Phenotyping coronary plaque by computed tomography in premature coronary artery disease

被引:8
作者
Rahoual, Ghilas [1 ]
Zeitouni, Michel [1 ]
Charpentier, Etienne
Ritvo, Paul-Gydeon [2 ]
Rouanet, Stephanie [3 ]
Procopi, Niki [1 ]
Boukhelifa, Sena [1 ]
Charleux, Pierre [1 ]
Guedeney, Paul [1 ]
Kerneis, Mathieu [1 ]
Barthelemy, Olivier [1 ]
Silvain, Johanne [1 ]
Montalescot, Gilles [1 ]
Redheuil, Alban [2 ]
Collet, Jean-Philippe [1 ]
机构
[1] Sorbonne Univ, Hop Pitie Salpetriere AP HP, CNRS, INSERM,UMR 1146,ACTION Study Grp,Inst Cardiol, 47-83 Blvd lHopital, F-75013 Paris, France
[2] Sorbonne Univ, Hop Pitie Salpetriere AP HP, CNRS, INSERM,UMRS 1146,Unite Imagerie Cardiovasc & Thora, F-75013 Paris, France
[3] StatEthic, Statistician Unit, ACT Study Grp, Levallois Perret, France
关键词
premature coronary artery disease; coronary computed tomography angiography; high-risk plaque; non-calcified plaque; CHOLESTEROL EFFLUX CAPACITY; SPOTTY CALCIFICATION; ATHEROSCLEROSIS; CALCIUM; PROGRESSION; RISK; INFLAMMATION; ASSOCIATION; MACROPHAGES; PROTEIN;
D O I
10.1093/ehjci/jead212
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Premature coronary artery disease (CAD) is an aggressive disease with multiple recurrences mostly related to new coronary lesions. This study aimed to compare coronary plaque characteristics of individuals with premature CAD with those of incidental plaques found in matched individuals free of overt cardiovascular disease, using coronary computed tomography angiography (CCTA).Methods and results Of 1552 consecutive individuals who underwent CCTA, 106 individuals with history of acute or stable obstructive CAD & LE;45 years were matched by age, sex, smoking status, cardiovascular heredity, and dyslipidaemia with 106 controls. CCTA were analysed for Coronary Artery Disease Reporting and Data System score, plaque composition, and high-risk plaque (HRP) features, including spotty calcification, positive remodelling, low attenuation, and napkin-ring sign. The characteristics of 348 premature CAD plaques were compared with those of 167 incidental coronary plaques of matched controls. The prevalence of non-calcified plaques was higher among individuals with premature CAD (65.1 vs. 30.2%, P < 0.001), as well as spotty calcification (42.5 vs. 17.9%, P < 0.001), positive remodelling (41.5 vs. 9.4%, P < 0.001), low attenuation (24.5 vs. 3.8%, P < 0.001), and napkin-ring sign (1.9 vs. 0.0%). They exhibited an average of 2.2 (2.7) HRP, while the control group displayed 0.4 (0.8) HRP (P < 0.001). Within a median follow-up of 24 (16, 34) months, individuals with premature CAD and ischaemic recurrence (n = 24) had more HRP [4.3 (3.9)] than those without ischaemic recurrence [1.5 (1.9)], mostly non-calcified with low attenuation and positive remodelling.Conclusion Coronary atherosclerosis in individuals with premature CAD is characterized by a high and predominant burden of non-calcified plaque and unusual high prevalence of HRP, contributing to disease progression with multiple recurrences. A comprehensive qualitative CCTA assessment of plaque characteristics may further risk stratify our patients, beyond cardiovascular risk factors.
引用
收藏
页码:257 / 266
页数:10
相关论文
共 39 条
[1]   Osteogenesis associates with inflammation in early-stage atherosclerosis evaluated by molecular imaging in vivo [J].
Aikawa, Elena ;
Nahrendorf, Matthias ;
Figueiredo, Jose-Luiz ;
Swirski, Filip K. ;
Shtatland, Timur ;
Kohler, Rainer H. ;
Jaffer, Farouc A. ;
Aikawa, Masanori ;
Weissleder, Ralph .
CIRCULATION, 2007, 116 (24) :2841-2850
[2]   Detecting human coronary inflammation by imaging perivascular fat [J].
Antonopoulos, Alexios S. ;
Sanna, Fabio ;
Sabharwal, Nikant ;
Thomas, Sheena ;
Oikonomou, Evangelos K. ;
Herdman, Laura ;
Margaritis, Marios ;
Shirodaria, Cheerag ;
Kampoli, Anna-Maria ;
Akoumianakis, Ioannis ;
Petrou, Mario ;
Sayeed, Rana ;
Krasopoulos, George ;
Psarros, Constantinos ;
Ciccone, Patricia ;
Brophy, Carl M. ;
Digby, Janet ;
Kelion, Andrew ;
Uberoi, Raman ;
Anthony, Suzan ;
Alexopoulos, Nikolaos ;
Tousoulis, Dimitris ;
Achenbach, Stephan ;
Neubauer, Stefan ;
Channon, Keith M. ;
Antoniades, Charalambos .
SCIENCE TRANSLATIONAL MEDICINE, 2017, 9 (398)
[3]   Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population [J].
