Comparison of Coronary Plaque Subtypes in Male and Female Patients Using 320-row MDCTA

Overview

Journal Atherosclerosis

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2013 Jan 5

PMID 23287639

Citations 11

Authors

Faisal Khosa

Atif N Khan

Khurram Nasir

Arash Bedayat

Zehra Malik

Ali F Jon

Ahmad R Cheema

Melvin E Clouse

Francine K Welty

Affiliations

Soon will be listed here.

Abstract

Objective: Determine plaque subtype and volume difference in male and female patients with obstructive and non-obstructive CAD using 320-row MDCTA.

Materials And Methods: 128 patients with suspected CAD underwent MDCTA. All studies were divided into two groups based on disease severity. 0-70% stenosis (non-obstructive CAD) & >70% (obstructive). All were compared for plaque quantity and subtypes by gender. Main arteries, RCA, LM, LAD and LCX were analyzed using Vitrea 5.2 software to quantify fatty, fibrous and calcified plaque. Thresholds for coronary plaque quantification (volume in mm(3)) were preset at 35 ± 12 HU for fatty, 90 ± 24 HU for fibrous and >130 HU for calcified/mixed plaque and analyzed using STATA software.

Results: Total plaque burden in 118 patients [65M: 53F] was significantly higher in all arteries in males compared to females with non-obstructive disease. Total plaque volume for males vs. females was: RCA: 10.10 ± 5.02 mm(3) vs. 6.89 ± 2.75 mm(3), respectively, p = 0.001; LAD: 7.21 ± 3.38 mm(3) vs. 5.89 ± 1.93 mm(3), respectively, p = 0.04; LCX: 9.13 ± 3.27 mm(3) vs. 7.16 ± 1.73 mm(3), respectively, p = 0.002; LM 15.13 ± 4.51 mm(3) vs. 11.85 ± 4.03 mm(3), respectively, p = 0.001. In sub-analyses, males had significantly more fibrous and fatty plaque in LM, LAD & LCX than females. However in the RCA, only fibrous plaque was significantly greater in males. Calcified plaque volume was not significantly different in both genders. Only 8% of patients had obstructive CAD (>70% stenosis); there was no significant difference in plaque volume or subtypes.

Conclusion: In patients with non-obstructive CAD, males were found to have significantly higher total coronary plaque volume with predominance of fibrous and fatty subtypes compared to females of the same age and BMI. There was no significant difference in plaque subtype or volume in patients with obstructive disease.

Citing Articles

Regression of Coronary Fatty Plaque and Risk of Cardiac Events According to Blood Pressure Status: Data From a Randomized Trial of Eicosapentaenoic Acid and Docosahexaenoic Acid in Patients With Coronary Artery Disease.

Welty F, Hariri E, Asbeutah A, Daher R, Amangurbanova M, Chedid G J Am Heart Assoc. 2023; 12(18):e030071.

PMID: 37681568 PMC: 10547278. DOI: 10.1161/JAHA.123.030071.

Consistency in Geometry Among Coronary Atherosclerotic Plaques Extracted From Computed Tomography Angiography.

Liu H, Wingert A, Wang X, Zhang J, Sun J, Chen F Front Physiol. 2021; 12:715265.

PMID: 34712147 PMC: 8546263. DOI: 10.3389/fphys.2021.715265.

Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction.

Williams M, Kwiecinski J, Doris M, McElhinney P, DSouza M, Cadet S JACC Cardiovasc Imaging. 2021; 14(9):1804-1814.

PMID: 33865779 PMC: 8435010. DOI: 10.1016/j.jcmg.2021.03.004.

Regression of human coronary artery plaque is associated with a high ratio of (18-hydroxy-eicosapentaenoic acid + resolvin E1) to leukotriene B.

Welty F, Schulte F, Alfaddagh A, Elajami T, Bistrian B, Hardt M FASEB J. 2021; 35(4):e21448.

PMID: 33749913 PMC: 8037777. DOI: 10.1096/fj.202002471R.

Conte E, Dwivedi A, Mushtaq S, Pontone G, Lin F, Hollenberg E Eur Heart J Cardiovasc Imaging. 2020; 22(1):24-33.

PMID: 32793985 PMC: 8218779. DOI: 10.1093/ehjci/jeaa210.

