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Plaque Characterization by Coronary Computed Tomography Angiography and the Likelihood of Acute Coronary Events in Mid-Term Follow-Up
Open accessAbstract
BACKGROUND Coronary computed tomography angiography (CTA)-verified positive remodeling and low attenuation plaques are considered morphological characteristics of high-risk plaque (HRP) and predict short-term risk of acute coronary syndrome (ACS). OBJECTIVES This study evaluated whether plaque characteristics by CTA predict mid-term likelihood of ACS. METHODS The presence of HRP and significant stenosis (SS) of ≥70% were evaluated in 3,158 patients undergoing CTA. Serial CTA was performed in 449 patients, and plaque progression (PP) was evaluated. Outcomes (fatal and nonfatal ACS) were recorded during follow-up (mean 3.9 ± 2.4 years). RESULTS ACS occurred in 88 (2.8%) patients: 48 (16.3%) of 294 HRP(+) and 40 (1.4%) of 2,864 HRP(-) patients. ACS was also significantly more frequent in SS(+) (36 of 659; 5.5%) than SS(-) patients (52 of 2,499; 2.1%). HRP(+)/SS(+) (19%) and HRP(+)/SS(-) (15%) had higher rates of ACS compared with no-plaque patients (0.6%). Although ACS incidence was relatively low in HRP(-) patients, the cumulative number of patients with ACS developing from HRP(-) lesions (n = 43) was similar to ACS patients with HRP(+) lesions (n = 45). In patients with serial CTA, PP also was an independent predictor of ACS, with HRP (27%; p < 0.0001) and without HRP (10%) compared with HRP(-)/PP(-) patients (0.3%). CONCLUSIONS CTA-verified HRP was an independent predictor of ACS. However, the cumulative number of ACS patients with HRP(-) was similar to patients with HRP(+). Additionally, plaque progression detected by serial CTA was an independent predictor of ACS.
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Metadata
- Authors
- Motoyama, S., Ito, H., Sarai, M., Kondo, T., Kawai, H., Nagahara, Y., Harigaya, H., Kan, S., Anno, H., Takahashi, H., Naruse, H., Ishii, J., Hecht, H., Shaw, L. J., Ozaki, Y., & Narula, J.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 66
- Issue
- 4
- Pages
- 337-346
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W988932408
- Cited by
- 831
- References
- 25
- FWCI
- 56.41
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Motoyama, S., Ito, H., Sarai, M., Kondo, T., Kawai, H., Nagahara, Y., Harigaya, H., Kan, S., Anno, H., Takahashi, H., Naruse, H., Ishii, J., Hecht, H., Shaw, L. J., Ozaki, Y., & Narula, J. (2015). Plaque Characterization by Coronary Computed Tomography Angiography and the Likelihood of Acute Coronary Events in Mid-Term Follow-Up. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2015.05.069
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