title: Correlation between acute coronary syndrome classification and multi-detector CT characterization of plaque.
abstract: OBJECTIVE
  To determine if multi-detector CT (MDCT) characterization of plaque is correlated with the classification of acute coronary syndrome (ACS).
  
  
  METHODS
  Altogether 1900 patients were examined by MDCT from December 2007 to May 2009, of whom 95 patients fulfilled the criteria of ACS. Those patients were divided into the discrete plaque group ( n=61) and diffuse plaque group ( n=34) based on the findings in MDCT. The clinical diagnosis of ACS and CT results were analyzed, including segment stenosis score, segment involvement score, 3-vessel plaque score, left main score, calcification score, and remodeling index. The incidences of major adverse cardiac events in follow-up period were also recorded.
  
  
  RESULTS
  The patients of the diffuse plaque group were older than those of the discrete plaque group ( Pü0.0001). The diffuse plaque group presented more cases of hypertension, peripheral artery disease, diabetes, and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardial infarction were found in discrete plaque group. The segment stenosis score of the discrete plaque group was lower than that of the diffuse plaque group(5.15±3.55 vs. 14.91±5.37, Pü0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of thediscrete plaque group was higher (1.12±0.16 vs.0.97±0.20, Pü0.05). Follow-up data showed that major adverse cardiac events occurred more frequently in diffuse plaque group than in discrete group (29.41% vs. 11.48%, P=0.0288).
  
  
  CONCLUSIONS
  Characteristics of discrete and diffuse plaques may be significantly different among different classes of ACS. The diffuse plaque may present higher risk, correlated to higher mortality. The diagnosis of discrete and diffuse plaques by MDCT would provide a new insight into the prognosis and treatment of ACS.
authors.affiliation: Department of Cardiology, The General Hospital of the People's Liberation Army, Beijing 100853, China.
authors.forename: Zhi-Guo
authors.initials: ZG
authors.lastname: Wang
authors.forename: Lu-Yue
authors.initials: LY
authors.lastname: Gai
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Gai
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Xia
authors.initials: X
authors.lastname: Yang
authors.forename: Qin-Hua
authors.initials: QH
authors.lastname: Jin
authors.forename: Yun-Dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Guan
mesh_terms: D054058:Acute Coronary Syndrome / Q000145:classification*; D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*