Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population
Introduction: Low-attenuation non-calcified plaque (LAP) burden and vascular inflammation by pericoronary adipose tissue (PCAT) measured from coronary CT angiography (CCTA) have shown to be predictors of cardiovascular outcomes. We aimed to investigate the relationships of cardiometabolic risk facto...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667723001198 |
| _version_ | 1797672025229099008 |
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| author | Toshiki Kuno Javier Arce Michael Fattouh Sharmila Sarkar John P Skendelas Jonathan Daich Aldo L Schenone Lili Zhang Carlos J Rodriguez Salim S Virani Piotr J Slomka Leslee J Shaw Eric E Williamson Daniel S Berman Mario J Garcia Damini Dey Leandro Slipczuk |
| author_facet | Toshiki Kuno Javier Arce Michael Fattouh Sharmila Sarkar John P Skendelas Jonathan Daich Aldo L Schenone Lili Zhang Carlos J Rodriguez Salim S Virani Piotr J Slomka Leslee J Shaw Eric E Williamson Daniel S Berman Mario J Garcia Damini Dey Leandro Slipczuk |
| author_sort | Toshiki Kuno |
| collection | DOAJ |
| description | Introduction: Low-attenuation non-calcified plaque (LAP) burden and vascular inflammation by pericoronary adipose tissue (PCAT) measured from coronary CT angiography (CCTA) have shown to be predictors of cardiovascular outcomes. We aimed to investigate the relationships of cardiometabolic risk factors including lipoprotein(a) and epicardial adipose tissue (EAT) with CCTA high-risk imaging biomarkers, LAP and vascular inflammation. Methods: The patient population consisted of consecutive patients who underwent CCTA for stable chest pain and had a complete cardiometabolic panel including lipoprotein(a). Plaque, PCAT and EAT were measured from CT using semiautomated software. Elevated LAP burden and PCAT attenuation were defined as ≥4% and ≥70.5 HU, respectively. The primary clinical end-point was a composite of myocardial infarction, revascularization or cardiovascular death. Results: A total of 364 consecutive patients were included (median age 56 years, 64% female); the majority of patients were of Hispanic (60%), and the rest were of non-Hispanic Black (21%), non-Hispanic White (6%) and non-Hispanic Asian (4%) race/ethnicity. The prevalence of elevated LAP burden and PCAT attenuation was 31 and 18%, respectively, while only 8% had obstructive stenosis. There were significant differences in plaque characteristics among different racial/ethnic groups (p<0.001). Lipoprotein(a) correlated with LAP burden in Hispanic patients. Patients with elevated LAP were older, more likely to be have diabetes, hypertension, hyperlipidemia and smoke with higher CAC and EAT volume (all P<0.05). Patients with elevated LAP were more likely to develop the primary clinical outcome (p<0.001) but those with elevated PCAT were not (p=0.797). Conclusion: The prevalence of LAP and PCAT attenuation were 31 and 18%, respectively. Lipoprotein(a) levels correlated with LAP burden in Hispanic patients. Age, male sex, hypertension and hyperlipidemia increased the odds of elevated LAP, which showed prognostic significance. |
| first_indexed | 2024-03-11T21:24:05Z |
| format | Article |
| id | doaj.art-99bcbe62bb5d439ca0f19af55f817afa |
| institution | Directory Open Access Journal |
| issn | 2666-6677 |
| language | English |
| last_indexed | 2024-03-11T21:24:05Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj.art-99bcbe62bb5d439ca0f19af55f817afa2023-09-28T05:26:37ZengElsevierAmerican Journal of Preventive Cardiology2666-66772023-09-0115100578Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient populationToshiki Kuno0Javier Arce1Michael Fattouh2Sharmila Sarkar3John P Skendelas4Jonathan Daich5Aldo L Schenone6Lili Zhang7Carlos J Rodriguez8Salim S Virani9Piotr J Slomka10Leslee J Shaw11Eric E Williamson12Daniel S Berman13Mario J Garcia14Damini Dey15Leandro Slipczuk16Cardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiothoracic and Vascular Surgery Department, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesOffice of the Vice Provost (Research), The Aga Khan University, Karachi, Pakistan; Division of Cardiology, The Texas Heart