Multidetector computed tomography evaluation of coronary plaque morphology in patients with stable angina.
The purpose of this study was to evaluate the morphology and composition of atherosclerotic coronary plaques in patients with stable coronary artery disease by 64-row multidetector computed tomography (CT) angiography. A total of 56 patients were divided into an ischemia-related (n = 31) and a nonischemia-related lesion group (n = 25) based on myocardial perfusion scintigraphy, invasive angiography, and 1-year clinical follow-up. The 56 lesions detected by CT imaging were analyzed; the severity of stenosis, the lesion length, CT attenuation value, and calcium deposition of the plaques were evaluated. Clinical characteristics and CT findings were compared using univariate and multivariate logistic regression analyses. Ischemia-related lesions exhibited a greater severity of coronary stenosis, were longer (17.8 ± 8.5 vs 9.1 ± 3.9 mm), and had a higher CT attenuation value (101.7 ± 36.7 vs 81.6 ± 32.6 HU) and larger calcium deposition. By univariate logistic analysis, severity of stenosis, lesion length, CT attenuation value, and calcium deposition were significantly associated with ischemia-related plaques. The odds ratio (OR) of these parameters was 6.874 (P = 0.007), 1.371 (P = 0.001), 1.018 (P = 0.044), and 5.400 (P = 0.004), respectively. By multivariate logistic analysis, the severity of stenosis and lesion length were significantly associated with ischemia-related plaques (OR 7.588, P = 0.036 and OR 1.365, P = 0.003, respectively). In conclusion, coronary CT angiography is useful for the identification of morphological differences between ischemia-related and nonischemia-related plaques in patients with stable coronary artery disease.
Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Kumamoto 860-0811, Japan. utsunomi@kumamoto-u.ac.jp
Daisuke
D
Utsunomiya
Takashi
T
Fukunaga
Seitaro
S
Oda
Kazuo
K
Awai
Takeshi
T
Nakaura
Joji
J
Urata
Yasuyuki
Y
Yamashita
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000209:etiology; D002114:Calcinosis / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D055414:Myocardial Perfusion Imaging; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed