Mengmeng Yu1, Zhigang Lu2, Wenbin Li1, Meng Wei2, Jing Yan3, Jiayin Zhang4. 1. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. 2. Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, China. 3. Siemens Healthcare Ltd, #278, Zhouzhugong Rd, Shanghai, China. 4. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China. andrewssmu@msn.com.
Abstract
OBJECTIVES: To assess pre-procedural plaque characteristics as determined by coronary CT angiography (CCTA) and their associations with late revascularization in symptomatic post-procedural patients. METHODS: Symptomatic patients with pre-procedural CCTA were prospectively enrolled and referred for invasive coronary angiography (ICA). Plaque characterization was performed on the basis of baseline CCTA data. Multivariate logistic regression analysis with a stepwise selection method was performed to identify independent predictors of late revascularization. RESULTS: Seventy-eight patients with 134 lesions were included. Late revascularization was performed to treat 15 ISRs and 22 de novo lesions. Lesions with late revascularization showed higher prevalence rates of low-attenuation plaque (LAP) and positive remodelling (PR) (70.3% vs. 23.7% and 86.5% vs. 30.9%; both p < 0.001) at baseline CCTA. However, the incidence of spotty calcification or napkin-ring sign (NRS) was not significantly different between the subgroups. According to ROC curve analysis, PR and LAP showed the largest AUC values for diagnosing lesions with late revascularization (AUC = 0.78 and 0.73, both p < 0.001). In multivariate analysis, LAP and PR (odds ratio = 6.30 and 13.94; both p < 0.05) were revealed to be independent predictors for late revascularization. CONCLUSIONS: LAP and PR observed by baseline CCTA independently predict late revascularization caused by ISR or progression of de novo lesions. KEY POINTS: • LAP and PR observed by baseline CT are predictors of late revascularization. • NRS and spotty calcification are not associated with late revascularization. • CT plaque characterization is useful in identifying lesions at high risk of late revascularization.
OBJECTIVES: To assess pre-procedural plaque characteristics as determined by coronary CT angiography (CCTA) and their associations with late revascularization in symptomatic post-procedural patients. METHODS: Symptomatic patients with pre-procedural CCTA were prospectively enrolled and referred for invasive coronary angiography (ICA). Plaque characterization was performed on the basis of baseline CCTA data. Multivariate logistic regression analysis with a stepwise selection method was performed to identify independent predictors of late revascularization. RESULTS: Seventy-eight patients with 134 lesions were included. Late revascularization was performed to treat 15 ISRs and 22 de novo lesions. Lesions with late revascularization showed higher prevalence rates of low-attenuation plaque (LAP) and positive remodelling (PR) (70.3% vs. 23.7% and 86.5% vs. 30.9%; both p < 0.001) at baseline CCTA. However, the incidence of spottycalcification or napkin-ring sign (NRS) was not significantly different between the subgroups. According to ROC curve analysis, PR and LAP showed the largest AUC values for diagnosing lesions with late revascularization (AUC = 0.78 and 0.73, both p < 0.001). In multivariate analysis, LAP and PR (odds ratio = 6.30 and 13.94; both p < 0.05) were revealed to be independent predictors for late revascularization. CONCLUSIONS: LAP and PR observed by baseline CCTA independently predict late revascularization caused by ISR or progression of de novo lesions. KEY POINTS: • LAP and PR observed by baseline CT are predictors of late revascularization. • NRS and spottycalcification are not associated with late revascularization. • CT plaque characterization is useful in identifying lesions at high risk of late revascularization.
Authors: Fumiyuki Otsuka; Robert A Byrne; Kazuyuki Yahagi; Hiroyoshi Mori; Elena Ladich; David R Fowler; Robert Kutys; Erion Xhepa; Adnan Kastrati; Renu Virmani; Michael Joner Journal: Eur Heart J Date: 2015-05-20 Impact factor: 29.983
Authors: R Hoffmann; G S Mintz; R Mehran; A D Pichard; K M Kent; L F Satler; J J Popma; H Wu; M B Leon Journal: J Am Coll Cardiol Date: 1998-01 Impact factor: 24.094
Authors: Gregg W Stone; Stephen G Ellis; David A Cox; James Hermiller; Charles O'Shaughnessy; James Tift Mann; Mark Turco; Ronald Caputo; Patrick Bergin; Joel Greenberg; Jeffrey J Popma; Mary E Russell Journal: N Engl J Med Date: 2004-01-15 Impact factor: 91.245
Authors: Christoph Stettler; Simon Wandel; Sabin Allemann; Adnan Kastrati; Marie Claude Morice; Albert Schömig; Matthias E Pfisterer; Gregg W Stone; Martin B Leon; José Suarez de Lezo; Jean-Jacques Goy; Seung-Jung Park; Manel Sabaté; Maarten J Suttorp; Henning Kelbaek; Christian Spaulding; Maurizio Menichelli; Paul Vermeersch; Maurits T Dirksen; Pavel Cervinka; Anna Sonia Petronio; Alain J Nordmann; Peter Diem; Bernhard Meier; Marcel Zwahlen; Stephan Reichenbach; Sven Trelle; Stephan Windecker; Peter Jüni Journal: Lancet Date: 2007-09-15 Impact factor: 79.321