Evaluation by multislice computed tomography of atherosclerotic coronary artery plaques in non-culprit, remote coronary arteries of patients with acute coronary syndrome.
BACKGROUND
Patients with acute coronary syndrome (ACS) frequently have vulnerable plaques in the remote coronary arteries, suggesting that ACS is part of the pan-coronary process. In the present study the computed tomography (CT) plaque density in non-culprit atherosclerotic coronary artery lesions was evaluated by multislice computed tomography (MSCT) in patients with ACS and non-ACS.


RESULTS
MSCT was performed in 21 patients with ACS and 53 patients with non-ACS: 16 of the 21 ACS patients (76%) and 30 of the non-ACS 53 patients (57 %) had non-calcified plaques in the non-culprit coronary arteries (p=0.18). CT-low-density plaques (CT density <68 Hounsfield units (HU)) were more frequent in the ACS group (13/16 patients, 81%) than in the non-ACS group (13/30 patients, 43%, p=0.03). In addition, the CT density of the non-culprit lesion was significantly lower in patients with ACS than in those with non-ACS (44.1+/-22.9 and 77.3+/-33.7 HU, respectively).


CONCLUSIONS
Patients with ACS more frequently had CT-low-density plaques in the non-culprit, remote arteries than those with non-ACS, which suggests that ACS treatment should focus not only on stabilizing the culprit lesion but also on systemic stabilization of non-culprit lesions.
Kunimasa
Taeko
T
Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Japan.
Sato
Yuichi
Y
Sugi
Kaoru
K
Moroi
Masao
M
D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D013577:Syndrome; D036542:Tomography, Spiral Computed / Q000379:methods