Noncalcifed coronary plaque volumes in healthy people with a family history of early onset coronary artery disease

Brian G. Kral, Lewis C. Becker, Dhananjay Vaidya, Lisa R. Yanek, Rehan Qayyum, Stefan L. Zimmerman, Damini Dey, Daniel S. Berman, Taryn F. Moy, Elliot K. Fishman, Diane M. Becker

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations

Abstract

Background-Although age and sex distributions of calcifed coronary plaque have been well described in the general population, noncalcifed plaque (NCP) distributions remain unknown. This is important because NCP is a putative precursor for clinical coronary artery disease and could serve as a sentinel for aggressive primary prevention, especially in high-risk populations. We examined the distributions of NCP and calcifed coronary plaque in healthy 30- to 74-year-old individuals from families with early onset coronary artery disease. Methods and Results-Participants in the GeneSTAR family study (N=805), mean age 51.1±10.8 years, 56% women, were screened for coronary artery disease risk factors and coronary plaque using dual-source computed tomographic angiography. Plaque volumes (mm3) were quantifed using a validated automated method. The prevalence of coronary plaque was 57.8% in men and 35.8% in women (P<0.0001). NCP volume increased with age (P<0.001) and was higher in men than women (P<0.001). Although NCP, as a percentage of total plaque, was inversely related to age (P<0.01), NCP accounted for most of the total plaque volume at all ages, especially in men and women <55 years (>70% and >80%, respectively). Higher Framingham risk was associated with the number of affected vessels (P<0.01), but 44% of men and 20.8% of women considered intermediate risk had left main and 3-vessel disease involvement. Conclusions-The majority of coronary plaque was noncalcifed, particularly in younger individuals. These fndings support the importance of assessing family history and suggest that early primary prevention interventions may be warranted at younger ages in families with early onset coronary artery disease.

Original languageEnglish (US)
Pages (from-to)446-453
Number of pages8
JournalCirculation: Cardiovascular Imaging
Volume7
Issue number3
DOIs
StatePublished - Jul 2014

Keywords

  • Asymptomatic diseases
  • Atherosclerosis
  • Multidetector computed tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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