How early can atherosclerosis be detected by coronary CT angiography? Insights from quantitative CT analysis of serial scans in the PARADIGM trial.
J Cardiovasc Comput Tomogr
; 17(6): 407-412, 2023.
Article
in En
| MEDLINE
| ID: mdl-37798157
ABSTRACT
BACKGROUND:
Non-obstructing small coronary plaques may not be well recognized by expert readers during coronary computed tomography angiography (CCTA) evaluation. Recent developments in atherosclerosis imaging quantitative computed tomography (AI-QCT) enabled by machine learning allow for whole-heart coronary phenotyping of atherosclerosis, but its diagnostic role for detection of small plaques on CCTA is unknown.METHODS:
We performed AI-QCT in patients who underwent serial CCTA in the multinational PARADIGM study. AI-QCT results were verified by a level III experienced reader, who was blinded to baseline and follow-up status of CCTA. This retrospective analysis aimed to characterize small plaques on baseline CCTA and evaluate their serial changes on follow-up imaging. Small plaques were defined as a total plaque volume <50 âmm3.RESULTS:
A total of 99 patients with 502 small plaques were included. The median total plaque volume was 6.8 âmm3 (IQR 3.5-13.9 âmm3), most of which was non-calcified (median 6.2 âmm3; 2.9-12.3 âmm3). The median age at the time of baseline CCTA was 61 years old and 63% were male. The mean interscan period was 3.8 â± â1.6 years. On follow-up CCTA, 437 (87%) plaques were present at the same location as small plaques on baseline CCTA; 72% were larger and 15% decreased in volume. The median total plaque volume and non-calcified plaque volume increased to 18.9 âmm3 (IQR 8.3-45.2 âmm3) and 13.8 âmm3 (IQR 5.7-33.4 âmm3), respectively, among plaques that persisted on follow-up CCTA. Small plaques no longer visualized on follow-up CCTA were significantly more likely to be of lower volume, shorter in length, non-calcified, and more distal in the coronary artery, as compared with plaques that persisted at follow-up.CONCLUSION:
In this retrospective analysis from the PARADIGM study, small plaques (<50 âmm3) identified by AI-QCT persisted at the same location and were often larger on follow-up CCTA.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Atherosclerosis
/
Plaque, Atherosclerotic
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Cardiovasc Comput Tomogr
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Year:
2023
Type:
Article