Coronary Artery Plaque Volume and Obesity in Patients with Diabetes: The Factor-64 Study

Kwan, Alan C.; May, Heidi T.; Cater, George; Sibley, Christopher T.; Rosen, Boaz D.; Lima, João A.C.; Rodriguez, Karen; Lappé, Donald; Muhlestein, Joseph B.; Anderson, Jeffrey L.; Bluemke, David A.

doi:10.1148/radiol.14140611

Cited by 38 publications

(29 citation statements)

References 29 publications

(28 reference statements)

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“…Plaque nomenclature followed that of Miller et al (18). Proximal coronary segments were defined as C1, L1, L2, and R1 after Kwan et al (19). Analysis times ranged from 15 to 30 minutes per subject.…”

Section: Discussionmentioning

confidence: 99%

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women

Rodriguez

Kwan

Lai³

et al. 2015

Radiology

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q RSNA, 2015 Purpose:To assess the relationship between total, calcified, and noncalcified coronary plaque burdens throughout the entire coronary vasculature at coronary computed tomographic (CT) angiography in relationship to cardiovascular risk factors in asymptomatic individuals with low-to-moderate risk. Materials and Methods:This HIPAA-compliant study had institutional review board approval, and written informed consent was obtained. Two hundred two subjects were recruited to an ongoing prospective study designed to evaluate the effect of HMG-CoA reductase inhibitors on atherosclerosis. Eligible subjects were asymptomatic individuals older than 55 years who were eligible for statin therapy. Coronary CT angiography was performed by using a 320-detector row scanner. Coronary wall thickness and plaque were evaluated in all epicardial coronary arteries greater than 2 mm in diameter. Images were analyzed by using dedicated software involving an adaptive lumen attenuation algorithm. Total plaque index (calcified plus noncalcified plaque) was defined as plaque volume divided by vessel length. Multivariable regression analysis was performed to determine the relationship between risk factors and plaque indexes. Results:The mean age of the subjects was 65.5 years 6 6.9 (standard deviation) (36% women), and the median coronary artery calcium (CAC) score was 73 (interquartile range, 1-434). The total coronary plaque index was higher in men than in women (42.06 mm 2 6 9.22 vs 34.33 mm 2 6 8.35; P , .001). In multivariable analysis controlling for all risk factors, total plaque index remained higher in men than in women (by 5.01 mm 2 ; P = .03) and in those with higher simvastatin doses (by 0.44 mm 2 /10 mg simvastatin dose equivalent; P = .02). Noncalcified plaque index was positively correlated with systolic blood pressure (b = 0.80 mm 2 /10 mm Hg; P = .03), diabetes (b = 4.47 mm 2 ; P = .03), and low-density lipoprotein (LDL) cholesterol level (b = 0.04 mm 2 /mg/dL; P = .02); the association with LDL cholesterol level remained significant (P = .02) after additional adjustment for the CAC score. Conclusion:LDL cholesterol level, systolic blood pressure, and diabetes were associated with noncalcified plaque burden at coronary CT angiography in asymptomatic individuals with low-to-moderate risk.q RSNA, 2015

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Section: Discussionmentioning

confidence: 99%

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women

Rodriguez

Kwan

Lai³

et al. 2015

Radiology

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“…Eligible patients who consented to receive CCTA were scanned on a 320 detector row unit (Aquilion ONE ViSION Edition; Toshiba Medical Systems, Otawara, Japan) using standard techniques [18,19] during their baseline visits on the same day that fasting blood samples were drawn (Fig. 1C and D).…”

Section: Methodsmentioning

confidence: 99%

Self-reported depression in psoriasis is associated with subclinical vascular diseases

et al. 2016

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Background and aims Psoriasis is a chronic inflammatory disorder associated with vascular inflammation, measured by 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT), and an increased risk of myocardial infarction. Patients with psoriasis are also more likely to suffer from comorbid depression. Whether depression accelerates the development of subclinical atherosclerosis in psoriasis is unknown. Methods Patients were selected from within a larger psoriasis cohort. Those who reported a history of depression (N = 36) on survey were matched by age and gender to patients who reported no history of psychiatric illness (N = 36). Target-to-background ratio from FDG PET/CT was used to assess aortic vascular inflammation and coronary CT angiography scans were analyzed to determine coronary plaque burden. Multivariable linear regression was performed to understand the effect of self-reported depression on vascular inflammation and coronary plaque burden after adjustment for Framingham risk (standardized β reported). Results In unadjusted analyses, vascular inflammation and coronary plaque burden were significantly increased in patients with self-reported depression as compared to patients with psoriasis alone. After adjustment for Framingham Risk Score, vascular inflammation (β = 0.26, p = 0.02), total plaque burden (β = 0.17, p = 0.03), and non-calcified burden (β = 0.17, p = 0.03) were associated with self-reported depression. Conclusions Self-reported depression in psoriasis is associated with increased vascular inflammation and coronary plaque burden. Depression may play an important role in promoting subclinical atherosclerosis beyond traditional cardiovascular risk factors.

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“…Moreover quantitative analysis of overall coronary plaque volume is now available. Studies showing increased non-calcified plaque volumes in ACS patients 53 or in obese diabetics 54 as well as response to statin therapy 34 suggest that overall coronary plaque burden may have clinical relevance.…”

Section: Imaging Of Atherosclerotic Plaque Burden and Progressionmentioning

confidence: 99%

“…Using this approach, Kwan et al showed that the percentage of calcified plaque was greater in diabetic patients with high calcium scores and larger CCTA total plaque volumes 54 (Figure 6). An ex-vivo comparison to histology showed the ability of CCTA to differentiate non-calcified, mixed and calcified plaques 85 .…”

Section: Coronary Ct Angiography Assessment Of Plaque Burden and Progmentioning

confidence: 99%

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Noninvasive Imaging of Atherosclerotic Plaque Progression

Sandfort

Lima

Bluemke

2015

Circ: Cardiovascular Imaging

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The process of coronary artery disease progression is infrequently visualized. Intravascular ultrasound has been used to gain important insights but is invasive and therefore limited to high risk patients. For low to moderate risk patients, noninvasive methods may be useful to quantitatively monitor plaque progression or regression, and to understand and personalize atherosclerosis therapy. This review discusses the potential for coronary CT angiography (CCTA) to evaluate the extent and subtypes of coronary plaque. CT technology is evolving and image quality of the method approaches the level required for plaque progression monitoring. Methods to quantify plaque on CT angiography are reviewed as well as a discussion of their use in clinical trials. Limitations of CCTA compared to competing modalities include limited evaluation of plaque subcomponents and incomplete knowledge of the value of the method especially in patients with low to moderate cardiovascular risk.

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Coronary Artery Plaque Volume and Obesity in Patients with Diabetes: The Factor-64 Study

Cited by 38 publications

References 29 publications

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women

Self-reported depression in psoriasis is associated with subclinical vascular diseases

Noninvasive Imaging of Atherosclerotic Plaque Progression

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