Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography

Udo Hoffmann, Fabian Moselewski, Koen Nieman, Ik Kyung Jang, Maros Ferencik, Ayaz M. Rahman, Ricardo C. Cury, Suhny Abbara, Hamid Joneidi-Jafari, Stephan Achenbach, Thomas J. Brady

Research output: Contribution to journalArticle

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Abstract

Objectives: The purpose of this study was to assess morphology and composition of culprit and stable coronary lesions by multidetector computed tomography (MDCT). Background: Noninvasive identification of culprit lesions has the potential to improve noninvasive risk stratification in patients with acute chest pain. Methods: Thirty-seven patients with acute coronary syndrome (ACS) or stable angina underwent coronary 16-slice MDCT and invasive selective angiography. In all significant coronary lesions two observers measured the degree of stenosis, plaque area at stenosis, and remodeling index and assessed plaque composition. Differences between culprit lesions in patients with ACS and stable lesions in patients with ACS or stable angina were determined. Results: We analyzed 40 lesions with excellent image quality in 14 patients with ACS and 9 patients with stable angina. Culprit lesions in patients with ACS (n = 14) had significantly greater plaque area and a higher remodeling index than both stable lesions in patients with ACS (n = 13) and in patients with stable angina (n = 13) (17.5 ± 5.9 mm2 vs. 9.1 ± 4.8 mm2 vs. 13.5 ± 10.7 mm2, p = 0.02; and 1.4 ± 0.3 vs. 1.0 ± 0.4 vs. 1.2 ± 0.3, p = 0.04, respectively). The prevalence of non-calcified plaque was 100%, 62%, and 77%, respectively, and the prevalence of calcified plaque was 71%, 92%, and 85%, respectively, in culprit lesions in patients with ACS and in stable lesions in patients with ACS or stable angina. Conclusions: We introduce the concept of noninvasive detection and characterization of coronary atherosclerotic lesions in patients with ACS by MDCT. We identified differences in lesion morphology and plaque composition between culprit lesions in ACS and stable lesions in ACS or stable angina, consistent with previous intravascular ultrasound studies.

Original languageEnglish (US)
Pages (from-to)1655-1662
Number of pages8
JournalJournal of the American College of Cardiology
Volume47
Issue number8
DOIs
StatePublished - Apr 18 2006
Externally publishedYes

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Stable Angina
Multidetector Computed Tomography
Acute Coronary Syndrome
Pathologic Constriction
Acute Pain
Chest Pain
Angiography

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography. / Hoffmann, Udo; Moselewski, Fabian; Nieman, Koen; Jang, Ik Kyung; Ferencik, Maros; Rahman, Ayaz M.; Cury, Ricardo C.; Abbara, Suhny; Joneidi-Jafari, Hamid; Achenbach, Stephan; Brady, Thomas J.

In: Journal of the American College of Cardiology, Vol. 47, No. 8, 18.04.2006, p. 1655-1662.

Research output: Contribution to journalArticle

Hoffmann, Udo ; Moselewski, Fabian ; Nieman, Koen ; Jang, Ik Kyung ; Ferencik, Maros ; Rahman, Ayaz M. ; Cury, Ricardo C. ; Abbara, Suhny ; Joneidi-Jafari, Hamid ; Achenbach, Stephan ; Brady, Thomas J. / Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography. In: Journal of the American College of Cardiology. 2006 ; Vol. 47, No. 8. pp. 1655-1662.
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abstract = "Objectives: The purpose of this study was to assess morphology and composition of culprit and stable coronary lesions by multidetector computed tomography (MDCT). Background: Noninvasive identification of culprit lesions has the potential to improve noninvasive risk stratification in patients with acute chest pain. Methods: Thirty-seven patients with acute coronary syndrome (ACS) or stable angina underwent coronary 16-slice MDCT and invasive selective angiography. In all significant coronary lesions two observers measured the degree of stenosis, plaque area at stenosis, and remodeling index and assessed plaque composition. Differences between culprit lesions in patients with ACS and stable lesions in patients with ACS or stable angina were determined. Results: We analyzed 40 lesions with excellent image quality in 14 patients with ACS and 9 patients with stable angina. Culprit lesions in patients with ACS (n = 14) had significantly greater plaque area and a higher remodeling index than both stable lesions in patients with ACS (n = 13) and in patients with stable angina (n = 13) (17.5 ± 5.9 mm2 vs. 9.1 ± 4.8 mm2 vs. 13.5 ± 10.7 mm2, p = 0.02; and 1.4 ± 0.3 vs. 1.0 ± 0.4 vs. 1.2 ± 0.3, p = 0.04, respectively). The prevalence of non-calcified plaque was 100{\%}, 62{\%}, and 77{\%}, respectively, and the prevalence of calcified plaque was 71{\%}, 92{\%}, and 85{\%}, respectively, in culprit lesions in patients with ACS and in stable lesions in patients with ACS or stable angina. Conclusions: We introduce the concept of noninvasive detection and characterization of coronary atherosclerotic lesions in patients with ACS by MDCT. We identified differences in lesion morphology and plaque composition between culprit lesions in ACS and stable lesions in ACS or stable angina, consistent with previous intravascular ultrasound studies.",
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T1 - Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography

