کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2943947 | 1577038 | 2015 | 10 صفحه PDF | دانلود رایگان |
BackgroundCoronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS).ObjectivesThis study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS.MethodsThe presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years).ResultsACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(−) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(−) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(−) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(−) patients, the cumulative number of patients with ACS developing from HRP(−) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(−)/PP(−) patients (0.3%).ConclusionsCTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(−) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.
Journal: Journal of the American College of Cardiology - Volume 66, Issue 4, 28 July 2015, Pages 337–346