References

Sun J, Zhang Z, Lu B, Yu W, Yang Y, Zhou Y . Identification and quantification of coronary atherosclerotic plaques: a comparison of 64-MDCT and intravascular ultrasound. AJR Am J Roentgenol. 2008; 190(3):748-54. DOI: 10.2214/AJR.07.2763. View

Achenbach S, Ropers D, Holle J, Muschiol G, Daniel W, Moshage W . In-plane coronary arterial motion velocity: measurement with electron-beam CT. Radiology. 2000; 216(2):457-63. DOI: 10.1148/radiology.216.2.r00au19457. View

Lloyd-Jones D, Adams R, Brown T, Carnethon M, Dai S, de Simone G . Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010; 121(7):948-54. DOI: 10.1161/CIRCULATIONAHA.109.192666. View

ESTES J, Quist W, Lo Gerfo F, Costello P . Noninvasive characterization of plaque morphology using helical computed tomography. J Cardiovasc Surg (Torino). 1998; 39(5):527-34. View

Hurlock G, Higashino H, Mochizuki T . History of cardiac computed tomography: single to 320-detector row multislice computed tomography. Int J Cardiovasc Imaging. 2009; 25 Suppl 1:31-42. DOI: 10.1007/s10554-008-9408-z. View

Einstein A, Elliston C, Arai A, Chen M, Mather R, Pearson G . Radiation dose from single-heartbeat coronary CT angiography performed with a 320-detector row volume scanner. Radiology. 2010; 254(3):698-706. PMC: 2826696. DOI: 10.1148/radiol.09090779. View

Austen W, Edwards J, Frye R, Gensini G, Gott V, Griffith L . A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975; 51(4 Suppl):5-40. DOI: 10.1161/01.cir.51.4.5. View

Khan A, Nasir K, Khosa F, Saghir A, Sarwar S, Clouse M . Prospective gating with 320-MDCT angiography: effect of volume scan length on radiation dose. AJR Am J Roentgenol. 2011; 196(2):407-11. PMC: 3294289. DOI: 10.2214/AJR.10.4903. View

STARY H, Chandler A, Dinsmore R, Fuster V, Glagov S, INSULL Jr W . A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Arterioscler Thromb Vasc Biol. 1995; 15(9):1512-31. DOI: 10.1161/01.atv.15.9.1512. View

10.

Stone G, Maehara A, Lansky A, De Bruyne B, Cristea E, Mintz G . A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011; 364(3):226-35. DOI: 10.1056/NEJMoa1002358. View

11.

Laine P, Naukkarinen A, Heikkila L, Penttila A, Kovanen P . Adventitial mast cells connect with sensory nerve fibers in atherosclerotic coronary arteries. Circulation. 2000; 101(14):1665-9. DOI: 10.1161/01.cir.101.14.1665. View

12.

Ritchie C, Godwin J, Crawford C, Stanford W, ANNO H, Kim Y . Minimum scan speeds for suppression of motion artifacts in CT. Radiology. 1992; 185(1):37-42. DOI: 10.1148/radiology.185.1.1523332. View

13.

Fuster V, Fayad Z, Badimon J . Acute coronary syndromes: biology. Lancet. 1999; 353 Suppl 2:SII5-9. DOI: 10.1016/s0140-6736(99)90234-9. View

14.

Maehara A, Cristea E, Mintz G, Lansky A, Dressler O, Biro S . Definitions and methodology for the grayscale and radiofrequency intravascular ultrasound and coronary angiographic analyses. JACC Cardiovasc Imaging. 2012; 5(3 Suppl):S1-9. DOI: 10.1016/j.jcmg.2011.11.019. View

15.

Pohle K, Achenbach S, MacNeill B, Ropers D, Ferencik M, Moselewski F . Characterization of non-calcified coronary atherosclerotic plaque by multi-detector row CT: comparison to IVUS. Atherosclerosis. 2006; 190(1):174-80. DOI: 10.1016/j.atherosclerosis.2006.01.013. View

16.

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

17.

Choi E, Choi S, Rivera J, Nasir K, Chang S, Chun E . Coronary computed tomography angiography as a screening tool for the detection of occult coronary artery disease in asymptomatic individuals. J Am Coll Cardiol. 2008; 52(5):357-65. DOI: 10.1016/j.jacc.2008.02.086. View

18.

Voros S, Rinehart S, Qian Z, Joshi P, Vazquez G, Fischer C . Coronary atherosclerosis imaging by coronary CT angiography: current status, correlation with intravascular interrogation and meta-analysis. JACC Cardiovasc Imaging. 2011; 4(5):537-48. DOI: 10.1016/j.jcmg.2011.03.006. View

19.

Schroeder S, Kopp A, Baumbach A, Meisner C, Kuettner A, Georg C . Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol. 2001; 37(5):1430-5. DOI: 10.1016/s0735-1097(01)01115-9. View

20.

Fujii K, Kobayashi Y, Mintz G, Takebayashi H, Dangas G, Moussa I . Intravascular ultrasound assessment of ulcerated ruptured plaques: a comparison of culprit and nonculprit lesions of patients with acute coronary syndromes and lesions in patients without acute coronary syndromes. Circulation. 2003; 108(20):2473-8. DOI: 10.1161/01.CIR.0000097121.95451.39. View