Association of coronary computed tomography angiography-derived plaque characteristics and brain white matter hyperintensity: an observational study

Abstract

Background

White matter hyperintensity (WMH) is a common finding in brain magnetic resonance imaging (MRI), but its relationship with coronary plaque characteristics remains unclear.

Purpose

To evaluate the association between coronary computed tomography angiography (CCTA)-derived plaque characteristics and WMH in brain MRI.

Material and Methods

CCTA and brain MRI of 392 consecutive patients were retrospectively collected. Degree of total WMH was evaluated based on Fazekas scale (0–6) and classified into mild (0–2) and moderate-to-severe (3–6) groups. Besides demographic and clinical data, morphological and quantitative parameters (e.g. aortic ulcer, Agatston Score, diameter stenosis, plaque volume, plaque length) were also evaluated based on CCTA. Chi-square (or Fisher's exact) test and Student's t-test (or Wilcoxon's signed-rank test) were used for comparing variables between two groups when appropriate. Multivariate logistic regression analyses were applied to identify the independent variables associated with moderate-to-severe WMH.

Results

Patients with moderate-to-severe WMH showed older age, larger plaque burden, plaque length, volume of noncalcified and calcified plaque, higher total cholesterol, triglyceride, low-density lipoprotein, Agatston Score, and higher proportion of male, hypertension, diabetes, aortic ulcer, and obstructive coronary artery disease (CAD) (all P  < 0.05). Age (odds ratio [OR]=1.061, 95% confidence interval [CI]=1.013–1.111; P = 0.012), plaque burden (OR=15.259, 95% CI=2.466–94.412; P = 0.003), obstructive CAD (OR=8.020, 95% CI=3.628–17.727; P <0.001), and Agatston Score (OR=1.004, 95% CI=1.002–1.006; P <0.001) were found to be independently associated with moderate-to-severe WMH.

Conclusion

Older age, larger plaque burden, higher Agatston score, and obstructive CAD were prone to moderate-to-severe WMH.