Natural History of Coronary Atherosclerosis by Multislice Computed Tomography

Objectives This study sought to analyze the natural history of coronary atherosclerosis by multislice computed tomography (MSCT) and assess the serial changes in coronary plaque burden, lumen dimensions, and arterial remodeling. Background MSCT can comprehensively assess coronary atherosclerosis by...

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Published in:JACC. Cardiovascular imaging 2012-03, Vol.5 (3), p.S28-S37
Main Authors: Papadopoulou, Stella-Lida, MD, Neefjes, Lisan A., MD, Garcia-Garcia, Hector M., MD, PhD, Flu, Willem-Jan, MD, PhD, Rossi, Alexia, MD, Dharampal, Anoeshka S., MD, Kitslaar, Pieter H., MSc, Mollet, Nico R., MD, PhD, Veldhof, Susan, RN, Nieman, Koen, MD, PhD, Stone, Gregg W., MD, Serruys, Patrick W., MD, PhD, Krestin, Gabriel P., MD, PhD, de Feyter, Pim J., MD, PhD
Format: Article
Language:English
Subjects:
Adult
Angioplasty, Balloon, Coronary - adverse effects
Cardiovascular
Coronary Angiography - methods
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - epidemiology
Coronary Artery Disease - therapy
Coronary Stenosis - diagnostic imaging
Coronary Stenosis - epidemiology
Coronary Stenosis - therapy
Disease Progression
Europe - epidemiology
Female
Humans
Male
Middle Aged
Observer Variation
Plaque, Atherosclerotic - diagnostic imaging
Plaque, Atherosclerotic - epidemiology
Plaque, Atherosclerotic - therapy
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Interventional
United States - epidemiology
Vascular Calcification - diagnostic imaging
Vascular Calcification - epidemiology
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Summary:Objectives This study sought to analyze the natural history of coronary atherosclerosis by multislice computed tomography (MSCT) and assess the serial changes in coronary plaque burden, lumen dimensions, and arterial remodeling. Background MSCT can comprehensively assess coronary atherosclerosis by combining lumen and plaque size parameters. Methods Thirty-two patients with acute coronary syndromes underwent 64-slice computed tomography angiography after percutaneous coronary intervention at baseline and after a median of 39 months. All patients received contemporary medical treatment. All available coronary segments in every subject were analyzed. The progression of atherosclerosis per segment and per patient was assessed by means of change in percent atheroma volume (PAV), change in normalized total atheroma volume (TAVnorm), and percent change in TAV (% change in TAV). Serial coronary remodeling was also assessed. Measures of lumen stenosis included percent diameter stenosis (%DS), minimum lumen diameter (MLD), percent area stenosis (%AS), and minimum lumen area (MLA). For each patient, the mean of all matched segments was calculated at the 2 time points. Clinical events at follow-up were documented. Results The PAV did not change significantly (−0.15 ± 3.64%, p = 0.72). The mean change in TAVnorm was 47.36 ± 143.24 mm3 (p = 0.071), and the % change in TAV was 6.7% (p = 0.029). The MLD and MLA increased by 0.15 mm (−0.09 to 0.24, p = 0.039) and 0.52 mm2 (−0.38 to 1.04, p = 0.034) respectively, which was accompanied by vessel enlargement, with 53% of the patients showing expansive positive remodeling. Patients with clinical events had a larger TAVnorm at baseline (969.72 mm3 vs. 810.77 mm3 , p = 0.010). Conclusions MSCT can assess the progression of coronary atherosclerosis and may be used for noninvasive monitoring of pharmacological interventions in coronary artery disease. (PROSPECT: An Imaging Study in Patients With Unstable Atherosclerotic Lesions; NCT00180466 )
ISSN:1936-878X
1876-7591
DOI:10.1016/j.jcmg.2012.01.009