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MDCT Findings Linked to Outcomes Following Stenting

Multidetector CT plaque evaluation appears useful in predicting myocardial injury after PCI

FRIDAY, Jan. 15 (HealthDay News) -- The use of multidetector computed tomography (MDCT) angiography to assess plaque in coronary lesions may help predict outcomes following stent implantation, according to research published in the January issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

Tadayuki Uetani, M.D., of the Chubu Rosai Hospital in Nagoya, Japan, and colleagues analyzed data from 189 patients with significant stenosis on angiography who underwent subsequent MDCT angiography shortly before elective percutaneous coronary intervention (PCI). Researchers assessed target lesions for low-, moderate-, and high-attenuation plaque based on CT density.

The researchers found that low-attenuation plaque (LAP) volume was associated with post-procedural myocardial injury/infarction, which was defined by post-procedural troponin-T level. Higher fraction of LAP in total plaque and lower moderate-attenuation plaque fraction were also found to predict cardiac biomarker elevation after the procedure.

"The procedure-related myocardial infarction is a major roadblock to improving clinical outcomes in patients who undergo PCI. Plaque evaluation by MDCT may provide useful information to identify high-risk patients who are expected to have a better outcome with aggressive medical treatment or bypass surgery. Evaluation of coronary plaque by MDCT involves significantly greater exposure to radiation as well as to the contrast medium. Therefore, further evaluation of the clinical benefits of this technique is required," the authors conclude.

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