Coronary artery calcium in acute coronary syndromes - A comparative study of electron-beam computed tomography, coronary angiography, and intracoronary ultrasound in survivors of acute myocardial infarction and unstable angina

被引:144
作者
Schmermund, A
Baumgart, D
Gorge, G
Seibel, R
Gronemeyer, D
Ge, JB
Haude, M
Rumberger, J
Erbel, R
机构
[1] UNIV ESSEN CLIN,DEPT CARDIOL,ESSEN,GERMANY
[2] UNIV WITTEN HERDECKE,INST DIAGNOST & INTERVENT RADIOL,MULHEIM,GERMANY
[3] RUHR UNIV BOCHUM,INST DEV & RES MICROTECHNOL,BOCHUM,GERMANY
关键词
angina; calcium; coronary disease; imaging; myocardial infarction;
D O I
10.1161/01.CIR.96.5.1461
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Quantification of coronary artery calcified plaques by electron-beam CT (EBCT) may predict cardiovascular events. However, whereas advanced coronary atherosclerotic plaques can be identified, mildly stenotic lipid-rich (soft) plaques may be difficult to detect. The value of EBCT in a subgroup of patients has therefore been questioned. To investigate this, we evaluated patients with acute coronary syndromes by EBCT and compared the results with coronary angiography and, in patients with an indeterminate angiogram, intracoronary ultrasound (ICUS). Methods and Results EBCT was performed in 118 consecutive patients (57+/-11 pears of age) with previous myocardial infarction (n=101) or unstable angina (n=17). A standard protocol requiring a CT density >130 Hounsfield units in an area greater than or equal to 1.03 mm(2) was used for the definition of coronary artery calcium. We found that 110 patients had moderate to severe coronary artery disease by coronary angiography, and 8 had either mildly stenotic plaques at a single site (4 patients, confirmed by ICUS) or nonatherosclerotic causes of the unstable coronary syndrome (4 patients). One hundred and five of the 110 patients (96%) with moderate to severe angiographic disease but only 1 of the 8 other patients (13%) had a positive EBCT. Patients with acute coronary syndromes and negative EBCTs were significantly younger than patients with positive EBCTs (46+/-12 versus 58+/-10 years, P<.001), and a higher percentage was actively smoking (100% of the smokers versus 46%, P<.05). Conclusions The vast majority of patients with acute coronary syndromes and at least moderate angiographic disease have identifiable coronary calcium by EBCT. Those patients with negative EBCTs have minimal or no atherosclerotic plaque formation. They are younger and tend to be active cigarette smokers.
引用
收藏
页码:1461 / 1469
页数:9
相关论文
共 45 条
  • [31] ACUTE EFFECT OF CIGARETTE-SMOKING ON THE CORONARY CIRCULATION - CONSTRICTION OF EPICARDIAL AND RESISTANCE VESSELS
    QUILLEN, JE
    ROSSEN, JD
    OSKARSSON, HJ
    MINOR, RL
    LOPEZ, JAG
    WINNIFORD, MD
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1993, 22 (03) : 642 - 647
  • [32] CORRELATION OF INTRACORONARY ULTRASOUND PLAQUE CHARACTERISTICS IN ATHEROSCLEROTIC CORONARY-ARTERY DISEASE PATIENTS WITH CLINICAL-VARIABLES
    RASHEED, Q
    NAIR, R
    SHEEHAN, H
    HODGSON, JM
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1994, 73 (11) : 753 - 758
  • [33] EVIDENCE THAT SELECTIVE ENDOTHELIAL DYSFUNCTION MAY OCCUR IN THE ABSENCE OF ANGIOGRAPHIC OR ULTRASOUND ATHEROSCLEROSIS IN PATIENTS WITH RISK-FACTORS FOR ATHEROSCLEROSIS
    REDDY, KG
    NAIR, RN
    SHEEHAN, HM
    HODGSON, JM
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1994, 23 (04) : 833 - 843
  • [34] CORONARY-ARTERIES IN UNSTABLE ANGINA-PECTORIS, ACUTE MYOCARDIAL-INFARCTION, AND SUDDEN CORONARY DEATH
    ROBERTS, WC
    KRAGEL, AH
    GERTZ, SD
    ROBERTS, CS
    [J]. AMERICAN HEART JOURNAL, 1994, 127 (06) : 1588 - 1593
  • [35] CORONARY-ARTERY CALCIUM AREA BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY AND CORONARY ATHEROSCLEROTIC PLAQUE AREA - A HISTOPATHOLOGIC CORRELATIVE STUDY
    RUMBERGER, JA
    SIMONS, DB
    FITZPATRICK, LA
    SHEEDY, PF
    SCHWARTZ, RS
    [J]. CIRCULATION, 1995, 92 (08) : 2157 - 2162
  • [36] CORONARY CALCIUM, AS DETERMINED BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY, AND CORONARY-DISEASE ON ARTERIOGRAM - EFFECT OF PATIENTS SEX ON DIAGNOSIS
    RUMBERGER, JA
    SHEEDY, PF
    BREEN, JF
    SCHWARTZ, RS
    [J]. CIRCULATION, 1995, 91 (05) : 1363 - 1367
  • [37] ELECTRON-BEAM TOMOGRAPHY IN CORONARY HEART-DISEASE - PREVALENCE AND DISTRIBUTION OF CALCIFICATION AND RELATIONSHIP TO CORONARY RISK-FACTORS IN 650 PATIENTS
    SCHMERMUND, A
    LANGE, S
    SEHNERT, C
    ALTMAIER, K
    BAUMGART, D
    GORGE, G
    ERBEL, R
    SEIBEL, R
    GRONEMEYER, D
    [J]. DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT, 1995, 120 (37) : 1229 - 1235
  • [38] RELATIONSHIPS BETWEEN RISK-FACTORS AND MORPHOLOGICAL PATTERNS OF HUMAN CAROTID ATHEROSCLEROTIC PLAQUES - A MULTIVARIATE DISCRIMINANT-ANALYSIS
    SPAGNOLI, LG
    MAURIELLO, A
    PALMIERI, G
    SANTEUSANIO, G
    AMANTE, A
    TAURINO, M
    [J]. ATHEROSCLEROSIS, 1994, 108 (01) : 39 - 60
  • [39] A DEFINITION OF ADVANCED TYPES OF ATHEROSCLEROTIC LESIONS AND A HISTOLOGICAL CLASSIFICATION OF ATHEROSCLEROSIS - A REPORT FROM THE COMMITTEE ON VASCULAR-LESIONS OF THE COUNCIL ON ARTERIOSCLEROSIS, AMERICAN-HEART-ASSOCIATION
    STARY, HC
    CHANDLER, AB
    DINSMORE, RE
    FUSTER, V
    GLAGOV, S
    INSULL, W
    ROSENFELD, ME
    SCHWARTZ, CJ
    WAGNER, WD
    WISSLER, RW
    [J]. CIRCULATION, 1995, 92 (05) : 1355 - 1374