Differences in coronary plaque composition with aging measured by coronary computed tomography angiography

Rajesh Tota-Maharaj, Michael Blaha, Juan J. Rivera, Travis S. Henry, Eue Keun Choi, Sung A. Chang, Yeonyee E. Yoon, Eun Ju Chun, Sang Il Choi, Roger S Blumenthal, Hyuk Jae Chang, Khurram Nasir

Research output: Contribution to journalArticle

Abstract

Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64% men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50% calcified tissue were classified as calcified (CAP), plaques with <50% calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5%, 3rd tertile: 38.5% [p <0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50% in the first tertile to approximately 20% in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)240-245
Number of pages6
JournalInternational Journal of Cardiology
Volume158
Issue number2
DOIs
StatePublished - Jul 12 2012

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Regression Analysis
Calcium
Health
Computed Tomography Angiography

Keywords

  • Aging
  • Atherosclerosis
  • CCTA
  • Coronary computed tomography angiography
  • Plaque subtype

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Differences in coronary plaque composition with aging measured by coronary computed tomography angiography. / Tota-Maharaj, Rajesh; Blaha, Michael; Rivera, Juan J.; Henry, Travis S.; Choi, Eue Keun; Chang, Sung A.; Yoon, Yeonyee E.; Chun, Eun Ju; Choi, Sang Il; Blumenthal, Roger S; Chang, Hyuk Jae; Nasir, Khurram.

In: International Journal of Cardiology, Vol. 158, No. 2, 12.07.2012, p. 240-245.

Research output: Contribution to journalArticle

Tota-Maharaj, R, Blaha, M, Rivera, JJ, Henry, TS, Choi, EK, Chang, SA, Yoon, YE, Chun, EJ, Choi, SI, Blumenthal, RS, Chang, HJ & Nasir, K 2012, 'Differences in coronary plaque composition with aging measured by coronary computed tomography angiography', International Journal of Cardiology, vol. 158, no. 2, pp. 240-245. https://doi.org/10.1016/j.ijcard.2011.01.041
Tota-Maharaj, Rajesh ; Blaha, Michael ; Rivera, Juan J. ; Henry, Travis S. ; Choi, Eue Keun ; Chang, Sung A. ; Yoon, Yeonyee E. ; Chun, Eun Ju ; Choi, Sang Il ; Blumenthal, Roger S ; Chang, Hyuk Jae ; Nasir, Khurram. / Differences in coronary plaque composition with aging measured by coronary computed tomography angiography. In: International Journal of Cardiology. 2012 ; Vol. 158, No. 2. pp. 240-245.
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abstract = "Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64{\%} men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50{\%} calcified tissue were classified as calcified (CAP), plaques with <50{\%} calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5{\%}, 3rd tertile: 38.5{\%} [p <0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50{\%} in the first tertile to approximately 20{\%} in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.",
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AU - Tota-Maharaj, Rajesh

AU - Blaha, Michael

AU - Rivera, Juan J.

AU - Henry, Travis S.

AU - Choi, Eue Keun

AU - Chang, Sung A.

AU - Yoon, Yeonyee E.

AU - Chun, Eun Ju

AU - Choi, Sang Il

AU - Blumenthal, Roger S

AU - Chang, Hyuk Jae

AU - Nasir, Khurram

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N2 - Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64% men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50% calcified tissue were classified as calcified (CAP), plaques with <50% calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5%, 3rd tertile: 38.5% [p <0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50% in the first tertile to approximately 20% in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.

AB - Background: Little is known about the independent impact of aging on coronary plaque morphology and composition in the era of cardiac computed tomography angiography (CCTA). Methods: We studied 1015 consecutive asymptomatic South Korean subjects (49 ± 10 years, 64% men) who underwent 64-slice CCTA during routine health evaluation. Coronary plaque characteristics were analyzed on a per-segment basis according to the modified AHA classification. Plaques with > 50% calcified tissue were classified as calcified (CAP), plaques with <50% calcified tissue were classified as mixed (MCAP), and plaques without calcium were classified as non-calcified (NCAP). Multiple regression analysis was employed to describe the cross-sectional association between age tertile and plaque type burden (≥ 2 affected segments) after adjustment for other cardiovascular risk factors. Results: The prevalence of coronary plaque increased with age, (1st tertile: 7.5%, 3rd tertile: 38.5% [p <0.001]). The relative contribution of NCAP to overall plaque burden decreased with age from nearly 50% in the first tertile to approximately 20% in the third, while there was a reciprocal increase in both MCAP and CAP subtypes. In multivariable analysis, patients in the oldest tertile had a 2.5-fold increase in burden of NCAP, yet a nearly 40-fold increase in MCAP and 16-fold increase in CAP compared to the youngest tertile. In conclusion, CCTA is an effective method for measuring age-related differences in the burden of individual coronary plaque subtypes. Future research is needed to determine whether the increase in mixed and calcified plaques seen with aging produce an independent contribution to the age-related increase in cardiovascular risk.

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KW - Atherosclerosis

KW - CCTA

KW - Coronary computed tomography angiography

KW - Plaque subtype

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