Erica Maffei  ;  Hugo Marques  ;  Gianluca Pontone  ;  Gilbert Raff  ;  Sanghoon Shin  ;  Peter H. Stone  ;  Habib Samady  ;  Renu Virmani  ;  Jagat Narula  ;  Daniel S. Berman  ;  Leslee J. Shaw  ;  Jeroen J. Bax  ;  Fay Y. Lin  ;  James K. Min  ;  Hyuk-Jae Chang 
Citation
 EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol.20(11) : 1307-1314, 2019 
Journal Title
 EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING 
ISSN
 2047-2404 
Issue Date
2019
Keywords
Agatston score ; coronary artery atherosclerosis ; coronary artery calcification ; coronary artery calcium score ; coronary computed tomography angiography ; statins
Abstract
AIMS: Coronary artery calcium score (CACS) is a strong predictor of major adverse cardiac events (MACE). Conversely, statins, which markedly reduce MACE risk, increase CACS. We explored whether CACS progression represents compositional plaque volume (PV) progression differently according to statin use. METHODS AND RESULTS: From a prospective multinational registry of consecutive patients (n = 2252) who underwent serial coronary computed tomography angiography (CCTA) at a ≥ 2-year interval, 654 patients (61 ± 10 years, 56% men, inter-scan interval 3.9 ± 1.5 years) with information regarding the use of statins and having a serial CACS were included. Patients were divided into non-statin (n = 246) and statin-taking (n = 408) groups. Coronary PVs (total, calcified, and non-calcified; sum of fibrous, fibro-fatty, and lipid-rich) were quantitatively analysed, and CACS was measured from both CCTAs. Multivariate linear regression models were constructed for both statin-taking and non-statin group to assess the association between compositional PV change and change in CACS. In multivariate linear regression analysis, in the non-statin group, CACS increase was positively associated with both non-calcified (β = 0.369, P = 0.004) and calcified PV increase (β = 1.579, P < 0.001). However, in the statin-taking group, CACS increase was positively associated with calcified PV change (β = 0.756, P < 0.001) but was negatively associated with non-calcified PV change (β = -0.194, P = 0.026). CONCLUSION: In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins.
Full Text
https://academic.oup.com/ehjcimaging/article/20/11/1307/5353147
DOI
10.1093/ehjci/jez022
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/22282913/174608
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