Coronary spotty calcification, compared with macro calcification, is associated with a higher level of vascular inflammation and plaque vulnerability in patients with stable angina

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2025-05-08 DOI:10.1016/j.atherosclerosis.2025.119237

Daichi Fujimoto , Daisuke Kinoshita , Keishi Suzuki , Takayuki Niida , Haruhito Yuki , Iris McNulty , Hang Lee , Hiromasa Otake , Junya Shite , Maros Ferencik , Damini Dey , Fernando Alfonso , Tsunekazu Kakuta , Ik-Kyung Jang

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Abstract

Background and aims

Spotty calcification in the coronary arteries is considered to represent plaque vulnerability, whereas more advanced calcification is thought to be a feature of advanced stable plaque. However, data supporting this notion is limited. Inflammation plays a key role in atherogenesis, including the formation of early-stage calcification. We aimed to correlate spotty calcification assessed by optical coherence tomography (OCT) with vascular inflammation assessed by percutaneous coronary adipose tissue (PCAT) attenuation on coronary computed tomography angiography (CCTA) and OCT-derived plaque vulnerability.

Methods

Patients with stable angina pectoris who had both CCTA and OCT prior to coronary intervention were included. Patients were classified into two groups according to the type of calcification assessed by OCT at the target lesion: spotty calcification (maximal calcification arc <90° and length <4 mm) and advanced calcification (maximal calcification arc ≥90° or length ≥4 mm) group. Non-calcified plaques, and plaques with mixed spotty and advanced calcification were excluded.

Results

Among 355 patients, 77 had spotty calcifications and 72 had advanced calcification. The spotty calcification group showed a significantly higher level of PCAT attenuation of target vessel (−69.6 [-75.2 to −66.1] vs. −74.6 [-83.1 to −69.7 HU], p < 0.001) and a significantly higher prevalence of lipid-rich plaque (94.8 % vs. 72.2 %, p < 0.001) and macrophage (77.9 % vs. 59.7 %, p = 0.016), compared with the advanced calcification group.

Conclusions

Plaques with spotty calcification are associated with a higher level of perivascular inflammation and a higher prevalence of features of plaque vulnerability than those with advanced calcification.

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与宏观钙化相比，冠状动脉点状钙化与稳定型心绞痛患者更高水平的血管炎症和斑块易损性相关

背景和目的冠状动脉点状钙化被认为代表斑块易损，而更晚期的钙化被认为是斑块晚期稳定的特征。然而，支持这一观点的数据有限。炎症在动脉粥样硬化中起关键作用，包括早期钙化的形成。我们的目的是将光学相干断层扫描（OCT）评估的点状钙化与冠状动脉计算机断层扫描（CCTA）经皮冠状动脉脂肪组织（PCAT）衰减评估的血管炎症与OCT衍生的斑块易损性联系起来。方法纳入冠心病介入治疗前行CCTA和OCT检查的稳定型心绞痛患者。根据靶病变OCT评估的钙化类型将患者分为点状钙化（最大钙化弧度≥90°，长度≥4mm）和晚期钙化（最大钙化弧度≥90°，长度≥4mm）两组。排除非钙化斑块、混合点状和晚期钙化斑块。结果355例患者中，点状钙化77例，晚期钙化72例。点状钙化组靶血管PCAT衰减水平显著高于点状钙化组(- 69.6[-75.2至- 66.1]vs. - 74.6[-83.1至- 69.7 HU], p <；0.001)，富脂斑块的患病率明显更高(94.8% vs. 72.2%, p <；0.001)和巨噬细胞（77.9% vs. 59.7%, p = 0.016）。结论点状钙化斑块与晚期钙化斑块相比，具有更高水平的血管周围炎症和斑块易损特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.