Assessment of coronary artery plaque progression using 64 slice multi-detector computed tomography (MDCT)

BACKGROUND: Coronary artery disease (CAD) is one of the leading cause of death. So the effective method for early detection of subclinical CAD and the prevention of developing acute coronary syndrome were emphasized for many years. Coronary MDCT is non-invasive technique, and enable to detect of non-calcified atherosclerotic plaque and assess the plaque composition. Also coronary MDCT is an effective tool for assessment of serial change in plaque volume and then it would be used as a surrogate endpoint in clinical trials testing the efficacy of anti-atherosclerotic therapy. OBJECTIVES: To evaluated the progression of atherosclerotic plaque during follow-up interval and its association with cardiovascular risk profile. MATERIALS AND METHODS: Fifty-six patients who had plaque detected on repeated 64-slice multi-detector computed tomography (MDCT) with a mean interval of 25 ± 10 months were enrolled in this retrospective study. Calcified plaque volume was measured using noncontrast calcium scoring CT. Non-calcified plaque volume was measured using contrastenhanced coronary CT angiography (CTA) and a commercially available plaque analysis tool. Changes in calcified and non-calcified plaque volumes and cardiovascular risk factors were assessed over time using the Wilcoxon signed-rank test. Absolute and relative changes in plaque volume were also compared using the Mann–Whitney test, and the association between rapid plaque progression and cardiovascular risk factors was determined using logistic regression analysis. RESULT: Diameter of the stenosis, length and calcified and non-calcified plaque volumes of the lesions (p < 0.001) increased significantly on follow-up CT. Absolute and relative annual changes in plaque volumes were significantly greater (p < 0.001) in non-calcified plaque (median, 22.7 mm3 and 90.4%) than in calcified plaque (median, 0.7 mm3 and 0%). Cardiovascular risk factors were significant predictors of progression of non-calcified plaque. In particular, obesity (BMI > 25 kg/m2), smoking history, and high-density lipoprotein (HDL) level were independent predictors of both rapid absolute (odds ratios [ORs], 2.41, 4.39, and 0.94, respectively) and relative (OR, 6.82, 5.48, and 0.87, respectively) annual changes in non-calcified plaque volume in a multivariate analysis. However, the progression of calcified plaque was not associated with any cardiovascular risk factors. CONCLUSION: Coronary plaque volume increased significantly on follow-up CT, but the rate of progression was greater for non-calcified plaque than for calcified plaque. Additionally, cardiovascular risk factors were independently associated with the rapid progression of noncalcified plaque volume as assessed by MDCT but not associated with the progression of calcified plaque.

Author dc:creator

• 김, 은영

Contributors dc:contributor

• 강, 두경
• 대학원 의학과
• 107322

• Coronary CT angiography
• coronary artery calcium
• atherosclerotic plaque
• cardiovascular risk factors

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000013441
000000013441

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/8625