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Association of atherosclerosis in the descending thoracic aorta with coronary artery disease on multi detector row computed tomography coronary angiography in patients with suspected coronary artery disease

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Abstract

The association between atherosclerosis in the descending thoracic aorta (DTA) visualized on computed tomography coronary angiography (CTA) and coronary artery disease (CAD) has not been extensively explored. Therefore, a comprehensive analysis of DTA atherosclerosis on CTA was performed and the association of DTA atherosclerosis with CAD was evaluated in patients with suspected CAD. A total of 344 patients (54 ± 12 years, 54 % men) with suspected CAD underwent CTA. CTA were classified based on CAD severity in no signs of atherosclerosis or minor wall-irregularities <30 %, non-significant CAD 30–50 %, or significant CAD ≥50 % stenosis. The DTA was divided in segments according the posterior intercostal arteries. Per segment the presence of atherosclerotic plaque (defined as ≥2 mm wall thickness) was determined and maximal wall thickness was measured. Plaque composition was scored as non-calcified or mixed and the percentage of DTA segments with atherosclerosis was calculated. Significant CAD was present in 152 (44 %) patients and 278 (81 %) had DTA atherosclerotic plaque. DTA maximal wall thickness and percentage of DTA segments with atherosclerosis were 2.7 ± 1 mm and 49 ± 36 %. The presence, severity and extent of DTA atherosclerosis significantly increased with increasing CAD severity. Multivariate logistic regression analysis corrected for age and other risk factors demonstrated independent associations of DTA plaque (OR 6.56, 95 % CI 1.78–24.19, p = 0.005) and maximal DTA wall thickness (OR 2.00, 95 % CI 1.28–3.12, p = 0.002) with significant CAD. The presence and severity of DTA atherosclerosis were independently related with significant CAD on CTA in patients with suspected CAD.

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References

  1. de Graaf FR, Schuijf JD, van Velzen JE, Kroft LJ, de R A, Reiber JH et al (2010) Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. Eur Heart J 31:1908–1915

    Article  PubMed  Google Scholar 

  2. Schuijf JD, Pundziute G, Jukema JW, Lamb HJ, van der Hoeven BL, de Roos A et al (2006) Diagnostic accuracy of 64-slice multislice computed tomography in the noninvasive evaluation of significant coronary artery disease. Am J Cardiol 98:145–148

    Article  PubMed  Google Scholar 

  3. Takasu J, Mao S, Budoff MJ (2003) Aortic atherosclerosis detected with electron-beam CT as a predictor of obstructive coronary artery disease. Acad Radiol 10:631–637

    Article  PubMed  Google Scholar 

  4. Wong ND, Gransar H, Shaw L, Polk D, Moon JH, Miranda-Peats R et al (2009) Thoracic aortic calcium versus coronary artery calcium for the prediction of coronary heart disease and cardiovascular disease events. JACC Cardiovasc Imaging 2:319–326

    Article  PubMed  Google Scholar 

  5. Agmon Y, Khandheria BK, Meissner I, Schwartz GL, Petterson TM, O’Fallon WM et al (2002) Relation of coronary artery disease and cerebrovascular disease with atherosclerosis of the thoracic aorta in the general population. Am J Cardiol 89:262–267

    Article  PubMed  Google Scholar 

  6. Ashida K, Momiyama Y, Fayad ZA, Tanaka N, Kato R, Taniguchi H et al (2007) Magnetic resonance evaluation of the associations of thoracic and abdominal aortic plaques with the presence and extent of coronary artery stenosis. J Cardiovasc Magn Reson 9:855–861

    Article  PubMed  Google Scholar 

  7. Eisen A, Tenenbaum A, Koren-Morag N, Tanne D, Shemesh J, Imazio M et al (2008) Calcification of the thoracic aorta as detected by spiral computed tomography among stable angina pectoris patients: association with cardiovascular events and death. Circulation 118:1328–1334

    Article  PubMed  Google Scholar 

  8. Gu X, He Y, Li Z, Kontos MC, Paulsen WH, Arrowood JA et al (2011) Relation between the incidence, location, and extent of thoracic aortic atherosclerosis detected by transesophageal echocardiography and the extent of coronary artery disease by angiography. Am J Cardiol 107:175–178

