Abstract 568: Coronary Artery Plaque Spatial Distribution Matches that of Thrombosis in STEMI, and is Underestimated by Calcified Plaque Segments Alone

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Catherine A Pastorius ◽  
Stacia Merkel-Kraus ◽  
Jonathan G Schwartz ◽  
Robert S Schwartz ◽  
Vicki Pink ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Plaque ◽  
Lesion Length ◽  
List Type ◽  
Plaque Volume ◽  
Coronary Artery Plaque ◽  
Atypical Symptoms ◽  
Calcified Plaque ◽  
Major Vessel

Angiographic studies of ST-elevation myocardial infarction (STEMI) show that occlusive thrombi occur in coronary arteries within the proximal third of each major vessel, within about 35 mm from the ostium. These findings suggest that these high-risk regions are sites of plaque vulnerability. Multidetector CTA (MDCTA) visualizes not only lumen but also calcified and uncalcified coronary plaque. We therefore studied the distribution of coronary plaque in patients to determine plaque distribution to compare result with location of angiographic myocardial infarction thrombus. Methods: 48 outpatients (mean age 57 +− 5) undergoing Dual Source MDCTA (asymptomatic or with atypical symptoms) were studied. Most distal plaque location was measured for ostial-termination distance and composition (calcified/noncalcified) determined by one expert observer using validated, commercial plaque characterization software for lesion location and lesion length. Results: Location of the most distal plaque was as follows, LAD (n=35) 31.8 mm, LCX (n=21) 33.0 mm, and RCA (n=24) 56.0 mm. Mean lesion lengths were LAD 19.4 +− 13.4 mm, LCX 15.1 +− 9.6 and RCA 18.4 +− 9.8 mm. Mean volume (cu mm) for calcified and noncalcified plaque was 130 +− 176 and 204 +− 249 respectively, for a ratio of 0.64. There was no propensity of either calcified or uncalcified plaque to aggregate longitudinally in the arteries. Conclusions: The distribution and location of coronary artery plaque by MDCTA identically matches the known location of coronary artery vulnerability determined by angiographic studies. This finding suggests that STEMI does not occur in distal coronary locations simply because little plaque occurs in these areas. Calcified plaque volume measured in 3-dimensions underestimates total plaque volume by a factor of 2.6. Calcific plaque is thus the ‘tip of the iceberg’.

Frequency and Healing of Nonculprit Coronary Artery Plaque Disruptions in Patients With Acute Myocardial Infarction

2011 ◽  
Vol 107 (10) ◽  
pp. 1426-1429 ◽  
Author(s):  
Katsuki Okada ◽  
Yasunori Ueda ◽  
Koshi Matsuo ◽  
Mayu Nishio ◽  
Akio Hirata ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Plaque

P5335Effect of anthropometrics, serostatus, medication and cocaine use on quantified coronary plaque volumes in patients with human immunodeficiency virus

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Kolossvary ◽  
H Lai ◽  
D Bluemke ◽  
R N Mandler ◽  
E K Fishman ◽  
...  
Keyword(s):  
Nucleoside Reverse Transcriptase Inhibitor ◽  
Coronary Plaque ◽  
Transcriptase Inhibitor ◽  
Plaque Volume ◽  
Hiv Patients ◽  
Cocaine Use ◽  
Calcified Plaque ◽  
Immunodeficiency Virus ◽  
Traditional Risk Factors ◽  
Reverse Transcriptase Inhibitor

