Total coronary atherosclerotic plaque burden is associated with myocardial ischemia in non-obstructive coronary artery disease

International Journal of Cardiology: Heart & Vasculature

Eva Gerdts¹  Pál Maurovich-Horvat²  Ingeborg Eskerud³  Terje H. Larsen³  Judit Simon⁴  Mai Tone Lønnebakken⁵ 

[1] Corresponding author at: Department of Clinical Science, University of Bergen, Postbox 7804, N-5020 Bergen, Norway.;Department of Biomedicine, University of Bergen, Postbox 7804, N-5020 Bergen, Norway;Department of Clinical Science, University of Bergen, PO box 7804, N-5020 Bergen, Norway;Department of Heart Disease, Haukeland University Hospital, PO box 1400, N-5021 Bergen, Norway;MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Városmajor Street, Budapest, Hungary;

关键词: Non-obstructive coronary artery disease;    INOCA;    Myocardial ischemia;    Coronary computed tomography angiography;    Coronary plaque burden;    Coronary plaque volume;   

DOI  :  

来源: DOAJ

【 摘 要 】

Aim: Whether the total coronary atherosclerotic plaque burden is independently associated with myocardial ischemia in non-obstructive coronary artery disease (CAD) is not well established. We aimed to test the association of total plaque burden quantified by coronary computed tomography angiography (CCTA) with myocardial ischemia in patients with chronic coronary syndrome and non-obstructive CAD. Methods: We included 125 patients (age 62 ± 9 years, 58% women) with chronic coronary syndrome and non-obstructive CAD (stenosis < 50%) by CCTA, who were grouped according to presence or absence of myocardial ischemia by myocardial contrast stress echocardiography. Total plaque burden was quantified by CCTA as the total plaque volume in the main coronary arteries, and positive remodelling was defined as remodelling index > 1.10. Results: Patients with myocardial ischemia (n = 66) had higher total plaque burden (847 ± 245 mm3 vs. 758 ± 251 mm3, p = 0.049) and higher left ventricular (LV) mass index (42.1 ± 9.9 g/m2.7 vs. 37.3 ± 8.0 g/m2.7, p = 0.004), while age, sex, prevalence of hypertension, diabetes, calcium score and positive remodelling did not differ between the groups (all p > 0.05). In multivariable regression analysis, total plaque burden remained associated with presence of myocardial ischemia (OR 1.02, 95% CI 1.00–1.04, p = 0.045) independent of age, sex, hypertension, diabetes, LV mass index, coronary calcium score and positive remodelling. Conclusion: Total coronary artery plaque burden by CCTA was independently associated with myocardial ischemia in patients with non-obstructive CAD. Whether plaque quantification is useful for clinical management of patients with non-obstructive CAD should be tested in prospective studies.ClinicalTrials.gov: Identifier NCT01853527.

【 授权许可】

Unknown