Author + information
- Received June 1, 2010
- Revision received June 22, 2010
- Accepted June 25, 2010
- Published online September 1, 2010.
- Norihiko Ohashi, MD*,
- Hideya Yamamoto, MD, PhD*,* (, )
- Jun Horiguchi, MD, PhD†,
- Toshiro Kitagawa, MD, PhD*,
- Eiji Kunita, MD*,
- Hiroto Utsunomiya, MD*,
- Toshiharu Oka, MD*,
- Nobuoki Kohno, MD, PhD‡ and
- Yasuki Kihara, MD, PhD*
- ↵*Reprint requests and correspondence:
Dr. Hideya Yamamoto, Department of Cardiovascular Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
Objectives We sought to investigate the association between visceral adipose tissue (VAT) with the presence, extent, and characteristics of noncalcified coronary plaques (NCPs) using 64-slice computed tomography angiography (CTA).
Background Although visceral adiposity is associated with cardiovascular events, its association with NCP burden and vulnerability is not well known.
Methods The study population consisted of 427 patients (age 67 ± 11 years; 63% men) with proven or suspected coronary artery disease who underwent 64-slice CTA. We assessed the presence and number of NCPs for each patient. The extent of NCP was tested for the difference between high (≥2) and low (≤1) counts. We further evaluated the vulnerable characteristics of NCPs with positive remodeling (remodeling index >1.05), low CT density (≤38 HU), and the presence of adjacent spotty calcium. Plain abdominal scans were also performed to measure the VAT and subcutaneous adipose tissue area.
Results A total of 260 (61%) patients had identifiable NCPs. Multivariate analyses revealed that increased VAT area (per 1 standard deviation, 58 cm2) was significantly associated with both the presence (odds ratio [OR]: 1.68; 95% confidence interval [CI]: 1.28 to 2.22) and extent (OR: 1.31; 95% CI: 1.03 to 1.68) of NCP. Other body composition measures, including subcutaneous adipose tissue area, body mass index, and waist circumference were not significantly associated with either presence or extent of NCP. Increased VAT area was also independently associated with the presence of NCP with positive remodeling (OR: 1.71; 95% CI: 1.18 to 2.53), low CT density (OR: 1.69; 95% CI: 1.17 to 2.47), and adjacent spotty calcium (OR: 1.52; 95% CI: 1.03 to 2.27).
Conclusions Increased VAT area was significantly associated with NCP burden and vulnerable characteristics identified by CTA. Our findings may explain the excessive cardiovascular risk in patients with visceral adiposity, and support the potential role of CTA to improve risk stratification in such patients.
- 64-slice computed tomography angiography
- noncalcified coronary plaque
- plaque vulnerability
- visceral adipose tissue
The authors have reported that they have no relationships to disclose.
- Received June 1, 2010.
- Revision received June 22, 2010.
- Accepted June 25, 2010.
- American College of Cardiology Foundation