The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?

(1) Background: Whether coronary computed tomography angiography (CTA) or the coronary artery calcium score (CACS) should be used for diagnosis of coronary heart disease, is an open debate. The aim of our study was to compare the atherosclerotic profile by coronary CTA in a young symptomatic high-ri...

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Autores principales:	Gudrun Maria Feuchtner, Christoph Beyer, Christian Langer, Sven Bleckwenn, Thomas Senoner, Fabian Barbieri, Anna Luger, Philipp Spitaler, Gerlig Widmann, Agne Adukauskaite, Wolfgang Dichtl, Guy Friedrich, Fabian Plank
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	atherosclerosis coronary arteries imaging computed tomography young high-risk population Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/1b497b4fa360493794b2dd4b7973d9e1
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spelling	oai:doaj.org-article:1b497b4fa360493794b2dd4b7973d9e12021-11-25T18:00:28ZThe Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?10.3390/jcdd81101572308-3425https://doaj.org/article/1b497b4fa360493794b2dd4b7973d9e12021-11-01T00:00:00Zhttps://www.mdpi.com/2308-3425/8/11/157https://doaj.org/toc/2308-3425(1) Background: Whether coronary computed tomography angiography (CTA) or the coronary artery calcium score (CACS) should be used for diagnosis of coronary heart disease, is an open debate. The aim of our study was to compare the atherosclerotic profile by coronary CTA in a young symptomatic high-risk population (age, 19–49 years) in comparison with the coronary artery calcium score (CACS). (2) Methods: 1137 symptomatic high-risk patients between 19–49 years (mean age, 42.4 y) who underwent coronary CTA and CACS were stratified into six age groups. CTA-analysis included stenosis severity and high-risk-plaque criteria (3) Results: Atherosclerosis was more often detected based on CTA than based on CACS (45 vs. 27%; <i>p</i> < 0.001), 50% stenosis in 13.6% and high-risk plaque in 17.7%. Prevalence of atherosclerosis was low and not different between CACS and CTA in the youngest age groups (19–30 y: 5.2 and 6.4% and 30–35 y: 10.6 and 16%). In patients older than >35 years, the rate of atherosclerosis based on CTA increased (<i>p</i> = 0.004, OR: 2.8, 95%CI:1.45–5.89); and was higher by CTA as compared to CACS (34.9 vs. 16.7%; <i>p</i> < 0.001), with a superior performance of CTA. In patients older than 35 years, stenosis severity (<i>p</i> = 0.002) and >50% stenosis increased from 2.6 to 12.5% (<i>p</i> < 0.001). High-risk plaque prevalence increased from 6.4 to 26.5%. The distribution of high-risk plaque between CACS 0 and >0.1 AU was similar among all age groups, with an increasing proportion in CACS > 0.1 AU with age. A total of 24.9% of CACS 0 patients had coronary artery disease based on CTA, 4.4% > 50% stenosis and 11.5% had high-risk plaque. (4) Conclusions: In a symptomatic young high-risk population older than 35 years, CTA performed superior than CACS. In patients aged 19–35 years, the rate of atherosclerosis was similar and low based on both modalities. CACS 0 did not rule out coronary artery disease in a young high-risk population.Gudrun Maria FeuchtnerChristoph BeyerChristian LangerSven BleckwennThomas SenonerFabian BarbieriAnna LugerPhilipp SpitalerGerlig WidmannAgne AdukauskaiteWolfgang DichtlGuy FriedrichFabian PlankMDPI AGarticleatherosclerosiscoronary arteriesimagingcomputed tomographyyoung high-risk populationDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Cardiovascular Development and Disease, Vol 8, Iss 157, p 157 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atherosclerosis coronary arteries imaging computed tomography young high-risk population Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atherosclerosis coronary arteries imaging computed tomography young high-risk population Diseases of the circulatory (Cardiovascular) system RC666-701 Gudrun Maria Feuchtner Christoph Beyer Christian Langer Sven Bleckwenn Thomas Senoner Fabian Barbieri Anna Luger Philipp Spitaler Gerlig Widmann Agne Adukauskaite Wolfgang Dichtl Guy Friedrich Fabian Plank The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?
description	(1) Background: Whether coronary computed tomography angiography (CTA) or the coronary artery calcium score (CACS) should be used for diagnosis of coronary heart disease, is an open debate. The aim of our study was to compare the atherosclerotic profile by coronary CTA in a young symptomatic high-risk population (age, 19–49 years) in comparison with the coronary artery calcium score (CACS). (2) Methods: 1137 symptomatic high-risk patients between 19–49 years (mean age, 42.4 y) who underwent coronary CTA and CACS were stratified into six age groups. CTA-analysis included stenosis severity and high-risk-plaque criteria (3) Results: Atherosclerosis was more often detected based on CTA than based on CACS (45 vs. 27%; <i>p</i> < 0.001), 50% stenosis in 13.6% and high-risk plaque in 17.7%. Prevalence of atherosclerosis was low and not different between CACS and CTA in the youngest age groups (19–30 y: 5.2 and 6.4% and 30–35 y: 10.6 and 16%). In patients older than >35 years, the rate of atherosclerosis based on CTA increased (<i>p</i> = 0.004, OR: 2.8, 95%CI:1.45–5.89); and was higher by CTA as compared to CACS (34.9 vs. 16.7%; <i>p</i> < 0.001), with a superior performance of CTA. In patients older than 35 years, stenosis severity (<i>p</i> = 0.002) and >50% stenosis increased from 2.6 to 12.5% (<i>p</i> < 0.001). High-risk plaque prevalence increased from 6.4 to 26.5%. The distribution of high-risk plaque between CACS 0 and >0.1 AU was similar among all age groups, with an increasing proportion in CACS > 0.1 AU with age. A total of 24.9% of CACS 0 patients had coronary artery disease based on CTA, 4.4% > 50% stenosis and 11.5% had high-risk plaque. (4) Conclusions: In a symptomatic young high-risk population older than 35 years, CTA performed superior than CACS. In patients aged 19–35 years, the rate of atherosclerosis was similar and low based on both modalities. CACS 0 did not rule out coronary artery disease in a young high-risk population.
format	article
author	Gudrun Maria Feuchtner Christoph Beyer Christian Langer Sven Bleckwenn Thomas Senoner Fabian Barbieri Anna Luger Philipp Spitaler Gerlig Widmann Agne Adukauskaite Wolfgang Dichtl Guy Friedrich Fabian Plank
author_facet	Gudrun Maria Feuchtner Christoph Beyer Christian Langer Sven Bleckwenn Thomas Senoner Fabian Barbieri Anna Luger Philipp Spitaler Gerlig Widmann Agne Adukauskaite Wolfgang Dichtl Guy Friedrich Fabian Plank
author_sort	Gudrun Maria Feuchtner
title	The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?
title_short	The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?
title_full	The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?
title_fullStr	The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?
title_full_unstemmed	The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?
title_sort	atherosclerotic profile of a young symptomatic population between 19 and 49 years: coronary computed tomography angiography or coronary artery calcium score?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1b497b4fa360493794b2dd4b7973d9e1
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The Atherosclerotic Profile of a Young Symptomatic Population between 19 and 49 Years: Coronary Computed Tomography Angiography or Coronary Artery Calcium Score?

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