Quantitative global plaque characteristics from coronary computed tomography angiography for the prediction of future cardiac mortality during long-term follow-up

Hell MM, Motwani M, Otaki Y, Cadet S, Gransar H, Miranda-Peats R, Valk J, Slomka PJ, Cheng VY, Rozanski A, Tamarappoo BK, Hayes S, Achenbach S, Berman DS, Dey D (2017)

Publication Type: Journal article

Publication year: 2017

Journal

European Heart Journal - Cardiovascular Imaging Oxford University Press

Book Volume: 18

Pages Range: 1331-1339

Journal Issue: 12

DOI: 10.1093/ehjci/jex183

Abstract

Aims: Adverse plaque characteristics determined by coronary computed tomography angiography (CTA) have been associated with future cardiac events. Our aim was to investigate whether quantitative global per-patient plaque characteristics from coronary CTA can predict subsequent cardiac death during long-term follow-up. Methods and results: Out of 2748 patients without prior history of coronary artery disease undergoing CTA with dual-source CT, 32 patients suffered cardiac death (mean follow-up of 5 ± 2 years). These patients were matched to 32 controls by age, gender, risk factors, and symptoms (total 64 patients, 59% male, age 69 ± 10 years). Coronary CTA data sets were analysed by semi-automated software to quantify plaque characteristics over the entire coronary tree, including total plaque volume, volumes of non-calcified plaque (NCP), low-density non-calcified plaque (LD-NCP, attenuation <30 Hounsfield units), calcified plaque (CP), and corresponding burden (plaque volume × 100%/vessel volume), as well as stenosis and contrast density difference (CDD, maximum percent difference in luminal attenuation/cross-sectional area compared to proximal cross-section). In patients who died from cardiac cause, NCP, LD-NCP, CP and total plaque volumes, quantitative stenosis, and CDD were significantly increased compared to controls (P < 0.025 for all). NCP > 146 mm³ [hazards ratio (HR) 2.24; 1.09-4.58; P = 0.027], LD-NCP > 10.6 mm³ (HR 2.26; 1.11-4.63; P = 0.025), total plaque volume > 179 mm³ (HR 2.30; 1.12-4.71; P = 0.022), and CDD > 35% in any vessel (HR 2.85;1.4-5.9; P = 0.005) were associated with increased risk of future cardiac death, when adjusted for segment involvement score. Conclusion: Among quantitative global plaque characteristics, total, non-calcified, and low-density plaque volumes as well as CDD predict cardiac death in long-term follow-up.

Authors with CRIS profile

Stephan Achenbach Department of Medicine 2 – Cardiology and Angiology

Involved external institutions

Cedars-Sinai Medical Center US United States (USA) (US) Mount Sinai Hospital US United States (USA) (US) Oklahoma Heart Institute US United States (USA) (US)

How to cite

APA:

Hell, M.M., Motwani, M., Otaki, Y., Cadet, S., Gransar, H., Miranda-Peats, R.,... Dey, D. (2017). Quantitative global plaque characteristics from coronary computed tomography angiography for the prediction of future cardiac mortality during long-term follow-up. European Heart Journal - Cardiovascular Imaging, 18(12), 1331-1339. https://doi.org/10.1093/ehjci/jex183

MLA:

Hell, Michaela M., et al. "Quantitative global plaque characteristics from coronary computed tomography angiography for the prediction of future cardiac mortality during long-term follow-up." European Heart Journal - Cardiovascular Imaging 18.12 (2017): 1331-1339.

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