Quantitative plaque characterisation and association with acute coronary syndrome on medium to long term follow up: insights from computed tomography coronary angiography.
Coronary artery disease (CAD)
acute coronary syndrome (ACS)
computed tomography coronary angiography (CTCA)
high-risk plaque (HRP)
Journal
Cardiovascular diagnosis and therapy
ISSN: 2223-3652
Titre abrégé: Cardiovasc Diagn Ther
Pays: China
ID NLM: 101601613
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
15
12
2021
accepted:
25
05
2022
entrez:
29
8
2022
pubmed:
30
8
2022
medline:
30
8
2022
Statut:
ppublish
Résumé
Computed tomography coronary angiography (CTCA) is an established imaging modality widely used for diagnosing coronary artery stenosis with expanding potential for comprehensive assessment of coronary artery disease (CAD). Lesion-based analyses of high-risk plaques (HRP) on CTCA may aid further in prognostication presenting with stable chest pain. We conduct qualitative and quantitative assessments to identify HRPs that are associated with acute coronary syndrome (ACS) on a medium to long term follow-up. Retrospective cohort study of patients who underwent CTCA for suspected CAD. Obstructive stenosis (OS) is defined as ≥50% and the presence of HRP and its constituents: positive-remodelling (PR), low-attenuation-plaque (LAP; <56 HU), very-low-attenuation-plaque (vLAP; <30 HU) and spotty-calcification (SC) were recorded. A cross-sectional quantitative analysis of HRP was performed at the site of minimum-luminal-area (MLA). The primary endpoint was fatal or non-fatal ACS on follow-up. A total of 1,257 patients were included (mean age 61±14 years old and 51% male) with a median follow-up of 7.24 years (interquartile range 5.5 to 7.7 years). The occurrence of ACS was significantly higher in HRP (+) patients compared to HRP (-) patients and patients with no plaques (20.5% The presence of OS and the LAP area at the site of MLA identify the HRP lesions that have the greatest association with development of future ACS.
Sections du résumé
Background
UNASSIGNED
Computed tomography coronary angiography (CTCA) is an established imaging modality widely used for diagnosing coronary artery stenosis with expanding potential for comprehensive assessment of coronary artery disease (CAD). Lesion-based analyses of high-risk plaques (HRP) on CTCA may aid further in prognostication presenting with stable chest pain. We conduct qualitative and quantitative assessments to identify HRPs that are associated with acute coronary syndrome (ACS) on a medium to long term follow-up.
Methods
UNASSIGNED
Retrospective cohort study of patients who underwent CTCA for suspected CAD. Obstructive stenosis (OS) is defined as ≥50% and the presence of HRP and its constituents: positive-remodelling (PR), low-attenuation-plaque (LAP; <56 HU), very-low-attenuation-plaque (vLAP; <30 HU) and spotty-calcification (SC) were recorded. A cross-sectional quantitative analysis of HRP was performed at the site of minimum-luminal-area (MLA). The primary endpoint was fatal or non-fatal ACS on follow-up.
Results
UNASSIGNED
A total of 1,257 patients were included (mean age 61±14 years old and 51% male) with a median follow-up of 7.24 years (interquartile range 5.5 to 7.7 years). The occurrence of ACS was significantly higher in HRP (+) patients compared to HRP (-) patients and patients with no plaques (20.5%
Conclusions
UNASSIGNED
The presence of OS and the LAP area at the site of MLA identify the HRP lesions that have the greatest association with development of future ACS.
Identifiants
pubmed: 36033222
doi: 10.21037/cdt-21-763
pii: cdt-12-04-415
pmc: PMC9412217
doi:
Types de publication
Journal Article
Langues
eng
Pagination
415-425Informations de copyright
2022 Cardiovascular Diagnosis and Therapy. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-21-763/coif). DW serves as an unpaid editorial board member of Cardiovascular Diagnosis and Therapy from February 2021 to January 2023, and DW received honoraria for lectures from Eli-Lilly, Pfizer and Boehringer. The other authors have no conflicts of interest to declare.
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