Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up

Sadako Motoyama, Hajime Ito, Masayoshi Sarai, Takeshi Kondo, Hideki Kawai, Yasuomi Nagahara, Hiroto Harigaya, Shino Kan, Hirofumi Anno, Hiroshi Takahashi, Hiroyuki Naruse, Junichi Ishii, Harvey Hecht, Leslee J. Shaw, Yukio Ozaki, Jagat Narula

研究成果: Article

244 引用 (Scopus)

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Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.

元の言語English
ページ(範囲)337-346
ページ数10
ジャーナルJournal of the American College of Cardiology
66
発行部数4
DOI
出版物ステータスPublished - 01-01-2015

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Acute Coronary Syndrome
Pathologic Constriction
Computed Tomography Angiography
Fatal Outcome

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Motoyama, Sadako ; Ito, Hajime ; Sarai, Masayoshi ; Kondo, Takeshi ; Kawai, Hideki ; Nagahara, Yasuomi ; Harigaya, Hiroto ; Kan, Shino ; Anno, Hirofumi ; Takahashi, Hiroshi ; Naruse, Hiroyuki ; Ishii, Junichi ; Hecht, Harvey ; Shaw, Leslee J. ; Ozaki, Yukio ; Narula, Jagat. / Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. :: Journal of the American College of Cardiology. 2015 ; 巻 66, 番号 4. pp. 337-346.
@article{5453ed0a034b45a69e8bddef621c3e2b,
title = "Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up",
abstract = "Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70{\%} were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8{\%}) patients: 48 (16.3{\%}) of 294 HRP(+) and 40 (1.4{\%}) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5{\%}) than SS(-) patients (52 of 2,499; 2.1{\%}). HRP(+)/SS(+) (19{\%}) and HRP(+)/SS(-) (15{\%}) had higher rates of ACS compared with no-plaque patients (0.6{\%}). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27{\%}; p < 0.0001) and without HRP (10{\%}) compared with HRP(-)/PP(-) patients (0.3{\%}). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.",
author = "Sadako Motoyama and Hajime Ito and Masayoshi Sarai and Takeshi Kondo and Hideki Kawai and Yasuomi Nagahara and Hiroto Harigaya and Shino Kan and Hirofumi Anno and Hiroshi Takahashi and Hiroyuki Naruse and Junichi Ishii and Harvey Hecht and Shaw, {Leslee J.} and Yukio Ozaki and Jagat Narula",
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language = "English",
volume = "66",
pages = "337--346",
journal = "Journal of the American College of Cardiology",
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Motoyama, S, Ito, H, Sarai, M, Kondo, T, Kawai, H, Nagahara, Y, Harigaya, H, Kan, S, Anno, H, Takahashi, H, Naruse, H, Ishii, J, Hecht, H, Shaw, LJ, Ozaki, Y & Narula, J 2015, 'Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up', Journal of the American College of Cardiology, 巻. 66, 番号 4, pp. 337-346. https://doi.org/10.1016/j.jacc.2015.05.069

Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up. / Motoyama, Sadako; Ito, Hajime; Sarai, Masayoshi; Kondo, Takeshi; Kawai, Hideki; Nagahara, Yasuomi; Harigaya, Hiroto; Kan, Shino; Anno, Hirofumi; Takahashi, Hiroshi; Naruse, Hiroyuki; Ishii, Junichi; Hecht, Harvey; Shaw, Leslee J.; Ozaki, Yukio; Narula, Jagat.

:: Journal of the American College of Cardiology, 巻 66, 番号 4, 01.01.2015, p. 337-346.

研究成果: Article

TY - JOUR

T1 - Plaque characterization by coronary computed tomography angiography and the likelihood of acute coronary events in mid-term follow-up

AU - Motoyama, Sadako

AU - Ito, Hajime

AU - Sarai, Masayoshi

AU - Kondo, Takeshi

AU - Kawai, Hideki

AU - Nagahara, Yasuomi

AU - Harigaya, Hiroto

AU - Kan, Shino

AU - Anno, Hirofumi

AU - Takahashi, Hiroshi

AU - Naruse, Hiroyuki

AU - Ishii, Junichi

AU - Hecht, Harvey

AU - Shaw, Leslee J.

AU - Ozaki, Yukio

AU - Narula, Jagat

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.

AB - Background Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). Objectives This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. Methods The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). Results ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). Conclusions CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.

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U2 - 10.1016/j.jacc.2015.05.069

DO - 10.1016/j.jacc.2015.05.069

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JO - Journal of the American College of Cardiology

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