Multidetector row computed tomography can identify and characterize the occlusive culprit lesions in patients early (within 24 hours) after acute myocardial infarction

Wei Chun Huang, Kuan Rau Chiou, Chun Peng Liu, Shih Kai Lin, Yi Luan Huang, Guang Yuan Mar, Shoa Lin Lin, Ming Ting Wu

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The reliable noninvasive assessment of occluded disrupted plaques and thromboses in culprit vessels could constitute an important step forward in risk stratification of patients early after acute myocardial infarction (AMI). However, noninvasive identification of patency of culprit vessels remains a challenging issue. This prospective study was designed to identify the occluded culprit vessels by multidetector row computed tomography (MDCT) and to compare the stenotic and occlusive culprit lesions by MDCT in patients early (within 24 hours) after AMI. Methods: We enrolled 62 patients with first Q-wave AMI (54 males). Multidetector row computed tomography was performed 16.5 ± 7.1 hours after the onset of chest pain without any complication. Coronary angiography was done within 6 hours after MDCT. Patients were divided into 2 groups according to angiographic findings: stenotic group (35 patients) and occluded group (27 patients). The following MDCT data were collected: luminal artery stenosis, remodeling index, plaque burden, and lesion attenuation. Results: Compared to coronary angiography, MDCT detected occluded culprit vessels with sensitivity, specificity, negative predict value, and positive predict value of 92.6%, 88.6%, 93.9%, and 86.2%, respectively. Compared with the stenotic group, culprit lesions in the occlusive group had significantly longer length (18.9 ± 9.7 vs 11.9 ± 6.2 mm; P = .024) and higher MDCT lesion attenuation (38.8 ± 15.6 vs 29.2 ± 12.9 Hounsfield unit; P = .008). Multidetector row computed tomography attenuation was negatively correlated with thrombolysis in myocardial infarction flow (Spearman ρ = -0.46; P < .001). Conclusions: Multidetector row computed tomography could accurately and safely identify occluded culprit lesions in patients early after AMI, providing important information to aid in risk stratification.

Original languageEnglish
Pages (from-to)914-922
Number of pages9
JournalAmerican Heart Journal
Volume154
Issue number5
DOIs
Publication statusPublished - Nov 1 2007
Externally publishedYes

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Multidetector Computed Tomography
Myocardial Infarction
Coronary Angiography
Chest Pain
Pathologic Constriction
Thrombosis
Arteries
Prospective Studies
Sensitivity and Specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Multidetector row computed tomography can identify and characterize the occlusive culprit lesions in patients early (within 24 hours) after acute myocardial infarction. / Huang, Wei Chun; Chiou, Kuan Rau; Liu, Chun Peng; Lin, Shih Kai; Huang, Yi Luan; Mar, Guang Yuan; Lin, Shoa Lin; Wu, Ming Ting.

In: American Heart Journal, Vol. 154, No. 5, 01.11.2007, p. 914-922.

Research output: Contribution to journalArticle

Huang, Wei Chun ; Chiou, Kuan Rau ; Liu, Chun Peng ; Lin, Shih Kai ; Huang, Yi Luan ; Mar, Guang Yuan ; Lin, Shoa Lin ; Wu, Ming Ting. / Multidetector row computed tomography can identify and characterize the occlusive culprit lesions in patients early (within 24 hours) after acute myocardial infarction. In: American Heart Journal. 2007 ; Vol. 154, No. 5. pp. 914-922.
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abstract = "Background: The reliable noninvasive assessment of occluded disrupted plaques and thromboses in culprit vessels could constitute an important step forward in risk stratification of patients early after acute myocardial infarction (AMI). However, noninvasive identification of patency of culprit vessels remains a challenging issue. This prospective study was designed to identify the occluded culprit vessels by multidetector row computed tomography (MDCT) and to compare the stenotic and occlusive culprit lesions by MDCT in patients early (within 24 hours) after AMI. Methods: We enrolled 62 patients with first Q-wave AMI (54 males). Multidetector row computed tomography was performed 16.5 ± 7.1 hours after the onset of chest pain without any complication. Coronary angiography was done within 6 hours after MDCT. Patients were divided into 2 groups according to angiographic findings: stenotic group (35 patients) and occluded group (27 patients). The following MDCT data were collected: luminal artery stenosis, remodeling index, plaque burden, and lesion attenuation. Results: Compared to coronary angiography, MDCT detected occluded culprit vessels with sensitivity, specificity, negative predict value, and positive predict value of 92.6{\%}, 88.6{\%}, 93.9{\%}, and 86.2{\%}, respectively. Compared with the stenotic group, culprit lesions in the occlusive group had significantly longer length (18.9 ± 9.7 vs 11.9 ± 6.2 mm; P = .024) and higher MDCT lesion attenuation (38.8 ± 15.6 vs 29.2 ± 12.9 Hounsfield unit; P = .008). Multidetector row computed tomography attenuation was negatively correlated with thrombolysis in myocardial infarction flow (Spearman ρ = -0.46; P < .001). Conclusions: Multidetector row computed tomography could accurately and safely identify occluded culprit lesions in patients early after AMI, providing important information to aid in risk stratification.",
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T1 - Multidetector row computed tomography can identify and characterize the occlusive culprit lesions in patients early (within 24 hours) after acute myocardial infarction

