Association of Cardiovascular Disease Risk Factor Burden With Progression of Coronary Atherosclerosis Assessed by Serial Coronary Computed Tomographic Angiography
Articolo
Data di Pubblicazione:
2020
Citazione:
Association of Cardiovascular Disease Risk Factor Burden With Progression of Coronary Atherosclerosis Assessed by Serial Coronary Computed Tomographic Angiography / D. Han, D.S. Berman, R.J.H. Miller, D. Andreini, M.J. Budoff, F. Cademartiri, K. Chinnaiyan, J.H. Choi, E. Conte, H. Marques, P. de Araújo Gonçalves, I. Gottlieb, M. Hadamitzky, J. Leipsic, E. Maffei, G. Pontone, S. Shin, Y. Kim, B.K. Lee, E.J. Chun, J.M. Sung, S. Lee, R. Virmani, H. Samady, P. Stone, J. Narula, J.J. Bax, L.J. Shaw, F.Y. Lin, J.K. Min, H. Chang. - In: JAMA NETWORK OPEN. - ISSN 2574-3805. - 3:7(2020 Jul 01), pp. e2011444.1-e2011444.13. [10.1001/jamanetworkopen.2020.11444]
Abstract:
Question Is the risk factor burden of cardiovascular disease, as assessed by atherosclerotic cardiovascular disease risk score, associated with coronary plaque progression and the development of adverse plaque characteristics? Findings In this cohort study of 1005 adult patients from an international multicenter registry who underwent serial coronary computed tomographic angiography, the progression of coronary atherosclerotic plaque volume and the development of adverse plaque characteristics was greater in patients with a high atherosclerotic cardiovascular disease risk score. Meaning The study findings suggest that the overall cardiovascular disease risk burden is associated with the progression of coronary atherosclerosis; the progression of fibrofatty plaque and low-attenuation plaque and the development of adverse plaque characteristics appear to be accelerated in patients with a high risk of atherosclerotic cardiovascular disease.Importance Several studies have reported that the progression of coronary atherosclerosis, as measured by serial coronary computed tomographic (CT) angiography, is associated with the risk of future cardiovascular events. However, the cumulative consequences of multiple risk factors for plaque progression and the development of adverse plaque characteristics have not been well characterized. Objectives To examine the association of cardiovascular risk factor burden, as assessed by atherosclerotic cardiovascular disease (ASCVD) risk score, with the progression of coronary atherosclerosis and the development of adverse plaque characteristics. Design, Setting, and Participants This cohort study is a subgroup analysis of participant data from the prospective observational Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging (PARADIGM) study, which evaluated the association between serial coronary CT angiography findings and clinical presentation. The PARADIGM international multicenter registry, which includes 13 centers in 7 countries (Brazil, Canada, Germany, Italy, Portugal, South Korea, and the US), was used to identify 1005 adult patients without known coronary artery disease who underwent serial coronary CT angiography scans (median interscan interval, 3.3 years; interquartile range [IQR], 2.6-4.8 years) between December 24, 2003, and December 16, 2015. Based on the 10-year ASCVD risk score, the cardiovascular risk factor burden was classified as low (<7.5%), intermediate (7.5%-20.0%), or high (>20.0%). Data were analyzed from February 8, 2019, to April 17, 2020. Exposures Association of baseline ASCVD risk burden with plaque progression. Main Outcomes and Measures Noncalcified plaque, calcified plaque, and total plaque volumes (mm(3)) were measured. Noncalcified plaque was subclassified using predefined Hounsfield unit thresholds for fibrous, fibrofatty, and low-attenuation plaque. The percent atheroma volume (PAV) was defined as plaque volume divided by vessel volume. Adverse plaque characteristics were defined as the presence of positive remodeling, low-attenuation plaque, or spotty calcification. Results In total, 1005 patients (mean [SD] age, 60 [8] years; 575 men [57.2%]) were included in the analysis. Of those, 463 patients (46.1%) had a low 10-year ASCVD risk score (low-risk group), 373 patients (37.1%) had an intermediate ASCVD risk score (intermediate-risk group), and 169 patients (16.8%) had a high ASCVD risk score (high-risk group). The annualized progression rate of PAV for total plaque, calcified plaque, and noncalcified plaque was associated with increasing ASCVD risk (r = 0.26 for total plaque, r = 0.23 for calcified plaque, and r = 0.11 for noncalcified plaque; P < .001). The annualized PAV progression of total plaque, calcified pla
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
D. Han, D.S. Berman, R.J.H. Miller, D. Andreini, M.J. Budoff, F. Cademartiri, K. Chinnaiyan, J.H. Choi, E. Conte, H. Marques, P. de Araújo Gonçalves, I. Gottlieb, M. Hadamitzky, J. Leipsic, E. Maffei, G. Pontone, S. Shin, Y. Kim, B.K. Lee, E.J. Chun, J.M. Sung, S. Lee, R. Virmani, H. Samady, P. Stone, J. Narula, J.J. Bax, L.J. Shaw, F.Y. Lin, J.K. Min, H. Chang
Link alla scheda completa:
Link al Full Text: