title: Noncalcified coronary plaque volumes in healthy people with a family history of early onset coronary artery disease.
abstract: BACKGROUND
  Although age and sex distributions of calcified coronary plaque have been well described in the general population, noncalcified plaque (NCP) distributions remain unknown. This is important because NCP is a putative precursor for clinical coronary artery disease and could serve as a sentinel for aggressive primary prevention, especially in high-risk populations. We examined the distributions of NCP and calcified coronary plaque in healthy 30- to 74-year-old individuals from families with early onset coronary artery disease.
  
  
  RESULTS
  Participants in the GeneSTAR family study (N=805), mean age 51.1±10.8 years, 56% women, were screened for coronary artery disease risk factors and coronary plaque using dual-source computed tomographic angiography. Plaque volumes (mm(3)) were quantified using a validated automated method. The prevalence of coronary plaque was 57.8% in men and 35.8% in women (P<0.0001). NCP volume increased with age (P<0.001) and was higher in men than women (P<0.001). Although NCP, as a percentage of total plaque, was inversely related to age (P<0.01), NCP accounted for most of the total plaque volume at all ages, especially in men and women <55 years (>70% and >80%, respectively). Higher Framingham risk was associated with the number of affected vessels (P<0.01), but 44% of men and 20.8% of women considered intermediate risk had left main and 3-vessel disease involvement.
  
  
  CONCLUSIONS
  The majority of coronary plaque was noncalcified, particularly in younger individuals. These findings support the importance of assessing family history and suggest that early primary prevention interventions may be warranted at younger ages in families with early onset coronary artery disease.
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA. bkral@jhmi.edu.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Kral
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Lewis C
authors.initials: LC
authors.lastname: Becker
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Vaidya
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Yanek
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Rehan
authors.initials: R
authors.lastname: Qayyum
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Stefan L
authors.initials: SL
authors.lastname: Zimmerman
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Damini
authors.initials: D
authors.lastname: Dey
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Taryn F
authors.initials: TF
authors.lastname: Moy
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Elliot K
authors.initials: EK
authors.lastname: Fishman
authors.affiliation: From the Johns Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., R.Q., T.F.M., D.M.B.) and Department of Radiology (S.L.Z., E.K.F.), The Johns Hopkins Medical Institutions, Baltimore, MD; and the Biomedical Imaging Research Institute, Department of Biomedical Sciences (D.D.) and Departments of Imaging and Medicine (D.S.B.), Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Becker
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: asymptomatic diseases; atherosclerosis; multidetector computed tomography