Comparison of quantitative atherosclerotic plaque burden from coronary CT angiography in patients with first acute coronary syndrome and stable coronary artery disease
Dey D, Achenbach S, Schuhbaeck A, Pflederer T, Nakazato R, Slomka PJ, Berman DS, Marwan M (2014)
Publication Type: Journal article
Publication year: 2014
Journal
Book Volume: 8
Pages Range: 368-74
Journal Issue: 5
DOI: 10.1016/j.jcct.2014.07.007
Abstract
Coronary CTA allows characterization of non-calcified and calcified plaque and identification of high-risk plaque features.We aimed to quantitatively characterize and compare coronary plaque burden from CTA in patients with a first acute coronary syndrome (ACS) and controls with stable coronary artery disease.We retrospectively analyzed consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI) or unstable angina with a first ACS, who underwent CTA as part of their initial workup before invasive coronary angiography and age- and gender-matched controls with stable chest pain; controls also underwent CTA with subsequent invasive angiography (total n = 28). Culprit arteries were identified in ACS patients. Coronary arteries were analyzed by automated software to quantify calcified plaque (CP), noncalcified plaque (NCP), and low-density NCP (LD-NCP, attenuation <30 Hounsfield units) volumes, and corresponding burden (plaque volume × 100%/vessel volume), stenosis, remodeling index, contrast density difference (maximum percent difference in attenuation/cross-sectional area from proximal cross-section), and plaque length.ACS patients had fewer lesions (median, 1), with higher total NCP and LD-NCP burdens (NCP: 57.4% vs 41.5%; LD-NCP: 12.5% vs 8%; P <= .04), higher maximal stenoses (85.6% vs 53.0%; P = .003) and contrast density differences (46.1 vs 16.3%; P < .006). Per-patient CP burden was not different between ACS and controls. NCP and LD-NCP plaque burden was higher in culprit vs nonculprit arteries (NCP: 57.8% vs 9.5%; LD-NCP: 8.4% vs 0.6%; P <= .0003); CP was not significantly different. Culprit arteries had increased plaque lengths, remodeling indices, stenoses, and contrast density differences (46.1% vs 10.9%; P <= .001).Noninvasive quantitative coronary artery analysis identified several differences for ACS, both on per-patient and per-vessel basis, including increased NCP, LD-NCP burden, and contrast density difference.
Authors with CRIS profile
Stephan Achenbach
Lehrstuhl für Innere Medizin II
Mohamed Marwan
Department of Medicine 2 – Cardiology and Angiology
Involved external institutions
United States (USA) (US)How to cite
APA:
Dey, D., Achenbach, S., Schuhbaeck, A., Pflederer, T., Nakazato, R., Slomka, P.J.,... Marwan, M. (2014). Comparison of quantitative atherosclerotic plaque burden from coronary CT angiography in patients with first acute coronary syndrome and stable coronary artery disease. Journal of Cardiovascular Computed Tomography, 8(5), 368-74. https://doi.org/10.1016/j.jcct.2014.07.007
MLA:
Dey, Damini, et al. "Comparison of quantitative atherosclerotic plaque burden from coronary CT angiography in patients with first acute coronary syndrome and stable coronary artery disease." Journal of Cardiovascular Computed Tomography 8.5 (2014): 368-74.
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