Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals
Objective Coronary CT angiography (CCTA) permits both qualitative and quantitative analysis of atherosclerotic plaque and may be a suitable risk modifier in assessing patients at intermediate risk of atherosclerotic cardiovascular disease. We sought to determine the association of plaque components...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/11/1/e002609.full |
| _version_ | 1797267924717666304 |
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| author | Andrew Taylor Dion Stub Andris Ellims Jason Bloom Josephine Warren Nigel Sutherland Philip Lew Helen Kavnoudias Sarang Paleri |
| author_facet | Andrew Taylor Dion Stub Andris Ellims Jason Bloom Josephine Warren Nigel Sutherland Philip Lew Helen Kavnoudias Sarang Paleri |
| author_sort | Andrew Taylor |
| collection | DOAJ |
| description | Objective Coronary CT angiography (CCTA) permits both qualitative and quantitative analysis of atherosclerotic plaque and may be a suitable risk modifier in assessing patients at intermediate risk of atherosclerotic cardiovascular disease. We sought to determine the association of plaque components with long-term major adverse cardiovascular events (MACEs) in asymptomatic intermediate-risk patients, compared with conventional coronary artery calcium (CAC) score.Methods 100 intermediate-risk patients underwent double-blinded CCTA. Follow-up was conducted at 10 years and data were cross-referenced with the National Death Index. The primary outcome was MACE, which was a composite of death, acute coronary syndrome (ACS), revascularisation and stroke.Results The median time from CCTA to follow-up was 9.5 years. 83 patients completed follow-up interview and mortality data were available on all 100 patients. MACE occurred in 17 (20.5%) patients, which included 2 (2%) deaths, 8 (10%) ACS, 3 (4%) strokes and 5 (6%) revascularisation procedures. 47 (57%) patients had mixed plaque, which was predictive of MACE (OR 4.68 (95% CI 1.19 to 18.5) p=0.028). The burden of non-calcified and mixed plaque, defined by non-calcified plaque segment stenosis score, was also a predictor of long-term MACE (OR 1.59 (95% CI 1.18 to 2.13) p=0.002). Neither calcified plaque (OR 3.92 (95% CI 0.80 to 19.3)) nor CAC score (OR 1.01 (95% CI 0.999 to 1.02)) was associated with long-term MACE.Conclusion The presence and burden of mixed plaque on CCTA is associated with an increased risk of long-term MACE among asymptomatic intermediate-risk patients and is a superior predictor to CAC score. |
| first_indexed | 2024-04-25T01:24:19Z |
| format | Article |
| id | doaj.art-1113f7e1a345438ba6f530ccc8ac47c1 |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-04-25T01:24:19Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-1113f7e1a345438ba6f530ccc8ac47c12024-03-09T05:05:09ZengBMJ Publishing GroupOpen Heart2053-36242024-03-0111110.1136/openhrt-2024-002609Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individualsAndrew Taylor0Dion Stub1Andris Ellims2Jason Bloom3Josephine Warren4Nigel Sutherland5Philip Lew6Helen Kavnoudias7Sarang Paleri8Department of Cardiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Cardiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Cardiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Cardiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Cardiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Cardiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Radiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Radiology, Alfred Hospital, Melbourne, Victoria, AustraliaDepartment of Cardiology, Royal Hobart Hospital, Hobart, Tasmania, AustraliaObjective Coronary CT angiography (CCTA) permits both qualitative and quantitative analysis of atherosclerotic plaque and may be a suitable risk modifier in assessing patients at intermediate risk of atherosclerotic cardiovascular disease. We sought to determine the association of plaque components with long-term major adverse cardiovascular events (MACEs) in asymptomatic intermediate-risk patients, compared with conventional coronary artery calcium (CAC) score.Methods 100 intermediate-risk patients underwent double-blinded CCTA. Follow-up was conducted at 10 years and data were cross-referenced with the National Death Index. The primary outcome was MACE, which was a composite of death, acute coronary syndrome (ACS), revascularisation and stroke.Results The median time from CCTA to follow-up was 9.5 years. 83 patients completed follow-up interview and mortality data were available on all 100 patients. MACE occurred in 17 (20.5%) patients, which included 2 (2%) deaths, 8 (10%) ACS, 3 (4%) strokes and 5 (6%) revascularisation procedures. 47 (57%) patients had mixed plaque, which was predictive of MACE (OR 4.68 (95% CI 1.19 to 18.5) p=0.028). The burden of non-calcified and mixed plaque, defined by non-calcified plaque segment stenosis score, was also a predictor of long-term MACE (OR 1.59 (95% CI 1.18 to 2.13) p=0.002). Neither calcified plaque (OR 3.92 (95% CI 0.80 to 19.3)) nor CAC score (OR 1.01 (95% CI 0.999 to 1.02)) was associated with long-term MACE.Conclusion The presence and burden of mixed plaque on CCTA is associated with an increased risk of long-term MACE among asymptomatic intermediate-risk patients and is a superior predictor to CAC score.https://openheart.bmj.com/content/11/1/e002609.full |
| spellingShingle | Andrew Taylor Dion Stub Andris Ellims Jason Bloom Josephine Warren Nigel Sutherland Philip Lew Helen Kavnoudias Sarang Paleri Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals Open Heart |
| title | Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals |
| title_full | Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals |
| title_fullStr | Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals |
| title_full_unstemmed | Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals |
| title_short | Mixed plaque on coronary CT angiography predicts atherosclerotic events in asymptomatic intermediate-risk individuals |
| title_sort | mixed plaque on coronary ct angiography predicts atherosclerotic events in asymptomatic intermediate risk individuals |
| url | https://openheart.bmj.com/content/11/1/e002609.full |
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