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Department of Clinical Epidemiology (DCE)

Jesper Møller Jensen

Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis

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Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. / Mortensen, Martin Bødtker; Dzaye, Omar; Steffensen, Flemming Hald et al.

In: Journal of the American College of Cardiology, Vol. 76, No. 24, 12.2020, p. 2803-2813.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Vancouver

Mortensen MB, Dzaye O, Steffensen FH, Bøtker HE , Jensen JM, Rønnow Sand NP et al. Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. Journal of the American College of Cardiology. 2020 Dec;76(24):2803-2813. doi: 10.1016/j.jacc.2020.10.021

Author

Mortensen, Martin Bødtker ; Dzaye, Omar ; Steffensen, Flemming Hald et al. / Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. In: Journal of the American College of Cardiology. 2020 ; Vol. 76, No. 24. pp. 2803-2813.

Bibtex

@article{82afdd2a73a440dcbded64106d1a5a0d,

title = "Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis",

abstract = "BACKGROUND: Patients with obstructive coronary artery disease (CAD) are at high risk for cardiovascular disease (CVD) events. However, it remains unclear whether the high risk is due to high atherosclerotic disease burden or if presence of stenosis has independent predictive value.OBJECTIVES: The purpose of this study was to evaluate if obstructive CAD provides predictive value beyond its association with total calcified atherosclerotic plaque burden as assessed by coronary artery calcium (CAC).METHODS: Among 23,759 symptomatic patients from the Western Denmark Heart Registry who underwent diagnostic computed tomography angiography (CTA), we assessed the risk of major CVD (myocardial infarction, stroke, and all-cause death) stratified by CAC burden and number of vessels with obstructive disease.RESULTS: During a median follow-up of 4.3 years, 1,054 patients experienced a first major CVD event. The event rate increased stepwise with both higher CAC scores and number of vessels with obstructive disease (by CAC scores: 6.2 per 1,000 person-years (PY) for CAC = 0 to 42.3 per 1,000 PY for CAC >1,000; by number of vessels with obstructive disease: 6.1 per 1,000 PY for no CAD to 34.7 per 1,000 PY for 3-vessel disease). When stratified by 5 groups of CAC scores (0, 1 to 99, 100 to 399, 400 to 1,000, and >1,000), the presence of obstructive CAD was not associated with higher risk than presence of nonobstructive CAD.CONCLUSIONS: Plaque burden, not stenosis per se, is the main predictor of risk for CVD events and death. Thus, patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events regardless of whether they have nonobstructive or obstructive CAD.",

author = "Mortensen, {Martin B{\o}dtker} and Omar Dzaye and Steffensen, {Flemming Hald} and B{\o}tker, {Hans Erik} and Jensen, {Jesper M{\o}ller} and {R{\o}nnow Sand}, {Niels Peter} and Kragholm, {Kristian Hay} and S{\o}rensen, {Henrik Toft} and Jonathon Leipsic and Michael M{\ae}ng and Blaha, {Michael J} and N{\o}rgaard, {Bjarne Linde}",

year = "2020",

month = dec,

doi = "10.1016/j.jacc.2020.10.021",

language = "English",

volume = "76",

pages = "2803--2813",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier",

number = "24",

}

RIS

TY - JOUR

T1 - Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis

AU - Mortensen, Martin Bødtker

AU - Dzaye, Omar

AU - Steffensen, Flemming Hald

AU - Bøtker, Hans Erik

AU - Jensen, Jesper Møller

AU - Rønnow Sand, Niels Peter

AU - Kragholm, Kristian Hay

AU - Sørensen, Henrik Toft

AU - Leipsic, Jonathon

AU - Mæng, Michael

AU - Blaha, Michael J

AU - Nørgaard, Bjarne Linde

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND: Patients with obstructive coronary artery disease (CAD) are at high risk for cardiovascular disease (CVD) events. However, it remains unclear whether the high risk is due to high atherosclerotic disease burden or if presence of stenosis has independent predictive value.OBJECTIVES: The purpose of this study was to evaluate if obstructive CAD provides predictive value beyond its association with total calcified atherosclerotic plaque burden as assessed by coronary artery calcium (CAC).METHODS: Among 23,759 symptomatic patients from the Western Denmark Heart Registry who underwent diagnostic computed tomography angiography (CTA), we assessed the risk of major CVD (myocardial infarction, stroke, and all-cause death) stratified by CAC burden and number of vessels with obstructive disease.RESULTS: During a median follow-up of 4.3 years, 1,054 patients experienced a first major CVD event. The event rate increased stepwise with both higher CAC scores and number of vessels with obstructive disease (by CAC scores: 6.2 per 1,000 person-years (PY) for CAC = 0 to 42.3 per 1,000 PY for CAC >1,000; by number of vessels with obstructive disease: 6.1 per 1,000 PY for no CAD to 34.7 per 1,000 PY for 3-vessel disease). When stratified by 5 groups of CAC scores (0, 1 to 99, 100 to 399, 400 to 1,000, and >1,000), the presence of obstructive CAD was not associated with higher risk than presence of nonobstructive CAD.CONCLUSIONS: Plaque burden, not stenosis per se, is the main predictor of risk for CVD events and death. Thus, patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events regardless of whether they have nonobstructive or obstructive CAD.

AB - BACKGROUND: Patients with obstructive coronary artery disease (CAD) are at high risk for cardiovascular disease (CVD) events. However, it remains unclear whether the high risk is due to high atherosclerotic disease burden or if presence of stenosis has independent predictive value.OBJECTIVES: The purpose of this study was to evaluate if obstructive CAD provides predictive value beyond its association with total calcified atherosclerotic plaque burden as assessed by coronary artery calcium (CAC).METHODS: Among 23,759 symptomatic patients from the Western Denmark Heart Registry who underwent diagnostic computed tomography angiography (CTA), we assessed the risk of major CVD (myocardial infarction, stroke, and all-cause death) stratified by CAC burden and number of vessels with obstructive disease.RESULTS: During a median follow-up of 4.3 years, 1,054 patients experienced a first major CVD event. The event rate increased stepwise with both higher CAC scores and number of vessels with obstructive disease (by CAC scores: 6.2 per 1,000 person-years (PY) for CAC = 0 to 42.3 per 1,000 PY for CAC >1,000; by number of vessels with obstructive disease: 6.1 per 1,000 PY for no CAD to 34.7 per 1,000 PY for 3-vessel disease). When stratified by 5 groups of CAC scores (0, 1 to 99, 100 to 399, 400 to 1,000, and >1,000), the presence of obstructive CAD was not associated with higher risk than presence of nonobstructive CAD.CONCLUSIONS: Plaque burden, not stenosis per se, is the main predictor of risk for CVD events and death. Thus, patients with a comparable calcified atherosclerosis burden generally carry a similar risk for CVD events regardless of whether they have nonobstructive or obstructive CAD.

U2 - 10.1016/j.jacc.2020.10.021

DO - 10.1016/j.jacc.2020.10.021

M3 - Journal article

C2 - 33303068

VL - 76

SP - 2803

EP - 2813

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 24

ER -