Coronary Arterial Plaque Characterized by Multislice Computed Tomography Predicts Coronary Events Following Coronary Intervention

Abstract

A reliable noninvasive method for assessing plaque configuration would constitute an important tool for predicting myocardial injury following percutaneous coronary intervention (PCI) . Multislice computed tomography (MSCT) shows promise in differentiating coronary lesion configurations. However, it is not clear whether the characteristics of coronary artery plaques measured by MSCT can predict complications after PCI. The aim of this study was to investigate the relationship between plaque configuration and complications following coronary intervention in patients with stable angina pectoris. MSCT was performed prospectively in patients with angina pectoris who were scheduled for PCI. Twenty-six patients (age ; 70 ± 11 years, 18 male patients) with coronary artery plaque stenosis, as measured by MSCT, were recruited in this study. Thirty-five plaques forming stenotic coronary lesions were divided into 3 groups on the basis of their MSCT-calculated densities; soft, intermediate, and hard. We investigated the association between these groups and complications following PCI. The soft plaque group (n =11) was significantly associated with the appearance of slow flow (n = 4) or side branch compromise (n =1) following PCI, whereas the hard plaque group (n =17) was associated with the appearance of dissection (n = 2) or perforation (n =1) following PCI (P = 0.004) . The intermediate plaque group (n = 7) had only one complication of side branch compromise (n = 1) . Coronary arterial plaque characterized by MSCT can predict coronary events following PCI. Plaque configuration by MSCT may be important for risk stratification of patients prior to scheduled PCI.