title: Computed tomography coronary angiography in patients with acute myocardial infarction without significant coronary stenosis.
abstract: BACKGROUND
  It is known that a significant number of patients experiencing an acute myocardial infarction have normal coronary arteries or nonsignificant coronary disease at coronary angiography (CA). Computed tomography coronary angiography (CTCA) can identify the presence of plaques, even in the absence of significant coronary stenosis. This study evaluated the role of 64-slice CTCA in detecting and characterizing coronary atherosclerosis in these patients.
  
  
  RESULTS
  Consecutive patients with documented acute myocardial infarction but without significant coronary stenosis at CA underwent late gadolinium-enhanced magnetic resonance and CTCA. Only the 50 patients with an area of myocardial infarction identified by late gadolinium-enhanced magnetic resonance were included in the study. All of the coronary segments were assessed for the presence of plaques. CTCA identified 101 plaques against the 41 identified by CA: 61 (60.4%) located in infarct-related arteries (IRAs) and 40 (39.6%) in non-IRAs. In the IRAs, 22 plaques were noncalcified, 17 mixed, and 22 calcified; in the non-IRAs, 5 plaques were noncalcified, 8 mixed, and 27 calcified (P=0.005). Mean plaque area was greater in the IRAs than in the non-IRAs (6.1±5.4 mm(2) versus 4.2±2.1 mm(2); P=0.03); there was no significant difference in mean percentage stenosis (33.5%±14.6 versus 31.7%±12.2; P=0.59), but the mean remodeling index was significantly different (1.25±0.41 versus 1.08±0.21; P=0.01).
  
  
  CONCLUSIONS
  CTCA detects coronary plaques in nonstenotic coronary arteries that are underestimated by CA, and identifies a different distribution of plaque types in IRAs and non-IRAs. It may therefore be valuable for diagnosing coronary atherosclerosis in acute myocardial infarction patients without significant coronary stenosis.
authors.affiliation: Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, 43100 Parma, Italy. aldrovandiac@yahoo.it
authors.forename: Annachiara
authors.initials: A
authors.lastname: Aldrovandi
authors.forename: Filippo
authors.initials: F
authors.lastname: Cademartiri
authors.forename: Daniele
authors.initials: D
authors.lastname: Arduini
authors.forename: Daniela
authors.initials: D
authors.lastname: Lina
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ugo
authors.forename: Erica
authors.initials: E
authors.lastname: Maffei
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.forename: Chiara
authors.initials: C
authors.lastname: Martini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Palumbo
authors.forename: Federico
authors.initials: F
authors.lastname: Bontardelli
authors.forename: Tiziano
authors.initials: T
authors.lastname: Gherli
authors.forename: Livia
authors.initials: L
authors.lastname: Ruffini
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018084:Ultrasonography, Interventional