J Cardiovasc Comput Tomogr. 2021;15(3):232-239.
Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy.
제1저자 김민관 · 교신저자 이승표
소속 (26)
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea; Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, South Korea.
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea. Electronic address: sproll1@snu.ac.kr.
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea.
- Centro Cardiologico Monzino, IRCCS Milan, Italy.
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA.
- Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA.
- Cardiovascular Imaging Center, SDN IRCCS, Naples, Italy.
- Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA.
- Pusan National University Hospital, Busan, South Korea.
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal.
- Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil.
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany.
- Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada.
- Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy.
- Division of Cardiology, Department of Internal Medicine, Ewha Woman's University Seoul Hospital, Seoul, South Korea.
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
- Seoul National University Bundang Hospital, Seongnam, South Korea.
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
- Division of Cardiology, Department of Internal Medicine, Ewha Woman's University Seoul Hospital, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
- Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA.
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA.
- Department of Pathology, CVPath Institute, Gaithersburg, MD, USA.
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA.
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Abstract
BACKGROUND The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA).
METHODS From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression.
RESULTS With a 3.3-years' median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm3/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm3/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and < 0.001, respectively). However, this tendency was not observed in any other plaque components. The annual volume changes of total plaque and dense calcification were also significantly different in the propensity score-matched lowest age quartile group versus the other age groups as was the composite clinical event (log-rank p = 0.003). In random forest analysis, age had comparable importance in the total plaque volume progression as other traditional factors.
CONCLUSIONS The rate of whole-heart plaque progression and dense calcification increases depending on age. Age is a significant factor in plaque growth, the importance of which is comparable to other traditional risk factors.
CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifiers: NCT02803411.
Copyright © 2020 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
Keywords
AgingComputed tomographyCoronary artery diseaseDisease progressionatherosclerotic plaque
Conflict of interest statement
Declaration of competing interest Dr. Min receives funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare and serves on the scientific advisory board of Arineta and GE Healthcare, and has an equity interest in Clearly. Dr. Samady serves on the scientific advisory board of Philips, has equity interest in Covanos Inc., and has a research grant from Medtronic. The remaining authors have no relevant disclosures.
그 밖의 정보
- 출판 형태
- Journal Article, Multicenter Study, Observational Study
- 저널
- Journal of cardiovascular computed tomography · eISSN 1876-861X
- 전자 출판
- 2020-10-01
- MeSH
- Adult · Age Factors · Aged · Computed Tomography Angiography* · Coronary Artery Disease / diagnostic imaging · Disease Progression · Female · Heart Disease Risk Factors · Humans · Male · Middle Aged · Plaque, Atherosclerotic* · Predictive Value of Tests · Prognosis · Prospective Studies · Registries · Risk Assessment · Vascular Calcification / diagnostic imaging
- 데이터
- ClinicalTrials.gov: NCT02803411