title: Coronary Computed Tomography Angiography-Derived Plaque Quantification in Patients With Acute Coronary Syndrome.
abstract: This study investigated the discriminatory value of quantitative atherosclerotic plaque markers derived from coronary computed tomography angiography (cCTA) in patients with first acute coronary syndrome (ACS) compared with patients with stable coronary artery disease (CAD). Forty patients (56.9 ± 9.3 years, 55% men) admitted with their first ACS and Framingham risk score-matched controls with stable CAD were retrospectively analyzed. All patients had undergone cCTA followed by invasive coronary angiography. Total plaque volume, calcified and noncalcified plaque volumes, plaque burden (in %), remodeling index, lesion length, presence of napkin-ring sign, segment involvement score, and segment stenosis score were derived from cCTA and compared between both groups on a per-lesion and per-patient level. Patients with ACS showed a significant higher number of obstructive CAD and higher values for segment stenosis score, segment involvement score, noncalcified plaque volume, lesion length, and remodeling index than the stable angina group (all p <0.05). On a per-lesion level, culprit lesions had significantly higher values for plaque burden, total plaque volume, noncalcified plaque volume, remodeling index, lesion length, and prevalence of napkin-ring sign in comparison to nonculprit lesions (all p <0.05). On receiver-operating characteristics (ROC) analysis, a stepwise model demonstrated incremental discriminatory power for identifying ACS both per-patient (area under the curve 0.92, p <0.0001) as well as per-lesion (area under the curve 0.88, p <0.0001). cCTA-derived culprit plaque markers show discriminatory value both on a per-patient and per-lesion level. A combination of markers added to the Framingham risk score yields the greatest discriminatory ability.
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Tesche
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza", Rome, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Caruso
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Darby C
authors.initials: DC
authors.lastname: Shuler
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Jess D
authors.initials: JD
authors.lastname: Rames
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Moritz H
authors.initials: MH
authors.lastname: Albrecht
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Taylor M
authors.initials: TM
authors.lastname: Duguay
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Akos
authors.initials: A
authors.lastname: Varga-Szemes
authors.affiliation: Department of Cardiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Jochheim
authors.affiliation: Department of Cardiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Baquet
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Bayer
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany.
authors.forename: Ullrich
authors.initials: U
authors.lastname: Ebersberger
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Sheldon E
authors.initials: SE
authors.lastname: Litwin
authors.affiliation: Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Salvatore A
authors.initials: SA
authors.lastname: Chiaramida
authors.affiliation: Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany.
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
authors.affiliation: Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, South Carolina; Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina. Electronic address: schoepf@musc.edu.
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging* / Q000453:epidemiology; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012372:ROC Curve; D012189:Retrospective Studies; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000453:epidemiology