TY - JOUR
T1 - Coronary Atherosclerosis in an Asymptomatic U.S. Population
T2 - Miami Heart Study at Baptist Health South Florida
AU - Nasir, Khurram
AU - Cainzos-Achirica, Miguel
AU - Valero-Elizondo, Javier
AU - Ali, Shozab S.
AU - Havistin, Ruby
AU - Lakshman, Suvasini
AU - Blaha, Michael J.
AU - Blankstein, Ron
AU - Shapiro, Michael D.
AU - Arias, Lara
AU - Saxena, Anshul
AU - Feldman, Theodore
AU - Budoff, Matthew J.
AU - Ziffer, Jack A.
AU - Fialkow, Jonathan
AU - Cury, Ricardo C.
N1 - Funding Information:
The Miami Heart Study was funded by Baptist Health South Florida. Dr Nasir is on the advisory board of Amgen, Novartis, Novo Nordisk; his research is partly supported by the Jerold B. Katz Academy of Translational Research; and he is a member of the Steering Committee of the PAK-SEHAT Study, which is partially funded by an unrestricted research grant from Getz Pharma. Dr Cainzos-Achirica is also member of the Steering Committee of the PAK-SEHAT Study. Dr Blankstein has received research support from Amgen Inc and Novartis Inc; and he is a consultant to Caristo Diagnostics, Silence Therapeutics, and Roivant Sciences Inc. Dr Shapiro is on the advisory boards of Amgen, Novartis, and Novo Nordisk. Dr Cury is consultant to GE Healthcare, Covera Health, and Cleerly. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2022 American College of Cardiology Foundation
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND: The burden of total coronary plaque, plaque subtypes, and high-risk plaque features was unknown in asymptomatic individuals from the general U.S. primary prevention population.OBJECTIVES: In a large, asymptomatic U.S. cohort evaluated using coronary computed tomography angiography (CCTA), we aimed to assess the burden of total coronary plaque, plaque subtypes, and high-risk plaque features; the interplay between CCTA findings and coronary artery calcium (CAC) scores; and identify independent predictors of coronary plaque.METHODS: Cross-sectional analysis in the MiHeart (Miami Heart Study), a cohort of 2,359 asymptomatic individuals from the Greater Miami Area (mean age 53 years, 50% women, 47% Hispanic/Latino, 43% non-Hispanic White). We estimated the burden of CAC (=0, >0 to <100, ≥100), CCTA-based plaque features (any plaque, stenosis ≥50%, ≥70%, high-risk features), and their interplay.RESULTS: Overall, 58% participants had CAC = 0, 28% CAC >0 to <100, and 13% CAC ≥100. A total of 49% participants had plaque on the CCTA, including 16% among those with CAC = 0. Overall, 6% participants had coronary stenosis ≥50% (12% among those with coronary plaque), 1.8% had stenosis ≥70% (3.7% among those with plaque), and 7% had at least 1 coronary plaque with ≥1 high-risk feature (13.8% among those with plaque). Only 0.8% participants with CAC = 0 had stenosis ≥50%, 0.1% stenosis ≥70%, and 2.3% plaque with high-risk features. In logistic regression models, independent predictors of coronary plaque and high-risk plaque were older age, male sex, tobacco use, diabetes, overweight, and obesity. Male sex, overweight, and obesity were independent predictors of plaque if CAC = 0.CONCLUSIONS: The Miami Heart Study confirms substantial prevalence of coronary plaque in asymptomatic individuals. Overall, 49% of participants had coronary plaque, 6% had stenosis ≥50%, and 7% had plaques with at least 1 high-risk feature. These proportions were 16%, 0.8%, and 2.3%, respectively, among those with CAC = 0. Longitudinal follow-up will shed further light on the prognostic implications of these findings in asymptomatic individuals.
AB - BACKGROUND: The burden of total coronary plaque, plaque subtypes, and high-risk plaque features was unknown in asymptomatic individuals from the general U.S. primary prevention population.OBJECTIVES: In a large, asymptomatic U.S. cohort evaluated using coronary computed tomography angiography (CCTA), we aimed to assess the burden of total coronary plaque, plaque subtypes, and high-risk plaque features; the interplay between CCTA findings and coronary artery calcium (CAC) scores; and identify independent predictors of coronary plaque.METHODS: Cross-sectional analysis in the MiHeart (Miami Heart Study), a cohort of 2,359 asymptomatic individuals from the Greater Miami Area (mean age 53 years, 50% women, 47% Hispanic/Latino, 43% non-Hispanic White). We estimated the burden of CAC (=0, >0 to <100, ≥100), CCTA-based plaque features (any plaque, stenosis ≥50%, ≥70%, high-risk features), and their interplay.RESULTS: Overall, 58% participants had CAC = 0, 28% CAC >0 to <100, and 13% CAC ≥100. A total of 49% participants had plaque on the CCTA, including 16% among those with CAC = 0. Overall, 6% participants had coronary stenosis ≥50% (12% among those with coronary plaque), 1.8% had stenosis ≥70% (3.7% among those with plaque), and 7% had at least 1 coronary plaque with ≥1 high-risk feature (13.8% among those with plaque). Only 0.8% participants with CAC = 0 had stenosis ≥50%, 0.1% stenosis ≥70%, and 2.3% plaque with high-risk features. In logistic regression models, independent predictors of coronary plaque and high-risk plaque were older age, male sex, tobacco use, diabetes, overweight, and obesity. Male sex, overweight, and obesity were independent predictors of plaque if CAC = 0.CONCLUSIONS: The Miami Heart Study confirms substantial prevalence of coronary plaque in asymptomatic individuals. Overall, 49% of participants had coronary plaque, 6% had stenosis ≥50%, and 7% had plaques with at least 1 high-risk feature. These proportions were 16%, 0.8%, and 2.3%, respectively, among those with CAC = 0. Longitudinal follow-up will shed further light on the prognostic implications of these findings in asymptomatic individuals.
KW - atherosclerosis
KW - computed tomography
KW - coronary artery calcium
KW - epidemiology
KW - subclinical
KW - Obesity
KW - Predictive Value of Tests
KW - Cross-Sectional Studies
KW - Constriction, Pathologic
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Male
KW - Plaque, Atherosclerotic
KW - Overweight
KW - Coronary Artery Disease/diagnostic imaging
KW - Female
KW - Protestantism
KW - Florida/epidemiology
KW - Coronary Angiography/methods
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U2 - 10.1016/j.jcmg.2022.03.010
DO - 10.1016/j.jcmg.2022.03.010
M3 - Article
C2 - 36075621
AN - SCOPUS:85136504806
SN - 1936-878X
VL - 15
SP - 1604
EP - 1618
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 9
ER -