Portal de Periódicos da CAPES

Relationship between patient presentation and morphology of coronary atherosclerosis by quantitative multidetector computed tomography

2018; Oxford University Press; Volume: 20; Issue: 11 Linguagem: Inglês

10.1093/ehjci/jey146

2047-2412

Martina Chantal de Knegt, Jesper J. Linde, Andreas Fuchs, Michael Huy Cuong Pham, Andreas Kryger Jensen, Børge G. Nordestgaard, Henning Kelbæk, Lars Køber, Merete Heitmann, G. Gleerup, Jens D. Hove, Klaus F. Kofoed, Klaus F. Kofoed, Børge G. Nordestgaard, Lars Køber, Jørgen Tobias Kühl, Andreas Fuchs, Per E. Sigvardsen, Mathias Sørgaard, Martina Chantal de Knegt, Jakob Norsk, Daria Frestad, Mads Mejdahl, Marie Bayer Elming, Samuel K. Sørensen, Louise Hindsøe, Anna F. Thomsen, Patricia Martens Udholm, Christian Pihl, Julia Nilsson, Christina Byrne, Andreas Dehlbæk Knudsen, Morten Haugen, Josefine Windfeld‐Mathiasen, Yaffah Tamar Laura Wiegandt, Michael Huy Cuong Pham, Christian Ballegaard, Kirsten Arnaa, Christina Møller, Kirsten Thrysøe, Jesper J. Linde, Klaus F. Kofoed, Jens D. Hove, Gorm Boje Jensen, Mathias Sørgaard, Henning Kelbæk, Jørgen Tobias Kühl, Walter Nielsen, Lars Køber, Kirsten Trysøe, Christina Møller, Tina Bock-Pedersen, Bettina E. Hansen, Patricia Martens Udholm, Martina Chantal de Knegt, Klaus F. Kofoed, Lars Køber, Lene Kløvgaard, Jesper J. Linde, Jørgen Tobias Kühl, Lene Holmvang, Thomas Engstrøm, Steffen Helquist, Erik Jørgensen, Frans Petersen, Kari Saunamäki, Peter Clemmensen, Martina Chantal de Knegt, Golnaz Sadjadieh, Peter Nørkjær Laursen, Peter Riis Hansen, Gunnar Gislason, Ulrik Abildgaard, Jan Skov Jensen, Søren Galatius, Thomas Fritz‐Hansen, Jan Bech, Christian Wachtell, Jan Kyst Madsen, Lærke Smedegaard, Cengiz Özcan, Ida Hastrup Svendsen, Olav Wendelboe Nielsen, Ole Peter Kristiansen, Andreas Fabricius Bjerre, Jens D. Hove, Walter Nielsen, Ulrik Dixen, Johnny Koertz Madsen, G. Gleerup, Ilan Raymond, Jawdat Abdulla, Stig Lyngbæk, Rolf Steffensen, Birgit Jurlander, Charlotte Kragelund, Helena Domínguez, Morten Schou, Henning Kelbæk, Hanne Elming, Susette Krohn Therkelsen,

Coronary Interventions and Diagnostics

Abstract Aims Quantitative computed tomography (QCT) allows assessment of morphological features of coronary atherosclerosis. We aimed to test the hypothesis that clinical patient presentation is associated with distinct morphological features of coronary atherosclerosis. Methods and results A total of 1652 participants, representing a spectrum of clinical risk profiles [787 asymptomatic individuals from the general population, 468 patients with acute chest pain without acute coronary syndrome (ACS), and 397 patients with acute chest pain and ACS], underwent multidetector computed tomography. Of these, 274 asymptomatic individuals, 254 patients with acute chest pain without ACS, and 327 patients with acute chest pain and ACS underwent QCT to assess coronary plaque volumes and proportions of dense calcium (DC), fibrous, fibro fatty (FF), and necrotic core (NC) tissue. Furthermore, the presence of vulnerable plaques, defined by plaque volume and tissue composition, was examined. Coronary plaque volume increased significantly with worsening clinical risk profile [geometric mean (95% confidence interval): 148 (129–166) mm3, 257 (224–295) mm3, and 407 (363–457) mm3, respectively, P < 0.001]. Plaque composition differed significantly across cohorts, P < 0.0001. The proportion of DC decreased, whereas FF and NC increased with worsening clinical risk profile (mean proportions DC: 33%, 23%, 23%; FF: 50%, 61%, 57%; and NC: 17%, 17%, 20%, respectively). Significant differences in plaque composition persisted after multivariable adjustment for age, gender, body surface area, hypertension, statin use at baseline, diabetes, smoking, family history of ischaemic heart disease, total plaque volume, and tube voltage, P < 0.01. Conclusion Coronary atherosclerotic plaque volume and composition are strongly associated to clinical presentation.