title: Natural history of coronary atherosclerosis by multislice computed tomography.
abstract: OBJECTIVE
  This study sought to analyze the natural history of coronary atherosclerosis by multislice computed tomography (MSCT) and assess the serial changes in coronary plaque burden, lumen dimensions, and arterial remodeling.
  
  
  BACKGROUND
  MSCT can comprehensively assess coronary atherosclerosis by combining lumen and plaque size parameters.
  
  
  METHODS
  Thirty-two patients with acute coronary syndromes underwent 64-slice computed tomography angiography after percutaneous coronary intervention at baseline and after a median of 39 months. All patients received contemporary medical treatment. All available coronary segments in every subject were analyzed. The progression of atherosclerosis per segment and per patient was assessed by means of change in percent atheroma volume (PAV), change in normalized total atheroma volume (TAVnorm), and percent change in TAV (% change in TAV). Serial coronary remodeling was also assessed. Measures of lumen stenosis included percent diameter stenosis (%DS), minimum lumen diameter (MLD), percent area stenosis (%AS), and minimum lumen area (MLA). For each patient, the mean of all matched segments was calculated at the 2 time points. Clinical events at follow-up were documented.
  
  
  RESULTS
  The PAV did not change significantly (-0.15 ± 3.64%, p = 0.72). The mean change in TAVnorm was 47.36 ± 143.24 mm(3) (p = 0.071), and the % change in TAV was 6.7% (p = 0.029). The MLD and MLA increased by 0.15 mm (-0.09 to 0.24, p = 0.039) and 0.52 mm(2) (-0.38 to 1.04, p = 0.034) respectively, which was accompanied by vessel enlargement, with 53% of the patients showing expansive positive remodeling. Patients with clinical events had a larger TAVnorm at baseline (969.72 mm(3) vs. 810.77 mm(3), p = 0.010).
  
  
  CONCLUSIONS
  MSCT can assess the progression of coronary atherosclerosis and may be used for noninvasive monitoring of pharmacological interventions in coronary artery disease. (
  
  
  CONCLUSIONS
  An Imaging Study in Patients With Unstable Atherosclerotic Lesions; NCT00180466).
authors.affiliation: Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Stella-Lida
authors.initials: SL
authors.lastname: Papadopoulou
authors.forename: Lisan A
authors.initials: LA
authors.lastname: Neefjes
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Willem-Jan
authors.initials: WJ
authors.lastname: Flu
authors.forename: Alexia
authors.initials: A
authors.lastname: Rossi
authors.forename: Anoeshka S
authors.initials: AS
authors.lastname: Dharampal
authors.forename: Pieter H
authors.initials: PH
authors.lastname: Kitslaar
authors.forename: Nico R
authors.initials: NR
authors.lastname: Mollet
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology