期刊
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY
卷 16, 期 6, 页码 491-497出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcct.2022.05.005
关键词
Coronary cta; Atherosclerosis; Early detection of heart attack
资金
- NIH [HL115150]
- Leading Foreign Research Institute Recruitment Program of the National Research Foundation of Korea, Ministry of Science ICT and Future Planning (Seoul, Korea)
The proportion of calcified plaque in patients with ACS increased significantly with older age, with lower calcification rates in patients younger than 50 years old. A high proportion of high risk markers such as low-attenuation plaque were observed in younger patients, while CACS was found to be >0 in a large percentage of patients older than 50 years.
Background: We examined age differences in whole-heart volumes of non-calcified and calcified atherosclerosis by coronary computed tomography angiography (CCTA) of patients with future ACS.Methods: A total of 234 patients with core-lab adjudicated ACS after baseline CCTA were enrolled. Atherosclerotic plaque was quantified and characterized from the main epicardial vessels and side branches on a 0.5 mm cross-sectional basis. Calcified plaque and non-calcified plaque were defined by above or below 350 Hounsfield units. Patients were categorized according to their age by deciles. Also, coronary artery calcium scores (CACS) were evaluated when available.Results: Patients were on average 62.2 +/- 11.5 years old. On the pre-ACS CCTA, patients showed diffuse, multi-site, predominantly non-obstructive atherosclerosis across all age categories, with plaque being detected in 93.5% of all ACS cases. The proportion calcified plaque from the total plaque burden increased significantly with older presentation (10% calcification in those <50 years, and 50% calcification in those >80 years old). Patients with ACS <50 years had remarkably lower atherosclerotic burden compared with older patients, but a high proportion of high risk markers such as low-attenuation plaque. CACS was >0 in 85% of the patients older than 50 years, and in 57% of patients younger than 50 years.Conclusion: The proportion of calcified plaque varied depending on patient age at the time of ACS. Only a small proportion of plaque was calcified when ACS occurred at <50 years old, while this increased gradually with older age. Purely non-calcified atherosclerotic plaque was not uncommon in patients <50 years.
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