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The culprit lesion score on multi-detector computed tomography can detect vulnerable coronary artery plaque.
MedLine Citation:
PMID:  20924792     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Vulnerable plaques are characterized by large lipid cores, positive remodeling and small coronary calcium deposits. Multi-detector computed tomography (MDCT) has recently been shown to be able to characterize coronary artery plaques. The aim of this study was to evaluate culprit coronary lesions for differentiating acute coronary syndrome (ACS) from stable angina pectoris (SAP) using MDCT. 64-slice MDCT was conducted on 71 patients (ACS: 35, SAP: 36). The culprit coronary lesions were assessed according to the type and plaque attenuation (PA) of the plaque and the remodeling index (RI) as the ratio of the lesion and the reference area. The culprit lesion score (CLS) was defined as the sum of every score as 1.2 for a PA ≤ 60 Hounsfield units (HU), 1.1 for a RI ≥ 1.05 and 1.2 for a non-calcified or spotty calcification. More spotty calcification (95.0% vs. 23.1%, P < 0.001), a lower PA (40.17 ± 20.08 HU vs. 96.96 ± 58.19 HU, respectively, P < 0.001) and a higher RI (1.44 ± 0.43 vs. 0.90 ± 0.44, respectively, P < 0.001) were observed in the ACS patients. Also, the CLS of the ACS patients was significantly higher than that of the SAP patients (3.07 ± 0.63 vs. 1.18 ± 1.12, respectively, P < 0.001). A CLS more than 2.0 helped us to differentiate ACS from SAP with a sensitivity of 97.1% and a specificity of 67.6%. The CLS might be a useful tool for differentiating ACS from SAP.
Authors:
So Yeon Kim; Kee-Sik Kim; Myeung Joon Seung; Jin Wook Chung; Jeung Hyeun Kim; Sung Hee Mun; Young Soo Lee; Jin Bae Lee; Jae Kean Ryu; Ji Yong Choi; Sung Gug Chang
Publication Detail:
Type:  Journal Article     Date:  2010-10-06
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  26     ISSN:  1875-8312     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-52     Citation Subset:  IM    
Affiliation:
Department of Cardiology, College of Medicine, Dongguk University Gyeongju Hospital, 1090-1, Seokjang-dong, Gyeongju, 780-350, Korea. sy.kim@live.co.kr
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