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Coronary CT Value in Quantitative Assessment of Intermediate Stenosis

Background and Objectives: Cardiac computed tomography angiography (CCTA) is an excellent non-invasive imaging tool to evaluate coronary arteries and exclude coronary artery disease (CAD). Managing intermediate coronary artery stenosis with negative or inconclusive functional tests is still a challe...

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Autores principales: Zajančkauskienė, Laura, Radionovaitė, Laura, Jankauskas, Antanas, Banišauskaitė, Audra, Šakalytė, Gintarė
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320498/
https://www.ncbi.nlm.nih.gov/pubmed/35888684
http://dx.doi.org/10.3390/medicina58070964
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author Zajančkauskienė, Laura
Radionovaitė, Laura
Jankauskas, Antanas
Banišauskaitė, Audra
Šakalytė, Gintarė
author_facet Zajančkauskienė, Laura
Radionovaitė, Laura
Jankauskas, Antanas
Banišauskaitė, Audra
Šakalytė, Gintarė
author_sort Zajančkauskienė, Laura
collection PubMed
description Background and Objectives: Cardiac computed tomography angiography (CCTA) is an excellent non-invasive imaging tool to evaluate coronary arteries and exclude coronary artery disease (CAD). Managing intermediate coronary artery stenosis with negative or inconclusive functional tests is still a challenge. A regular stenosis evaluation together with high-risk plaque features, using semi-automated programs, are becoming promising tools. This case–control study was designed to evaluate the intermediate lesion features’ impact on CAD outcomes, using a semi-automated CCTA atherosclerotic plaque analysis program. Materials and Methods: We performed a single-center, prospective cohort study. A total of 133 patients with low to intermediate risk of CAD, older than 18 years with no previous history of CAD and good quality CCTA images were included in the study, and 194 intermediate stenosis (CAD-RADS 3) were analyzed. For more detailed morphological analysis, we used semi-automated CCTA-dedicated software. Enrolled patients were prospectively followed-up for 2 years. Results: Agatston score was significantly higher in the major adverse cardiovascular events (MACE) group (p = 0.025). Obstruction site analysis showed a significantly lower coronary artery remodeling index (RI) among patients with MACE (p = 0.037); nonetheless RI was negative in both groups. Plaque consistency analysis showed significantly bigger necrotic core area in the MACE group (p = 0.049). In addition, unadjusted multivariate analysis confirmed Agatston score and RI as significant MACE predictors. Conclusions: The Agatston score showes the total area of calcium deposits and higher values are linked to MACE. Higher plaque content of necrotic component is also associated with MACE. Additionally, negatively remodeled plaques are linked to MACE and could be a sign of advanced CAD. The Agatston score and RI are significant in risk stratification for the development of MACE.
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spelling pubmed-93204982022-07-27 Coronary CT Value in Quantitative Assessment of Intermediate Stenosis Zajančkauskienė, Laura Radionovaitė, Laura Jankauskas, Antanas Banišauskaitė, Audra Šakalytė, Gintarė Medicina (Kaunas) Article Background and Objectives: Cardiac computed tomography angiography (CCTA) is an excellent non-invasive imaging tool to evaluate coronary arteries and exclude coronary artery disease (CAD). Managing intermediate coronary artery stenosis with negative or inconclusive functional tests is still a challenge. A regular stenosis evaluation together with high-risk plaque features, using semi-automated programs, are becoming promising tools. This case–control study was designed to evaluate the intermediate lesion features’ impact on CAD outcomes, using a semi-automated CCTA atherosclerotic plaque analysis program. Materials and Methods: We performed a single-center, prospective cohort study. A total of 133 patients with low to intermediate risk of CAD, older than 18 years with no previous history of CAD and good quality CCTA images were included in the study, and 194 intermediate stenosis (CAD-RADS 3) were analyzed. For more detailed morphological analysis, we used semi-automated CCTA-dedicated software. Enrolled patients were prospectively followed-up for 2 years. Results: Agatston score was significantly higher in the major adverse cardiovascular events (MACE) group (p = 0.025). Obstruction site analysis showed a significantly lower coronary artery remodeling index (RI) among patients with MACE (p = 0.037); nonetheless RI was negative in both groups. Plaque consistency analysis showed significantly bigger necrotic core area in the MACE group (p = 0.049). In addition, unadjusted multivariate analysis confirmed Agatston score and RI as significant MACE predictors. Conclusions: The Agatston score showes the total area of calcium deposits and higher values are linked to MACE. Higher plaque content of necrotic component is also associated with MACE. Additionally, negatively remodeled plaques are linked to MACE and could be a sign of advanced CAD. The Agatston score and RI are significant in risk stratification for the development of MACE. MDPI 2022-07-20 /pmc/articles/PMC9320498/ /pubmed/35888684 http://dx.doi.org/10.3390/medicina58070964 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zajančkauskienė, Laura
Radionovaitė, Laura
Jankauskas, Antanas
Banišauskaitė, Audra
Šakalytė, Gintarė
Coronary CT Value in Quantitative Assessment of Intermediate Stenosis
title Coronary CT Value in Quantitative Assessment of Intermediate Stenosis
title_full Coronary CT Value in Quantitative Assessment of Intermediate Stenosis
title_fullStr Coronary CT Value in Quantitative Assessment of Intermediate Stenosis
title_full_unstemmed Coronary CT Value in Quantitative Assessment of Intermediate Stenosis
title_short Coronary CT Value in Quantitative Assessment of Intermediate Stenosis
title_sort coronary ct value in quantitative assessment of intermediate stenosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320498/
https://www.ncbi.nlm.nih.gov/pubmed/35888684
http://dx.doi.org/10.3390/medicina58070964
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