Key result
In healthy subjects, Framingham risk score did not differ significantly among CCTA plaque patterns (p=0.086), but HbA1c, smoking, and hypertension were independently associated with specific plaque types.
Why the study?
Do cardiovascular risk factors differ according to coronary plaque patterns on CCTA in healthy subjects?
Cross-Sectional (n=3,914)
No
Do cardiovascular risk factors differ according to coronary plaque patterns on CCTA in healthy subjects?
Different cardiovascular risk factors are independently associated with specific coronary plaque patterns on CCTA in asymptomatic subjects, suggesting a role for individualized risk reduction.
Although it is known that coronary computed tomographic angiography (CCTA) offers highly negative predictive value to exclude obstructive coronary lesions, the plaque pattern on CCTA has not been fully understood. The purpose of this study was to explore the difference of the plaque patterns on CCTA and to assess the cardiovascular risks in healthy subjects. A total of 3914 subjects (mean age: 55 ± 10 years, M : F = 2649 : 1265) who underwent CCTA for health check-up between January 2009 and December 2012 were enrolled. According to coronary artery calcium score (CACS) and plaque pattern on CCTA, subjects were categorized into four groups (group 1: normal; group 2: “non-calcified” plaque; group 3: “calcified” plaque; group 4: mixed plaque). We analyzed cardiovascular risks and Framingham risk score (FRS) among the groups. The incidence of each group was group 1 in 55.0% (2152/3914), group 2 in 5.1% (200/3914), group 3 in 8.2% (319/3914), and group 4 in 7.2% (280/3914), respectively. There was no difference of FRS among the groups (6.4 ± 6.4%; 6.5 ± 4.6%; 8.2 ± 5.8%; 7.7 ± 5.7% p = 0.086). In multivariate analysis, HbA1c (OR = 2.285; 95%CI = 1.029 - 5.071; p = 0.042) in group 2; age (OR = 1.115; 95%CI = 1.034 - 1.202; p = 0.005) and smoking status (OR = 3.386; 95%CI = 1.124 - 10.202; p = 0.030) in group 3; and age (OR = 1.054; 95%CI = 1.011 - 1.099; p = 0.014) and hypertension (OR = 3.087; 95%CI = 1.536 - 6.202; p = 0.001) in group 4 were independent factors. Our data suggest that more individualized therapy for reduction of cardiovascular risks associated with plaque pattern on CCTA could be considered in healthy subjects.
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Lee et al. (2017) conducted a cross-sectional in Healthy subjects (subclinical coronary atherosclerosis) (n=3,914). Coronary computed tomographic angiography (CCTA) plaque pattern assessment vs. Normal coronary arteries (Group 1) was evaluated on Framingham risk score (FRS) among plaque pattern groups (p=0.086). In healthy subjects, Framingham risk score did not differ significantly among CCTA plaque patterns (p=0.086), but HbA1c, smoking, and hypertension were independently associated with specific plaque types.
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