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

Young Joon Hong; Myung Ho Jeong; Yun Ha Choi; Soo Young Park; Hyun Ju Seon; Hyun Sung Lee; Yun Hyun Kim; Sang Cheol Cho; Jae Young Cho; Hae Chang Jeong; Soo Young Jang; Jong Hyun Yoo; Ji Eun Song; Ki Hong Lee; Keun Ho Park; Doo Sun Sim; Nam Sik Yoon; Hyun Ju Yoon; Kye Hun Kim; Hyung Wook Park; Ju Han Kim; Youngkeun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang

doi:10.12997/jla.2014.3.2.79

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Hong, Jeong, Choi, Park, Seon, Lee, Kim, Cho, Cho, Jeong, Jang, Yoo, Song, Lee, Park, Sim, Yoon, Yoon, Kim, Park, Kim, Ahn, Cho, Park, and Kang: 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

Original Article

Journal of Lipid and Atherosclerosis 2014; 3(2): 79-87.

Published online: 31 December 2014

DOI: https://doi.org/10.12997/jla.2014.3.2.79

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

Young Joon Hong¹, Myung Ho Jeong¹, Yun Ha Choi¹, Soo Young Park¹, Hyun Ju Seon², Hyun Sung Lee², Yun Hyun Kim², Sang Cheol Cho¹, Jae Young Cho¹, Hae Chang Jeong¹, Soo Young Jang¹, Jong Hyun Yoo¹, Ji Eun Song¹, Ki Hong Lee¹, Keun Ho Park¹, Doo Sun Sim¹, Nam Sik Yoon¹, Hyun Ju Yoon¹, Kye Hun Kim¹, Hyung Wook Park¹, Ju Han Kim¹, Youngkeun Ahn¹, Jeong Gwan Cho¹, Jong Chun Park¹, Jung Chaee Kang¹

¹Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.

²Department of Radiology, Chonnam National University Hospital, Gwangju, Korea.

Corresponding Author: Myung Ho Jeong, Department of Cardiology, Chonnam National University Hospital, 42 Jaebong-ro, Donggu, Gwangju 501-757, Korea. Tel: +82-62-220-6243, Fax: +82-62-228-7174, myungho@chollian.net

Received 14 July 2014 Revised 11 September 2014 Accepted 16 October 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.

Keywords: Subclinical atherosclerosis, Plaque, Computed tomography, Virtual histology-intravascualr ultrasound

Figures and Tables

Fig. 1

Coronary computed tomography angiography (A), coronary angiography (B), and virtual histology-intravascular ultrasound findings (C) in patients with diabetes mellitus, hypertension, smoking, and hyperlipidemia.

Fig. 2

Correlation between plaque volume by coronary computed tomography angiography (CCTA) with that by virtual histology-intravascular ultrasound (VH-IVUS) (A), and correlation between plaque volume by CCTA with absolute necrotic core volume by VH-IVUS (B), and correlation between lesion site calcium score by CCTA with absolute dense calcium volume by VH-IVUS (C).

Table 1

Baseline characteristics in patients who underwent both computed tomography angiography and virtual histology-intravascular ultrasound

Values are presented as mean±standard deviation or number (%) LDL-C; low density lipoprotein cholesterol, HDL-C; high density lipoprotein cholesterol, hs-CRP; high sensitivity C-reactive protein, ACE; angiotensin converting enzyme, ARB; angiotensin receptor blocker

Table 2

Computed tomography angiography and quantitative coronary angiography findings in patients who underwent both computed tomography angiography and virtual histology-intravascular ultrasound

ACC/AHA; American College of Cardiology/American Heart Association

Table 3

Virtual histology-intravascular ultrasound findings in patients who underwent both computed tomography angiography and virtual histology-intravascular ultrasound

EEM; external elastic membrane, CSA; cross-sectional area, P&M; plaque plus media, MLA; minimum lumen area, IVUS; intravascular ultrasound, FT; fibrotic, FF; fibro-fatty, DC; dense calcium, NC; necrotic core

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