Hybrid strategy of coronary atherosclerosis characterization with T1-weighted MRI and CT angiography to non-invasively predict periprocedural myocardial injury

Matsumoto, H; Higuchi, S; Li, D; Tanisawa, H; Isodono, K; Irie, D; Ohya, H; Kitamura, R; Kaneko, K; Nakazawa, M; Suzuki, K; Komori, Y; Hondera, T; Cadet, S; Lee, HL; Christodoulou, AG; Slomka, PJ; Dey, D; Xie, Y; Shinke, T

doi:10.1093/ehjci/jeaf116

Coronary disease & ACS

Hybrid strategy of coronary atherosclerosis characterization with T1-weighted magnetic resonance imaging (MRI) and CT angiography to non-invasively predict periprocedural myocardial injury

Eur Heart J Cardiovasc ImagingPublished 17 Apr 2025prospective, multi-centre study

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Authors' conclusion

Integrating MRI with CCTA improves PMI prediction compared with CCTA alone.

Study context

Population: Patients scheduled for elective percutaneous coronary intervention (PCI) for an atherosclerotic lesion detected on coronary computed tomography angiography (CCTA) without prior revascularization132 lesions from 120 patients, 43 lesions resulted in periprocedural myocardial injury (PMI)
Participants: 120 patients

Exposure: MRI integration with CCTA vs CCTA alone for prediction of PMI
Outcome: Independent predictors of PMI, CCTA-only strategy

Main finding

As reported in the abstract

Low-attenuation plaque (LAP) volume independently associated with PMI

P = 0.012

Non-calcified plaque (NCP) volume independently associated with PMI

P = 0.016

Observational data: associations, not effects.

Further findings

Outcome	CCTA-only strategy	MRI integration with CCTA	Hybrid CCTA-MRI strategy	P value
C-statistic for PMI predictionMRI integration with CCTA vs CCTA-only strategy · higher with MRI integration	C-statistic 0.738	C-statistic 0.880	Not reported in the abstract	P = 0.004	hybrid CCTA-MRI strategy: not reported in the abstract
Diagnostic accuracy for PMIHybrid CCTA-MRI strategy vs CCTA-only strategy · superior with hybrid strategy	0.705	Not reported in the abstract	0.803	P = 0.028	MRI integration with CCTA: not reported in the abstract

Independent predictors of PMI, integrating MRI with CCTA

LAP volume independent predictor: P = 0.029
High-intensity plaque (HIP) volume independent predictor: P = 0.024

Reference

Authors: Matsumoto H, Higuchi S, Li D, Tanisawa H, Isodono K, Irie D, et al.
All 20 authors
Matsumoto H, Higuchi S, Li D, Tanisawa H, Isodono K, Irie D, Ohya H, Kitamura R, Kaneko K, Nakazawa M, Suzuki K, Komori Y, Hondera T, Cadet S, Lee HL, Christodoulou AG, Slomka PJ, Dey D, Xie Y, Shinke T
Journal: European Heart Journal – Cardiovascular Imaging
Published: 17 Apr 2025
DOI: 10.1093/ehjci/jeaf116
PubMed: 40241659

Topic: Coronary disease & ACS
Also indexed: Cardiovascular imaging

Exposure

MRI integration with CCTA vs CCTA alone for prediction of PMI (post-PCI troponin-T > 5× the upper reference limit)

Exposure definitions

CCTA-only strategy: volumes of total plaque, calcified plaque, NCP and LAP quantified on CCTA with deep learning-enabled software
MRI integration with CCTA: CCTA plus HIP volume on non-contrast T1-weighted MRI
hybrid CCTA-MRI strategy: incorporating MRI for lesions with intermediate PMI risk based on CCTA

Original publication

Hybrid strategy of coronary atherosclerosis characterization with T1-weighted MRI and CT angiography to non-invasively predict periprocedural myocardial injury. Eur Heart J Cardiovasc Imaging. Published 17 April 2025. doi:10.1093/ehjci/jeaf116

Read the original article ↗

Summarised from the published abstract; every number is checked against it