Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up
Sadako Motoyama, Hajime Ito, Masayoshi Sarai, Takeshi Kondo, Hideki Kawai, Yasuomi Nagahara, Hiroto Harigaya, Shino Kan, Hirofumi Anno, Hiroshi Takahashi, Hiroyuki Naruse, Junichi Ishii, Harvey Hecht, Leslee J. Shaw, Yukio Ozaki, Jagat Narula
Faculty of Rehabilitation
Joint Research Laboratory of Clinical Medicine
Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.
https://doi.org/10.1016/j.jacc.2015.05.069
10.1016/j.jacc.2015.05.069
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Computed Tomography Angiography Medicine & Life Sciences
Acute Coronary Syndrome Medicine & Life Sciences
Pathologic Constriction Medicine & Life Sciences
Fatal Outcome Medicine & Life Sciences
Motoyama, S., Ito, H., Sarai, M., Kondo, T., Kawai, H., Nagahara, Y., Harigaya, H., Kan, S., Anno, H., Takahashi, H., Naruse, H., Ishii, J., Hecht, H., Shaw, L. J., Ozaki, Y., & Narula, J. (2015). Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. Journal of the American College of Cardiology, 66(4), 337-346. https://doi.org/10.1016/j.jacc.2015.05.069
Motoyama, Sadako ; Ito, Hajime ; Sarai, Masayoshi ; Kondo, Takeshi ; Kawai, Hideki ; Nagahara, Yasuomi ; Harigaya, Hiroto ; Kan, Shino ; Anno, Hirofumi ; Takahashi, Hiroshi ; Naruse, Hiroyuki ; Ishii, Junichi ; Hecht, Harvey ; Shaw, Leslee J. ; Ozaki, Yukio ; Narula, Jagat. / Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. In: Journal of the American College of Cardiology. 2015 ; Vol. 66, No. 4. pp. 337-346.
@article{5453ed0a034b45a69e8bddef621c3e2b,
title = "Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up",
abstract = "Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.",
author = "Sadako Motoyama and Hajime Ito and Masayoshi Sarai and Takeshi Kondo and Hideki Kawai and Yasuomi Nagahara and Hiroto Harigaya and Shino Kan and Hirofumi Anno and Hiroshi Takahashi and Hiroyuki Naruse and Junichi Ishii and Harvey Hecht and Shaw, {Leslee J.} and Yukio Ozaki and Jagat Narula",
note = "Publisher Copyright: {\textcopyright} 2015 American College of Cardiology Foundation. Copyright: Copyright 2015 Elsevier B.V., All rights reserved.",
doi = "10.1016/j.jacc.2015.05.069",
journal = "Journal of the American College of Cardiology",
publisher = "Elsevier USA",
Motoyama, S, Ito, H, Sarai, M, Kondo, T, Kawai, H, Nagahara, Y, Harigaya, H, Kan, S, Anno, H, Takahashi, H, Naruse, H, Ishii, J, Hecht, H, Shaw, LJ, Ozaki, Y & Narula, J 2015, 'Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up', Journal of the American College of Cardiology, vol. 66, no. 4, pp. 337-346. https://doi.org/10.1016/j.jacc.2015.05.069
Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. / Motoyama, Sadako; Ito, Hajime; Sarai, Masayoshi; Kondo, Takeshi; Kawai, Hideki; Nagahara, Yasuomi; Harigaya, Hiroto; Kan, Shino; Anno, Hirofumi; Takahashi, Hiroshi; Naruse, Hiroyuki; Ishii, Junichi; Hecht, Harvey; Shaw, Leslee J.; Ozaki, Yukio; Narula, Jagat.
In: Journal of the American College of Cardiology, Vol. 66, No. 4, 28.07.2015, p. 337-346.
T1 - Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up
AU - Motoyama, Sadako
AU - Ito, Hajime
AU - Sarai, Masayoshi
AU - Kondo, Takeshi
AU - Kawai, Hideki
AU - Nagahara, Yasuomi
AU - Harigaya, Hiroto
AU - Kan, Shino
AU - Anno, Hirofumi
AU - Takahashi, Hiroshi
AU - Naruse, Hiroyuki
AU - Ishii, Junichi
AU - Hecht, Harvey
AU - Shaw, Leslee J.
AU - Ozaki, Yukio
AU - Narula, Jagat
N1 - Publisher Copyright: © 2015 American College of Cardiology Foundation. Copyright: Copyright 2015 Elsevier B.V., All rights reserved.
N2 - Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.
AB - Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.
U2 - 10.1016/j.jacc.2015.05.069
DO - 10.1016/j.jacc.2015.05.069
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
Motoyama S, Ito H, Sarai M, Kondo T, Kawai H, Nagahara Y et al. Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. Journal of the American College of Cardiology. 2015 Jul 28;66(4):337-346. https://doi.org/10.1016/j.jacc.2015.05.069
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