Coronary Computed Tomography (CT) Angiography Characteristics of High-Risk Plaque: Correlation with Stress Myocardial Perfusion Imaging in Patients with Moderate Coronary Stenosis

BACKGROUND The aim of this study was to investigate the ability of coronary computed tomographic angiography (CCTA) characteristics of high-risk plaque (HRP) in moderate stenosis to improve differentiation of myocardial ischemia detected by stress CT perfusion (CTP) imaging. MATERIAL AND METHODS Six...

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Published in:Medical science monitor 2020-06, Vol.26, p.e920950-e920950
Main Authors: Qi, Lin, Shi, Kailei, Li, Cheng, Ju, Zhiguo, Mao, Dingbiao, Zhang, Lukai, Qu, Xinkai, Hua, Yanqing, Li, Ming
Format: Article
Language:English
Subjects:
Aged
Clinical Research
Computed Tomography Angiography - methods
Coronary Angiography - methods
Coronary Artery Disease - physiopathology
Coronary Stenosis - diagnostic imaging
Female
Heart - physiopathology
Humans
Male
Middle Aged
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - physiopathology
Myocardial Perfusion Imaging - methods
Plaque, Atherosclerotic - diagnostic imaging
Plaque, Atherosclerotic - physiopathology
Predictive Value of Tests
Tomography, Emission-Computed, Single-Photon - methods
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Summary:BACKGROUND The aim of this study was to investigate the ability of coronary computed tomographic angiography (CCTA) characteristics of high-risk plaque (HRP) in moderate stenosis to improve differentiation of myocardial ischemia detected by stress CT perfusion (CTP) imaging. MATERIAL AND METHODS Sixty-two patients with coronary plaques and moderate stenosis confirmed by invasive coronary angiography (ICA) had stress CTP and 26 of these patients were found to have myocardial ischemia. The other 36 patients without myocardial ischemia were defined as controls. Characteristics of major plaques on CCTA images of the ischemia and non-ischemia groups were analyzed and compared. RESULTS Differences between the 2 groups were observed in plaque volume, burden and rough inner surface necrotic core volume, plaque-lipid interface and plaque length. In a multivariable analysis, plaque burden and necrotic core volume were significantly associated with myocardial ischemia: plaque burden odds ratio (OR) was 1.28 (95% confidence interval [CI], 1.12-1.48); necrotic core volume OR was 1.78 (95% CI, 1.03-1.34). Compared with other quantitative measurements, optimized thresholds for plaque burden (area under the curve was 0.852) and necrotic core volume (area under the curve was 0.730) showed significantly higher diagnostic performance for ischemia with threshold values of 60.8% and 11.25 mm³, respectively. CONCLUSIONS CCTA characteristics of major plaques may improve the discrimination of ACS patients with myocardial ischemia on stress CTP.
ISSN:1643-3750
1234-1010
1643-3750
DOI:10.12659/MSM.920950