CLINICAL RESEARCH: CARDIAC IMAGING
Prevalence of Noncalcified Coronary Plaques by 64-Slice Computed Tomography in Patients With an Intermediate Risk for Significant Coronary Artery Disease
Jörg Hausleiter, MD*,*,
Tanja Meyer, MD ,
Martin Hadamitzky, MD*,
Adnan Kastrati, MD*,
Stefan Martinoff, MD and
Albert Schömig, MD*
* Klinik für Herz- und Kreislauferkrankungen, Klinik an der TU München, Munich, Germany.
Institut für Radiologie und Nuklearmedizin, Deutsches Herzzentrum München; Klinik an der TU München, Munich, Germany.
Manuscript received August 31, 2005;
revised manuscript received January 20, 2006,
accepted February 14, 2006.
* Reprint requests and correspondence: Dr. Jörg Hausleiter, Deutsches Herzzentrum, Lazarettstrasse 36, 80636 München, Germany. (Email: hausleiter{at}dhm.mhn.de).
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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Abbreviations and Acronyms
| | ASE = Agatston score equivalent | | CAD = coronary artery disease | | CRP = C-reactive protein | | CT = computed tomography | | IQR = interquartile range | | LDL = low-density lipoprotein | | MSCT = multislice computed tomography | | PROCAM = Prospective Cardiovascular Münster score |
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