Differential association between the progression of coronary artery calcium score and coronary plaque volume progression according to statins: the Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging (PARADIGM) study

被引：74

作者：

Lee, Sang-Eun ^{[1
,2
]}

Sung, Ji Min ^{[1
,2
]}

Andreini, Daniele ^{[3
]}

Budoff, Matthew J. ^{[4
]}

Cademartiri, Filippo ^{[5
]}

Chinnaiyan, Kavitha ^{[6
]}

Choi, Jung Hyun ^{[7
]}

Chun, Eun Ju ^{[8
]}

Conte, Edoardo ^{[3
]}

Gottlieb, Ilan ^{[9
]}

Hadamitzky, Martin ^{[10
]}

Kim, Yong Jin ^{[11
,12
]}

Kumar, Amit ^{[13
,14
]}

Lee, Byoung Kwon ^{[15
]}

Leipsic, Jonathon A. ^{[16
]}

Maffei, Erica ^{[17
]}

Marques, Hugo ^{[18
]}

Pontone, Gianluca ^{[3
]}

Raff, Gilbert ^{[6
]}

Shin, Sanghoon ^{[19
]}

Stone, Peter H. ^{[20
]}

Samady, Habib ^{[21
]}

Virmani, Renu ^{[22
]}

Narula, Jagat ^{[23
,24
]}

Berman, Daniel S. ^{[25
]}

Shaw, Leslee J. ^{[21
]}

Bax, Jeroen J. ^{[26
]}

Lin, Fay Y. ^{[13
,14
]}

Min, James K. ^{[13
,14
]}

Chang, Hyuk-Jae ^{[1
,2
]}

机构：

[1] Yonsei Univ Hlth Syst, Yonsei Univ, Severance Cardiovasc Hosp, Dept Internal Med,Div Cardiol, Seoul 03722, South Korea

[2] Yonsei Univ Hlth Syst, Yonsei Univ, Yonsei Cedars Sinai Integrat Cardiovasc Imaging R, Coll Med, Seoul 03722, South Korea

[3] IRCCS, Ctr Cardiol Monzino, I-20138 Milan, Italy

[4] Los Angeles Biomed Res Inst, Dept Med, Torrance, CA 90502 USA

[5] SDN Fdn IRCCS, Cardiovasc Imaging Unit, Naples, Italy

[6] William Beaumont Hosp, Dept Cardiol, Royal Oak, MI 48073 USA

[7] Busan Univ Hosp, Dept Internal Med, Busan 49241, South Korea

[8] Seoul Natl Univ, Bundang Hosp, Dept Radiol, Gyeonggi Do 13620, South Korea

[9] Casa Saude Sao Jose, Dept Radiol, Rio De Janeiro, Brazil

[10] German Heart Ctr Munich, Dept Radiol & Nucl Med, D-80636 Munich, Germany

[11] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul 03080, South Korea

[12] Seoul Natl Univ Hosp, Seoul 03080, South Korea

[13] New York Presbyterian Hosp, Dalio Inst Cardiovasc Imaging, New York, NY 10065 USA

[14] Weill Cornell Med Coll, New York, NY 10065 USA

[15] Yonsei Univ, Coll Med, Gangnam Severance Hosp, Dept Internal Med, Seoul 06273, South Korea

[16] Univ British Columbia, Dept Med & Radiol, Vancouver, BC V6T 1Z4, Canada

[17] Area Vasta 1 ASUR Marche, Dept Radiol, Urbino, Italy

[18] Hosp Luz, Unit Cardiovasc Imaging, UNICA, Lisbon, Portugal

[19] Natl Hlth Insurance Serv Ilsan Hosp, Dept Internal Med, Gyeonggi Do 10444, South Korea

[20] Brigham & Womens Hosp, Div Cardiovasc Med, Boston, MA 02115 USA

[21] Emory Univ, Sch Med, Div Cardiol, Atlanta, GA 30307 USA

[22] CVPath Inst, Dept Pathol, Gaithersburg, MD 20878 USA

[23] Icahn Sch Med Mt Sinai, Mt Sinai Heart, Zena & Michael A Wiener Cardiovasc Inst, New York, NY 10029 USA

[24] Marie Josee & Henry R Kravis Ctr Cardiovasc Hlth, New York, NY 10029 USA

[25] Cedars Sinai Med Ctr, Dept Imaging & Med, Los Angeles, CA 90048 USA

[26] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands

来源：

EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING | 2019年 / 20卷 / 11期

基金：

美国国家卫生研究院; 新加坡国家研究基金会;

关键词：

coronary artery atherosclerosis; statins; coronary computed tomography angiography; coronary artery calcium score; coronary artery calcification; Agatston score; CARDIOVASCULAR EVENTS; SCCT GUIDELINES; CT ANGIOGRAPHY; IMPACT; QUANTIFICATION; ACQUISITION; THERAPY; DISEASE; RISK; CALCIFICATION;

D O I：

10.1093/ehjci/jez022

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Coronary artery calcium score (CACS) is a strong predictor of major adverse cardiac events (MACE). Conversely, statins, which markedly reduce MACE risk, increase CACS. We explored whether CACS progression represents compositional plaque volume (PV) progression differently according to statin use. Methods and results From a prospective multinational registry of consecutive patients (n = 2252) who underwent serial coronary computed tomography angiography (CCTA) at a >= 2-year interval, 654 patients (61 +/- 10 years, 56% men, inter-scan interval 3.9 +/- 1.5 years) with information regarding the use of statins and having a serial CACS were included. Patients were divided into non-statin (n = 246) and statin-taking (n = 408) groups. Coronary PVs (total, calcified, and non-calcified; sum of fibrous, fibro-fatty, and lipid-rich) were quantitatively analysed, and CACS was measured from both CCTAs. Multivariate linear regression models were constructed for both statin-taking and non-statin group to assess the association between compositional PV change and change in CACS. In multivariate linear regression analysis, in the non-statin group, CACS increase was positively associated with both non-calcified (beta = 0.369, P = 0.004) and calcified PV increase (beta = 1.579, P < 0.001). However, in the statin-taking group, CACS increase was positively associated with calcified PV change (beta = 0.756, P < 0.001) but was negatively associated with non-calcified PV change (beta = -0.194, P = 0.026). Conclusion In the non-statin group, CACS progression indicates the progression of both non-calcified and calcified PV progression. However, under the effect of statins, CACS progression indicates only calcified PV progression, but not non-calcified PV progression. Thus, the result of serial CACS should be differently interpreted according to the use of statins.

引用

页码：1307 / 1314

页数：8

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