Incremental prognostic value of quantitative plaque assessment in coronary CT angiography during 5 years of follow up

Nadjiri, Jonathan; Hausleiter, Jörg; Jähnichen, Christin; Will, Albrecht; Hendrich, Eva; Martinoff, Stefan; Hadamitzky, Martin

doi:10.1016/j.jcct.2016.01.007

Cited by 100 publications

(63 citation statements)

References 26 publications

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“…Taken together, the results of these past studies, along with our results, suggest that EPA and DHA affect plaque composition and volume. Although our trial was not designed to assess cardiovascular events, it is worth noting that several studies assessing coronary plaque subtypes with CCTA have shown that higher volume of total noncalcified plaque and total plaque volume are associated with higher rates of cardiac death, myocardial infarction, and coronary revascularization47 and higher rates of acute coronary syndrome 48, 49. Furthermore, evidence from intravascular ultrasound studies shows that progression of plaque atheroma volume is independently associated with higher rates of a composite of cardiac death, myocardial infarction, and coronary revascularization ( P <0.002) and regression is associated with fewer events 3.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…The study illustrated that evaluation of coronary CTA plaque characteristics may provide incremental prognostic value to the number of diseased vessels and the FRS. Another study has also showed that low attenuation plaque volume, positive remodeling and presence of the NRS are predictors of major adverse cardiac events independently of clinical risk presentation [23]. Low attenuation plaque volume carried additional prognostic information beyond the calcium score and conventional coronary CTA analysis.…”

Section: Discussionmentioning

confidence: 99%

High-risk carotid plaques identified by CT-angiogram can predict acute myocardial infarction

Mosleh

Adib

Punnanithinont

et al. 2016

Int J Cardiovasc Imaging

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Purpose Prior studies identified the incremental value of non-invasive imaging by CT-angiogram (CTA) to detect high-risk coronary atherosclerotic plaques. Due to their superficial locations, larger calibers and motion-free imaging, the carotid arteries provide the best anatomic access for the non-invasive characterization of atherosclerotic plaques. We aim to assess the ability of predicting obstructive coronary artery disease (CAD) or acute myocardial infarction (MI) based on high-risk carotid plaque features identified by CTA. Methods We retrospectively examined carotid CTAs of 492 patients that presented with acute stroke to characterize the atherosclerotic plaques of the carotid arteries and examined development of acute MI and obstructive CAD within 12-months. Carotid lesions were defined in terms of calcifications (large or speckled), presence of low-attenuation plaques, positive remodeling, and presence of napkin ring sign (NRS). Adjusted relative risks were calculated for each plaque features. Results Patients with speckled (<3mm) calcifications and/or larger calcifications on CTA had a higher risk of developing an MI and/or obstructive CAD within one year compared to patients without [adjusted RR of 7.51, 95%CI 1.26 to 73.42, P= 0.001]. Patients with low-attenuation plaques on CTA had a higher risk of developing an MI and/or obstructive CAD within one year than patients without [adjusted RR of 2.73, 95%CI 1.19 to 8.50, P= 0.021]. Presence of carotid calcifications and low-attenuation plaques also portended higher sensitivity (100% and 79.17%, respectively) for the development of acute MI. Conclusions Presence of carotid calcifications and low-attenuation plaques can predict the risk of developing acute MI and/or obstructive CAD within 12-months. Given their high sensitivity, their absence can reliably exclude 12-month events.

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“…Более того, это трудно охарактеризовать гистологически [25]. Послед-ние исследования МСКТ-АГ показывают, что «napkin-ring» демонстрирует различную частоту в зависимости от исследуемой популяции [29,33]. Тем не менее, в популяциях, где «napkin ring» распространен, признак был связан с не-стабильными АСБ [29,33].…”

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Diagnostic Aspects of Unstable Atherosclerotic Plaque in Carrying Out Multislice Computed Tomography

Muraveva¹,

Серова²

2018

Rejr

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Муравьёва П.А., Серова Н.С.реимущественно, интракоронарный тромбоз является причиной острого ко-ронарного синдрома. Строение атеросклеротической бляшки играет важную роль в развитии механизма интракоронарного тромбоза. В настоящее время существуют различные лучевые методы диагностики атеросклеротических бляшек коронарных артерий. Текущий обзор раскрывает тематику «косвенных» при-знаков нестабильности атеросклеротических бляшек, их сочетания и встречаемость, выявляемые при компьютерной томографии.Ретроспективные исследования показали целесообразность этих признаков бля-шек в оценке прогноза развития острых коронарных событий. В обзоре сопоставлены результаты компьютерной томографии (КТ) и внутрисосудистого ультразвукового ис-следования (ВСУЗИ), которое является «золотым» стандартом в диагностике морфологии атеросклеротической бляшки.Ключевые слова: нестабильные атеросклеротические бляшки, компьютерная то-мография коронарных артерии , внутрисосудистое ультразвуковое исследование, ише-мическая болезнь сердца, атеросклероз, острый коронарный синдром. DIAGNOSTIC ASPECTS OF UNSTABLE ATHEROSCLEROTIC PLAQUE IN CARRYING OUT MULTISLICE COMPUTED TOMOGRAPHYMuraveva P.A., Serova N.S.ainly, intracoronary thrombosis is the cause of acute coronary syndrome. The structure of the atherosclerotic plaque plays an important role in the development of the mechanism of intracoronary thrombosis. Currently, there are various radiological methods for diagnosis of atherosclerotic plaques of the coronary arteries. The current review reveals the theme of "indirect" signs of instability of atherosclerotic plaques, their combinations and occurrence, detected by computed tomography. Retrospective studies have shown the feasibility of these signs of plaques in the assessment of the prognosis of acute coronary events. The review compares the results of computed tomography (CT) and intravascular ultrasound, which is the gold standard in the diagnosis of atherosclerotic plaque morphology.

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Incremental prognostic value of quantitative plaque assessment in coronary CT angiography during 5 years of follow up

Cited by 100 publications

References 26 publications

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

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

High-risk carotid plaques identified by CT-angiogram can predict acute myocardial infarction

Diagnostic Aspects of Unstable Atherosclerotic Plaque in Carrying Out Multislice Computed Tomography

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