Association of coronary artery calcium score with qualitatively and quantitatively assessed adverse plaque on coronary CT angiography in the SCOT-HEART trial.

European Heart Journal Cardiovascular Imaging
Maia Osborne-GrinterMichelle C Williams


Coronary artery calcification is a marker of cardiovascular risk, but its association with qualitatively and quantitatively assessed plaque subtypes is unknown. In this post-hoc analysis, computed tomography (CT) images and 5-year clinical outcomes were assessed in SCOT-HEART trial participants. Agatston coronary artery calcium score (CACS) was measured on non-contrast CT and was stratified as zero (0 Agatston units, AU), minimal (1-9 AU), low (10-99 AU), moderate (100-399 AU), high (400-999 AU), and very high (≥1000 AU). Adverse plaques were investigated by qualitative (visual categorization of positive remodelling, low-attenuation plaque, spotty calcification, and napkin ring sign) and quantitative (calcified, non-calcified, low-attenuation, and total plaque burden; Autoplaque) assessments. Of 1769 patients, 36% had a zero, 9% minimal, 20% low, 17% moderate, 10% high, and 8% very high CACS. Amongst patients with a zero CACS, 14% had non-obstructive disease, 2% had obstructive disease, 2% had visually assessed adverse plaques, and 13% had low-attenuation plaque burden >4%. Non-calcified and low-attenuation plaque burden increased between patients with zero, minimal, and low CACS (P < 0.001), but there was no statistically sign...Continue Reading


Mar 15, 1990·Journal of the American College of Cardiology·A S AgatstonR Detrano
Jun 13, 2009·JACC. Cardiovascular Imaging·Ammar SarwarKhurram Nasir
Jun 27, 2009·Journal of the American College of Cardiology·Sadako MotoyamaJagat Narula
Jan 20, 2010·Journal of Cardiovascular Computed Tomography·Damini DeyDaniel S Berman
Dec 15, 2012·JACC. Cardiovascular Imaging·Pál Maurovich-HorvatUdo Hoffmann
Nov 20, 2013·JAMA : the Journal of the American Medical Association·Michael H CriquiMatthew A Allison
Apr 1, 2014·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Sana ShahLeslee J Shaw
Dec 30, 2015·Journal of Cardiovascular Computed Tomography·Kristian Altern ØvrehusDamini Dey
Apr 16, 2016·Journal of the American College of Cardiology·Michelle C WilliamsUNKNOWN SCOT-HEART Investigators
Aug 28, 2018·The New England Journal of Medicine·UNKNOWN SCOT-HEART InvestigatorsMichelle C Williams
Jan 27, 2019·Journal of the American College of Cardiology·Michelle C WilliamsEdward D Nicol
Oct 2, 2019·Journal of Cardiovascular Computed Tomography·Thomas SenonerGudrun M Feuchtner
Jan 23, 2020·JAMA Cardiology·Alexander R van RosendaelLeslee J Shaw
Feb 6, 2020·Journal of Cardiovascular Computed Tomography·Maurice W J de RondeSara-Joan Pinto-Sietsma
Jun 20, 2020·Journal of the American College of Cardiology·Jacek KwiecinskiMarc R Dweck
Jun 26, 2020·European Heart Journal Cardiovascular Imaging·Carlijn M van der AalstHarry J de Koning

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