Jonas, Rebecca; Earls, James; Marques, Hugo; Chang, Hyuk-Jae; Choi, Jung Hyun; Doh, Joon-Hyung; Her, Ae-Young; Koo, Bon Kwon; Nam, Chang-Wook; Park, Hyung-Bok; Shin, Sanghoon; Cole, Jason; Gimelli, Alessia; Khan, Muhammad Akram; Lu, Bin; Gao, Yang; Nabi, Faisal; Nakazato, Ryo; Schoepf, U Joseph; Driessen, Roel S; Bom, Michiel J; Thompson, Randall C; Jang, James J; Ridner, Michael; Rowan, Chris; Avelar, Erick; Genereux, Philippe; Knaapen, Paul; de Waard, Guus A; Pontone, Gianluca; Andreini, Daniele; Al-Mallah, Mouaz H; Jennings, Robert; Crabtree, Tami R; Villines, Todd C; Min, James K; Choi, Andrew D
Open heart
2021Nov ; 8 ( 2 ) :.
PMID : 34785589
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Jonas, Rebecca - Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Earls, James - Cleerly Health, New York, New York, USA.
Marques, Hugo - UNICA, Unit of Cardiovascular Imaging, CHRC Campus Nova Medical School, Lisboa, Portugal.
Chang, Hyuk-Jae - Cardiology, Yonsei University Health System, Seodaemun-gu, Seoul, Korea.
Choi, Jung Hyun - Ontact Health, Inc, Seoul, Korea.
Doh, Joon-Hyung - Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Her, Ae-Young - Cardiology, Kangwon National University Hospital, Chuncheon, Kangwon, Korea.
Koo, Bon Kwon - Department of Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea.
Nam, Chang-Wook - Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu, Korea.
Park, Hyung-Bok - Division of Cardiology, Department of Internal Medicine, Catholic Kwandong University International Saint Mary's Hospital, Incheon, Korea (the Republic of).
Shin, Sanghoon - Cardiology, Ewha Women's University Mokdong Hospital, Seoul, Korea.
Cole, Jason - Mobile Cardiology Associates, Mobile, Alabama, USA.
Gimelli, Alessia - Department of Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
Khan, Muhammad Akram - Cardiac Center of Texas, McKinney, Texas, USA.
Lu, Bin - Department of Radiology, Fuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, China.
Gao, Yang - Fuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, China.
Nabi, Faisal - Houston Methodist Hospital, Houston, Texas, USA.
Nakazato, Ryo - Cardiovascular Center, Saint Luke's International Hospital, Chuo-ku, Tokyo, Japan.
Schoepf, U Joseph - Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.
Driessen, Roel S - VU University Medical Centre Amsterdam, Amsterdam, Noord-Holland, Netherlands.
Bom, Michiel J - Department of Cardiology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Thompson, Randall C - Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.
Jang, James J - Cardiology, Kaiser Permanente, San Jose, California, USA.
Ridner, Michael - Heart Center Research, Huntsville, Alabama, USA.
Rowan, Chris - Renown Health, Reno, Nevada, USA.
Avelar, Erick - Oconee Heart and Vascular Center, Saint Marys Medical Group, Athens, Georgia, USA.
Genereux, Philippe - Division of Cardiology, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada.
Knaapen, Paul - Cardiology, VU University Medical Centre Amsterdam, Amsterdam, Noord-Holland, Netherlands.
de Waard, Guus A - Cardiology, VU University Medical Centre Amsterdam, Amsterdam, Noord-Holland, Netherlands.
Pontone, Gianluca - Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Lombardia, Italy.
Andreini, Daniele - Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Lombardia, Italy.
Al-Mallah, Mouaz H - Cardiology, Houston Methodist Hospital, Houston, Texas, USA.
Jennings, Robert - Cleerly Health, New York, New York, USA.
Crabtree, Tami R - Cleerly Health, New York, New York, USA.
Villines, Todd C - Medicine (Cardiology), University of Virginia Health System, Charlottesville, Virginia, USA.
Min, James K - Cleerly Health, New York, New York, USA.
Choi, Andrew D - Division of Cardiology and Department of Radiology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA adchoi@mfa.gwu.edu.
ABSTRACT
OBJECTIVE: The study evaluates the relationship of coronary stenosis, atherosclerotic plaque characteristics (APCs) and age using artificial intelligence enabled quantitative coronary computed tomographic angiography (AI-QCT).
METHODS: This is a post-hoc analysis of data from 303 subjects enrolled in the CREDENCE (Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia) trial who were referred for invasive coronary angiography and subsequently underwent coronary computed tomographic angiography (CCTA). In this study, a blinded core laboratory analysing quantitative coronary angiography images classified lesions as obstructive (??0%) or non-obstructive (<50%) while AI software quantified APCs including plaque volume (PV), low-density non-calcified plaque (LD-NCP), non-calcified plaque (NCP), calcified plaque (CP), lesion length on a per-patient and per-lesion basis based on CCTA imaging. Plaque measurements were normalised for vessel volume and reported as % percent atheroma volume (%PAV) for all relevant plaque components. Data were subsequently stratified by age <65 and ??5 years.
RESULTS: The cohort was 64.4±10.2 years and 29% women. Overall, patients >65 had more PV and CP than patients <65. On a lesion level, patients >65 had more CP than younger patients in both obstructive (29.2 mm(3) vs 48.2 mm(3); p<0.04) and non-obstructive lesions (22.1 mm(3) vs 49.4 mm(3); p<0.004) while younger patients had more %PAV (LD-NCP) (1.5% vs 0.7%; p<0.038). Younger patients had more PV, LD-NCP, NCP and lesion lengths in obstructive compared with non-obstructive lesions. There were no differences observed between lesion types in older patients. CONCLUSION: AI-QCT identifies a unique APC signature that differs by age and degree of stenosis and provides a foundation for AI-guided age-based approaches to atherosclerosis identification, prevention and treatment. CI - ??Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
keyword
atherosclerosis; carotid artery diseases; computed tomography angiography; coronary angiography; diagnostic imaging
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