Clinical InvestigationImaging and Diagnostic TestingVolumetric evaluation of coronary plaque in patients presenting with acute myocardial infarction or stable angina pectoris—a multislice computerized tomography study
Section snippets
Methods
Patients undergoing invasive coronary angiography at Rigshospitalet, Copenhagen, Denmark, presenting clinically with either NSTEMI or SA as defined in the European Society of Cardiology guidelines were randomly selected for inclusion in the study.14 Selection of patients for the study reflected the casemix of referred patients and was performed in a 3:1 ratio (NSTEMI/SA), matched by the number of significant coronary lesions (>50% diameter stenosis) identified by invasive coronary angiography
Results
A total of 76 patients were included in the study: 57 patients with a recent NSTEMI and 19 with SA. Patient characteristics are summarized in Table I. The 2 patient groups were well matched, except that more patients with SA had hypertension. More than one significant coronary lesion was noted in 11 patients with SA and 30 patients with NSTEMI. In 7 patients with SA, the coronary study lesion was identified based on stress testing and in 4 as the most severely stenosed lesion. In the 30
Discussion
Our results demonstrate that MSCT allows noninvasive quantification of differences in coronary plaque characteristics between patients with unstable and stable coronary artery disease, although a considerable overlap between groups was noted. We found a significant difference in mean plaque signal intensity value and plaque subtypes of culprit lesions between the 2 patient groups despite similar global Agatston calcium scores. Furthermore, culprit lesions in patients with NSTEMI showed positive
Conclusion
Volumetric quantification of coronary artery atherosclerotic plaque composition can be achieved by MSCT. There was a significant difference in the distribution of plaque subtypes in patients with NSTEMI and SA. Further studies are warranted to determine whether MSCT plaque evaluation can provide prognostic information in the search of the vulnerable patient.
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