Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

Christopher L. Schlett, W. Nance John, U. Joseph Schoepf, Terrence X. O'Brien, Ullrich Ebersberger, Gary F. Headden, Udo Hoffmann, Fabian Bamberg

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Objective CT angiography (CTA) has prognostic value in patients. But it is unknown whether differences in atherosclerosis by CTA predict the development of unstable angina pectoris (UAP) vs. major adverse cardiac events (MACE). Methods We followed patients undergoing CTA as part of their acute chest pain work-up. Primary outcome was the development of UAP or MACE (cardiac death, myocardial infarction, revascularization) during a minimum follow-up of 12-months. CTAs were assessed for extent and composition of coronary plaque and stenosis. Ordinal regression with a 3-level outcome (no events, UAP, MACE) was applied. Results Among 315 patients, 22 developed UAP and 31 MACE. While UAP patients had higher atherosclerosis burden with respect to all assessed features compared to patients with no events (p ≤ 0.02), only mixed plaque extent was significantly different between UAP and MACE patients (p = 0.02). The odds ratio was 4.55 for being in a higher disease-level comparing patients with low extent to those with no mixed plaque, and 3.02 comparing patients with high to those with low. These findings remained after adjustments for potential confounders. Conclusion The extent of mixed coronary plaque is different between patients who develop UAP vs. MACE, supporting the hypothesis that it is a more culprit morphology.

Original languageEnglish (US)
Pages (from-to)1113-1119
Number of pages7
JournalEuropean Journal of Radiology
Volume83
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • Computed tomographic angiography
  • Major adverse cardiac events
  • Partially calcified plaque
  • Unstable angina pectoris
  • Vulnerable plaque

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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