Computed Tomography Coronary Angiography Possibilities in 'High Risk' Plaque Identification in Patients with non-ST-Elevation Acute Coronary Syndrome: Comparison with Intravascular Ultrasound
| Autor: | M.S. Shabanova, I. I. Staroverov, T.N. Veselova, N. A. Barysheva, T. S. Sukhinina, R. M. Shakhnovich, M.A. Shariya, N. I. Zhukova, S. A. Gaman, I. N. Merkulova, V. M. Mironov, Sergey K. Ternovoy |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography 030218 nuclear medicine & medical imaging Coronary artery disease 03 medical and health sciences Coronary circulation 0302 clinical medicine Internal medicine Intravascular ultrasound medicine Humans Acute Coronary Syndrome Ultrasonography Interventional medicine.diagnostic_test business.industry ST elevation medicine.disease Coronary Vessels Thrombosis Plaque Atherosclerotic medicine.anatomical_structure Cardiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Calcification Artery |
| Zdroj: | Kardiologiia. 60:64-75 |
| ISSN: | 2412-5660 0022-9040 |
| Popis: | Aim To evaluate structural characteristics of atherosclerotic plaques (ASP) by coronary computed tomography arteriography (CCTA) and intravascular ultrasound (IVUS).Material and methods This study included 37 patients with acute coronary syndrome (ACS). 64-detector-row CCTA, coronarography, and grayscale IVUS were performed prior to coronary stenting. The ASP length and burden, remodeling index (RI), and known CT signs of unstable ASP (presence of dot calcification, positive remodeling of the artery in the ASP area, irregular plaque contour, presence of a peripheral high-density ring and a low-density patch in the ASP). The ASP type and signs of rupture or thrombosis were determined by IVUS.Results The IVUS study revealed 45 unstable ASP (UASP), including 25 UASP with rupture and 20 thin-cap fibroatheromas (TCFA), and 13 stable ASP (SASP). No significant differences were found between distribution of TCFA and ASP with rupture among symptom-associated plaques (SAP, n=28) and non-symptom-associated plaques (NSAP, n=30). They were found in 82.1 and 73.3 % of cases, respectively (p>0.05), which indicated generalization of the ASP destabilization process in the coronary circulation. However, the incidence of mural thrombus was higher for SAP (53.5 and 16.6 % of ASP, respectively; pConclusion According to IVUS data, two X-ray signs are most characteristic for UASP, the irregular contour and a patch with X-ray density ≤46 HU. The presence of these signs 11- and 7-fold, respectively, increases the likelihood of unstable ASP. |
| Databáze: | OpenAIRE |
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