title: Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.
abstract: Purpose To assess the relationship between total, calcified, and noncalcified coronary plaque burdens throughout the entire coronary vasculature at coronary computed tomographic (CT) angiography in relationship to cardiovascular risk factors in asymptomatic individuals with low-to-moderate risk. Materials and Methods This HIPAA-compliant study had institutional review board approval, and written informed consent was obtained. Two hundred two subjects were recruited to an ongoing prospective study designed to evaluate the effect of HMG-CoA reductase inhibitors on atherosclerosis. Eligible subjects were asymptomatic individuals older than 55 years who were eligible for statin therapy. Coronary CT angiography was performed by using a 320-detector row scanner. Coronary wall thickness and plaque were evaluated in all epicardial coronary arteries greater than 2 mm in diameter. Images were analyzed by using dedicated software involving an adaptive lumen attenuation algorithm. Total plaque index (calcified plus noncalcified plaque) was defined as plaque volume divided by vessel length. Multivariable regression analysis was performed to determine the relationship between risk factors and plaque indexes. Results The mean age of the subjects was 65.5 years ± 6.9 (standard deviation) (36% women), and the median coronary artery calcium (CAC) score was 73 (interquartile range, 1-434). The total coronary plaque index was higher in men than in women (42.06 mm(2) ± 9.22 vs 34.33 mm(2) ± 8.35; P < .001). In multivariable analysis controlling for all risk factors, total plaque index remained higher in men than in women (by 5.01 mm(2); P = .03) and in those with higher simvastatin doses (by 0.44 mm(2)/10 mg simvastatin dose equivalent; P = .02). Noncalcified plaque index was positively correlated with systolic blood pressure (β = 0.80 mm(2)/10 mm Hg; P = .03), diabetes (β = 4.47 mm(2); P = .03), and low-density lipoprotein (LDL) cholesterol level (β = 0.04 mm(2)/mg/dL; P = .02); the association with LDL cholesterol level remained significant (P = .02) after additional adjustment for the CAC score. Conclusion LDL cholesterol level, systolic blood pressure, and diabetes were associated with noncalcified plaque burden at coronary CT angiography in asymptomatic individuals with low-to-moderate risk. (©) RSNA, 2015 Online supplemental material is available for this article.
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Karen
authors.initials: K
authors.lastname: Rodriguez
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Kwan
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Shenghan
authors.initials: S
authors.lastname: Lai
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: João A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Davis
authors.initials: D
authors.lastname: Vigneault
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Veit
authors.initials: V
authors.lastname: Sandfort
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Puskar
authors.initials: P
authors.lastname: Pattanayak
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ahlman
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Marissa
authors.initials: M
authors.lastname: Mallek
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Sibley
authors.affiliation: From the Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Bldg 10/1C355, Bethesda, MD 20892 (K.R., A.C.K., D.V., V.S., P.P., M.A.A., M.M., C.T.S., D.A.B.); and Department of Radiology (S.L.) and Cardiology Division, Department of Medicine (J.A.C.L.), Johns Hopkins University, Baltimore, Md.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed