The importance of nonobstructive plaque characteristics in symptomatic and asymptomatic coronary artery disease

We examined obstructive and nonobstructive plaque volumes in populations with subclinical and clinically manifested coronary artery disease (CAD) using quantitative computed tomography (QCT). 855 participants with CAD (274 asymptomatic individuals, 254 acute chest pain patients without acute coronar...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of cardiovascular computed tomography Vol. 18; no. 2; pp. 203 - 210
Main Authors:	de Knegt, Martina C., Linde, Jesper J., Sigvardsen, Per E., Engstrøm, Thomas, Fuchs, Andreas, Jensen, Andreas K., Elming, Hanne, Kühl, J. Tobias, Hansen, Peter R., Høfsten, Dan E., Kelbæk, Henning, Nordestgaard, Børge G., Hove, Jens D., Køber, Lars V., Kofoed, Klaus F., Nordestgaard, Børge, Sørgaard, Mathias, Norsk, Jakob, Frestad, Daria, Mejdahl, Mads, Elming, Marie, Sørensen, Samuel Kiil, Hindsøe, Louise, Thomsen, Anna Foged, Udholm, Patricia Martens, Pihl, Christian, Nilsson, Julia, Byrne, Christina, Knudsen, Andreas Dehlbæk, Haugen, Morten, Windfeld-Mathiasen, Josefine, Laura Wiegandt, Yaffah Tamar, Pham, Michael H.C., Ballegaard, Christian, Arnaa, Kirsten, Møller, Christina, Thrysøe, Kirsten, Jensen, Gorm B., Nielsen, Walter, Trysøe, Kirsten, Bock-Pedersen, Tina, Hansen, Bettina, Kløvgaard, Lene, Holmvang, Lene, Helquist, Steffen, Jørgensen, Erik, Petersen, Frans, Saunamaki, Kari, Clemmensen, Peter, Sadjadieh, Golnaz, Laursen, Peter Nørkjær, Petersen, Christian Torp, Hansen, Peter Riis, Gislason, Gunnar, Abildgaard, Ulrik, Jensen, Jan Skov, Galatius, Søren, Fritz-Hansen, Thomas, Bech, Jan, Wachtell, Christian, Madsen, Jan Kyst, Smedegaard, Lærke, Özcan, Cengiz, Heitmann, Merete, Svendsen, Ida Hastrup, Nielsen, Olav Wendelboe, Kristiansen, Ole, Bjerre, Andreas Fabricius, Dixen, Ulrik, Madsen, Johnny Koertz, Fornitz, Gitte Gleerup, Raymond, Ilan, Abdulla, Jawdat, Lyngbæk, Stig, Steffensen, Rolf, Jurlander, Birgit, Kragelund, Charlotte, Dominguez, Helena, Schou, Morten, Therkelsen, Susette
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-03-2024
Subjects:	Acute Coronary Syndrome Calcium Chest Pain Computed tomography Coronary Angiography - methods Coronary artery disease Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - epidemiology Humans Necrosis Nonobstructive plaque Plaque composition Plaque, Atherosclerotic Predictive Value of Tests Quantitative computed tomography NSTEMI VERDICT Nonobstructive plaque QCT UAP Plaque composition CAD ECG Coronary artery disease ACS BSA CCTA Quantitative computed tomography Computed tomography CATCH CGPS
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	We examined obstructive and nonobstructive plaque volumes in populations with subclinical and clinically manifested coronary artery disease (CAD) using quantitative computed tomography (QCT). 855 participants with CAD (274 asymptomatic individuals, 254 acute chest pain patients without acute coronary syndrome (ACS), and 327 patients with ACS) underwent QCT of proximal coronary segments to assess participant-level plaque volumes of dense calcium, fibrous, fibrofatty, and necrotic core tissue. Nonobstructive (<50% stenosis) plaque volumes were greater than obstructive plaque volumes, irrespective of population (all p<0.0001): Asymptomatic individuals (mean (95% CI)): 218 [190-250] vs. 16 [12-22] mm3; acute chest pain patients without ACS: 300 [263-341] vs. 51 [41-62] mm3; patients with ACS: 370 [332-412] vs. 159 [139-182] mm3. After multivariable adjustment, nonobstructive fibrous and fibrofatty tissue volumes were greater in acute chest pain patients without ACS compared to asymptomatic individuals (fibrous tissue: 122 [107-139] vs. 175 [155-197] mm3, p<0.01; fibrofatty tissue: 44 [38-50] vs. 71 [63-80] mm3, p<0.01. Necrotic core tissue was greater in ACS patients (29 [26-33] mm3) compared to both asymptomatic individuals (15 [13-18] mm3, p<0.0001) and acute chest pain patients without ACS (21 [18-24] mm3, p<0.05). Nonobstructive dense calcium volumes did not differ between the three populations: 29 [24-36], 29 [23-35], and 41 [34-48] mm3, p>0.3 respectively. Nonobstructive CAD was the predominant contributor to total atherosclerotic plaque volume in both subclinical and clinically manifested CAD. Nonobstructive fibrous, fibrofatty and necrotic core tissue volumes increased with worsening clinical presentation, while nonobstructive dense calcium tissue volumes did not.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1934-5925 1876-861X
DOI:	10.1016/j.jcct.2024.01.014