Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction

2021 ◽  
Author(s):  
Michelle C. Williams ◽  
Jacek Kwiecinski ◽  
Mhairi Doris ◽  
Priscilla McElhinney ◽  
Michelle S. D’Souza ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Coronary Plaque ◽  
Plaque Characterization

Sex-specific CT Coronary Plaque Characterization And Risk Of Myocardial Infarction

2021 ◽  
Vol 15 (4) ◽  
pp. S41-S42
Author(s):  
M. Williams ◽  
J. Kwiecinski ◽  
M. Doris ◽  
P. McElhinney ◽  
S. Cadet ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Plaque ◽  
Plaque Characterization

106Plasma trimethylamine N-oxide is associated with culprit plaque characterization as assessed by optical coherence tomography in patients with acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z Sheng ◽  
Y Tan ◽  
H Yan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Optical Coherence Tomography ◽  
Plaque Rupture ◽  
Demographic Data ◽  
Coronary Plaque ◽  
Optical Coherence ◽  
Plaque Characterization ◽  
Medical Sciences ◽  
Laboratory Findings

Abstract Background Previous study have demonstrated that plasma trimethylamine N-oxide (TMAO) is associated with vulnerable plaque characteristics as assessed by optical coherence tomography (OCT) in patients with coronary artery disease. However, the relation between TMAO and the culprit plaque characteristics as assessed by OCT in patients with acute myocardial infarction (AMI) exhibiting plaque rupture at the site of the culprit stenosis is unknown. Objective To explore the relation between plasma TMAO and coronary culprit plaque characterization assessed by OCT in AMI patients exhibiting plaque rupture. Method We prospectively enrolled 90 AMI patients with plaque rupture identified by OCT and collected demographic data, risk factors, coronary angiography and OCT data, medical history and laboratory findings of all patients. Plasma TMAO levels were detected by stable isotope dilution liquid chromatography tandem mass spectrometry. Macrophage presence in coronary culprit plaque was quantified by normalized standard deviation (NSD). Result All patients were divided into two groups (high TMAO group and low TMAO group) according to the median plasma TMAO level (3.22uM). The culprit plaques in the high TMAO group exhibited a thinner fibrous cap thickness (60um [60–100um] versus 90um [70–110um], P=0.013]), higher frequency of thin-cap fibroatheroma (TCFA) (15.6% versus 55.6%, P<0.001), microvessel (24.4% versus 4.4%, P=0.014) and macrophage infiltration (66.7% versus 26.7%, P<0.001) compared with the low TMAO group. Moreover, the level of TMAO was significantly positively associated with NSD (Pearson's correlation coefficient: r=0.766, P<0.001). Conclusion Plasma TMAO levels are associated with coronary plaque vulnerability and inflammation in patients with AMI exhibiting plaque rupture. Acknowledgement/Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2016-I2M-1-009)

scholarly journals Clinical Relevance of Coronary Computed Tomography Angiography Beyond Coronary Artery Stenosis

2021 ◽  
Author(s):  
Mohammed Nooruddin Meah ◽  
Michelle C. Williams
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
High Risk ◽  
Atherosclerotic Plaque ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Calcium Score ◽  
Coronary Plaque ◽  
Coronary Computed Tomography ◽  
Low Attenuation Plaque

Background The capabilities of coronary computed tomography angiography (CCTA) have advanced significantly in the past decade. Its capacity to detect stenotic coronary arteries safely and consistently has led to a marked decline in invasive diagnostic angiography. However, CCTA can do much more than identify coronary artery stenoses. Method This review discusses applications of CCTA beyond coronary stenosis assessment, focusing in particular on the visual and quantitative analysis of atherosclerotic plaque. Results Established signs of visually assessed high-risk plaque on CT include positive remodeling, low-attenuation plaque, spotty calcification, and the napkin-ring sign, which correlate with the histological thin-cap fibroatheroma. Recently, quantification of plaque subtypes has further improved the assessment of coronary plaque on CT. Quantitatively assessed low-attenuation plaque, which correlates with the necrotic core of the thin-cap fibroatheroma, has demonstrated superiority over stenosis severity and coronary calcium score in predicting subsequent myocardial infarction. Current research aims to use radiomic and machine learning methods to further improve our understanding of high-risk atherosclerotic plaque subtypes identified on CCTA. Conclusion Despite rapid technological advances in the field of coronary computed tomography angiography, there remains a significant lag in routine clinical practice where use is often limited to lumenography. We summarize some of the most promising techniques that significantly improve the diagnostic and prognostic potential of CCTA. Key Points:  Citation Format

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