Impact of age on coronary artery plaque progression and clinical outcome: A PARADIGM substudy

• Published in: Journal of cardiovascular computed tomography 2021-05, Vol.15 (3), p.232-239
• Main Authors: Kim, Minkwan, Lee, Seung-Pyo, Kwak, Soongu, Yang, Seokhun, Kim, Yong-Jin, Andreini, Daniele, Al-Mallah, Mouaz H., Budoff, Matthew J., Cademartiri, Filippo, Chinnaiyan, Kavitha, Choi, Jung Hyun, Conte, Edoardo, Marques, Hugo, de Araújo Gonçalves, Pedro, Gottlieb, Ilan, Hadamitzky, Martin, Leipsic, Jonathon A., Maffei, Erica, Pontone, Gianluca, Raff, Gilbert L., Shin, Sanghoon, Lee, Byoung Kwon, Chun, Eun Ju, Sung, Ji Min, Lee, Sang-Eun, Berman, Daniel S., Lin, Fay Y., Virmani, Renu, Samady, Habib, Stone, Peter H., Narula, Jagat, Bax, Jeroen J., Shaw, Leslee J., Min, James K., Chang, Hyuk-Jae
• Format: Article
• Language: English
• Subjects: Aging; atherosclerotic plaque; Computed tomography; Coronary artery disease; Disease progression
• ISSN: 1934-5925; 1876-861X
• DOI: 10.1016/j.jcct.2020.09.009

The association of age with coronary plaque dynamics is not well characterized by coronary computed tomography angiography (CCTA). From a multinational registry of patients who underwent serial CCTA, 1153 subjects (61 ± 5 years old, 61.1% male) were analyzed. Annualized volume changes of total, fibrous, fibrofatty, necrotic core, and dense calcification plaque components of the whole heart were compared by age quartile groups. Clinical events, a composite of all-cause death, acute coronary syndrome, and any revascularization after 30 days of the initial CCTA, were also analyzed. Random forest analysis was used to define the relative importance of age on plaque progression. With a 3.3-years’ median interval between the two CCTA, the median annual volume changes of total plaque in each age quartile group was 7.8, 10.5, 10.8, and 12.1 mm3/year and for dense calcification, 2.5, 4.6, 5.4, and 7.1 mm3/year, both of which demonstrated a tendency to increase by age (p-for-trend = 0.001 and