中度冠心病危险患者中应用64层CT检出冠状动脉非钙化性斑块的发生率

作     者：Hausleiter J. Meyer T. Hadamitzky M. 黄浙勇 

作者机构：Klinik fr Herz-und Kreislauferkrankungen Klinik an der TU Mnchen Munich Germany Dr. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2006年第2卷第12期

页      面：50-51页

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：冠状动脉 非钙化性斑块 冠心病 冠状动脉病 发生率 检出 患者 CT 

摘      要：Objectives: In this prospective study, we investigated the prevalence and characteristics of clearly discernible noncalcified coronary plaques in a patient population with suspected significant coronary artery disease(CAD) by using 64-slice computed tomography(CT). Background: The assessment of noncalcified coronary plaques by noninvasive strategies may be important to improve cardiovascular risk stratification. Methods: To rule out significant stenosis, high-resolution 64-slice coronary CT(0.6-mm collimation, 330-ms gantry rotation time) was performed in 161 consecutive patients with an intermediate risk for having CAD. Computed tomography data sets were evaluated for presence of coronary calcifications, noncalcified plaques, and/or lumen narrowing. Results: Noncalcified coronary plaques were detected in 48(29.8%) of 161 enrolled patients. Although noncalcified plaques together with coronary calcifications were present in 38 of 161(23.6%) patients, the prevalence of noncalcified plaques as the only manifestation of CAD was 6.2%(10 of 161 patients). Patients with noncalcified plaques were characterized by significantly higher total cholesterol, low-density lipoprotein, and C-reactive protein levels as well as a trend for more diabetes mellitus. The majority of noncalcified plaques resulted in lumen narrowing of 50%. Of the remaining 113 patients, CAD and coronary calcifications were ruled out in 53 of 161(32.9%) patients, whereas 60 of 161(37.3%) patients presented with calcifications in the absence of noncalcified plaque. Conclusions: With the use of 64-slice CT, clearly discernible noncalcified atherosclerotic coronary plaques can be detected in a large group of patients with an intermediate risk for having CAD. The assessment of these plaques by CT angiography may allow for improved cardiovascular risk stratification.