A novel density-volume calcium score by non-contrast CT predicts coronary plaque burden on coronary CT angiography: Results from the MACS (Multicenter AIDS cohort study)

Rine Nakanishi, Joseph A. Delaney, Wendy S Post, Christopher Dailing, Michael Blaha, Frank Palella, Mallory Witt, Todd T Brown, Lawrence A. Kingsley, Kazuhiro Osawa, Indre Ceponiene, Negin Nezarat, Sina Rahmani, Mitsuru Kanisawa, Lisa Paula Jacobson, Matthew J. Budoff

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this study is to determine if a new score calculated with coronary artery calcium (CAC) density and volume is associated with total coronary artery plaque burden and composition on coronary CT angiography (CCTA) compared to the Agatston score (AS). Methods: We identified 347 men enrolled in the Multicenter AIDS cohort study who underwent contrast and non-contrast CCTs, and had CAC>0. CAC densities (mean Hounsfield Units [HU]) per plaque) and volumes on non-contrast CCT were measured. A Density-Volume Calcium score was calculated by multiplying the plaque volume by a factor based on the mean HU of the plaque (4, 3, 2 and 1 for 130–199, 200–299, 300–399, and ≥400HU). Total Density-Volume Calcium score was determined by the sum of these individual scores. The semi-quantitative partially calcified and total plaque scores (PCPS and TPS) on CCTA were calculated. The associations between Density-Volume Calcium score, PCPS and TPS were examined. Results: Overall, 2879 CAC plaques were assessed. Multivariable linear regression models demonstrated a stronger association between the log Density-Volume Calcium score and both the PCPS (β 0.99, 95%CI 0.80–1.19) and TPS (β 2.15, 95%CI 1.88–2.42) compared to the log of AS (PCPS: β 0.77, 95%CI 0.61–0.94; TPS: β 1.70, 95%CI 1.48–1.94). Similar results were observed for numbers of PC or TP segments. Conclusion: The new CAC score weighted towards lower density demonstrated improved correlation with semi-quantitative PC and TP burden on CCTA compared to the traditional AS, which suggests it has utility as an alternative measure of atherosclerotic burden.

Original languageEnglish (US)
JournalJournal of cardiovascular computed tomography
DOIs
StateAccepted/In press - Jan 1 2019

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Coronary Angiography
Acquired Immunodeficiency Syndrome
Cohort Studies
Calcium
Coronary Vessels
Linear Models
Computed Tomography Angiography

Keywords

  • Calcium density
  • Calcium volume
  • Coronary artery calcium
  • Coronary computed tomographic angiography
  • Human immunodeficiency virus

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

A novel density-volume calcium score by non-contrast CT predicts coronary plaque burden on coronary CT angiography : Results from the MACS (Multicenter AIDS cohort study). / Nakanishi, Rine; Delaney, Joseph A.; Post, Wendy S; Dailing, Christopher; Blaha, Michael; Palella, Frank; Witt, Mallory; Brown, Todd T; Kingsley, Lawrence A.; Osawa, Kazuhiro; Ceponiene, Indre; Nezarat, Negin; Rahmani, Sina; Kanisawa, Mitsuru; Jacobson, Lisa Paula; Budoff, Matthew J.

In: Journal of cardiovascular computed tomography, 01.01.2019.

Research output: Contribution to journalArticle

Nakanishi, Rine ; Delaney, Joseph A. ; Post, Wendy S ; Dailing, Christopher ; Blaha, Michael ; Palella, Frank ; Witt, Mallory ; Brown, Todd T ; Kingsley, Lawrence A. ; Osawa, Kazuhiro ; Ceponiene, Indre ; Nezarat, Negin ; Rahmani, Sina ; Kanisawa, Mitsuru ; Jacobson, Lisa Paula ; Budoff, Matthew J. / A novel density-volume calcium score by non-contrast CT predicts coronary plaque burden on coronary CT angiography : Results from the MACS (Multicenter AIDS cohort study). In: Journal of cardiovascular computed tomography. 2019.
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abstract = "Background: The purpose of this study is to determine if a new score calculated with coronary artery calcium (CAC) density and volume is associated with total coronary artery plaque burden and composition on coronary CT angiography (CCTA) compared to the Agatston score (AS). Methods: We identified 347 men enrolled in the Multicenter AIDS cohort study who underwent contrast and non-contrast CCTs, and had CAC>0. CAC densities (mean Hounsfield Units [HU]) per plaque) and volumes on non-contrast CCT were measured. A Density-Volume Calcium score was calculated by multiplying the plaque volume by a factor based on the mean HU of the plaque (4, 3, 2 and 1 for 130–199, 200–299, 300–399, and ≥400HU). Total Density-Volume Calcium score was determined by the sum of these individual scores. The semi-quantitative partially calcified and total plaque scores (PCPS and TPS) on CCTA were calculated. The associations between Density-Volume Calcium score, PCPS and TPS were examined. Results: Overall, 2879 CAC plaques were assessed. Multivariable linear regression models demonstrated a stronger association between the log Density-Volume Calcium score and both the PCPS (β 0.99, 95{\%}CI 0.80–1.19) and TPS (β 2.15, 95{\%}CI 1.88–2.42) compared to the log of AS (PCPS: β 0.77, 95{\%}CI 0.61–0.94; TPS: β 1.70, 95{\%}CI 1.48–1.94). Similar results were observed for numbers of PC or TP segments. Conclusion: The new CAC score weighted towards lower density demonstrated improved correlation with semi-quantitative PC and TP burden on CCTA compared to the traditional AS, which suggests it has utility as an alternative measure of atherosclerotic burden.",
keywords = "Calcium density, Calcium volume, Coronary artery calcium, Coronary computed tomographic angiography, Human immunodeficiency virus",
author = "Rine Nakanishi and Delaney, {Joseph A.} and Post, {Wendy S} and Christopher Dailing and Michael Blaha and Frank Palella and Mallory Witt and Brown, {Todd T} and Kingsley, {Lawrence A.} and Kazuhiro Osawa and Indre Ceponiene and Negin Nezarat and Sina Rahmani and Mitsuru Kanisawa and Jacobson, {Lisa Paula} and Budoff, {Matthew J.}",
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language = "English (US)",
journal = "Journal of Cardiovascular Computed Tomography",
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TY - JOUR

