医学
计算机断层摄影术
冠状动脉造影
放射科
计算机断层血管造影
心肌梗塞
内科学
心脏病学
作者
Daisuke Kinoshita,Keishi Suzuki,Eisuke Usui,Masahiro Hada,Ik‐Kyung Jang,Takayuki Niida,Yoshiyasu Minami,Hang Lee,Iris McNulty,Junya Ako,Maros Ferencik,Tsunekazu Kakuta,Ik‐Kyung Jang
标识
DOI:10.1016/j.jcmg.2023.08.005
摘要
Although patients with high-risk plaque (HRP) on coronary computed tomography angiography (CTA) are reportedly at increased risk for future cardiovascular events, individual HRP features have not been systematically validated against high-resolution intravascular imaging. The aim of this study was to correlate HRP features on CTA with plaque characteristics on optical coherence tomography (OCT). Patients who underwent both CTA and OCT before coronary intervention were enrolled. Plaques in culprit vessels identified by CTA were evaluated with the use of OCT at the corresponding sites. HRP was defined as a plaque with at least 2 of the following 4 features: positive remodeling (PR), low-attenuation plaque (LAP), napkin-ring sign (NRS), and spotty calcification (SC). Patients were followed for up to 3 years. The study included 448 patients, with a median age of 67 years and of whom 357 (79.7%) were male, and 203 (45.3%) presented with acute coronary syndromes. A total of 1,075 lesions were analyzed. All 4 HRP features were associated with thin-cap fibroatheroma. PR was associated with all OCT features of plaque vulnerability, LAP was associated with lipid-rich plaque, macrophage, and cholesterol crystals, NRS was associated with cholesterol crystals, and SC was associated with microvessels. The cumulative incidence of the composite endpoint (target vessel nontarget lesion revascularization and cardiac death) was significantly higher in patients with HRP than in those without HRP (4.7% vs 0.5%; P = 0.010). All 4 HRP features on CTA were associated with features of vulnerability on OCT. (Massachusetts General Hospital and Tsuchiura Kyodo General Hospital Coronary Imaging Collaboration; NCT04523194)
科研通智能强力驱动
Strongly Powered by AbleSci AI