    Article  PubMed  Google Scholar 

  9. Kalsch H, Lehmann N, Mohlenkamp S, Hammer C, Mahabadi AA, Moebus S et al (2013) Prevalence of thoracic aortic calcification and its relationship to cardiovascular risk factors and coronary calcification in an unselected population-based cohort: the Heinz Nixdorf Recall Study. Int J Cardiovasc Imaging 29:207–216

    Article  PubMed  Google Scholar 

  10. Takasu J, Budoff MJ, O’Brien KD, Shavelle DM, Probstfield JL, Carr JJ et al (2009) Relationship between coronary artery and descending thoracic aortic calcification as detected by computed tomography: the multi-ethnic study of atherosclerosis. Atherosclerosis 204:440–446

    Article  PubMed  CAS  Google Scholar 

  11. Kim EJ, Yong HS, Seo HS, Lim SY, Kim SW, Kim MN et al (2011) Association between aortic calcification and stable obstructive coronary artery disease. Int J Cardiol 153:192–195

    Article  PubMed  Google Scholar 

  12. Santos RD, Rumberger JA, Budoff MJ, Shaw LJ, Orakzai SH, Berman D et al (2010) Thoracic aorta calcification detected by electron beam tomography predicts all-cause mortality. Atherosclerosis 209:131–135

    Article  PubMed  CAS  Google Scholar 

  13. de Graaf FR, van Velzen JE, de Boer SM, van Werkhoven JM, Kroft LJ, de Roos A et al (2013) Non-invasive computed tomography coronary angiography as a gatekeeper for invasive coronary angiography. Int J Cardiovasc Imaging 29:221–228

    Article  PubMed  Google Scholar 

  14. Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51:5–40

    Article  PubMed  CAS  Google Scholar 

  15. Leber AW, Knez A, Becker A, Becker C, von Ziegler F, Nikolaou K et al (2004) Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J Am Coll Cardiol 43:1241–1247

    Article  PubMed  Google Scholar 

  16. van Werkhoven JM, Schuijf JD, Gaemperli O, Jukema JW, Kroft LJ, Boersma E et al (2009) Incremental prognostic value of multi-slice computed tomography coronary angiography over coronary artery calcium scoring in patients with suspected coronary artery disease. Eur Heart J 30:2622–2629

    Article  PubMed  Google Scholar 

  17. Kylintireas I, Shirodaria C, Lee JM, Cunningon C, Lindsay A, Francis J et al (2011) Multimodal cardiovascular magnetic resonance quantifies regional variation in vascular structure and function in patients with coronary artery disease: relationships with coronary disease severity. J Cardiovasc Magn Reson 13:61

    Article  PubMed  Google Scholar 

  18. Rudd JH, Myers KS, Bansilal S, Machac J, Woodward M, Fuster V et al (2009) Relationships among regional arterial inflammation, calcification, risk factors, and biomarkers: a prospective fluorodeoxyglucose positron-emission tomography/computed tomography imaging study. Circ Cardiovasc Imaging 2:107–115

    Article  PubMed  Google Scholar 

  19. Russo C, Jin Z, Rundek T, Homma S, Sacco RL, Di Tullio MR (2009) Atherosclerotic disease of the proximal aorta and the risk of vascular events in a population-based cohort: the aortic plaques and risk of ischemic stroke (APRIS) study. Stroke 40:2313–2318

    Article  PubMed  Google Scholar 

  20. Jeltsch M, Klass O, Klein S, Feuerlein S, Aschoff AJ, Brambs HJ et al (2009) Aortic wall thickness assessed by multidetector computed tomography as a predictor of coronary atherosclerosis. Int J Cardiovasc Imaging 25:209–217

    Article  PubMed  Google Scholar 

  21. Okuyama T, Ehara S, Shirai N, Sugioka K, Yamashita H, Kataoka T et al (2008) Assessment of aortic atheromatous plaque and stiffness by 64-slice computed tomography is useful for identifying patients with coronary artery disease. Circ J 72:2021–2027

    Article  PubMed  Google Scholar 

  22. Yamamoto R, Takasu J, Yokoyama K, Watanabe S, Taguchi R, Itani Y et al (2000) Descending aorta wall volume and coronary artery disease: a comparative study using enhanced computed tomography of the chest and coronary angiography. Jpn Circ J 64:842–847

