Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound

Ramshanker Ramanathan*, Damini Dey, Bjarne L. Nørgaard, Marcus Goeller, Ida S. Bjerrum, Ronald Antulov, Axel Cosmus Pyndt Diederichsen, Johannes Jakobsen Sidelmann, Jørgen Brodersen Gram, Niels Peter Sand

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objectives: To describe carotid plaque composition by computed tomography angiography (CTA) in asymptomatic subjects and to compare this to carotid plaque assessment by ultrasound, coronary plaques by coronary CTA, and inflammatory biomarkers in plasma. Methods: Middle-aged asymptomatic men, n = 43, without known cardiovascular disease and diabetes were included. Plaques in coronary and carotid arteries were evaluated using CTA. Total plaque volumes and plaque composition were assessed by a validated plaque analysis software. The 60% centile cut point was used to divide the population into low or high carotid total plaque volumes. The occurrence of carotid plaques and intima-media thickness (IMT) was estimated by ultrasound. Results: Carotid plaque by ultrasound was undiagnosed in 13 of 28 participants (46%) compared to CTA. Participants having carotid plaques by ultrasound had significantly higher absolute volumes of all CTA-defined carotid plaque subtypes and a higher fraction of calcified plaque. A high carotid total plaque volume was independently associated with age (adjusted odds ratio (OR) 1.41 [95% confidence interval (CI) 1.14–1.74], p = 0.001), IMT (adjusted OR 2.26 [95% CI 1.10–4.65], p = 0.03), and D-dimer (adjusted OR 8.86 [95% CI 1.26–62.37], p = 0.03). All coronary plaque features were significantly higher in participants with a high carotid total plaque volume. Conclusion: The occurrence of carotid plaques in asymptomatic individuals is underestimated by ultrasound compared to plaque assessment by CTA. Carotid plaque composition by CTA is different in individuals with and without carotid plaques by ultrasound. Key Points: • The occurrence of carotid plaques by ultrasound was underestimated in 46% of participants who had plaques by carotid CTA. • Participants with carotid plaques by ultrasound had higher volumes of all plaque subtypes and a higher calcified plaque component as determined by carotid CTA compared to participants without carotid plaques by ultrasound. • A high carotid total plaque volume was independently associated with age, intima-media thickness, and D-dimer.

Original languageEnglish
JournalEuropean Radiology
Volume29
Issue number11
Pages (from-to)5920-5931
ISSN0938-7994
DOIs
Publication statusPublished - Nov 2019

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Odds Ratio
Confidence Intervals
Computed Tomography Angiography
Population

Keywords

  • Atherosclerotic
  • Carotid arteries
  • Computed tomography angiography
  • Plaque
  • Ultrasonography

Cite this

@article{64e264809c1e45f387230d67f578f5d1,
title = "Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound",
abstract = "Objectives: To describe carotid plaque composition by computed tomography angiography (CTA) in asymptomatic subjects and to compare this to carotid plaque assessment by ultrasound, coronary plaques by coronary CTA, and inflammatory biomarkers in plasma. Methods: Middle-aged asymptomatic men, n = 43, without known cardiovascular disease and diabetes were included. Plaques in coronary and carotid arteries were evaluated using CTA. Total plaque volumes and plaque composition were assessed by a validated plaque analysis software. The 60{\%} centile cut point was used to divide the population into low or high carotid total plaque volumes. The occurrence of carotid plaques and intima-media thickness (IMT) was estimated by ultrasound. Results: Carotid plaque by ultrasound was undiagnosed in 13 of 28 participants (46{\%}) compared to CTA. Participants having carotid plaques by ultrasound had significantly higher absolute volumes of all CTA-defined carotid plaque subtypes and a higher fraction of calcified plaque. A high carotid total plaque volume was independently associated with age (adjusted odds ratio (OR) 1.41 [95{\%} confidence interval (CI) 1.14–1.74], p = 0.001), IMT (adjusted OR 2.26 [95{\%} CI 1.10–4.65], p = 0.03), and D-dimer (adjusted OR 8.86 [95{\%} CI 1.26–62.37], p = 0.03). All coronary plaque features were significantly higher in participants with a high carotid total plaque volume. Conclusion: The occurrence of carotid plaques in asymptomatic individuals is underestimated by ultrasound compared to plaque assessment by CTA. Carotid plaque composition by CTA is different in individuals with and without carotid plaques by ultrasound. Key Points: • The occurrence of carotid plaques by ultrasound was underestimated in 46{\%} of participants who had plaques by carotid CTA. • Participants with carotid plaques by ultrasound had higher volumes of all plaque subtypes and a higher calcified plaque component as determined by carotid CTA compared to participants without carotid plaques by ultrasound. • A high carotid total plaque volume was independently associated with age, intima-media thickness, and D-dimer.",
keywords = "Atherosclerotic, Carotid arteries, Computed tomography angiography, Plaque, Ultrasonography",
author = "Ramshanker Ramanathan and Damini Dey and N{\o}rgaard, {Bjarne L.} and Marcus Goeller and Bjerrum, {Ida S.} and Ronald Antulov and Diederichsen, {Axel Cosmus Pyndt} and Sidelmann, {Johannes Jakobsen} and Gram, {J{\o}rgen Brodersen} and Sand, {Niels Peter}",
year = "2019",
month = "11",
doi = "10.1007/s00330-019-06086-y",
language = "English",
volume = "29",
pages = "5920--5931",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Heinemann",
number = "11",

}

Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound. / Ramanathan, Ramshanker; Dey, Damini; Nørgaard, Bjarne L.; Goeller, Marcus; Bjerrum, Ida S.; Antulov, Ronald; Diederichsen, Axel Cosmus Pyndt; Sidelmann, Johannes Jakobsen; Gram, Jørgen Brodersen; Sand, Niels Peter.

