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Plaque Character and Progression According to the Location of Coronary Atherosclerotic Plaque

Title
Plaque Character and Progression According to the Location of Coronary Atherosclerotic Plaque
Authors
Bax A.M.Yoon Y.E.Gianni U.Ma X.Lu Y.Lee B.C.Goebel B.Han D.Lee S.-E.Sung J.M.Andreini D.Al-Mallah M.H.Budoff M.J.Cademartiri F.Chinnaiyan K.Choi J.H.Chun E.J.Conte E.Gottlieb I.Hadamitzky M.Kim Y.J.Lee B.K.Leipsic J.A.Maffei E.Marques H.Gonçalves P.D.A.Pontone G.Shin S.Narula J.Lin F.Y.-H.Shaw L.J.Chang H.-J.
Ewha Authors
신상훈이상은
SCOPUS Author ID
신상훈scopusscopus; 이상은scopus
Issue Date
2021
Journal Title
American Journal of Cardiology
ISSN
0002-9149JCR Link
Citation
American Journal of Cardiology vol. 158, pp. 15 - 22
Publisher
Elsevier Inc.
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Although acute coronary syndrome culprit lesions occur more frequently in the proximal coronary artery, whether the proximal clustering of high-risk plaque is reflected in earlier-stage atherosclerosis remains unclarified. We evaluated the longitudinal distribution of stable atherosclerotic lesions on coronary computed tomography angiography (CCTA) in 1,478 patients (mean age, 61 years; men, 58%) enrolled from a prospective multinational registry of consecutive patients undergoing serial CCTA. Of 3,202 coronary artery lesions identified, 2,140 left lesions were classified (based on the minimal lumen diameter location) into left main (LM, n = 128), proximal (n = 739), and other (n = 1,273), and 1,062 right lesions were classified into proximal (n = 355) and other (n = 707). Plaque volume (PV) was the highest in proximal lesions (median, 26.1 mm3), followed by LM (20.6 mm3) and other lesions (15.0 mm3, p <0.001), for left lesions, and was lager in proximal (25.8 mm3) than in other lesions (15.2 mm3, p <0.001) for right lesions. On both sides, proximally located lesions tended to have greater necrotic core and fibrofatty components than other lesions (left: LM, 10.6%; proximal, 5.8%; other, 3.4% of the total PV, p <0.001; right: proximal, 8.4%; other 3.1%, p <0.001), with less calcified plaque component (left: LM, 18.3%; proximal, 30.3%; other, 37.7%, p <0.001; right: proximal, 23.3%, other, 36.6%, p <0.001), and tended to progress rapidly (adjusted odds ratios: left: LM, reference; proximal, 0.95, p = 0.803; other, 0.64, p = 0.017; right: proximal, reference; other, 0.52, p <0.001). Proximally located plaques were larger, with more risky composition, and progressed more rapidly. © 2021 Elsevier Inc.
DOI
10.1016/j.amjcard.2021.07.040
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의료원 > 의료원 > Journal papers
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