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04 June 2020 : Clinical Research  

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

Lin Qi1AB, Kailei Shi2AD, Cheng Li1EF, Zhiguo Ju3EF, Dingbiao Mao1E, Lukai Zhang1D, Xinkai Qu2A, Yanqing Hua1CD, Ming Li1AFG*

DOI: 10.12659/MSM.920950

Med Sci Monit 2020; 26:e920950

Abstract

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.

Keywords: Coronary Artery Disease, Myocardial Ischemia, Tomography Scanners, X-Ray Computed, computed tomography angiography, Coronary Angiography, Coronary Stenosis, Heart, myocardial perfusion imaging, Plaque, Atherosclerotic, Predictive Value of Tests, Tomography, Emission-Computed, Single-Photon

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750