AU - Huang, Wei Chun

AU - Chiou, Kuan Rau

AU - Liu, Chun Peng

AU - Lin, Shih Kai

AU - Huang, Yi Luan

AU - Mar, Guang Yuan

AU - Lin, Shoa Lin

AU - Wu, Ming Ting

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Background: The reliable noninvasive assessment of occluded disrupted plaques and thromboses in culprit vessels could constitute an important step forward in risk stratification of patients early after acute myocardial infarction (AMI). However, noninvasive identification of patency of culprit vessels remains a challenging issue. This prospective study was designed to identify the occluded culprit vessels by multidetector row computed tomography (MDCT) and to compare the stenotic and occlusive culprit lesions by MDCT in patients early (within 24 hours) after AMI. Methods: We enrolled 62 patients with first Q-wave AMI (54 males). Multidetector row computed tomography was performed 16.5 ± 7.1 hours after the onset of chest pain without any complication. Coronary angiography was done within 6 hours after MDCT. Patients were divided into 2 groups according to angiographic findings: stenotic group (35 patients) and occluded group (27 patients). The following MDCT data were collected: luminal artery stenosis, remodeling index, plaque burden, and lesion attenuation. Results: Compared to coronary angiography, MDCT detected occluded culprit vessels with sensitivity, specificity, negative predict value, and positive predict value of 92.6%, 88.6%, 93.9%, and 86.2%, respectively. Compared with the stenotic group, culprit lesions in the occlusive group had significantly longer length (18.9 ± 9.7 vs 11.9 ± 6.2 mm; P = .024) and higher MDCT lesion attenuation (38.8 ± 15.6 vs 29.2 ± 12.9 Hounsfield unit; P = .008). Multidetector row computed tomography attenuation was negatively correlated with thrombolysis in myocardial infarction flow (Spearman ρ = -0.46; P < .001). Conclusions: Multidetector row computed tomography could accurately and safely identify occluded culprit lesions in patients early after AMI, providing important information to aid in risk stratification.

AB - Background: The reliable noninvasive assessment of occluded disrupted plaques and thromboses in culprit vessels could constitute an important step forward in risk stratification of patients early after acute myocardial infarction (AMI). However, noninvasive identification of patency of culprit vessels remains a challenging issue. This prospective study was designed to identify the occluded culprit vessels by multidetector row computed tomography (MDCT) and to compare the stenotic and occlusive culprit lesions by MDCT in patients early (within 24 hours) after AMI. Methods: We enrolled 62 patients with first Q-wave AMI (54 males). Multidetector row computed tomography was performed 16.5 ± 7.1 hours after the onset of chest pain without any complication. Coronary angiography was done within 6 hours after MDCT. Patients were divided into 2 groups according to angiographic findings: stenotic group (35 patients) and occluded group (27 patients). The following MDCT data were collected: luminal artery stenosis, remodeling index, plaque burden, and lesion attenuation. Results: Compared to coronary angiography, MDCT detected occluded culprit vessels with sensitivity, specificity, negative predict value, and positive predict value of 92.6%, 88.6%, 93.9%, and 86.2%, respectively. Compared with the stenotic group, culprit lesions in the occlusive group had significantly longer length (18.9 ± 9.7 vs 11.9 ± 6.2 mm; P = .024) and higher MDCT lesion attenuation (38.8 ± 15.6 vs 29.2 ± 12.9 Hounsfield unit; P = .008). Multidetector row computed tomography attenuation was negatively correlated with thrombolysis in myocardial infarction flow (Spearman ρ = -0.46; P < .001). Conclusions: Multidetector row computed tomography could accurately and safely identify occluded culprit lesions in patients early after AMI, providing important information to aid in risk stratification.

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