TY - JOUR
T1 - Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography
AU - Hoffmann, Udo
AU - Moselewski, Fabian
AU - Nieman, Koen
AU - Jang, Ik Kyung
AU - Ferencik, Maros
AU - Rahman, Ayaz M.
AU - Cury, Ricardo C.
AU - Abbara, Suhny
AU - Joneidi-Jafari, Hamid
AU - Achenbach, Stephan
AU - Brady, Thomas J.
N1 - Funding Information:
This work was supported in part by New York Cardiac Center, New York and Siemens Medical Solutions. Dr. Nieman was supported by the Interuniversity Cardiology Institute of the Netherlands. Dr. Ferencik was supported in part by National Institutes of Health Grant 1 T32 HL076136-02.
PY - 2006/4/18
Y1 - 2006/4/18
N2 - Objectives: The purpose of this study was to assess morphology and composition of culprit and stable coronary lesions by multidetector computed tomography (MDCT). Background: Noninvasive identification of culprit lesions has the potential to improve noninvasive risk stratification in patients with acute chest pain. Methods: Thirty-seven patients with acute coronary syndrome (ACS) or stable angina underwent coronary 16-slice MDCT and invasive selective angiography. In all significant coronary lesions two observers measured the degree of stenosis, plaque area at stenosis, and remodeling index and assessed plaque composition. Differences between culprit lesions in patients with ACS and stable lesions in patients with ACS or stable angina were determined. Results: We analyzed 40 lesions with excellent image quality in 14 patients with ACS and 9 patients with stable angina. Culprit lesions in patients with ACS (n = 14) had significantly greater plaque area and a higher remodeling index than both stable lesions in patients with ACS (n = 13) and in patients with stable angina (n = 13) (17.5 ± 5.9 mm2 vs. 9.1 ± 4.8 mm2 vs. 13.5 ± 10.7 mm2, p = 0.02; and 1.4 ± 0.3 vs. 1.0 ± 0.4 vs. 1.2 ± 0.3, p = 0.04, respectively). The prevalence of non-calcified plaque was 100%, 62%, and 77%, respectively, and the prevalence of calcified plaque was 71%, 92%, and 85%, respectively, in culprit lesions in patients with ACS and in stable lesions in patients with ACS or stable angina. Conclusions: We introduce the concept of noninvasive detection and characterization of coronary atherosclerotic lesions in patients with ACS by MDCT. We identified differences in lesion morphology and plaque composition between culprit lesions in ACS and stable lesions in ACS or stable angina, consistent with previous intravascular ultrasound studies.
AB - Objectives: The purpose of this study was to assess morphology and composition of culprit and stable coronary lesions by multidetector computed tomography (MDCT). Background: Noninvasive identification of culprit lesions has the potential to improve noninvasive risk stratification in patients with acute chest pain. Methods: Thirty-seven patients with acute coronary syndrome (ACS) or stable angina underwent coronary 16-slice MDCT and invasive selective angiography. In all significant coronary lesions two observers measured the degree of stenosis, plaque area at stenosis, and remodeling index and assessed plaque composition. Differences between culprit lesions in patients with ACS and stable lesions in patients with ACS or stable angina were determined. Results: We analyzed 40 lesions with excellent image quality in 14 patients with ACS and 9 patients with stable angina. Culprit lesions in patients with ACS (n = 14) had significantly greater plaque area and a higher remodeling index than both stable lesions in patients with ACS (n = 13) and in patients with stable angina (n = 13) (17.5 ± 5.9 mm2 vs. 9.1 ± 4.8 mm2 vs. 13.5 ± 10.7 mm2, p = 0.02; and 1.4 ± 0.3 vs. 1.0 ± 0.4 vs. 1.2 ± 0.3, p = 0.04, respectively). The prevalence of non-calcified plaque was 100%, 62%, and 77%, respectively, and the prevalence of calcified plaque was 71%, 92%, and 85%, respectively, in culprit lesions in patients with ACS and in stable lesions in patients with ACS or stable angina. Conclusions: We introduce the concept of noninvasive detection and characterization of coronary atherosclerotic lesions in patients with ACS by MDCT. We identified differences in lesion morphology and plaque composition between culprit lesions in ACS and stable lesions in ACS or stable angina, consistent with previous intravascular ultrasound studies.
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U2 - 10.1016/j.jacc.2006.01.041
DO - 10.1016/j.jacc.2006.01.041
M3 - Article
C2 - 16631006
AN - SCOPUS:33646047719
SN - 0735-1097
VL - 47
SP - 1655
EP - 1662
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 8
ER -