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Kavitha Chinnaiyan, M.D.
Article
Plaque character and progression according to the location of coronary atherosclerotic plaque
American Journal of Cardiology (2021)
  • A Maxim Bax, NewYork–Presbyterian Hospital
  • Yeonyee E. Yoon, NewYork–Presbyterian Hospital
  • Umberto Gianni, NewYork–Presbyterian Hospital
  • Xiaoyue Ma, New York Presbyterian Hospital
  • Yao Lu, New York Presbyterian Hospital
  • Benjamin C Lee, New York Presbyterian Hospital
  • Benjamin Goebel, NewYork–Presbyterian Hospital
  • Donghee Han, Cedars-Sinai Medical Center
  • Sang-Eun Lee, Ewha Womans University Seoul Hospital
  • Ji Min Sung, Yonsei University Health System
  • Daniele Andreini, Centro Cardiologico Monzino, IRCCS Milan
  • Mouaz H. Al-Mallah, Houston Methodist Hospital
  • Matthew J Budoff, Harbor UCLA Medical Center
  • Filippo Cademartiri, SDN IRCCS
  • Kavitha M Chinnaiyan, Beaumont
  • Jung Hyun Choi, Pusan National University
  • Eun Ju Chun, Seoul National University Bundang Hospital
  • Edoardo Conte, Centro Cardiologico Monzino, IRCCS
  • Ilan Gottlieb, Casa de Saude Sao Jose
  • Martin Hadamitzky, German Heart Centre Munich
  • Yong Jin Kim, Seoul National University Hospital
  • Byoung Kwon Lee, Yonsei University
  • Jonathon A. Leipsic, University of British Columbia
  • Erica Maffei, Area Vasta 1/ASUR Marche, Viale Federico Comandino
  • Hugo Marques, Hospital da Luz
  • Pedro de Araujo Goncalves, Hospital da Luz
  • Gianluca Pontone, Centro Cardiologico Monzino IRCCS Milan Italy.
  • Sanghoon Shin, Ewha Womans University
  • Jagat Narula, Mount Sinai Heart
  • Fay Yu-Huei Lin, SDN IRCCS, Naples
  • Leslee J Shah, SDN IRCCS, Naples
  • Hyuk-Jae Chang, Yonsei University Health System
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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.
Keywords
  • coronary artery disease,
  • computed tomography
Disciplines
Publication Date
November 1, 2021
DOI
10.1016/j.amjcard.2021.07.040
Citation Information
Bax AM, Yoon YE, Gianni U, Ma X, Lu Y, Lee BC, Goebel B, Han D, 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, Gonçalves PA, Pontone G, Shin S, Narula J, Lin FY, Shaw LJ, Chang HJ. Plaque Character and Progression According to the Location of Coronary Atherosclerotic Plaque. Am J Cardiol. 2021 Nov 1;158:15-22. doi: 10.1016/j.amjcard.2021.07.040. Epub 2021 Aug 29. PMID: 34465463.