Bergstrom, Goran ;
Persson, Margaretha ;
Adiels, Martin ;
Bjornson, Elias ;
Bonander, Carl ;
Ahlstrom, Hakan ;
Alfredsson, Joakim ;
Angeras, Oskar ;
Berglund, Goran ;
Blomberg, Anders ;
Brandberg, John ;
Borjesson, Mats ;
Cederlund, Kerstin ;
de Faire, Ulf ;
Duvernoy, Olov ;
Ekblom, Orjan ;
Engstrom, Gunnar ;
Engvall, Jan E. ;
Fagman, Erika ;
Eriksson, Mats ;
Erlinge, David ;
Fagerberg, Bjorn ;
Flinck, Agneta ;
Goncalves, Isabel ;
Hagstrom, Emil ;
Hjelmgren, Ola ;
Lind, Lars ;
Lindberg, Eva ;
Lindqvist, Per ;
Ljungberg, Johan ;
Magnusson, Martin ;
Mannila, Maria ;
Markstad, Hanna ;
Mohammad, Moman A. ;
Nystrom, Fredrik H. ;
Ostenfeld, Ellen ;
Persson, Anders ;
Rosengren, Annika ;
Sandstrom, Anette ;
Sjalander, Anders ;
Skold, Magnus C. ;
Sundstrom, Johan ;
Swahn, Eva ;
Soderberg, Stefan ;
Toren, Kjell ;
Ostgren, Carl Johan ;
Jernberg, Tomas .
CIRCULATION, 2021, 144 (12) :916-929
[4]   Association of Coronary Artery Calcium in Adults Aged 32 to 46 Years With Incident Coronary Heart Disease and Death [J].
Carr, John Jeffrey ;
Jacobs, David R., Jr. ;
Terry, James G. ;
Shay, Christina M. ;
Sidney, Stephen ;
Liu, Kiang ;
Schreiner, Pamela J. ;
Lewis, Cora E. ;
Shikany, James M. ;
Reis, Jared P. ;
Goff, David C., Jr. .
JAMA CARDIOLOGY, 2017, 2 (04) :391-399
[5]   Altered fibrin architecture is associated with hypofibrinolysis and premature coronary atherothrombosis [J].
Collet, J. P. ;
Allali, Y. ;
Lesty, C. ;
Tanguy, M. L. ;
Silvain, J. ;
Ankri, A. ;
Blanchet, B. ;
Dumaine, R. ;
Gianetti, J. ;
Payot, L. ;
Weisel, J. W. ;
Montalescot, G. .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2006, 26 (11) :2567-2573
[6]   Long-Term Evolution of Premature Coronary Artery Disease [J].
Collet, Jean-Philippe ;
Zeitouni, Michel ;
Procopi, Niki ;
Hulot, Jean-Sebastien ;
Silvain, Johanne ;
Kerneis, Mathieu ;
Thomas, Daniel ;
Lattuca, Benoit ;
Barthelemy, Olivier ;
Lavie-Badie, Yoan ;
Esteve, Jean-Baptiste ;
Payot, Laurent ;
Brugier, Delphine ;
Lopes, Izolina ;
Diallo, Abdourahmane ;
Vicaut, Eric ;
Montalescot, Gilles .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2019, 74 (15) :1868-1878
[7]   Cytochrome P450 2C19 polymorphism in young patients treated with clopidogrel after myocardial infarction: a cohort study [J].
Collet, Jean-Philippe ;
Hulot, Jean-Sebastien ;
Pena, Anna ;
Villard, Eric ;
Esteve, Jean-Baptiste ;
Silvain, Johanne ;
Payot, Laurent ;
Brugier, Delphine ;
Cayla, Guillaume ;
Beygui, Farzin ;
Bensimon, Gilbert ;
Funck-Brentano, Christian ;
Montalescot, Gilles .
LANCET, 2009, 373 (9660) :309-317
[8]   CAD-RADSTM 2.0-2022 Coronary Artery Disease-Reporting and Data System An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR), and the North America Society of Cardiovascular Imaging (NASCI) [J].
Cury, Ricardo C. ;
Leipsic, Jonathon ;
Abbara, Suhny ;
Achenbach, Stephan ;
Berman, Daniel ;
Bittencourt, Marcio ;
Budoff, Matthew ;
Chinnaiyan, Kavitha ;
Choi, Andrew D. ;
Ghoshhajra, Brian ;
Jacobs, Jill ;
Koweek, Lynne ;
Lesser, John ;
Maroules, Christopher ;
Rubin, Geoffrey D. ;
Rybicki, Frank J. ;
Shaw, Leslee J. ;
Williams, Michelle C. ;
Williamson, Eric ;
White, Charles S. ;
Villines, Todd C. ;
Blankstein, Ron .
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, 2022, 16 (06) :536-557
[9]   CAD-RADS™ Coronary Artery Disease - Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology [J].
Cury, Ricardo C. ;
Abbara, Suhny ;
Achenbach, Stephan ;
Agatston, Arthur ;
Berman, Daniel S. ;
Budoff, Matthew J. ;
Dill, Karin E. ;
Jacobs, Jill E. ;
Maroules, Christopher D. ;
Rubin, Geoffrey D. ;
Rybicki, Frank J. ;
Schoepf, U. Joseph ;
Shaw, Leslee J. ;
Stillman, Arthur E. ;
White, Charles S. ;
Woodard, Pamela K. ;
Leipsic, Jonathon A. .
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, 2016, 10 (04) :269-281
[10]   Spotty calcification typifies the culprit plaque in patients with acute myocardial infarction - An intravascular ultrasound study [J].
Ehara, S ;
Kobayashi, Y ;
Yoshiyama, M ;
Shimada, K ;
Shimada, Y ;
Fukuda, D ;
Nakamura, Y ;
Yamashita, H ;
Yamagishi, H ;
Takeuchi, K ;
Naruko, T ;
Haze, K ;
Becker, AE ;
Yoshikawa, J ;
Ueda, M .
CIRCULATION, 2004, 110 (22) :3424-3429