BACKGROUND: previous studies have shown that the presence of stenosis alone on multislice computed tomography (MSCT) has a limited positive predictive value for the presence of ischemia on myocardial perfusion imaging (MPI). The purpose of this study was to assess which variables of atherosclerosis on MSCT angiography are related to ischemia on MPI. METHODS AND RESULTS: both MSCT and MPI were performed in 514 patients. On MSCT, the calcium score, degree of stenosis (≥ 50% and ≥ 70% stenosis), and plaque extent and location were determined. Plaque composition was classified as noncalcified, mixed, or calcified. Ischemia was defined as a summed difference score (≥ 2 on a per-patient basis. Ischemia was observed in 137 patients (27%). On a per-patient basis, multivariate analysis showed that the degree of stenosis (presence of (≥ 70% stenosis, odds ratio=3.5), plaque extent and composition (mixed plaques (≥3, odds ratio=1.7; calcified plaques ≥ 3, odds ratio=2.0), and location (atherosclerotic disease in the left main coronary artery and/or proximal left anterior descending coronary artery, odds ratio=1.6) were independent predictors for ischemia on MPI. In addition, MSCT variables of atherosclerosis, such as plaque extent, composition, and location, had significant incremental value for the prediction of ischemia over the presence of ≥70% stenosis. CONCLUSIONS: in addition to the degree of stenosis, MSCT variables of atherosclerosis describing plaque extent, composition, and location are predictive of the presence of ischemia on MPI.
BACKGROUND: previous studies have shown that the presence of stenosis alone on multislice computed tomography (MSCT) has a limited positive predictive value for the presence of ischemia on myocardial perfusion imaging (MPI). The purpose of this study was to assess which variables of atherosclerosis on MSCT angiography are related to ischemia on MPI. METHODS AND RESULTS: both MSCT and MPI were performed in 514 patients. On MSCT, the calcium score, degree of stenosis (≥ 50% and ≥ 70% stenosis), and plaque extent and location were determined. Plaque composition was classified as noncalcified, mixed, or calcified. Ischemia was defined as a summed difference score (≥ 2 on a per-patient basis. Ischemia was observed in 137 patients (27%). On a per-patient basis, multivariate analysis showed that the degree of stenosis (presence of (≥ 70% stenosis, odds ratio=3.5), plaque extent and composition (mixed plaques (≥3, odds ratio=1.7; calcified plaques ≥ 3, odds ratio=2.0), and location (atherosclerotic disease in the left main coronary artery and/or proximal left anterior descending coronary artery, odds ratio=1.6) were independent predictors for ischemia on MPI. In addition, MSCT variables of atherosclerosis, such as plaque extent, composition, and location, had significant incremental value for the prediction of ischemia over the presence of ≥70% stenosis. CONCLUSIONS: in addition to the degree of stenosis, MSCT variables of atherosclerosis describing plaque extent, composition, and location are predictive of the presence of ischemia on MPI.
Authors: Haim Shmilovich; Victor Y Cheng; Balaji K Tamarappoo; Damini Dey; Ryo Nakazato; Heidi Gransar; Louise E J Thomson; Sean W Hayes; John D Friedman; Guido Germano; Piotr J Slomka; Daniel S Berman Journal: Atherosclerosis Date: 2011-08-07 Impact factor: 5.162
Authors: Michiel A de Graaf; Heba M El-Naggar; Mark J Boogers; Caroline E Veltman; Alexander Broersen; Pieter H Kitslaar; Jouke Dijkstra; Lucia J Kroft; Imad Al Younis; Johan H Reiber; Jeroen J Bax; Victoria Delgado; Arthur J Scholte Journal: Eur J Nucl Med Mol Imaging Date: 2013-05-29 Impact factor: 9.236
Authors: Stephanie Saade; Jean-Baptiste Cazier; Michella Ghassibe-Sabbagh; Sonia Youhanna; Danielle A Badro; Yoichiro Kamatani; Jörg Hager; Joumana S Yeretzian; Georges El-Khazen; Marc Haber; Angelique K Salloum; Bouchra Douaihy; Raed Othman; Nabil Shasha; Samer Kabbani; Hamid El Bayeh; Elie Chammas; Martin Farrall; Dominique Gauguier; Daniel E Platt; Pierre A Zalloua Journal: PLoS One Date: 2011-12-27 Impact factor: 3.240
Authors: Jörg Hager; Yoichiro Kamatani; Jean-Baptiste Cazier; Sonia Youhanna; Michella Ghassibe-Sabbagh; Daniel E Platt; Antoine B Abchee; Jihane Romanos; Georges Khazen; Raed Othman; Danielle A Badro; Marc Haber; Angelique K Salloum; Bouchra Douaihy; Nabil Shasha; Samer Kabbani; Hana Sbeite; Elie Chammas; Hamid el Bayeh; Francis Rousseau; Diana Zelenika; Ivo Gut; Mark Lathrop; Martin Farrall; Dominique Gauguier; Pierre A Zalloua Journal: PLoS One Date: 2012-06-20 Impact factor: 3.240