Relationship between patient presentation and morphology of coronary atherosclerosis by quantitative multidetector computed tomography.

Autor:	de Knegt MC; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark.; Department of Cardiology, Amager-Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, Hvidovre, Copenhagen, Denmark., Linde JJ; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark., Fuchs A; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark., Pham MHC; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark., Jensen AK; Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, Denmark., Nordestgaard BG; Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, Copenhagen, Denmark., Kelbæk H; Department of Cardiology, Zealand University Hospital, Sygehusvej 10, Roskilde, Denmark., Køber LV; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark., Heitmann M; Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, Denmark., Fornitz G; Department of Cardiology, Amager-Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, Hvidovre, Copenhagen, Denmark., Hove JD; Department of Cardiology, Amager-Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, Hvidovre, Copenhagen, Denmark., Kofoed KF; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark.; Department of Radiology, The Diagnostic Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2019 Nov 01; Vol. 20 (11), pp. 1221-1230.
DOI:	10.1093/ehjci/jey146
Abstrakt:	Aims: Quantitative computed tomography (QCT) allows assessment of morphological features of coronary atherosclerosis. We aimed to test the hypothesis that clinical patient presentation is associated with distinct morphological features of coronary atherosclerosis. Methods and Results: A total of 1652 participants, representing a spectrum of clinical risk profiles [787 asymptomatic individuals from the general population, 468 patients with acute chest pain without acute coronary syndrome (ACS), and 397 patients with acute chest pain and ACS], underwent multidetector computed tomography. Of these, 274 asymptomatic individuals, 254 patients with acute chest pain without ACS, and 327 patients with acute chest pain and ACS underwent QCT to assess coronary plaque volumes and proportions of dense calcium (DC), fibrous, fibro fatty (FF), and necrotic core (NC) tissue. Furthermore, the presence of vulnerable plaques, defined by plaque volume and tissue composition, was examined. Coronary plaque volume increased significantly with worsening clinical risk profile [geometric mean (95% confidence interval): 148 (129-166) mm3, 257 (224-295) mm3, and 407 (363-457) mm3, respectively, P < 0.001]. Plaque composition differed significantly across cohorts, P < 0.0001. The proportion of DC decreased, whereas FF and NC increased with worsening clinical risk profile (mean proportions DC: 33%, 23%, 23%; FF: 50%, 61%, 57%; and NC: 17%, 17%, 20%, respectively). Significant differences in plaque composition persisted after multivariable adjustment for age, gender, body surface area, hypertension, statin use at baseline, diabetes, smoking, family history of ischaemic heart disease, total plaque volume, and tube voltage, P < 0.01. Conclusion: Coronary atherosclerotic plaque volume and composition are strongly associated to clinical presentation. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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