Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study
Background The role of coronary calcification in cardiovascular events and plaque stabilization is still being debated, and factors involved in the progression of coronary calcification are not fully understood. This study aimed to identify the predictors for rapid progression of coronary calcificat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019235 |
| _version_ | 1828859158460366848 |
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| author | Akihiro Nakajima Makoto Araki Osamu Kurihara Yoshiyasu Minami Tsunenari Soeda Taishi Yonetsu Takumi Higuma Tsunekazu Kakuta Iris McNulty Hang Lee Rajeev Malhotra Sunao Nakamura Ik‐Kyung Jang |
| author_facet | Akihiro Nakajima Makoto Araki Osamu Kurihara Yoshiyasu Minami Tsunenari Soeda Taishi Yonetsu Takumi Higuma Tsunekazu Kakuta Iris McNulty Hang Lee Rajeev Malhotra Sunao Nakamura Ik‐Kyung Jang |
| author_sort | Akihiro Nakajima |
| collection | DOAJ |
| description | Background The role of coronary calcification in cardiovascular events and plaque stabilization is still being debated, and factors involved in the progression of coronary calcification are not fully understood. This study aimed to identify the predictors for rapid progression of coronary calcification. Methods and Results Patients with serial optical coherence tomography imaging at baseline and at 6 months were selected. Changes in the calcification index and predictors for progression of calcification were studied. Calcification index was defined as the product of the mean calcification arc and calcification length. Rapid progression of calcification was defined as an increase in the calcification index above the median value. Among 187 patients who had serial optical coherence tomography imaging, 235 calcified plaques were identified in 105 patients (56.1%) at baseline. After 6 months, the calcification index increased in 95.3% of calcified plaques from 132.0 to 178.2 (P<0.001). In multivariable analysis, diabetes mellitus (odds ratio [OR], 3.911; P<0.001), chronic kidney disease (OR, 2.432; P=0.037), lipid‐rich plaque (OR, 2.698; P=0.034), and macrophages (OR, 6.782; P<0.001) were found to be independent predictors for rapid progression of coronary calcification. Interestingly, rapid progression of calcification was associated with a significant reduction of inflammatory features (thin‐cap fibroatheroma; from 21.2% to 11.9%, P=0.003; macrophages; from 74.6% to 61.0%, P=0.001). Conclusions Diabetes mellitus, chronic kidney disease, lipid‐rich plaque, and macrophages were independent predictors for rapid progression of coronary calcification. Baseline vascular inflammation and subsequent stabilization may be related to rapid progression of calcification. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01110538. |
| first_indexed | 2024-12-13T02:12:51Z |
| format | Article |
| id | doaj.art-0db6208f80924aa7812b9e95895c7890 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T02:12:51Z |
| publishDate | 2021-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-0db6208f80924aa7812b9e95895c78902022-12-22T00:02:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-02-0110310.1161/JAHA.120.019235Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography StudyAkihiro Nakajima0Makoto Araki1Osamu Kurihara2Yoshiyasu Minami3Tsunenari Soeda4Taishi Yonetsu5Takumi Higuma6Tsunekazu Kakuta7Iris McNulty8Hang Lee9Rajeev Malhotra10Sunao Nakamura11Ik‐Kyung Jang12Cardiology Division Massachusetts General HospitalHarvard Medical School Boston MACardiology Division Massachusetts General HospitalHarvard Medical School Boston MACardiology Division Massachusetts General HospitalHarvard Medical School Boston MADepartment of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Kanagawa JapanDepartment of Cardiovascular Medicine Nara Medical University Kashihara Nara JapanDepartment of Interventional Cardiology Tokyo Medical and Dental University Tokyo JapanDivision of Cardiology Department of Internal Medicine St. Marianna University School of Medicine Kanagawa JapanDepartment of Cardiology Tsuchiura Kyodo General Hospital Tsuchiura Ibaraki JapanCardiology Division Massachusetts General HospitalHarvard Medical School Boston MABiostatistics Center Massachusetts General HospitalHarvard Medical School Boston MACardiology Division Massachusetts General HospitalHarvard Medical School Boston MAInterventional Cardiology Unit New Tokyo Hospital Chiba JapanCardiology Division Massachusetts General HospitalHarvard Medical School Boston MABackground The role of coronary calcification in cardiovascular events and plaque stabilization is still being debated, and factors involved in the progression of coronary calcification are not fully understood. This study aimed to identify the predictors for rapid progression of coronary calcification. Methods and Results Patients with serial optical coherence tomography imaging at baseline and at 6 months were selected. Changes in the calcification index and predictors for progression of calcification were studied. Calcification index was defined as the product of the mean calcification arc and calcification length. Rapid progression of calcification was defined as an increase in the calcification index above the median value. Among 187 patients who had serial optical coherence tomography imaging, 235 calcified plaques were identified in 105 patients (56.1%) at baseline. After 6 months, the calcification index increased in 95.3% of calcified plaques from 132.0 to 178.2 (P<0.001). In multivariable analysis, diabetes mellitus (odds ratio [OR], 3.911; P<0.001), chronic kidney disease (OR, 2.432; P=0.037), lipid‐rich plaque (OR, 2.698; P=0.034), and macrophages (OR, 6.782; P<0.001) were found to be independent predictors for rapid progression of coronary calcification. Interestingly, rapid progression of calcification was associated with a significant reduction of inflammatory features (thin‐cap fibroatheroma; from 21.2% to 11.9%, P=0.003; macrophages; from 74.6% to 61.0%, P=0.001). Conclusions Diabetes mellitus, chronic kidney disease, lipid‐rich plaque, and macrophages were independent predictors for rapid progression of coronary calcification. Baseline vascular inflammation and subsequent stabilization may be related to rapid progression of calcification. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01110538.https://www.ahajournals.org/doi/10.1161/JAHA.120.019235calcificationinflammationlipid‐rich plaquemacrophageoptical coherence tomography |
| spellingShingle | Akihiro Nakajima Makoto Araki Osamu Kurihara Yoshiyasu Minami Tsunenari Soeda Taishi Yonetsu Takumi Higuma Tsunekazu Kakuta Iris McNulty Hang Lee Rajeev Malhotra Sunao Nakamura Ik‐Kyung Jang Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease calcification inflammation lipid‐rich plaque macrophage optical coherence tomography |
| title | Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study |
| title_full | Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study |
| title_fullStr | Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study |
| title_full_unstemmed | Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study |
| title_short | Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study |
| title_sort | predictors for rapid progression of coronary calcification an optical coherence tomography study |
| topic | calcification inflammation lipid‐rich plaque macrophage optical coherence tomography |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019235 |
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