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Kavitha Chinnaiyan, M.D.
Article
Differential progression of coronary atherosclerosis according to plaque composition: a cluster analysis of PARADIGM registry data.
Scientific Reports (2021)
  • Yeonyee E. Yoon, NewYork–Presbyterian Hospital
  • Yeonyee E. Yoon, Seoul National University Hospital
  • Yeonyee E. Yoon, Seoul National University Bundang Hospital
  • Lohendran Baskaran, NewYork–Presbyterian Hospital
  • Benjamin C. Lee, NewYork–Presbyterian Hospital
  • Mohit Kumar Pandey, Ipsos US Public Affairs, New York, NY, USA.
  • Benjamin Goebel, NewYork–Presbyterian Hospital
  • Sang-Eun Lee, Ewha Womans University
  • Sang-Eun Lee, University Health System
  • Ji Min Sung, University Health System
  • Daniele Andreini, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.
  • Mouaz H. Al-Mallah, Houston Methodist Hospital
  • Matthew J. Budoff, UCLA Medical Center
  • Filippo Cademartiri, Cardiovascular Imaging Unit, SDN IRCCS, Naples, Italy.
  • Kavitha Chinnaiyan, Beaumont Hospital
  • Jung Hyun Choi, Pusan National University
  • Eun Ju Chun, Seoul National University Bundang Hospital
  • Edoardo Conte, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.
  • Ilan Gottlieb, Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil.
  • Martin Hadamitzky, Department of Radiology and Nuclear Medicine, German Heart Centre Munich, Munich, Germany.
  • Yong Jin Kim, Seoul National University Hospital
  • Byoung Kwon Lee, Yonsei University
  • Jonathon A. Leipsic, University of British Columbia
  • Erica Maffei, Unica Corporation
  • Hugo Marques, Unica Corporation
  • Pedro de Araújo Gonçalves, Nova Southeastern University
  • Pedro de Araújo Gonçalves, Unica Corporation
  • Gianluca Pontone, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.
  • Sanghoon Shin, Ewha Womans University
  • Jagat Narula, Icahn School of Medicine at Mount Sinai
  • Jeroen J. Bax, Leiden University
  • Fay Yu-Huei Lin, NewYork–Presbyterian Hospital
  • Leslee Shaw, NewYork–Presbyterian Hospital
  • Hyuk-Jae Chang, University Health System
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Abstract
Patient-specific phenotyping of coronary atherosclerosis would facilitate personalized risk assessment and preventive treatment. We explored whether unsupervised cluster analysis can categorize patients with coronary atherosclerosis according to their plaque composition, and determined how these differing plaque composition profiles impact plaque progression. Patients with coronary atherosclerotic plaque (n = 947; median age, 62 years; 59% male) were enrolled from a prospective multi-national registry of consecutive patients who underwent serial coronary computed tomography angiography (median inter-scan duration, 3.3 years). K-means clustering applied to the percent volume of each plaque component and identified 4 clusters of patients with distinct plaque composition. Cluster 1 (n = 52), which comprised mainly fibro-fatty plaque with a significant necrotic core (median, 55.7% and 16.0% of the total plaque volume, respectively), showed the least total plaque volume (PV) progression (+ 23.3 mm3), with necrotic core and fibro-fatty PV regression (- 5.7 mm3 and - 5.6 mm3, respectively). Cluster 2 (n = 219), which contained largely fibro-fatty (39.2%) and fibrous plaque (46.8%), showed fibro-fatty PV regression (- 2.4 mm3). Cluster 3 (n = 376), which comprised mostly fibrous (62.7%) and calcified plaque (23.6%), showed increasingly prominent calcified PV progression (+ 21.4 mm3). Cluster 4 (n = 300), which comprised mostly calcified plaque (58.7%), demonstrated the greatest total PV increase (+ 50.7mm3), predominantly increasing in calcified PV (+ 35.9 mm3). Multivariable analysis showed higher risk for plaque progression in Clusters 3 and 4, and higher risk for adverse cardiac events in Clusters 2, 3, and 4 compared to that in Cluster 1. Unsupervised clustering algorithms may uniquely characterize patient phenotypes with varied atherosclerotic plaque profiles, yielding distinct patterns of progressive disease and outcome.
Disciplines
Publication Date
August 24, 2021
DOI
10.1038/S41598-021-96616-W
Citation Information
Yoon YE, Baskaran L, Lee BC, Pandey MK, Goebel B, Lee SE, Sung JM, Andreini D, Al-Mallah MH, Budoff MJ, Cademartiri F, Chinnaiyan K, Choi JH, Chun EJ, Conte E, Gottlieb I, Hadamitzky M, Kim YJ, Lee BK, Leipsic JA, Maffei E, Marques H, de Araújo Gonçalves P, Pontone G, Shin S, Narula J, Bax JJ, Lin FY, Shaw L, Chang HJ. Differential progression of coronary atherosclerosis according to plaque composition: a cluster analysis of PARADIGM registry data. Sci Rep. 2021 Aug 24;11(1):17121. doi: 10.1038/s41598-021-96616-w. PMID: 34429500; PMCID: PMC8385056.