What is the clinical evidence from this study?

Study design: Observational. Population: Acute Coronary Syndrome and Stable Angina (n=57). Intervention: Acute Coronary Syndrome (ACS) vs. Stable Angina (SA). Primary outcome: Positive coronary artery remodeling (PCAR) (p=<0.0001).

What does this research mean for the field?

Positive coronary artery remodeling assessed by multislice computed tomography (MSCT) is significantly more frequent in patients with acute coronary syndrome than in those with stable angina. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether multislice computed tomography can accurately assess coronary artery remodeling in patients presenting with acute coronary syndrome versus stable angina.

January 1, 2004Circulation JournalOpen Access

Evaluation of Coronary Artery Remodeling in Patients With Acute Coronary Syndrome and Stable Angina by Multislice Computed Tomography

Q: What are the key findings of this study?

Positive coronary artery remodeling assessed by MSCT was significantly more frequent in patients with acute coronary syndrome (61.3%) than in those with stable angina (0%; p<0.0001).

Q: What does this research mean for the field?

Positive coronary artery remodeling assessed by multislice computed tomography (MSCT) is significantly more frequent in patients with acute coronary syndrome than in those with stable angina. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine whether multislice computed tomography can accurately assess coronary artery remodeling in patients presenting with acute coronary syndrome versus stable angina.

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Key result

Positive coronary artery remodeling assessed by MSCT was significantly more frequent in patients with acute coronary syndrome (61.3%) than in those with stable angina (0%; p<0.0001).

Why the study?

Does MSCT accurately assess coronary artery remodeling compared to IVUS in patients with acute coronary syndrome and stable angina?

Population

57 patients who underwent invasive coronary angiography, including 31 patients with acute coronary syndrome…

Comparison

Multislice computed tomography to assess… vs Intravascular ultrasound performed in a subset…

Design

Cross-sectional

Authors

TIT ImazekiNihon University YSYuichi SatoSaitama University FIFumio InoueNihon University

Discussion

Member takes

Implication

MSCT may aid noninvasive differentiation of ACS from stable angina; leaves open validation against IVUS before practice change.

Key Points

To determine whether multislice computed tomography can accurately assess coronary artery remodeling in patients presenting with acute coronary syndrome versus stable angina.
Performed multislice computed tomography (MSCT) in 31 patients with acute coronary syndrome (ACS) and 26 patients with stable angina (SA) (total N=57).
Conducted intravascular ultrasound (IVUS) in 28 of the 57 patients to validate MSCT measurements against the invasive standard.
Calculated the remodeling index (RI) in both modalities, defining positive remodeling as RI >1.10 and negative remodeling as RI <0.95.
MSCT assessments correlated strongly with IVUS for both the remodeling index (r=0.86, n=28) and vessel area at maximum narrowing (r=0.92).
Positive remodeling occurred in 61.3% (19/31) of ACS patients compared to 0% (0/26) of SA patients (p<0.0001), whereas negative remodeling occurred in 3.2% (1/31) of ACS versus 62.9% (18/26) of SA patients.
The mean remodeling index was significantly greater in ACS patients (1.19 ± 0.18) than in SA patients (0.89 ± 0.10, p<0.0001).

Study Design

Type

Observational (n=57)

Structured PICO

Does MSCT accurately assess coronary artery remodeling compared to IVUS in patients with acute coronary syndrome and stable angina?

Population

57 patients who underwent invasive coronary angiography, including 31 patients with acute coronary syndrome (ACS) diagnosed within the previous 3 months (mean age 60.1, 27 males) and 26 patients with stable angina (SA) (mean age 60.7, 24 males).

Intervention

Multislice computed tomography (MSCT) to assess coronary artery remodeling.

Comparator

Intravascular ultrasound (IVUS) performed in a subset of 28 patients, and comparison between ACS and SA groups.

Outcome

Coronary artery remodeling assessed by the remodeling index (RI) and its correlation between MSCT and IVUS.surrogate

Main Result

Absolute Event Rate: 61.3% vs 0%

p-value: p=<0.0001

MSCT is an accurate non-invasive imaging modality for assessing coronary artery remodeling, capable of differentiating positive remodeling in acute coronary syndrome from negative remodeling in stable angina.

Limitations

Patients were selected on a clinical basis, not on a pathological basis.
Poor spatial resolution of MSCT limits the assessment of distal coronary arteries, heavily calcified lesions, and plaque area/volume.
Different doses of nitroglycerin given during the MSCT and IVUS studies may have caused disagreement in vessel area measurements.
Temporal resolution of MSCT is unsatisfactory, requiring beta-blockers and excluding patients with bronchial asthma or deteriorated left ventricular function.

Cite This Study

Imazeki et al. (2004) conducted an observational in Acute Coronary Syndrome and Stable Angina (n=57). Acute Coronary Syndrome (ACS) vs. Stable Angina (SA) was evaluated on Positive coronary artery remodeling (PCAR) (p=<0.0001). Positive coronary artery remodeling assessed by MSCT was significantly more frequent in patients with acute coronary syndrome (61.3%) than in those with stable angina (0%; p<0.0001).

synapsesocial.com/papers/6a15955137103a43379ff110 https://doi.org/10.1253/circj.68.1045

Topics

Coronary CT angiography

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Evaluation of Coronary Artery Remodeling in Patients With Acute Coronary Syndrome and Stable Angina by Multislice Computed Tomography

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Evaluation of Coronary Artery Remodeling in Patients With Acute Coronary Syndrome and Stable Angina by Multislice Computed Tomography

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider