Long-term prognostic implication of coronary plaque characterization as detected by 64-multidetector computed tomography in Egyptian population
We aimed to determine the role of multi-detector computed tomography (MDCT) in prognosis of patients with known or suspected coronary artery disease (CAD) by applying plaque characterization and whether obstructive versus non-obstructive plaque volume is a predictor of future cardiac events. Vulnera...
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| Published in: | The Egyptian heart journal Vol. 69; no. 1; pp. 63 - 70 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Germany
Elsevier B.V
01-03-2017
Egyptian Society of Cardiology SpringerOpen |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | We aimed to determine the role of multi-detector computed tomography (MDCT) in prognosis of patients with known or suspected coronary artery disease (CAD) by applying plaque characterization and whether obstructive versus non-obstructive plaque volume is a predictor of future cardiac events.
Vulnerable plaques may occur across the full spectrum of severity of stenosis, underlining that also non-obstructive lesions may contribute to coronary events.
We included 1000 consecutive patients with intermediate pretest likelihood of CAD who were evaluated by 64-MDCT. Coronary artery calcium scoring, assessment of degree of coronary stenosis and quantitative assessment of plaque composition and volume were performed. The end point was cardiac death, acute coronary syndrome, or symptom-driven revascularization.
After a median follow-up of 16months, 190 patients had sufferedcardiac events. In a multivariateregression analysis for events, the total amount of non-calcified plaque (NCP) in non-obstructivelesions was independently associated with an increased hazardratio for non-fatal MI (1.01–1.9/100-mm3plaque volume increase, p=0.039), total amount of obstructive plaque was independently associated with symptoms driven revascularization (p=0.04) and coronary artery calcium scoring (CACS) was independently associated with cardiac deaths (p=0.001).
MDCT is a non-invasive imaging modality with a prognostic utility in patients with known or suspected coronary artery disease by applying plaque characterization and it could identify vulnerable plaques by measuring the total amount of NCP in non-obstructive lesions which could be useful for detecting patients at risk of acute coronary syndrome (ACS) and guide further preventive therapeutic strategies. CACS was shown to be an independent predictor of mortality, while total amount of obstructive volume was shown to be an independent predictor of symptoms driven revascularization. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 1110-2608 2090-911X |
| DOI: | 10.1016/j.ehj.2016.08.003 |