    Article  PubMed  CAS  Google Scholar 

  23. Jang S, Yong HS, Doo KW, Kang EY, Woo OH, Choi EJ (2012) Relation of aortic calcification, wall thickness, and distensibility with severity of coronary artery disease: evaluation with coronary CT angiography. Acta Radiol 53:839–844

    Article  PubMed  Google Scholar 

  24. Patel MR, Bailey SR, Bonow RO, Chambers CE, Chan PS, Dehmer GJ et al (2012) ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, Society of Thoracic Surgeons. J Thorac Cardiovasc Surg 144:39–71

    Article  PubMed  Google Scholar 

  25. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115:459–467

    Article  PubMed  Google Scholar 

  26. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM et al (2010) Arterial stiffness and cardiovascular events: the Framingham heart study. Circulation 121:505–511

    Article  PubMed  Google Scholar 

  27. Pletcher MJ, Tice JA, Pignone M, Browner WS (2004) Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis. Arch Intern Med 164:1285–1292

    Article  PubMed  Google Scholar 

  28. Allison MA, Hsi S, Wassel CL, Morgan C, Ix JH, Wright CM et al (2012) Calcified atherosclerosis in different vascular beds and the risk of mortality. Arterioscler Thromb Vasc Biol 32:140–146

    Article  PubMed  CAS  Google Scholar 

  29. Elias-Smale SE, Wieberdink RG, Odink AE, Hofman A, Hunink MG, Koudstaal PJ et al (2011) Burden of atherosclerosis improves the prediction of coronary heart disease but not cerebrovascular events: the Rotterdam study. Eur Heart J 32:2050–2058

    Article  PubMed  Google Scholar 

  30. Virmani R, Avolio AP, Mergner WJ, Robinowitz M, Herderick EE, Cornhill JF et al (1991) Effect of aging on aortic morphology in populations with high and low prevalence of hypertension and atherosclerosis. Comparison between occidental and Chinese communities. Am J Pathol 139:1119–1129

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The department of Cardiology received research grants from Biotronik (Berlin, Germany), Lantheus (North Billerica, Massachusetts), Boston Scientific (Natick, Massachusetts), Edwards Lifesciences (Irvine, California), GE Healthcare (Buckinghamshire, United Kingdom), Medtronic (Minneapolis, Minnesota) and St. Jude Medical (St. Paul, Minnesota). V. Delgado received consulting fees from St. Jude Medical and Medtronic. J. Wouter Jukema received research grants from and was speaker on (CME accredited) meetings sponsored by Astellas, Astra-Zeneca, Biotronik, Boston Scientific, Daiichi Sankyo, Lilly, Genzyme, Medtronic, Merck-Schering-Plough, Pfizer, Orbus Neich, Novartis, Roche, Servier, Sanofi Aventis, the Netherlands Heart Foundation, the Interuniversity Cardiology Institute of the Netherlands and the European Community Framework KP7 Programme.

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Authors and Affiliations

  1. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Cornelis J. Roos, Agnieszka J. Witkowska, Michiel A. de Graaf, Caroline E. Veltman, Victoria Delgado, Greetje J. de Grooth, J. Wouter Jukema, Jeroen J. Bax & Arthur J. Scholte

  2. The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands

    Cornelis J. Roos, Michiel A. de Graaf, Caroline E. Veltman & J. Wouter Jukema

  3. Department of Cardiology, 4th Military Hospital, Wroclaw, Poland

    Agnieszka J. Witkowska

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  1. Cornelis J. Roos
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  2. Agnieszka J. Witkowska
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  3. Michiel A. de Graaf
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  4. Caroline E. Veltman
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  5. Victoria Delgado
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  6. Greetje J. de Grooth
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  7. J. Wouter Jukema
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  8. Jeroen J. Bax
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  9. Arthur J. Scholte
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Correspondence to Arthur J. Scholte.

Additional information

Cornelis J. Roos and Agnieszka J. Witkowska are shared first authors.

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Roos, C.J., Witkowska, A.J., de Graaf, M.A. et al. Association of atherosclerosis in the descending thoracic aorta with coronary artery disease on multi detector row computed tomography coronary angiography in patients with suspected coronary artery disease. Int J Cardiovasc Imaging 29, 1829–1837 (2013). https://doi.org/10.1007/s10554-013-0266-y

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  • DOI: https://doi.org/10.1007/s10554-013-0266-y

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