Coronary plaque characteristics on baseline CT predict the need for late revascularization in symptomatic patients after percutaneous intervention
Coronary plaque characteristics on baseline CT predict the need for late revascularization in symptomatic patients after percutaneous intervention
复制标题
基线 CT 上的冠状动脉斑块特征预测有症状患者经皮介入治疗后是否需要晚期血运重建。
DOI：
10.1007/s00330-018-5320-7
复制
发表时间：
2018-08-01
影响因子：
5.9
通讯作者：
Zhang, Jiayin
中科院分区：
文献类型：
--
作者：
Yu, Mengmeng;Lu, Zhigang;Zhang, Jiayin
为了评估冠状动脉CT血管造影（CCTA）确定的术前斑块特征及其与症状性术后患者晚期血运重建的相关性，前瞻性招募术前CCTA的症状性患者，并转诊进行侵入性冠状动脉血管造影（伊卡）。基于基线CCTA数据进行斑块表征。采用逐步选择法进行多因素logistic回归分析，以确定晚期血运重建的独立预测因素。对15例ISR和22例原发病变进行了晚期血运重建。晚期血运重建的病变在基线CCTA时显示出更高的低衰减斑块（VLP）和阳性重塑（PR）患病率（70.3% vs. 23.7%和86.5% vs. 30.9%;均p < 0.001）。然而，点状钙化或纳金环征（NRS）的发生率在亚组之间没有显著差异。根据ROC曲线分析，PR和PR显示诊断晚期血运重建病变的最大AUC值（AUC = 0.78和0.73，均p < 0.001）。在多变量分析中，（比值比= 6.30和13.94;均p < 0.05）基线CCTA观察到的钙化和PR是晚期血运重建的独立预测因子。基线CCTA观察到的钙化和PR独立预测ISR或新发病变进展引起的晚期血运重建。基线CT观察到的钙化和PR是晚期血运重建的预测因子。与晚期血运重建无关。欧洲中心CT斑块特征在鉴别晚期血运重建高危病变方面是有用的。
To assess pre-procedural plaque characteristics as determined by coronary CT angiography (CCTA) and their associations with late revascularization in symptomatic post-procedural patients.Symptomatic patients with pre-procedural CCTA were prospectively enrolled and referred for invasive coronary angiography (ICA). Plaque characterization was performed on the basis of baseline CCTA data. Multivariate logistic regression analysis with a stepwise selection method was performed to identify independent predictors of late revascularization.Seventy-eight patients with 134 lesions were included. Late revascularization was performed to treat 15 ISRs and 22 de novo lesions. Lesions with late revascularization showed higher prevalence rates of low-attenuation plaque (LAP) and positive remodelling (PR) (70.3% vs. 23.7% and 86.5% vs. 30.9%; both p < 0.001) at baseline CCTA. However, the incidence of spotty calcification or napkin-ring sign (NRS) was not significantly different between the subgroups. According to ROC curve analysis, PR and LAP showed the largest AUC values for diagnosing lesions with late revascularization (AUC = 0.78 and 0.73, both p < 0.001). In multivariate analysis, LAP and PR (odds ratio = 6.30 and 13.94; both p < 0.05) were revealed to be independent predictors for late revascularization.LAP and PR observed by baseline CCTA independently predict late revascularization caused by ISR or progression of de novo lesions.aEuro cent LAP and PR observed by baseline CT are predictors of late revascularization.aEuro cent NRS and spotty calcification are not associated with late revascularization.aEuro cent CT plaque characterization is useful in identifying lesions at high risk of late revascularization.