Anatomic and Hemodynamic Plaque Characteristics for Subsequent Coronary Events

Frontiers in Cardiovascular Medicine

article

Hyeon-Cheol Gwon¹  Junbo Ge²  Joo Myung Lee¹  Seung Hun Lee³  David Hong¹  Neng Dai²  Doosup Shin⁴  Ki Hong Choi¹  Sung Mok Kim⁵  Hyun Kuk Kim⁶  Ki-Hyun Jeon⁷  Sang Jin Ha⁸  Kwan Yong Lee⁹  Taek Kyu Park¹  Jeong Hoon Yang¹  Young Bin Song¹  Joo-Yong Hahn¹  Seung-Hyuk Choi¹  Yeon Hyeon Choe⁵ 

[1] Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University;Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School;Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine;Department of Radiology, Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine;Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, University of Chosun College of Medicine;Division of Cardiovascular Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital;Division of Cardiology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine;Cardiovascular Center and Cardiology Division, Seoul St. Mary's Hospital, The Catholic University of Korea

关键词: coronary artery disease;    coronary CT angiography;    myocardial ischemia;    vulnerable plaques;    prognosis;   

DOI  :  10.3389/fcvm.2022.871450

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Objectives While coronary computed tomography angiography (CCTA) enables the evaluation of anatomic and hemodynamic plaque characteristics of coronary artery disease (CAD), the clinical roles of these characteristics are not clear. We sought to evaluate the prognostic implications of CCTA-derived anatomic and hemodynamic plaque characteristics in the prediction of subsequent coronary events. Methods The study cohort consisted of 158 patients who underwent CCTA with suspected CAD within 6–36 months before percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) or unstable angina and age-/sex-matched 62 patients without PCI as the control group. Preexisting high-risk plaque characteristics (HRPCs: low attenuation plaque, positive remodeling, napkin-ring sign, spotty calcification, minimal luminal area 0.80), adding HRPCs into clinical risk factors significantly increased discriminant and reclassification abilities for subsequent coronary events (c-index 0.687 vs. 0.576, P = 0.005; NRI 0.412, P = 0.002; IDI 0.064, P = 0.001) but not for vessels with positive FFR CT (≤0.80). Conclusion In predicting subsequent coronary events, both HRPCs and hemodynamic parameters by CCTA allow better prediction of subsequent coronary events than clinical risk factors. HRPCs provide more incremental predictability than clinical risk factors alone among vessels with negative FFR CT but not among vessels with positive FFR CT .

【 授权许可】

CC BY