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Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography
BACKGROUND: A previous coronary computed tomography (CT) angiographic study failed to discriminate optical coherence tomography‐defined intact fibrous cap culprit lesions (IFC group) from those with ruptured fibrous caps (RFC group) in patients with coronary artery disease. This study aimed to evalu...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227319/ https://www.ncbi.nlm.nih.gov/pubmed/37183866 http://dx.doi.org/10.1161/JAHA.122.029239 |
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author | Nagamine, Tatsuhiro Hoshino, Masahiro Yonetsu, Taishi Sugiyama, Tomoyo Kanaji, Yoshihisa Matsuda, Kazuki Sayama, Kodai Ueno, Hiroki Nogami, Kai Hanyu, Yoshihiro Misawa, Toru Hada, Masahiro Usui, Eisuke Sasano, Tetsuo Kakuta, Tsunekazu |
author_facet | Nagamine, Tatsuhiro Hoshino, Masahiro Yonetsu, Taishi Sugiyama, Tomoyo Kanaji, Yoshihisa Matsuda, Kazuki Sayama, Kodai Ueno, Hiroki Nogami, Kai Hanyu, Yoshihiro Misawa, Toru Hada, Masahiro Usui, Eisuke Sasano, Tetsuo Kakuta, Tsunekazu |
author_sort | Nagamine, Tatsuhiro |
collection | PubMed |
description | BACKGROUND: A previous coronary computed tomography (CT) angiographic study failed to discriminate optical coherence tomography‐defined intact fibrous cap culprit lesions (IFC group) from those with ruptured fibrous caps (RFC group) in patients with coronary artery disease. This study aimed to evaluate the diagnostic efficacy of preprocedural coronary CT imaging in identifying subsequently performed optical coherence tomography‐defined plaque rupture or erosion at culprit lesions in patients with non–ST‐segment–elevation acute myocardial infarction. METHODS AND RESULTS: This study used data from 2 recently published studies that tested the hypothesis that coronary CT angiography (CCTA) before percutaneous coronary intervention may provide diagnostic information on the high‐risk atherosclerotic burden in patients with non–ST‐segment–elevation acute myocardial infarction. In the analysis of 186 patients, optical coherence tomography identified 106 RFC plaques and 80 IFC plaques as the culprit lesions. On CT, the prevalence of low‐attenuation plaque, positive remodeling, napkin‐ring sign, and spotty calcification were all significantly lower in the IFC group. The culprit vessel pericoronary adipose tissue inflammation and coronary artery calcium scores were significantly lower in the IFC group than in the RFC group. The absence of low‐attenuation plaque, napkin‐ring sign, zero coronary artery calcium, and low pericoronary adipose tissue inflammation were independent predictors of IFC. When stratified into 5 subgroups according to the number of these 4 CT factors, the prevalence of IFC was 8.3%, 20.8%, 44.6%, 75.6%, and 100% (P<0.001), respectively. CONCLUSIONS: Preprocedural comprehensive coronary CT imaging, including coronary artery calcium and pericoronary adipose tissue inflammation assessment, can accurately and noninvasively identify optical coherence tomography‐defined IFC or RFC culprit lesions. |
format | Online Article Text |
id | pubmed-10227319 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102273192023-05-31 Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography Nagamine, Tatsuhiro Hoshino, Masahiro Yonetsu, Taishi Sugiyama, Tomoyo Kanaji, Yoshihisa Matsuda, Kazuki Sayama, Kodai Ueno, Hiroki Nogami, Kai Hanyu, Yoshihiro Misawa, Toru Hada, Masahiro Usui, Eisuke Sasano, Tetsuo Kakuta, Tsunekazu J Am Heart Assoc Original Research BACKGROUND: A previous coronary computed tomography (CT) angiographic study failed to discriminate optical coherence tomography‐defined intact fibrous cap culprit lesions (IFC group) from those with ruptured fibrous caps (RFC group) in patients with coronary artery disease. This study aimed to evaluate the diagnostic efficacy of preprocedural coronary CT imaging in identifying subsequently performed optical coherence tomography‐defined plaque rupture or erosion at culprit lesions in patients with non–ST‐segment–elevation acute myocardial infarction. METHODS AND RESULTS: This study used data from 2 recently published studies that tested the hypothesis that coronary CT angiography (CCTA) before percutaneous coronary intervention may provide diagnostic information on the high‐risk atherosclerotic burden in patients with non–ST‐segment–elevation acute myocardial infarction. In the analysis of 186 patients, optical coherence tomography identified 106 RFC plaques and 80 IFC plaques as the culprit lesions. On CT, the prevalence of low‐attenuation plaque, positive remodeling, napkin‐ring sign, and spotty calcification were all significantly lower in the IFC group. The culprit vessel pericoronary adipose tissue inflammation and coronary artery calcium scores were significantly lower in the IFC group than in the RFC group. The absence of low‐attenuation plaque, napkin‐ring sign, zero coronary artery calcium, and low pericoronary adipose tissue inflammation were independent predictors of IFC. When stratified into 5 subgroups according to the number of these 4 CT factors, the prevalence of IFC was 8.3%, 20.8%, 44.6%, 75.6%, and 100% (P<0.001), respectively. CONCLUSIONS: Preprocedural comprehensive coronary CT imaging, including coronary artery calcium and pericoronary adipose tissue inflammation assessment, can accurately and noninvasively identify optical coherence tomography‐defined IFC or RFC culprit lesions. John Wiley and Sons Inc. 2023-05-15 /pmc/articles/PMC10227319/ /pubmed/37183866 http://dx.doi.org/10.1161/JAHA.122.029239 Text en © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Nagamine, Tatsuhiro Hoshino, Masahiro Yonetsu, Taishi Sugiyama, Tomoyo Kanaji, Yoshihisa Matsuda, Kazuki Sayama, Kodai Ueno, Hiroki Nogami, Kai Hanyu, Yoshihiro Misawa, Toru Hada, Masahiro Usui, Eisuke Sasano, Tetsuo Kakuta, Tsunekazu Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography |
title | Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography |
title_full | Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography |
title_fullStr | Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography |
title_full_unstemmed | Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography |
title_short | Identification of Optical Coherence Tomography‐Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography |
title_sort | identification of optical coherence tomography‐defined coronary plaque erosion by preprocedural computed tomography angiography |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10227319/ https://www.ncbi.nlm.nih.gov/pubmed/37183866 http://dx.doi.org/10.1161/JAHA.122.029239 |
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