Abstract Introduction The effect of human immunodeficiency virus (HIV) and its medications on coronary artery disease (CAD) is controversial. Furthermore, illicit drug use such as cocaine occurs more often in these populations, however its potential modulating impact on CAD poorly understood. Purpose We sought to assess the effect of anthropometrics, serostatus, HIV medications and cocaine use in HIV patients on coronary plaque volumes assessed using coronary CT angiography (CTA). Methods We randomly selected 100 HIV patients without known CAD, but with coronary CTA confirmed coronary stenosis. All major epicardial vessels were segmented. Total plaque volume, low-attenuation non-calcified plaque volume and calcified plaque volumes were quantified from vessel portions which contained coronary atherosclerosis. We used linear regression analysis to assess the association between anthropometric (age, sex, body mass index), traditional risk factors (hypertension, diabetes, positive family history, HDL, LDL, cholesterol, triglycerides levels, years of alcohol and smoking), HIV associated parameters (years of HIV infection, months of protease inhibitor, nucleoside reverse transcriptase inhibitor, non-nucleoside reverse transcriptase inhibitor, antiretroviral therapy medication use, hepatitis virus C infection, endothelin 1 levels, CD4 levels and viral load), years of cocaine use and coronary plaque volumes. Results Among anthropometric and traditional risk factors age (β=10.35, p=0.006) and smoking years (β=2.72, p=0.044) showed a significant association with total plaque volume, while all other parameters did not. Among HIV related parameters non-showed a significant association with the total plaque volume. However, the years of cocaine use significantly increased the amount of plaque volume (β=4.51, p=0.024). The amount of low-attenuation non-calcified plaque volume was only associated with the years of cocaine use (β=0.30, p=0.031), while all other parameters were non-significant. The amount of calcified plaque volume was associated with age (β=2.82, p=0.047) and years of cocaine use (β=1.52=0.043). Conclusions Cocaine use significantly increases the amount of low-attenuation non-calcified plaque volume, calcified plaque volume and overall plaque volume in HIV patients. Our results suggest the importance of cocaine use prevention in HIV patients as it increases plaque volumes which have been shown to be associated with poor cardiovascular outcomes. Acknowledgement/Funding This study was supported by grants from the US National Institute on Drug Abuse, National Institutes of Health (U01DA040325).

Sex-Related Differences in the Association of BMI and Pericardial Fat Volume With Coronary Atherosclerotic Markers in Young

Angiology ◽  
2020 ◽  
pp. 000331972097423
Author(s):  
Hussein Nafakhi ◽  
Abdulameer A. Al-Mosawi ◽  
Karrar al-Buthabhak
Keyword(s):  
Coronary Artery ◽  
Young Patients ◽  
Young Male ◽  
Calcium Score ◽  
Coronary Plaque ◽  
Pericardial Fat ◽  
Calcified Plaque ◽  
Luminal Stenosis ◽  
Independent Association ◽  
Fat Volume

We assessed sex-related differences in the association of pericardial fat volume (PFV) and obesity measured by body mass index (BMI) with coronary atherosclerotic markers (coronary artery calcium score [CAC], coronary luminal stenosis severity, and coronary plaque) in young patients. Patients (n = 174; age <50 years) with suspected coronary artery disease who underwent 64-slice multidetector computed tomography angiography were enrolled. Females tended to have a younger age and increased BMI, normal coronary arteries (free from luminal stenosis), and increased percentage of absent coronary plaque compared with males. There was a significant independent association between PFV with coronary luminal stenosis and between PFV and BMI with coronary noncalcified plaque presence after adjustment for conventional cardiac risk factors. On the other hand, males showed a more increment in PFV, CAC, percentage of calcified plaque, and percentage of significant coronary luminal stenosis compared with females. There was a significant independent association of PFV with CAC, significant coronary stenosis, and calcified plaque presence, while no association was observed between BMI with coronary markers in young males. In conclusion, PFV, but not BMI, showed a significant independent association with advanced coronary atherosclerosis in young male patients.

CRP and CD14 polymorphisms correlate with coronary plaque volume in patients with coronary artery disease – IVUS substudy of the ENCORE trials

2012 ◽  
Vol 220 (1) ◽  
pp. 172-176 ◽  
Author(s):  
Matthias Hermann ◽  
Dieter Fischer ◽  
Michael M. Hoffmann ◽  
Theo Gasser ◽  
Kurt Quitzau ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Plaque ◽  
Plaque Volume ◽  
Artery Disease ◽  
Coronary Plaque Volume

scholarly journals Diagnostic Efficacy of CCTA And CT-FFR Based On Risk Factors For Myocardial Ischemia

2021 ◽  
Author(s):  
Yongguang Gao ◽  
Yibing Shi ◽  
Ping Xia ◽  
Jinyao Zhang ◽  
Yufei Fu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Regression Analysis ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Plaque Volume ◽  
Diagnostic Efficacy ◽  
Ischemic Group ◽  
Calcified Plaque ◽  
Ischemia Group

