Assessing culprit lesions and active complex lesions in patients with early acute myocardial infarction by multidetector computed tomography

Wei Chun Huang, Ming Ting Wu, Kuan Rau Chiou, Guang Yuan Mar, Shih Hung Hsiao, Shih Kai Lin, Tung Cheng Yeh, Yi Luan Huang, Hsiang Chiang Hsiao, Doyal Lee, Chuen Wang Chiou, Shoa Lin Lin, Chun Peng Liu

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Background: Accurate, non-invasive characterization of culprit lesions in patients after acute myocardial infarction (AMI) remains challenging. In this prospective study, multidetector row computed tomography (MDCT) is used to assess culprit and active complex lesions in patients early after AMI. Methods and Results: We enrolled 103 patients with first non ST-elevation AMI who underwent 64-slices MDCT and conventional coronary angiography (CCAG). The definition of culprit lesion, stable non-culprit lesions and non-culprit active complex lesions was based on the findings of CCAG. The lesions were analyzed with MDCT data. In culprit lesions (n=103), luminal artery stenosis, remodeling index, plaque area and burden were significantly higher than non-culprit lesions (n=129). Multivariate discriminant analysis showed that MDCT density could discriminate culprit from non-culprit lesions. Receiver-operator characteristic curve analysis identified the optimal cutoff value of lesion density for discrimination between culprit and non-culprit lesion as 49.6 Hounsfield units (HU); this value was associated with a sensitivity, specificity and accuracy of 88.4%, 87.4%, and 87.9%, respectively. The MDCT in the stable non-culprit lesions (81.8±15.5 HU) was significantly higher than that in culprit lesions or non-culprit active complex lesions (33.2±13.8 and 48.3±15.7 HU, p<0.001). Conclusions: MDCT can predict culprit lesions in patients early after AMI, and identify multiple complex lesions.

Original languageEnglish
Pages (from-to)1806-1813
Number of pages8
JournalCirculation Journal
Volume72
Issue number11
DOIs
Publication statusPublished - Nov 11 2008
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Culprit lesions
  • Multidetector row computed tomography
  • Remodeling index

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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