In: European Radiology, Vol. 29, No. 11, 11.2019, p. 5920-5931.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound

AU - Ramanathan, Ramshanker

AU - Dey, Damini

AU - Nørgaard, Bjarne L.

AU - Goeller, Marcus

AU - Bjerrum, Ida S.

AU - Antulov, Ronald

AU - Diederichsen, Axel Cosmus Pyndt

AU - Sidelmann, Johannes Jakobsen

AU - Gram, Jørgen Brodersen

AU - Sand, Niels Peter

PY - 2019/11

Y1 - 2019/11

N2 - Objectives: To describe carotid plaque composition by computed tomography angiography (CTA) in asymptomatic subjects and to compare this to carotid plaque assessment by ultrasound, coronary plaques by coronary CTA, and inflammatory biomarkers in plasma. Methods: Middle-aged asymptomatic men, n = 43, without known cardiovascular disease and diabetes were included. Plaques in coronary and carotid arteries were evaluated using CTA. Total plaque volumes and plaque composition were assessed by a validated plaque analysis software. The 60% centile cut point was used to divide the population into low or high carotid total plaque volumes. The occurrence of carotid plaques and intima-media thickness (IMT) was estimated by ultrasound. Results: Carotid plaque by ultrasound was undiagnosed in 13 of 28 participants (46%) compared to CTA. Participants having carotid plaques by ultrasound had significantly higher absolute volumes of all CTA-defined carotid plaque subtypes and a higher fraction of calcified plaque. A high carotid total plaque volume was independently associated with age (adjusted odds ratio (OR) 1.41 [95% confidence interval (CI) 1.14–1.74], p = 0.001), IMT (adjusted OR 2.26 [95% CI 1.10–4.65], p = 0.03), and D-dimer (adjusted OR 8.86 [95% CI 1.26–62.37], p = 0.03). All coronary plaque features were significantly higher in participants with a high carotid total plaque volume. Conclusion: The occurrence of carotid plaques in asymptomatic individuals is underestimated by ultrasound compared to plaque assessment by CTA. Carotid plaque composition by CTA is different in individuals with and without carotid plaques by ultrasound. Key Points: • The occurrence of carotid plaques by ultrasound was underestimated in 46% of participants who had plaques by carotid CTA. • Participants with carotid plaques by ultrasound had higher volumes of all plaque subtypes and a higher calcified plaque component as determined by carotid CTA compared to participants without carotid plaques by ultrasound. • A high carotid total plaque volume was independently associated with age, intima-media thickness, and D-dimer.

AB - Objectives: To describe carotid plaque composition by computed tomography angiography (CTA) in asymptomatic subjects and to compare this to carotid plaque assessment by ultrasound, coronary plaques by coronary CTA, and inflammatory biomarkers in plasma. Methods: Middle-aged asymptomatic men, n = 43, without known cardiovascular disease and diabetes were included. Plaques in coronary and carotid arteries were evaluated using CTA. Total plaque volumes and plaque composition were assessed by a validated plaque analysis software. The 60% centile cut point was used to divide the population into low or high carotid total plaque volumes. The occurrence of carotid plaques and intima-media thickness (IMT) was estimated by ultrasound. Results: Carotid plaque by ultrasound was undiagnosed in 13 of 28 participants (46%) compared to CTA. Participants having carotid plaques by ultrasound had significantly higher absolute volumes of all CTA-defined carotid plaque subtypes and a higher fraction of calcified plaque. A high carotid total plaque volume was independently associated with age (adjusted odds ratio (OR) 1.41 [95% confidence interval (CI) 1.14–1.74], p = 0.001), IMT (adjusted OR 2.26 [95% CI 1.10–4.65], p = 0.03), and D-dimer (adjusted OR 8.86 [95% CI 1.26–62.37], p = 0.03). All coronary plaque features were significantly higher in participants with a high carotid total plaque volume. Conclusion: The occurrence of carotid plaques in asymptomatic individuals is underestimated by ultrasound compared to plaque assessment by CTA. Carotid plaque composition by CTA is different in individuals with and without carotid plaques by ultrasound. Key Points: • The occurrence of carotid plaques by ultrasound was underestimated in 46% of participants who had plaques by carotid CTA. • Participants with carotid plaques by ultrasound had higher volumes of all plaque subtypes and a higher calcified plaque component as determined by carotid CTA compared to participants without carotid plaques by ultrasound. • A high carotid total plaque volume was independently associated with age, intima-media thickness, and D-dimer.

KW - Atherosclerotic

KW - Carotid arteries

KW - Computed tomography angiography

KW - Plaque

KW - Ultrasonography

U2 - 10.1007/s00330-019-06086-y

DO - 10.1007/s00330-019-06086-y

M3 - Journal article

VL - 29

SP - 5920

EP - 5931

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 11

ER -