The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2019
Multi-slice CT coronary angiography assessment of remodeling index in patients with low- to intermediate-risk stable angina.
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Mostafa Shaimaa A, Aboelazem Tarek, Sanad Osama, Abdelghafar Haytham, Azam Ahmed
Аннотация
BACKGROUND: Early identification of vulnerable plaques by remodeling index prior to rupture and development of acute event is of considerable importance especially by a reliable non-invasive method as CT coronary angiography (CTA), so we aim to evaluate coronary artery remodeling index in patients with low- to intermediate-risk stable angina by CTA.
RESULTS: This single-center, cross-sectional, observational study included 150 patients with stable angina with normal resting ECG, negative markers, normal systolic function by 2D echocardiography (EF > 50%), and without regional wall motion abnormality at rest who were referred to MSCT evaluation of the coronary artery tree; the mean age was 56.8 ± 6.4 years, 83.3% had one-vessel disease, and 16.7% had two-vessel diseases. The mean remodeling index (RI) was 1.04 ± 0.28, 38% had significant positive remodeling, LAD was the most affected vessel (55.3), and proximal lesions were predominant in 48.5%; there was a statistically significant positive correlation between RI and cholesterol, triglyceride, LDL, duration of DM, HBA1c, and plaque burden (P < 0.001) and a statistically significant negative correlation with HDL (P < 0.001). Predictors of higher RI were positive family history, diabetes mellitus, low HDL, HBA1c, and plaque burden% (P < 0.001). Patients with remodeling index > 1.1 were diabetic, hypertensive, smoker, with longer duration of diabetes mellitus, higher HBA1c, cholesterol, triglyceride, LDL, plaque burden, wall lumen ratio, stenosis area, and lower HDL.
CONCLUSION: CTA was able to detect the presence and extent of early, non-obstructive but significant coronary artery-positive remodeling in patients with low- to intermediate-risk stable angina patients.
TRIAL REGISTRATION: NCT03963609 , 22 May 2019.
RESULTS: This single-center, cross-sectional, observational study included 150 patients with stable angina with normal resting ECG, negative markers, normal systolic function by 2D echocardiography (EF > 50%), and without regional wall motion abnormality at rest who were referred to MSCT evaluation of the coronary artery tree; the mean age was 56.8 ± 6.4 years, 83.3% had one-vessel disease, and 16.7% had two-vessel diseases. The mean remodeling index (RI) was 1.04 ± 0.28, 38% had significant positive remodeling, LAD was the most affected vessel (55.3), and proximal lesions were predominant in 48.5%; there was a statistically significant positive correlation between RI and cholesterol, triglyceride, LDL, duration of DM, HBA1c, and plaque burden (P < 0.001) and a statistically significant negative correlation with HDL (P < 0.001). Predictors of higher RI were positive family history, diabetes mellitus, low HDL, HBA1c, and plaque burden% (P < 0.001). Patients with remodeling index > 1.1 were diabetic, hypertensive, smoker, with longer duration of diabetes mellitus, higher HBA1c, cholesterol, triglyceride, LDL, plaque burden, wall lumen ratio, stenosis area, and lower HDL.
CONCLUSION: CTA was able to detect the presence and extent of early, non-obstructive but significant coronary artery-positive remodeling in patients with low- to intermediate-risk stable angina patients.
TRIAL REGISTRATION: NCT03963609 , 22 May 2019.