High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain: Results from the ROMICAT-II trial

Stefan B. Puchner, Ting Liu, Thomas Mayrhofer, Quynh A. Truong, Hang Lee, Jerome L. Fleg, John T. Nagurney, James E. Udelson, Udo Hoffmann, Maros Ferencik

    Research output: Contribution to journalArticle

    160 Citations (Scopus)

    Abstract

    Background It is not known whether high-risk plaque, as detected by coronary computed tomography angiography (CTA), permits improved early diagnosis of acute coronary syndromes (ACS) independently to the presence of significant coronary artery disease (CAD) in patients with acute chest pain. Objectives The primary aim of this study was to determine whether high-risk plaque features, as detected by CTA in the emergency department (ED), may improve diagnostic certainty of ACS independently and incrementally to the presence of significant CAD and clinical risk assessment in patients with acute chest pain but without objective evidence of myocardial ischemia or myocardial infarction (MI). Methods We included patients randomized to the coronary CTA arm of the ROMICAT-II (Rule Out Myocardial Infarction/Ischemia Using Computer-Assisted Tomography II) trial. Readers assessed coronary CTA qualitatively for the presence of nonobstructive CAD (1% to 49% stenosis), significant CAD (≥50% or ≥70% stenosis), and the presence of at least 1 of the high-risk plaque features (positive remodeling, low

    Original languageEnglish (US)
    Pages (from-to)684-692
    Number of pages9
    JournalJournal of the American College of Cardiology
    Volume64
    Issue number7
    DOIs
    StatePublished - Aug 19 2014

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    Acute Pain
    Acute Coronary Syndrome
    Coronary Angiography
    Chest Pain
    Myocardial Ischemia
    Coronary Artery Disease
    Pathologic Constriction
    Myocardial Infarction
    Tomography
    Licensure
    Hospital Emergency Service
    Early Diagnosis
    Computed Tomography Angiography

    Keywords

    • acute chest pain
    • acute coronary syndrome
    • coronary atherosclerotic plaque
    • coronary computed tomography

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain : Results from the ROMICAT-II trial. / Puchner, Stefan B.; Liu, Ting; Mayrhofer, Thomas; Truong, Quynh A.; Lee, Hang; Fleg, Jerome L.; Nagurney, John T.; Udelson, James E.; Hoffmann, Udo; Ferencik, Maros.

    In: Journal of the American College of Cardiology, Vol. 64, No. 7, 19.08.2014, p. 684-692.

    Research output: Contribution to journalArticle

    Puchner, Stefan B. ; Liu, Ting ; Mayrhofer, Thomas ; Truong, Quynh A. ; Lee, Hang ; Fleg, Jerome L. ; Nagurney, John T. ; Udelson, James E. ; Hoffmann, Udo ; Ferencik, Maros. / High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain : Results from the ROMICAT-II trial. In: Journal of the American College of Cardiology. 2014 ; Vol. 64, No. 7. pp. 684-692.
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    abstract = "Background It is not known whether high-risk plaque, as detected by coronary computed tomography angiography (CTA), permits improved early diagnosis of acute coronary syndromes (ACS) independently to the presence of significant coronary artery disease (CAD) in patients with acute chest pain. Objectives The primary aim of this study was to determine whether high-risk plaque features, as detected by CTA in the emergency department (ED), may improve diagnostic certainty of ACS independently and incrementally to the presence of significant CAD and clinical risk assessment in patients with acute chest pain but without objective evidence of myocardial ischemia or myocardial infarction (MI). Methods We included patients randomized to the coronary CTA arm of the ROMICAT-II (Rule Out Myocardial Infarction/Ischemia Using Computer-Assisted Tomography II) trial. Readers assessed coronary CTA qualitatively for the presence of nonobstructive CAD (1{\%} to 49{\%} stenosis), significant CAD (≥50{\%} or ≥70{\%} stenosis), and the presence of at least 1 of the high-risk plaque features (positive remodeling, low",
    keywords = "acute chest pain, acute coronary syndrome, coronary atherosclerotic plaque, coronary computed tomography",
    author = "Puchner, {Stefan B.} and Ting Liu and Thomas Mayrhofer and Truong, {Quynh A.} and Hang Lee and Fleg, {Jerome L.} and Nagurney, {John T.} and Udelson, {James E.} and Udo Hoffmann and Maros Ferencik",
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    T1 - High-risk plaque detected on coronary CT angiography predicts acute coronary syndromes independent of significant stenosis in acute chest pain

    T2 - Results from the ROMICAT-II trial

    AU - Puchner, Stefan B.

    AU - Liu, Ting

    AU - Mayrhofer, Thomas

    AU - Truong, Quynh A.

    AU - Lee, Hang

    AU - Fleg, Jerome L.

    AU - Nagurney, John T.

    AU - Udelson, James E.

    AU - Hoffmann, Udo

    AU - Ferencik, Maros

    PY - 2014/8/19

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    N2 - Background It is not known whether high-risk plaque, as detected by coronary computed tomography angiography (CTA), permits improved early diagnosis of acute coronary syndromes (ACS) independently to the presence of significant coronary artery disease (CAD) in patients with acute chest pain. Objectives The primary aim of this study was to determine whether high-risk plaque features, as detected by CTA in the emergency department (ED), may improve diagnostic certainty of ACS independently and incrementally to the presence of significant CAD and clinical risk assessment in patients with acute chest pain but without objective evidence of myocardial ischemia or myocardial infarction (MI). Methods We included patients randomized to the coronary CTA arm of the ROMICAT-II (Rule Out Myocardial Infarction/Ischemia Using Computer-Assisted Tomography II) trial. Readers assessed coronary CTA qualitatively for the presence of nonobstructive CAD (1% to 49% stenosis), significant CAD (≥50% or ≥70% stenosis), and the presence of at least 1 of the high-risk plaque features (positive remodeling, low

    AB - Background It is not known whether high-risk plaque, as detected by coronary computed tomography angiography (CTA), permits improved early diagnosis of acute coronary syndromes (ACS) independently to the presence of significant coronary artery disease (CAD) in patients with acute chest pain. Objectives The primary aim of this study was to determine whether high-risk plaque features, as detected by CTA in the emergency department (ED), may improve diagnostic certainty of ACS independently and incrementally to the presence of significant CAD and clinical risk assessment in patients with acute chest pain but without objective evidence of myocardial ischemia or myocardial infarction (MI). Methods We included patients randomized to the coronary CTA arm of the ROMICAT-II (Rule Out Myocardial Infarction/Ischemia Using Computer-Assisted Tomography II) trial. Readers assessed coronary CTA qualitatively for the presence of nonobstructive CAD (1% to 49% stenosis), significant CAD (≥50% or ≥70% stenosis), and the presence of at least 1 of the high-risk plaque features (positive remodeling, low

    KW - acute chest pain

    KW - acute coronary syndrome

    KW - coronary atherosclerotic plaque

    KW - coronary computed tomography

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