Objectives Major adverse cardiac events (MACE) often occur suddenly resulting in high mortality and morbidity. Analysing the characteristics of coronary plaque by Coronary CT Angiography (CCTA) may help forecasting the MACE. Methods The patients who underwent CCTA from Jan.2008 to Feb.2010 were consecutively enrolled in the study. The hospital data base was screened for patients who later developed acute ST elevated myocardial infarction (STEMI) or non ST elevated acute myocardial infarction (NSTEMI) or cardiac death. The definition of the plaque score as follow: 1. Minor plaque 1 point; 2. Moderate plaque 2 points; 3. Severe localised stenosis 3 points; 4.The erosive plaque 5 points; 5. Calcification 1 point; 6. DES 5 points. 7. Plaque with positive remodeling 3 points. 8. Complete occlusion 3 points; 9. Diffused moderate lesions 2 points. Two-way analysis of variance was performed. Results A total of 8557 consecutive cases of CCTA were performed in the institution. Among them 25 patients was found to develop MACE after CCTA, including 6 cases of deaths, 2 cases of heart failure, 11 cases of STEMI and 6 cases of NSTEMI. One way ANOVA analysis showed that advanced age, AF, past history of PCI, low Hb, tachycardia and high Grace Score contributed to death and heart failure. The differences were significant, p<0.05. The patients who had erosion plaques and high degree localised lesions had high likelihood of developing MACE, 95% CI 0.6472 to 1.538., p=0.000. The death and heart failure had the highest plaque score, 95% CI 0.4882 to 1.379, p=0.000. Conclusions The plaque characteristics identify high risk patients. E176Heart 2012;98(Suppl 2): E1-E319
A comparison of the three different imaging modalities (CA, CTCA, and OCT) in CAD pointed out the benefits as well as the limits. A combination of CA, CTCA, and OCT was found to provide the best approach to evaluating the coronary arteries. CTCA best revealed the vessel wall while OCT provided optimal visualization of the intima. The extent of coronary artery disease was best detered with CA and CTCA.
Objectives Major adverse cardiac events (MACE) often occur suddenly resulting in high mortality and morbidity. A modified clinical coronary plaque score system incorporating both clinical variable and plaque variables may improve the accuracy of prediction. Methods The patients who underwent Coronary CT Angiography (CCTA) from Jan.2008 to Feb.2010 were included in the study. The hospital data base was screened for patients who later developed acute ST elevated myocardial infarction (STEMI) or non ST elevated acute myocardial infarction (NSTEMI) or cardiac death. The plaque score system was established to quantify the lesions severity. The plaque score and the clinical variable were compared against the clinical MACE Score. Two-way analysis of variance and Pearson correlation were performed. Results A total of 8557 consecutive cases of CCTA were performed in the institution. Among them 25 patients was found to develop MACE after CCTA, including 6 cases of deaths, 2 cases of heart failure, 11 cases of STEMI and 6 cases of NSTEMI. E176Heart 2012;98(Suppl 2): E1-E319
Objectives The Framingham study was the 'pioneer study' of coronary risk factors by long-term follow-up of relatively normal populations for major adverse cardiac events (MACE). The accuracy of the prediction has been validated by coronary angiography (CAG). However, CAG shows the arterial lumen while the main pathology is on the arterial wall. The coronary CT angiography (CCTA) provides information on both the arterial lumen and plaque characteristics. Therefore it is better technique to study the coronary risk factors. Methods CCTA was done consecutively in 706 patients from June 2008 to April 2011 in the department of cardiology. The severity of coronary artery disease (CAD) was graded to 'normal', 'mild', 'moderate', 'severe', and 'revascularisation'. Risk factors were correlated with coronary plaques. Pearson correlation and ANOVA were used to evaluate the relationship between risk factors and coronary plaque. The predictive accuracy was determined by receiver operating characteristic (ROC). Results A total of 40.37% of patients had normal CCTA whereas 58.63% of patients had abnormal CCTA. There were four main findings. First, the risk factors of age, sex, hypertension, hyperlipidaemia, diabetes mellitus, cerebral infarction, coronary heart disease and myocardial infarction were moderately correlated with coronary-plaque formation of which a clinical diagnosis of CAD was the most accurate predictor, p<0.01. Second, the biochemical parameters of total cholesterol (TC), low-density lipoprotein, high-density lipoprotein, creatinine and homocysteine were moderately correlated with coronary plaque ( p<0.01). Third, plaque was correlated with carotid intimamedia thickness and Framingham risk score ( p<0.01). ROC areas were 0.845 for Framingham risk score, 0.766 for creatinine, 0.697 for homocysteine, 0.693 for IMT and 0.316 for HDL, p<0.001. Conclusions CCTA has validated the Framingham risk score, creatinine, homocysteine, carotid intima-media thickness and highdensity lipoprotein as the major coronary risk factors.Heart 2012;98(Suppl 2): E1-E319 E141 ABSTRACTS on 11 April 2019 by guest. Protected by copyright.
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