Keywords:
Arteriosclerosis, Acute, Screening, Computer Applications-Detection, diagnosis, CAD, Percutaneous, CT-Angiography, Emergency, Cardiovascular system
Authors:
M. Shabanova, V. Mironov, I. N. Merkulova, S. Gaman, M. Shariya, T. N. Veselova, N. Barysheva, R. Bakhtiozin; Moscow/RU
Methods and Materials
CTCA and IVUS were performed in 37 patients with ACS (mean age 58 [44; 65] years,
29 men,
8 women,
25 with unstable angina,
12 with NSTE myocardial infarction) during the same hospitalization.
64 CT-scanner and IVUS (40 MHz) with automatic pull back were used for visualization of coronary walls.
First of all according to CTCA results all calcified plaques were excluded from further analysis because of the most of known CTCA-signs of vulnerable plaques are unavailable for detection in calcified plaques.
Sixty soft and mixed plaques with good quality of CTCA-imaging (without artefacts from heart movements etc.) were evaluated in 55 coronary arteries.
All plaques were distributed in two groups – 28 SRP and 32 SNP,
according to clinical data (ECG,
ECHO,
stress-tests etc.).
We compared frequency and differences in values of CTCA-plaque features CTCA-signs of vulnerability in these groups (plaque length,
remodeling index - RI,
positive remodeling - RI > 1.05,
spotty calcinates – diameter no more than 3 mm,
low density area – less than 46 HU,
irregular surface -visual assessment,
and “nupkin-ring” – low density component in plaque surrounded like “ring” with higher density component,
but less than 130 HU).
Coronary plaque types were evaluated with color-code map (IVUS).
Plaque ruptures were detected with IVUS in grey scale.
2 fibrous plaques,
10 thick-cap fibroatheromas,
20 TCFAs and 25 ruptured plaques were detected with IVUS.
1 calcified plaque,
1 spontaneous dissection and 1 intramural hematoma were evaluated with IVUS in gray scale and were excluded from further analysis.
We compared differences in the incidence of all plaque types in SRP an SNP with IVUS.
P-value was significant < 0,05.