Comparison of coronary plaque subtypes in male and female patients using 320-row MDCTA

Khosa, Faisal; Khan, Atif; Nasir, Khurram; Bedayat, Arash; Malik, Zehra; Jon, Ali F.; Cheema, Ali; Clouse, Melvin E.; Welty, Francine K.

doi:10.1016/j.atherosclerosis.2012.11.033

Cited by 11 publications

(8 citation statements)

References 45 publications

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“…In conclusion, with our methods, LBW exhibited the strongest correlation with aortic and hepatic enhancement. We suggest it as the best body in atherosclerotic changes may be involved, as the degree of carotid atherosclerosis is higher in men than in women (32,33), as is the severity of coronary artery atherosclerosis (34)(35)(36). Atherosclerotic changes may increase vascular resistance, and this may affect enhancement of the aorta and liver.…”

Section: Discussionmentioning

confidence: 96%

The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study

et al. 2016

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Section: Discussionmentioning

confidence: 96%

The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study

et al. 2016

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“…The protocol for performance of CCTA, plaque identification, and quantification has been previously published14, 15 with image acquisition details and references in Appendix 1 in Supplement 2 of Hauser et al 15…”

Section: Methodsmentioning

confidence: 99%

“…Imaging was performed at Beth Israel Deaconess Medical Center using a 320-row detector scanner (Aquilion ONE; Toshiba Medical Systems, Otawara, Japan) with prospective ECG gating. The protocol for performance of CCTA, plaque identification, and quantification has been previously published 14,15 with image acquisition details and references in Appendix 1 in Supplement 2 of Hauser et al 15 Coronary Plaque Analysis CCTA images underwent 3-dimensional reconstruction for coronary segment plaque volume analysis using semiautomated software (SUREPlaque, version 6.3.2; Vital Images, Minnetonka, MN). 7,[22][23][24] Representative images have been previously published (Supplement 2 in Hauser et al).…”

Section: Image Acquisition and Reconstructionmentioning

confidence: 99%

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Effect of Eicosapentaenoic and Docosahexaenoic Acids Added to Statin Therapy on Coronary Artery Plaque in Patients With Coronary Artery Disease: A Randomized Clinical Trial

Alfaddagh

Elajami

Ashfaque

et al. 2017

JAHA

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BackgroundAlthough statins reduce cardiovascular events, residual risk remains. Therefore, additional modalities are needed to reduce risk. We evaluated the effect of eicosapentaenoic acid and docosahexaenoic acid in pharmacologic doses added to statin treatment on coronary artery plaque volume.Methods and ResultsA total of 285 subjects with stable coronary artery disease on statins were randomized to omega‐3 ethyl‐ester (1.86 g of eicosapentaenoic acid and 1.5 g of docosahexaenoic acid daily) or no omega‐3 (control) for 30 months. Coronary plaque volume was assessed by coronary computed tomographic angiography. Mean (SD) age was 63.0 (7.7) years; mean low‐density lipoprotein cholesterol ≤80 mg/dL. In the intention‐to‐treat analysis, our primary endpoint, noncalcified plaque volume, was not different between groups (P=0.14) but approached significance in the per protocol analysis (P=0.07). When stratified by age in the intention‐to‐treat analysis, younger omega‐3 subjects had significantly less progression of the primary endpoint, noncalcified plaque (P=0.013), and fibrous, calcified and total plaque. In plaque subtype analysis, controls had significant progression of fibrous plaque compared to no change in the omega‐3 ethyl‐ester group (median % change [interquartile range], 5.0% [−5.7, 20.0] versus −0.1% [−12.3, 14.5], respectively; P=0.018). Among those on low‐intensity statins, omega‐3 ethyl‐ester subjects had attenuation of fibrous plaque progression compared to controls (median % change [interquartile range], 0.3% [−12.8, 9.0] versus 4.8% [−5.1, 19.0], respectively; P=0.032). In contrast, those on high‐intensity statins had no difference in plaque change in either treatment arm.ConclusionsHigh‐dose eicosapentaenoic acid and docosahexaenoic acid provided additional benefit to statins in preventing progression of fibrous coronary plaque in subjects adherent to therapy with well‐controlled low‐density lipoprotein cholesterol levels. The benefit on low‐intensity statin, but not high‐intensity statin, suggests that statin intensity affects plaque volume.Clinical Trial Registration URL: http://www.ClinicalTrials.gov. Unique identifier: NCT01624727.

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“…Coronary computed tomography angiography (CCTA) has proved to be sensitive in the detection of early atherosclerosis [ 8 ] and the prediction of adverse cardiac events [ 9 , 10 ], but large cohorts for differentiated qualitative plaque analysis are scarce and results diverging [ 11 – 14 ]. Recent reports underline the potential of CCTA to identify high-risk plaques based on quantitative analysis of plaque morphology.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in coronary artery plaque composition detected by coronary computed tomography: quantitative and qualitative analysis

et al. 2019

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Background Sex differences in the calculation of coronary heart disease risk have been analysed extensively. However, data on coronary plaque morphology diverge. We analysed plaque characteristics in patients with suspected coronary artery disease (CAD) and defined prognostic factors using coronary computed tomography angiography (CCTA). Methods A total of 6,050 consecutive patients underwent CCTA and were enrolled in the registry. Patients with known CAD were excluded. The patients were propensity score matched (1:1 male:female) for age and known coronary risk factors. Coronary arteries were evaluated for stenosis, plaque types (non-calcified, mixed and calcified) and high-risk plaque features (napkin-ring sign, low-attenuation plaque, spotty calcifications, positive remodelling). Clinical follow-up was performed. Results A total of 1,050 patients (525 female, 525 male) in matched cohorts were selected for analysis. CCTA showed significantly higher calcium scores for males (mean 180.5 vs 67.8 AU, p < 0.0001) and a higher rate of CAD (66.0% vs 34.1%, p < 0.0001). In a total of 16,800 segments, males had significantly more plaques (861 vs 752, p < 0.0001) with a significantly larger proportion of calcified plaques, while females had more mixed and non-calcified plaques (33.5% vs 24.4%, p = 0.006 and 24.1% vs 13.6%, p = 0.22, respectively). After a mean follow-up of 5.6 years, major adverse cardiac event (MACE) rate was 5.3% in male and 1.9% in female patients ( p < 0.05). The relative odds ratio for high-risk plaque features to predict MACE was higher in females. Conclusion Based on a higher relative risk for women with high-risk plaque features, the findings of our study support the increased importance of a differentiated qualitative plaque analysis to improve the risk stratification for both sexes.

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Comparison of coronary plaque subtypes in male and female patients using 320-row MDCTA

Cited by 11 publications

References 45 publications

The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study

The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study

Effect of Eicosapentaenoic and Docosahexaenoic Acids Added to Statin Therapy on Coronary Artery Plaque in Patients With Coronary Artery Disease: A Randomized Clinical Trial

Sex differences in coronary artery plaque composition detected by coronary computed tomography: quantitative and qualitative analysis

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