title: Coronary high-intensity plaque on T1-weighted magnetic resonance imaging and its association with myocardial injury after percutaneous coronary intervention.
abstract: OBJECTIVE
  Non-contrast T1-weighted imaging (T1WI) has emerged as a novel non-invasive imaging for vulnerable coronary plaque showing a high-intensity plaque (HIP). However, the association between HIP and percutaneous coronary intervention (PCI) has not been evaluated. We investigated the association between the presence of HIP and the incidence of myocardial injury after PCI.
  
  
  RESULTS
  A total of 77 patients with stable angina were imaged with non-contrast T1WI by using a 1.5 T magnetic resonance system (HIP and non-HIP group, N = 31 and 46 patients, respectively). We defined HIP as a coronary plaque to myocardium signal intensity ratio (PMR) of ≥1.4. High-sensitive cardiac troponin-T (hs-cTnT) was measured at baseline and 24 h after PCI. Percutaneous coronary intervention-related myocardial injury (PMI) was defined as an elevation of hs-cTnT >5× 99th percentile upper reference limit. High-intensity plaque was associated with the characteristics of ultrasound attenuation and positive remodelling on intravascular ultrasound. Although baseline hs-cTnT was similar between the groups, increase in hs-cTnT was significantly greater in the HIP vs. non-HIP group (0.065 [0.023-0.304] vs. 0.017 [0.005-0.026], P < 0.001). Percutaneous coronary intervention-related myocardial injury occurred more frequently in the HIP than non-HIP group (58.1 vs. 10.9%, P < 0.001), and the cut-off value of PMR found to be 1.44 for predicting PMI (sensitivity 78.3% and specificity 81.5%). In multivariate analysis, a PMR of ≥1.4 was a significant predictor of PMI (odds ratio 5.63, 95% confidence interval 1.28-24.7, P = 0.022).
  
  
  CONCLUSIONS
  High-intensity plaque on non-contrast T1WI was characterized as vulnerable coronary plaque on IVUS and was associated with higher incidence of PMI.
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan hoshi.tm@md.tsukuba.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hoshi
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Akiyama
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Hiraya
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sakai
authors.affiliation: Department of Radiology, University of Tsukuba Hospital, Tsukuba, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Shindo
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Aonuma
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000473:pathology*; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006335:Heart Injuries / Q000209:etiology / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000473:pathology; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D012372:ROC Curve; D020107:Troponin T / Q000378:metabolism
chemical_list: D020107:Troponin T
keywords: Coronary artery disease; Magnetic resonance imaging; Plaque