Skip to main content
SpringerLink
Log in

Coronary artery plaques and myocardial ischaemia

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To prospectively examine coronary artery plaques as predictors of myocardial ischaemia using cardiac magnetic resonance (CMR).

Methods

Fifty-two patients (46 men; age 64 ± 10) with suspected coronary artery disease (CAD) referred for catheter coronary angiography (CA) underwent CMR and computed tomography coronary angiography (CTCA). All coronary segments were evaluated for morphological stenosis based on CA. Any plaque according to its composition was assessed based on CTCA.

Results

Numbers of total and calcified coronary artery plaques represented the best predictors of myocardial ischaemia (AUC = 0.87; [95%CI: 0.77–0.97] and AUC = 0.87; [95%CI: 0.77–0.96], respectively, p = 0.56) with the total plaque number significantly higher in patients with corresponding ischaemia than those without (p < 0.01, p < 0.05 adjusted for pre-test probability and stenosis). Compared with the AUC of coronary stenosis assessment by CA (AUC = 0.90; [95%CI: 0.80–1.00]), AUCs were equivalent using either the total number or the number of calcified plaques alone (p = 0.73 and p = 0.69). Multivariate logistic regression analyses demonstrated the total plaque number as an independent predictor of ischaemia (odds +20%; [95%CI: 1.096–1.368]), improving a model including clinical probability estimates of CAD (c-statistics, 0.66 to 0.89).

Conclusion

Coronary artery plaque number according to CTCA is a significant, independent predictor of myocardial ischaemia with similar accuracy to stenosis assessment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Budoff MJ, Achenbach S, Blumenthal RS et al (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114:1761–1791

    Article  PubMed  Google Scholar 

  2. Hendel RC, Patel MR, Kramer CM et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 48:1475–1497

    Article  PubMed  Google Scholar 

  3. Leschka S, Alkadhi H, Plass A et al (2005) Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 26:1482–1487

    Article  PubMed  Google Scholar 

  4. Weustink AC, Meijboom WB, Mollet NR et al (2007) Reliable high-speed coronary computed tomography in symptomatic patients. J Am Coll Cardiol 50:786–794

    Article  PubMed  Google Scholar 

  5. Hacker M, Jakobs T, Matthiesen F et al (2005) Comparison of spiral multidetector CT angiography and myocardial perfusion imaging in the noninvasive detection of functionally relevant coronary artery lesions: first clinical experiences. J Nucl Med 46:1294–1300

    PubMed  Google Scholar 

  6. Gaemperli O, Schepis T, Valenta I et al (2008) Functionally relevant coronary artery disease: comparison of 64-section CT angiography with myocardial perfusion SPECT. Radiology 248:414–423

    Article  PubMed  Google Scholar 

  7. Schroeder S, Kopp AF, Baumbach A et al (2001) Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol 37:1430–1435

    Article  PubMed  CAS  Google Scholar 

  8. Leber AW, Knez A, Becker A et al (2004) Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J Am Coll Cardiol 43:1241–1247

    Article  PubMed  Google Scholar 

  9. Achenbach S, Moselewski F, Ropers D et al (2004) Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation 109:14–17

    Article  PubMed  Google Scholar 

  10. Schenker MP, Dorbala S, Hong EC et al (2008) Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease: a combined positron emission tomography/computed tomography study. Circulation 117:1693–1700

    Article  PubMed  Google Scholar 

  11. Scheffel H, Alkadhi H, Leschka S et al (2008) Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart 94:1132–1137

    Article  PubMed  CAS  Google Scholar 

  12. Diamond GA, Forrester JS (1979) Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med 300:1350–1358

    Article  PubMed  CAS  Google Scholar 

  13. Austen WG, Edwards JE, Frye RL et al (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51(4 Suppl):5–40

    PubMed  CAS  Google Scholar 

  14. Sato A, Ohigashi H, Nozato T et al (2010) Coronary artery spatial distribution, morphology, and composition of nonculprit coronary plaques by 64-slice computed tomographic angiography in patients with acute myocardial infarction. Am J Cardiol 105:930–935

    Article  PubMed  Google Scholar 

  15. Raff GL, Gallagher MJ, O’Neill WW, Goldstein JA (2005) Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46:552–557

    Article  PubMed  Google Scholar 

  16. Berman DS, Hachamovitch R, Shaw LJ et al (2006) Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease. J Nucl Med 47:1107–1118

    PubMed  Google Scholar 

  17. Shaw LJ, Bairey Merz CN, Pepine CJ et al (2006) Insights from the NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE) Study: Part I: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol 47:4–20

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland

    Paul Stolzmann, Olivio F. Donati, Hatem Alkadhi & Hans Scheffel

  2. Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Paul Stolzmann, Udo Hoffmann, Hatem Alkadhi & Hans Scheffel

  3. Department of Radiology, KSSG, St. Gallen, Switzerland

    Lotus Desbiolles

  4. Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland

    Sebastian Kozerke

Authors
  1. Paul Stolzmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Olivio F. Donati
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lotus Desbiolles
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sebastian Kozerke
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Udo Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hatem Alkadhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hans Scheffel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul Stolzmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stolzmann, P., Donati, O.F., Desbiolles, L. et al. Coronary artery plaques and myocardial ischaemia. Eur Radiol 21, 1628–1634 (2011). https://doi.org/10.1007/s00330-011-2097-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-011-2097-3

Keywords

Search

Navigation