T1 - A novel density-volume calcium score by non-contrast CT predicts coronary plaque burden on coronary CT angiography

T2 - Results from the MACS (Multicenter AIDS cohort study)

AU - Nakanishi, Rine

AU - Delaney, Joseph A.

AU - Post, Wendy S

AU - Dailing, Christopher

AU - Blaha, Michael

AU - Palella, Frank

AU - Witt, Mallory

AU - Brown, Todd T

AU - Kingsley, Lawrence A.

AU - Osawa, Kazuhiro

AU - Ceponiene, Indre

AU - Nezarat, Negin

AU - Rahmani, Sina

AU - Kanisawa, Mitsuru

AU - Jacobson, Lisa Paula

AU - Budoff, Matthew J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The purpose of this study is to determine if a new score calculated with coronary artery calcium (CAC) density and volume is associated with total coronary artery plaque burden and composition on coronary CT angiography (CCTA) compared to the Agatston score (AS). Methods: We identified 347 men enrolled in the Multicenter AIDS cohort study who underwent contrast and non-contrast CCTs, and had CAC>0. CAC densities (mean Hounsfield Units [HU]) per plaque) and volumes on non-contrast CCT were measured. A Density-Volume Calcium score was calculated by multiplying the plaque volume by a factor based on the mean HU of the plaque (4, 3, 2 and 1 for 130–199, 200–299, 300–399, and ≥400HU). Total Density-Volume Calcium score was determined by the sum of these individual scores. The semi-quantitative partially calcified and total plaque scores (PCPS and TPS) on CCTA were calculated. The associations between Density-Volume Calcium score, PCPS and TPS were examined. Results: Overall, 2879 CAC plaques were assessed. Multivariable linear regression models demonstrated a stronger association between the log Density-Volume Calcium score and both the PCPS (β 0.99, 95%CI 0.80–1.19) and TPS (β 2.15, 95%CI 1.88–2.42) compared to the log of AS (PCPS: β 0.77, 95%CI 0.61–0.94; TPS: β 1.70, 95%CI 1.48–1.94). Similar results were observed for numbers of PC or TP segments. Conclusion: The new CAC score weighted towards lower density demonstrated improved correlation with semi-quantitative PC and TP burden on CCTA compared to the traditional AS, which suggests it has utility as an alternative measure of atherosclerotic burden.

AB - Background: The purpose of this study is to determine if a new score calculated with coronary artery calcium (CAC) density and volume is associated with total coronary artery plaque burden and composition on coronary CT angiography (CCTA) compared to the Agatston score (AS). Methods: We identified 347 men enrolled in the Multicenter AIDS cohort study who underwent contrast and non-contrast CCTs, and had CAC>0. CAC densities (mean Hounsfield Units [HU]) per plaque) and volumes on non-contrast CCT were measured. A Density-Volume Calcium score was calculated by multiplying the plaque volume by a factor based on the mean HU of the plaque (4, 3, 2 and 1 for 130–199, 200–299, 300–399, and ≥400HU). Total Density-Volume Calcium score was determined by the sum of these individual scores. The semi-quantitative partially calcified and total plaque scores (PCPS and TPS) on CCTA were calculated. The associations between Density-Volume Calcium score, PCPS and TPS were examined. Results: Overall, 2879 CAC plaques were assessed. Multivariable linear regression models demonstrated a stronger association between the log Density-Volume Calcium score and both the PCPS (β 0.99, 95%CI 0.80–1.19) and TPS (β 2.15, 95%CI 1.88–2.42) compared to the log of AS (PCPS: β 0.77, 95%CI 0.61–0.94; TPS: β 1.70, 95%CI 1.48–1.94). Similar results were observed for numbers of PC or TP segments. Conclusion: The new CAC score weighted towards lower density demonstrated improved correlation with semi-quantitative PC and TP burden on CCTA compared to the traditional AS, which suggests it has utility as an alternative measure of atherosclerotic burden.

KW - Calcium density

KW - Calcium volume

KW - Coronary artery calcium

KW - Coronary computed tomographic angiography

KW - Human immunodeficiency virus

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