High risk plaque criteria by multislice coronary CT angiography in patients with stable vs. unstable coronary artery disease: analytic cross-sectional study

Abstract

Abstract Background Coronary atherosclerotic plaques susceptible to rupture have distinct morphology in comparison to the stable one. Those with high lipid core overlied by fibrous cap are considered to be the most vulnerable one triggering thrombosis and acute coronary syndrome. The purpose of this study was to evaluate the role of 320-row multidetector CT as a non-invasive imaging modality for detection of high-risk plaque criteria via semi-automated quantitative coronary plaque analysis. Results Fifty-eight atherosclerotic plaques were evaluated by multislice coronary CT angiography; 36 lesions were detected at unstable patient group and 22 lesions were detected at stable patient group. Non-calcified plaques were more prevalent at unstable patient group, whereas calcified lesions were more prevalent at stable patient group. There was strong correlation between plaque characteristics and clinical presentation represented by OR and 95% CI (NRS; OR 11.870 and 95% CI was 2.65–53.08, LAP; OR was 6.015 and 95% CI was 2.56–14.12). So, NRS and LAP are considered to be high-risk plaque criteria. Conclusion Multislice coronary CT angiography could non-invasively detect high-risk plaque criteria. NRS and LAP < 60 are considered to be high-risk plaque criteria suggesting their integration into coronary risk stratification, as well as an intensification of preventive measures.

Keywords

• Low attenuation plaque
• Remodeling index
• Napkin ring
• High-risk plaque
• Hounsfield unit