Age related compositional plaque burden by CT in patients with future ACS

Area of Science:

• Cardiovascular Imaging
• Atherosclerosis Research
• Geriatric Cardiology

Background:

• Investigated age-related differences in non-calcified and calcified atherosclerosis.
• Utilized coronary computed tomography angiography (CCTA) in patients with future acute coronary syndrome (ACS).

Purpose of the Study:

• To analyze age-specific patterns of atherosclerotic plaque composition.
• To understand how plaque characteristics differ across age groups in ACS patients.

Main Methods:

• Enrolled 234 patients with adjudicated ACS post-baseline CCTA.
• Quantified and characterized atherosclerotic plaque, distinguishing calcified (>350 HU) and non-calcified (<350 HU) plaque.
• Categorized patients by age deciles and evaluated coronary artery calcium scores (CACS).

Main Results:

• Patients averaged 62.2 years; 93.5% had detectable plaque.
• Plaque calcification increased with age (10% in <50 years to 50% in >80 years).
• Younger patients (<50 years) had lower burden but high-risk non-calcified plaque; 57% had CACS >0.

Conclusions:

• Plaque calcification proportion is age-dependent in ACS.
• Younger ACS patients (<50 years) predominantly exhibit non-calcified plaque.
• Non-calcified plaque is a significant finding in pre-ACS patients under 50.