title: Differences in coronary plaque composition with aging measured by coronary computed tomography angiography.
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.
authors.affiliation: Johns Hopkins Ciccarone Preventive Cardiology Center, Baltimore, MD, United States.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Tota-Maharaj
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Rivera
authors.forename: Travis S
authors.initials: TS
authors.lastname: Henry
authors.forename: Eue-Keun
authors.initials: EK
authors.lastname: Choi
authors.forename: Sung-A
authors.initials: SA
authors.lastname: Chang
authors.forename: Yeonyee E
authors.initials: YE
authors.lastname: Yoon
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000473:pathology*; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods