Importance of plaque volume and composition for the prediction of myocardial ischaemia using sequential coronary computed tomography angiography/positron emission tomography imaging
Authors' conclusion
The volume of necrotic core on CCTA independently and incrementally predicts myocardial ischaemia on PET, beyond diameter stenosis alone.
Study context
- Population
- Symptomatic patients with suspected CAD and clinically indicated coronary computed tomography angiography (CCTA) with sequential [15O]H2O positron emission tomography (PET) myocardial perfusion imagingmean age 63, 54% men
- Participants
- 493 patients
- Exposure
- Stenosis model vs plaque volume model vs plaque composition model for prediction of ischaemia
- Outcome
- Myocardial ischaemia on PET (absolute stress myocardial blood flow ≤2.4 mL/g/min in ≥1 segment)
Methodological detailsregistry-based
- Registry-based
Main finding
As reported in the abstract
Myocardial ischaemia on PET
Stenosis model
138
χ2
Plaque volume model
164
χ2
Plaque composition model
169
χ2
Plaque composition model vs Stenosis model: P < 0.001 · Plaque composition model vs Plaque volume model: P = 0.021
- Myocardial ischaemia detected on PET
- 153 (31%)
- Diameter stenosis ≥50% independently associated with ischaemia
- P < 0.001
- Necrotic core volume independently associated with ischaemia
- P = 0.029
- Total plaque volume, borderline significance
- P = 0.052
Observational data: associations, not effects.
Original publication
Importance of plaque volume and composition for the prediction of myocardial ischaemia using sequential coronary computed tomography angiography/positron emission tomography imaging. Eur Heart J Cardiovasc Imaging. Published 1 September 2022. doi:10.
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