Abstract Background: Coronary artery CCTA can observe the degree of coronary artery stenosis and FFR can evaluate the physiological function of coronary artery. However, noninvasive imaging examination that can both observe the above two methods at the same time has not yet been elucidated.Objective: To investigate the diagnostic efficacy of coronary computed tomography angiography (CCTA) and computed tomography-derived fractional flow reserve (CT-FFR) based on different risk factors for myocardial ischemia.Methods: Patients undergoing CCTA in our hospital from August 18, 2020 to April 28, 2021 were randomly selected, and the data were subjected to CT-FFR analysis. Vascular characteristics were measured, including total plaque volume, calcified plaque volume, non-calcified plaque volume, plaque length, and lumen stenosis, and the patients were categorized into a non-ischemia group (FFR>0.8) and an ischemia group (FFR≤0.8). Plaque characteristics were compared between the two groups, and logistic regression analysis was employed to explore the correlations between plaque characteristics and ischemic lesions.Results: From a total of 122 patients enrolled in the study, there were 218 vascular branches with FFR>0.8 and 174 vascular branches with FFR≤0.8. There were significant group differences in total plaque volume, calcified plaque volume, plaque length, and lumen stenosis >50% (n). The obtained data were as follows: non-ischemic group 10.57 (4.80, 259.65), ischemic group 14.87 (3.39, 424.45), Z=9.772, p=0.002, non-ischemic group 10.57 (0, 168.77), ischemic group 14.87 (0, 191.00), Z=2.503，p≤0.001), non-ischemic group 8.17 (37.05, 40.53), ischemic group 8.38 (56.66, 86.47), Z=5.923, p=0.016, and lumen stenosis >50%, non-ischemic group 46, ischemic group 90, x2=14.77，p≤0.001. The regression analysis results indicated that total plaque volume, calcified plaque volume, plaque length and lumen stenosis >50% were risk factors for myocardial ischemia, with ORs and p values of (2.311, p=0.002), (1.021, p=0.004), (2.159, p<0.001), and (0.181, p<0.001), respectively.Conclusion: Total plaque volume, calcified plaque volume, plaque length and lumen stenosis >50% are predictors for myocardial ischemia. Coronary artery CCTA combined with CT-FFR could simultaneously observe the anatomical stenosis and evaluate myocardial blood supply at the functional level. Thus, myocardial ischemia could be better diagnosed.

scholarly journals Association of Coronary Artery Atherosclerosis With Brain White Matter Hyperintensity

Stroke ◽  
2021 ◽  
Author(s):  
Michelle C. Johansen ◽  
Rebecca F. Gottesman ◽  
Brian G. Kral ◽  
Dhananjay Vaidya ◽  
Lisa R. Yanek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Plaque ◽  
White Matter Hyperintensity ◽  
Plaque Volume ◽  
Artery Disease ◽  
Coronary Plaque Volume

Background and Purpose: We aim to determine, in healthy high-risk adults, the association between subclinical coronary artery disease and white matter hyperintensity (WMH) volume and location, independent of atherosclerotic risk factors. Methods: Seven hundred eighty-two asymptomatic first-degree relatives of index cases with early-onset coronary artery disease (<60 years old) from GeneSTAR (Genetic Study of Atherosclerosis Risk) with contemporaneous coronary computed tomography angiography and brain magnetic resonance imaging were analyzed. Multilevel mixed-effects linear regression models, accounting for family structure, evaluated the association of total WMH volume and 3 regions (deep WMH, periventricular WMH [PVWMH], or borderzone [cuff]) with markers of coronary artery disease. Separate models were created for total WMH, deep WMH, PVWMH, and cuff volumes, each, as dependent variables, across coronary computed tomography angiography variables, adjusted for covariates. Results: Mean age was 51 years ±10, with 58% women and 39% African American people. Participants with any coronary plaque had 52% larger WMH volumes than those without plaque (95% CI, 0.24–0.59). Per 1% greater coronary plaque volume, total WMH volumes were 0.07% larger (95% CI, 0.04–0.10). Every 1% higher total coronary plaque volume was associated with 5.03% larger deep WMH volume (95% CI, 4.67–5.38), 5.10% PVWMH larger volume (95% CI, 4.72–5.48), and 2.74% larger cuff volume (95% CI, 2.38–3.09) with differences in this association when comparing deep WMH to PVWMH ( P interaction, 0.001) or cuff ( P interaction, <0.001), respectively. Conclusions: In healthy, high-risk individuals, the presence and volume of coronary artery plaque are associated with larger WMH volumes, appearing the strongest for PVWMH. These findings in high-risk families suggest a disease relationship in 2 different vascular beds, beyond traditional risk factors, possibly due to genetic predisposition.

