Predictors and Prognostic value of Coronary Computed Tomography Angiography for Unrecognized Myocardial Infarction in Patients with Chronic Coronary Syndrome.
chronic coronary syndrome
coronary computed tomography angiography
inflammation
percutaneous coronary intervention
unrecognized myocardial infarction
Journal
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
ISSN: 2241-5955
Titre abrégé: Hellenic J Cardiol
Pays: Netherlands
ID NLM: 101257381
Informations de publication
Date de publication:
15 Jul 2024
15 Jul 2024
Historique:
received:
19
12
2023
revised:
21
06
2024
accepted:
02
07
2024
medline:
18
7
2024
pubmed:
18
7
2024
entrez:
17
7
2024
Statut:
aheadofprint
Résumé
Unrecognized myocardial infarction (UMI) on delayed-enhancement cardiac magnetic resonance imaging (DE-CMR) and coronary computed tomography angiography (CCTA) derived high-risk features provide prognostic information in patients with chronic coronary syndrome (CCS). The study aimed to assess the prognostic value of UMI and predictors of UMI using CCTA in patients with CCS undergoing elective percutaneous coronary intervention (PCI). This study enrolled 181 CCS patients underwent both DE-CMR and CCTA before elective PCI. The CCTA-derived predictors of UMI and the association of baseline clinical characteristics, CCTA findings, and CMR-derived factors including UMI with MACE, defined as death, nonfatal myocardial infarction, unplanned late revascularization, hospitalization for congestive heart failure, and stroke were investigated. UMI was detected in 57 patients (31.5%). ROC analysis revealed the optimal cut-off values of Agatston score and mean pericoronary fat attenuation index (FAI) for predicting the presence of UMI were 397 and -69.8, respectively. Multivariable logistic regression analysis revealed that left ventricular mass, Agatston score >397, mean FAI >-69.8, positive remodeling of the target lesion, and CCTA-derived stenosis severity were independent predictors of UMI. Kaplan-Meier analysis revealed that patients with UMI were associated with increased risk of MACE. Cox's proportional hazards analysis showed post-PCI minimum lumen diameter and the presence of UMI were independent predictors of MACE. The risk of MACE significantly increased according to the number of 4 preprocedural CCTA relevant features of UMI. Preprocedural comprehensive CCTA analysis may help predict the presence of UMI and provide prognostic information in patients with CCS undergoing PCI.
Sections du résumé
BACKGROUND
BACKGROUND
Unrecognized myocardial infarction (UMI) on delayed-enhancement cardiac magnetic resonance imaging (DE-CMR) and coronary computed tomography angiography (CCTA) derived high-risk features provide prognostic information in patients with chronic coronary syndrome (CCS). The study aimed to assess the prognostic value of UMI and predictors of UMI using CCTA in patients with CCS undergoing elective percutaneous coronary intervention (PCI).
METHODS
METHODS
This study enrolled 181 CCS patients underwent both DE-CMR and CCTA before elective PCI. The CCTA-derived predictors of UMI and the association of baseline clinical characteristics, CCTA findings, and CMR-derived factors including UMI with MACE, defined as death, nonfatal myocardial infarction, unplanned late revascularization, hospitalization for congestive heart failure, and stroke were investigated.
RESULTS
RESULTS
UMI was detected in 57 patients (31.5%). ROC analysis revealed the optimal cut-off values of Agatston score and mean pericoronary fat attenuation index (FAI) for predicting the presence of UMI were 397 and -69.8, respectively. Multivariable logistic regression analysis revealed that left ventricular mass, Agatston score >397, mean FAI >-69.8, positive remodeling of the target lesion, and CCTA-derived stenosis severity were independent predictors of UMI. Kaplan-Meier analysis revealed that patients with UMI were associated with increased risk of MACE. Cox's proportional hazards analysis showed post-PCI minimum lumen diameter and the presence of UMI were independent predictors of MACE. The risk of MACE significantly increased according to the number of 4 preprocedural CCTA relevant features of UMI.
CONCLUSION
CONCLUSIONS
Preprocedural comprehensive CCTA analysis may help predict the presence of UMI and provide prognostic information in patients with CCS undergoing PCI.
Identifiants
pubmed: 39019330
pii: S1109-9666(24)00159-3
doi: 10.1016/j.hjc.2024.07.004
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Competing Interests: The authors have no relevant financial or non-financial interests to disclose.