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Published in: European Radiology 8/2011

01-08-2011 | Cardiac

Coronary artery plaques and myocardial ischaemia

Authors: Paul Stolzmann, Olivio F. Donati, Lotus Desbiolles, Sebastian Kozerke, Udo Hoffmann, Hatem Alkadhi, Hans Scheffel

Published in: European Radiology | Issue 8/2011

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Abstract

Objective

To prospectively examine coronary artery plaques as predictors of myocardial ischaemia using cardiac magnetic resonance (CMR).

Methods

Fifty-two patients (46 men; age 64 ± 10) with suspected coronary artery disease (CAD) referred for catheter coronary angiography (CA) underwent CMR and computed tomography coronary angiography (CTCA). All coronary segments were evaluated for morphological stenosis based on CA. Any plaque according to its composition was assessed based on CTCA.

Results

Numbers of total and calcified coronary artery plaques represented the best predictors of myocardial ischaemia (AUC = 0.87; [95%CI: 0.77–0.97] and AUC = 0.87; [95%CI: 0.77–0.96], respectively, p = 0.56) with the total plaque number significantly higher in patients with corresponding ischaemia than those without (p < 0.01, p < 0.05 adjusted for pre-test probability and stenosis). Compared with the AUC of coronary stenosis assessment by CA (AUC = 0.90; [95%CI: 0.80–1.00]), AUCs were equivalent using either the total number or the number of calcified plaques alone (p = 0.73 and p = 0.69). Multivariate logistic regression analyses demonstrated the total plaque number as an independent predictor of ischaemia (odds +20%; [95%CI: 1.096–1.368]), improving a model including clinical probability estimates of CAD (c-statistics, 0.66 to 0.89).

Conclusion

Coronary artery plaque number according to CTCA is a significant, independent predictor of myocardial ischaemia with similar accuracy to stenosis assessment.
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Metadata
Title
Coronary artery plaques and myocardial ischaemia
Authors
Paul Stolzmann
Olivio F. Donati
Lotus Desbiolles
Sebastian Kozerke
Udo Hoffmann
Hatem Alkadhi
Hans Scheffel
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 8/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2097-3

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