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Anatomical criteria of malignancy by computed tomography angiography in patients with anomalous coronary arteries with an interarterial course

  • Cardiac
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Abstract

Purpose

We sought to determine the relation between major adverse cardiac events (MACE) and anatomical criteria assessed by coronary computed tomography angiography (CCTA) in patients with an anomalous coronary artery with an interarterial course (ACAIAC).

Material and methods

We selected CCTA studies of patients with an ACAIAC from a database of 4,160 examinations and studied anatomical criteria according to the presence of prior MACE, defined as syncope, unstable angina, myocardial infarction and resuscitated sudden cardiac death.

Results

There were 19 patients (18 males) with an ACAIAC during the study period (incidence 0.46 %). Seven patients with prior MACE were younger (26 years vs 59 years, p < 0.001), had a smaller minimal lumen area (3.6 mm2 vs 9.0 mm2, p = 0.001), a higher degree of area stenosis (57 % vs 24 %, p = 0.001), a longer interarterial course (14.7 vs 8.6 mm, p = 0.003) and a smaller proximal segment width (1.6 mm vs 2.5 mm, p = 0.02) compared with the 12 patients without prior MACE. All patients with MACE had the following concomitant anatomical characteristics: minimum lumen area ≤4 mm2, an area stenosis ≥50 % and intra-arterial length >10 mm

Conclusions

Prior MACE is associated with specific anatomical CCTA characteristics among patients with ACAIAC. CCTA may therefore contribute to distinguish patients at risk of adverse events.

Key Points

• Anomalous coronary origin may lead to adverse cardiac events in young people

• CT angiography provides high-resolution images of the anomalous coronary artery connection

• Specific CT-derived anatomical criteria are associated with major adverse cardiac events

• CT angiography helps with risk stratification in patients with anomalous coronary artery

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Abbreviations

ACAIAC:

anomalous coronary artery with an interarterial course

CCTA:

coronary computed tomography angiography

CT:

computed tomography

MACE:

major adverse cardiac events

MI:

myocardial infarction

MLA:

minimum lumen area

SCD:

sudden cardiac death

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Acknowledgments

The scientific guarantor of this publication is Jean-François Paul, MD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, observational, performed at one institution.

Furthermore, the authors gratefully thank Dr Laurence Iserin and Dr Pierre Aubry for their input and comments.

Author information

Authors and Affiliations

  1. Department of Radiology, Cardiovascular Imaging Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Université Paris Descartes, 20 rue Leblanc, 75015, Paris, France

    Golmehr Ashrafpoor

  2. Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Université Paris Descartes, 20 rue Leblanc, 75015, Paris, France

    Nicolas Danchin

  3. Department of Congenital Cardiac Surgery, Centre Chirurgical Marie-Lannelongue, 133 Avenue de la Résistance, 92350, Le Plessis-Robinson, France

    Lucile Houyel & Emre Belli

  4. Department of Cardiac Surgery, Centre Chirurgical Marie-Lannelongue, 133 Avenue de la Résistance, 92350, Le Plessis-Robinson, France

    Ramzi Ramadan

  5. Department of Radiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Jean-François Paul

Authors
  1. Golmehr Ashrafpoor
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  2. Nicolas Danchin
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  3. Lucile Houyel
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  4. Ramzi Ramadan
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  5. Emre Belli
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  6. Jean-François Paul
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Corresponding author

Correspondence to Jean-François Paul.

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Ashrafpoor, G., Danchin, N., Houyel, L. et al. Anatomical criteria of malignancy by computed tomography angiography in patients with anomalous coronary arteries with an interarterial course. Eur Radiol 25, 760–766 (2015). https://doi.org/10.1007/s00330-014-3454-9

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  • DOI: https://doi.org/10.1007/s00330-014-3454-9

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