Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients intermediate risk for significant with an coronary artery disease

被引:183
作者
Hausleiter, Joerg
Meyer, Tanja
Hadamitzky, Martin
Kastrati, Adnan
Martinoff, Stefan
Schoemig, Albert
机构
[1] Deutsch Herzzentrum, Klin Herz & Kreislauferkrankungen, D-80636 Munich, Germany
[2] Deutsch Herzzentrum, Inst Radiol & Nukl Med, D-80636 Munich, Germany
[3] Klin TU Munchen, Munich, Germany
关键词
D O I
10.1016/j.jacc.2006.02.064
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES In this prospective study, we investigated the prevalence and characteristics of clearly discernible noncalcified coronary plaques in a patient population with suspected significant coronary artery disease (CAD) by using 64-slice computed tomography (CT). BACKGROUND The assessment of noncalcified coronary plaques by noninvasive strategies may be important to improve cardiovascular risk stratification. METHODS To rule out significant stenosis, high-resolution 64-slice coronary CT (0.6-mm collimation, 330-ms gantry rotation time) was performed in 161 consecutive patients with an intermediate risk for having CAD. Computed tomography data sets were evaluated for presence of coronary calcifications, noncalcified plaques, and/or lumen narrowing. RESULTS Noncalcified coronary plaques were detected in 48 (29.8%) of 161 enrolled patients. Although noncalcified plaques together with coronary calcifications were present in 38 of 161 (23.6%) patients, the prevalence of noncalcified plaques as the only manifestation of CAD was 6.2% (10 of 161 patients). Patients with noncalcified plaques were characterized by significantly higher total cholesterol, low-density lipoprotein, and C-reactive protein levels as well as a trend for more diabetes mellitus. The majority of noncalcified plaques resulted in lumen narrowing of < 50%. Of the remaining 113 patients, CAD and coronary calcifications were ruled out in 53 of 161 (32.9%) patients, whereas 60 of 161 (37.3%) patients presented with calcifications in the absence of noncalcified plaque. CONCLUSIONS With the use of 64-slice CT, clearly discernible noncalcified atherosclerotic coronary plaques can be detected in a large group of patients with an intermediate risk for having CAD. The assessment of these plaques by CT angiography may allow for improved cardiovascular risk stratification.
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页码:312 / 318
页数:7
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