scholarly journals Biochemical Markers for Determining Vulnerable Atherosclerotic Plaque in Stenotic Patient: Biochemical Markers Study of Myeloperoxidase (MPO), Matrix Metallo-Proteinase-9 (MMP-9), Secretory Phospholipase A2 (SPLA2) and CD40 Ligand

2009 ◽  
Vol 1 (2) ◽  
pp. 59
Author(s):  
Tommy Heryantho ◽  
Andi Wijaya ◽  
Teguh Santoso
Keyword(s):  
Coronary Artery ◽  
Phospholipase A2 ◽  
Biochemical Markers ◽  
Coronary Plaque ◽  
Cd40 Ligand ◽  
Secretory Phospholipase A2 ◽  
Blood Samples ◽  
Coronary Artery Plaque ◽  
Secretory Phospholipase ◽  
Unstable Plaques

BACKGROUND: Thrombus is a main cause of cardiac death. Therefore identifying which coronary artery plaque is vulnerable to rupture is a critical step for cardiac intervention to prevent future cardiac events. Systemic biochemical markers are used for predicting rupture of coronary plaque or identifying stenotic coronary artery plaque(s) vulnerable to rupture.METHODS: Blood samples of 2x24 locations (2x10 controls, 2x12 stable plaques and 2x2 unstable plaques) of 13 patients to undergo stent placement were taken from an artery which showed no stenosis (control), 70% or more stenosis of stable plaques and unstable plaques, respectively. The blood samples were taken by using microcatheter distally and proximally. Concentrations of MPO, MMP-9, SPLA2 and CD40L of each sample were assayed.RESULTS: Concentration of MMP-9 in unstable coronary artery plaque (94.7+14.4 ng/ml) significantly increased compared with that of stable coronary artery plaque (71.0+67.8 ng/ml, p=0.024). SPLA2 concentration significantly decreased in unstable coronary artery plaque (45.9+14.0 pg/ml) compared with that of stable coronary artery plaque (80.9+39.3 pg/ml, p=0.015). Nine of ten studied subjects showed an average of 14.5% (range: 0.0-28.8%) decrease of the SPLA2 concentration in stable plaques compared with that of the non-stenotic coronary artery.CONCLUSION: MMP-9 increased in unstable coronary artery plaque compared with that of stable coronary plaque. Unstable coronary artery plaques absorbed SPLA2 from the vasculars more than the stable plaques and control plaques. MMP-9 and SPLA2 may be used as markers of stability of a plaque in coronary artery in relation to its rupture potential.KEYWORDS: stable and unstable plaque, myeloperoxidase, matrix metalloproteinase-9, secretory phospholipase A2, CD40 Ligand

Unstable Angina and Other Acute Coronary Syndromes

2019 ◽  
Author(s):  
R Scott Wright ◽  
Joseph G Murphy
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiogenic Shock ◽  
Coronary Artery Occlusion ◽  
Coronary Plaque ◽  
The United States ◽  
Patient Death ◽  
Coronary Syndrome ◽  
Artery Disease

Patients with coronary artery disease (CAD) present clinically when their disease enters an unstable phase known as an acute coronary syndrome (ACS), in which the cap of a previously stable atheromatous coronary plaque ruptures or erodes, which in turn activates a thrombotic cascade that may lead to coronary artery occlusion, myocardial infarction (MI), cardiogenic shock, and patient death. There are nearly 2 million episodes of ACS in the United States annually; it is the most common reason for hospitalization with CAD and is the leading cause of death in the developed world. This review contains 2 figures, 16 tables, and 70 references. Key Words: coronary artery disease, myocardial infarction, cardiogenic shock

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