AU - Hoffmann, Udo

AU - Moselewski, Fabian

AU - Nieman, Koen

AU - Jang, Ik Kyung

AU - Ferencik, Maros

AU - Rahman, Ayaz M.

AU - Cury, Ricardo C.

AU - Abbara, Suhny

AU - Joneidi-Jafari, Hamid

AU - Achenbach, Stephan

AU - Brady, Thomas J.

PY - 2006/4/18

Y1 - 2006/4/18

N2 - Objectives: The purpose of this study was to assess morphology and composition of culprit and stable coronary lesions by multidetector computed tomography (MDCT). Background: Noninvasive identification of culprit lesions has the potential to improve noninvasive risk stratification in patients with acute chest pain. Methods: Thirty-seven patients with acute coronary syndrome (ACS) or stable angina underwent coronary 16-slice MDCT and invasive selective angiography. In all significant coronary lesions two observers measured the degree of stenosis, plaque area at stenosis, and remodeling index and assessed plaque composition. Differences between culprit lesions in patients with ACS and stable lesions in patients with ACS or stable angina were determined. Results: We analyzed 40 lesions with excellent image quality in 14 patients with ACS and 9 patients with stable angina. Culprit lesions in patients with ACS (n = 14) had significantly greater plaque area and a higher remodeling index than both stable lesions in patients with ACS (n = 13) and in patients with stable angina (n = 13) (17.5 ± 5.9 mm2 vs. 9.1 ± 4.8 mm2 vs. 13.5 ± 10.7 mm2, p = 0.02; and 1.4 ± 0.3 vs. 1.0 ± 0.4 vs. 1.2 ± 0.3, p = 0.04, respectively). The prevalence of non-calcified plaque was 100%, 62%, and 77%, respectively, and the prevalence of calcified plaque was 71%, 92%, and 85%, respectively, in culprit lesions in patients with ACS and in stable lesions in patients with ACS or stable angina. Conclusions: We introduce the concept of noninvasive detection and characterization of coronary atherosclerotic lesions in patients with ACS by MDCT. We identified differences in lesion morphology and plaque composition between culprit lesions in ACS and stable lesions in ACS or stable angina, consistent with previous intravascular ultrasound studies.

AB - Objectives: The purpose of this study was to assess morphology and composition of culprit and stable coronary lesions by multidetector computed tomography (MDCT). Background: Noninvasive identification of culprit lesions has the potential to improve noninvasive risk stratification in patients with acute chest pain. Methods: Thirty-seven patients with acute coronary syndrome (ACS) or stable angina underwent coronary 16-slice MDCT and invasive selective angiography. In all significant coronary lesions two observers measured the degree of stenosis, plaque area at stenosis, and remodeling index and assessed plaque composition. Differences between culprit lesions in patients with ACS and stable lesions in patients with ACS or stable angina were determined. Results: We analyzed 40 lesions with excellent image quality in 14 patients with ACS and 9 patients with stable angina. Culprit lesions in patients with ACS (n = 14) had significantly greater plaque area and a higher remodeling index than both stable lesions in patients with ACS (n = 13) and in patients with stable angina (n = 13) (17.5 ± 5.9 mm2 vs. 9.1 ± 4.8 mm2 vs. 13.5 ± 10.7 mm2, p = 0.02; and 1.4 ± 0.3 vs. 1.0 ± 0.4 vs. 1.2 ± 0.3, p = 0.04, respectively). The prevalence of non-calcified plaque was 100%, 62%, and 77%, respectively, and the prevalence of calcified plaque was 71%, 92%, and 85%, respectively, in culprit lesions in patients with ACS and in stable lesions in patients with ACS or stable angina. Conclusions: We introduce the concept of noninvasive detection and characterization of coronary atherosclerotic lesions in patients with ACS by MDCT. We identified differences in lesion morphology and plaque composition between culprit lesions in ACS and stable lesions in ACS or stable angina, consistent with previous intravascular ultrasound studies.

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