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2017 ; 18
(3
): 487-497
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Characteristics Detected on Computed Tomography Angiography Predict Coronary
Artery Plaque Progression in Non-Culprit Lesions
#MMPMID28458601
Tan Y
; Zhou J
; Zhou Y
; Yang X
; Yang J
; Chen Y
Korean J Radiol
2017[May]; 18
(3
): 487-497
PMID28458601
show ga
OBJECTIVE: This study sought to determine whether variables detected on coronary
computed tomography angiography (CCTA) would predict plaque progression in
non-culprit lesions (NCL). MATERIALS AND METHODS: In this single-center trial, we
analyzed 103 consecutive patients who were undergoing CCTA and percutaneous
coronary intervention (PCI) for culprit lesions. Follow-up CCTA was scheduled 12
months after the PCI, and all patients were followed for 3 years after their
second CCTA examination. High-risk plaque features and epicardial adipose tissue
(EAT) volume were assessed by CCTA. Each NCL stenosis grade was compared visually
between two CCTA scans to detect plaque progression, and patients were stratified
into two groups based on this. Logistic regression analysis was used to evaluate
the factors that were independently associated with plaque progression in NCLs.
Time-to-event curves were compared using the log-rank statistic. RESULTS:
Overall, 34 of 103 patients exhibited NCL plaque progression (33%). Logistic
regression analyses showed that the NCL progression was associated with a history
of ST-elevated myocardial infarction (odds ratio [OR] = 5.855, 95% confidence
interval [CI] = 1.391-24.635, p = 0.016), follow-up low-density lipoprotein
cholesterol level (OR = 6.832, 95% CI = 2.103-22.200, p = 0.001), baseline
low-attenuation plaque (OR = 7.311, 95% CI = 1.242-43.028, p = 0.028) and EAT (OR
= 1.015, 95% CI = 1.000-1.029, p = 0.044). Following the second CCTA examination,
major adverse cardiac events (MACEs) were observed in 12 patients, and NCL plaque
progression was significantly associated with future MACEs (log rank p = 0.006).
CONCLUSION: Noninvasive assessment of NCLs by CCTA has potential prognostic
value.