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KMID : 1036020140030020079
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지질.동맥경화학회지
2014 Volume.3 No. 2 p.79 ~ p.87
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Comparison of Coronary Plaque and Stenosis Between Coronary Computed Tomography Angiography and Virtual Histology-Intravascular Ultrasound in Asymptomatic Patients with Risk Factors for Coronary Artery Disease
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Hong Young-Joon
Jeong Myung-Ho
Choi Yun-Ha
Park Soo-Young
Seon Hyun-Ju
Lee Hyun-Sung
Kim Yun-Hyun
Cho Sang-Cheol
Cho Jae-Young
Jeong Hae-Chang
Jang Soo-Young
Yoo Jong-Hyun
Song Ji-Eun
Lee Ki-Hong
Park Keun-Ho
Sim Doo-Sun
Yoon Nam-Sik
Yoon Hyun-Ju
Kim Kye-Hun
Park Hyung-Wook
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
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Abstract
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Objectives: The purpose of the study was to compare plaque characteristics by coronary computed tomography angiography (CCTA) with those by virtual histology-intravascular ultrasound (VH-IVUS).
Methods: We enrolled 50 asymptomatic patients with diabetes mellitus or more than two risk factors for coronary artery disease such as hypertension, smoking, and hyperlipidemia. If the patient had a coronary lesion (plaque with more than 50% stenosis or calcium score more than 100), we recommended coronary angiography and VH-IVUS and compared CCTA findings with VH-IVUS findings.
Results: 35 patients (70%) had coronary lesions, and we performed both CCTA and VH-IVUS in 23 patients. All 23 patients had multiple risk factors, and the majority of target lesions were located at left anterior descending artery (73.9%), and calcium score of lesion site was 106±162 with plaque volume of 232±153 mm3 by CCTA. Calcium score of lesion site was significantly greater in diabetic patients (n=14) than non-diabetic patients (n=9) (118±159 vs. 88±175, p=0.038). By VH-IVUS, plaque volume was 174±127 mm3, absolute necrotic core (NC) volume was 22±21 mm3, and relative NC volume was 20.8±8.7%. Absolute dense calcium (DC) volume and absolute NC volumes were significantly greater in diabetic patients than non-diabetic patients (11.5±13.8 mm3 vs. 9.1±11.0 mm3,p=0.028, and 23.9±24.7 mm3 vs. 18.1±14.3 mm3,p=0.035, respectively). Plaque volume by CCTA correlated with that of VH-IVUS (r=0.742, p<0.001), and plaque volume by CCTA correlated with absolute NC volume by VH-IVUS (r=0.621, p<0.001), and calcium score of lesion site by CCTA correlated with absolute dense calcium volume by VH-IVUS (r=0.478, p=0.028).
Conclusion: Coronary lesion was detected by CCTA in 70% of asymptomatic patients with multiple coronary risk factors, and parameters detected by CCTA correlated well with those detected by VH-IVUS.
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KEYWORD
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Subclinical atherosclerosis, Plaque, Computed tomography, Virtual histology-intravascualr ultrasound
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