Correlation between major adverse cardiac events and coronary plaque characteristics.
BACKGROUND
Unstable plaque is believed to be responsible for major adverse cardiac events (MACE).


OBJECTIVE
To determine whether coronary computed tomography angiography (CCTA) could be used to predict future MACE.


METHODS
Patients undergoing CCTA between January 2008 and February 2010 were consecutively enrolled in the study. The hospital database was screened for patients who later developed acute ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI) or cardiac death. Plaque scores were calculated and analyzed using one-way ANOVA to examine the relationship between plaque scores and MACE.


RESULTS
Of the 8557 patients who underwent CCTA, 1055 had hospital records available for follow-up. During follow-up, 25 patients experienced MACE including death (six patients), heart failure (two patients), STEMI (11 patients) and NSTEMI (six patients). The plaque scores were significantly increased in patients who later died, developed heart failure or experienced STEMI (P<0.05). Calcification, erosion and severe stenosis were responsible for the events (P<0.05). Mild and moderate lesions, positive remodelling, drug-eluting stent placement, occlusion and diffuse lesions were not predictive of MACE (P>0.05).


CONCLUSIONS
Severe calcification, erosion and severe stenosis predict death, heart failure and STEMI.
Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
Bin
B
He
Luyue
L
Gai
Jingjing
J
Gai
Huaiyu
H
Qiao
Shuoyang
S
Zhang
Zhiwei
Z
Guan
Li
L
Yang
Yundai
Y
Chen
Coronary computed tomography angiography; Coronary plaque; Major adverse cardiac events; Risk factor