Institute/Baylor College of Medicine, Houston, TX, United StatesDivision of Cardiology, The Texas Heart Institute/Baylor College of Medicine, Houston, TX, United StatesDepartments of Medicine (Cardiology) and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesMayo Clinic, Rochester, MN, United StatesDivision of Cardiology, The Texas Heart Institute/Baylor College of Medicine, Houston, TX, United StatesCardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United StatesDepartment of Imaging, Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, United States; Corresponding authors.Cardiology Division, Montefiore Medical Center, Montefiore Medical Center/Albert Einstein Colalege of Medicine, Cardiology Division. 111 E210th, Bronx, NY 10467, United States; Corresponding authors.Introduction: Low-attenuation non-calcified plaque (LAP) burden and vascular inflammation by pericoronary adipose tissue (PCAT) measured from coronary CT angiography (CCTA) have shown to be predictors of cardiovascular outcomes. We aimed to investigate the relationships of cardiometabolic risk factors including lipoprotein(a) and epicardial adipose tissue (EAT) with CCTA high-risk imaging biomarkers, LAP and vascular inflammation. Methods: The patient population consisted of consecutive patients who underwent CCTA for stable chest pain and had a complete cardiometabolic panel including lipoprotein(a). Plaque, PCAT and EAT were measured from CT using semiautomated software. Elevated LAP burden and PCAT attenuation were defined as ≥4% and ≥70.5 HU, respectively. The primary clinical end-point was a composite of myocardial infarction, revascularization or cardiovascular death. Results: A total of 364 consecutive patients were included (median age 56 years, 64% female); the majority of patients were of Hispanic (60%), and the rest were of non-Hispanic Black (21%), non-Hispanic White (6%) and non-Hispanic Asian (4%) race/ethnicity. The prevalence of elevated LAP burden and PCAT attenuation was 31 and 18%, respectively, while only 8% had obstructive stenosis. There were significant differences in plaque characteristics among different racial/ethnic groups (p<0.001). Lipoprotein(a) correlated with LAP burden in Hispanic patients. Patients with elevated LAP were older, more likely to be have diabetes, hypertension, hyperlipidemia and smoke with higher CAC and EAT volume (all P<0.05). Patients with elevated LAP were more likely to develop the primary clinical outcome (p<0.001) but those with elevated PCAT were not (p=0.797). Conclusion: The prevalence of LAP and PCAT attenuation were 31 and 18%, respectively. Lipoprotein(a) levels correlated with LAP burden in Hispanic patients. Age, male sex, hypertension and hyperlipidemia increased the odds of elevated LAP, which showed prognostic significance.http://www.sciencedirect.com/science/article/pii/S2666667723001198High-risk plaqueCT coronary angiogramRisk factorsPCATLAPEpicardial adipose tissue |
| spellingShingle | Toshiki Kuno Javier Arce Michael Fattouh Sharmila Sarkar John P Skendelas Jonathan Daich Aldo L Schenone Lili Zhang Carlos J Rodriguez Salim S Virani Piotr J Slomka Leslee J Shaw Eric E Williamson Daniel S Berman Mario J Garcia Damini Dey Leandro Slipczuk Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population American Journal of Preventive Cardiology High-risk plaque CT coronary angiogram Risk factors PCAT LAP Epicardial adipose tissue |
| title | Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population |
| title_full | Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population |
| title_fullStr | Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population |
| title_full_unstemmed | Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population |
| title_short | Cardiometabolic predictors of high-risk CCTA phenotype in a diverse patient population |
| title_sort | cardiometabolic predictors of high risk ccta phenotype in a diverse patient population |
| topic | High-risk plaque CT coronary angiogram Risk factors PCAT LAP Epicardial adipose tissue |
| url | http://www.sciencedirect.com/science/article/pii/S2666667723001198 |
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