Characterization of Noncalcified Coronary Plaques and Identification of Culprit Lesions in Patients With Acute Coronary Syndrome by 64-Slice Computed Tomography

Characterization of Noncalcified Coronary Plaques and Identification of Culprit Lesions in Patients With Acute Coronary Syndrome by 64-Slice Computed Tomography Toshiro Kitagawa, Hideya Yamamoto, Jun Horiguchi, Norihiko Ohhashi, Futoshi Tadehara, Tomoki Shokawa, Yoshihiro Dohi, Eiji Kunita, Hiroto Utsunomiya, Nobuoki Kohno, Yasuki Kihara Lower computed tomography (CT) density, positive remodeling, and adjacent spotty coronary calcium are characteristic vessel changes in unstable coronary plaques. The authors studied noncalcified coronary atherosclerotic plaques (NCPs) in patients presenting with acute coronary syndromes (ACS) and compared them to stable patients. More NCPs were observed in ACS patients, in whom minimum CT density was lower and frequency of adjacent spotty calcium was higher. In the ACS group, remodeling index was significantly greater and a larger index was independently related to the culprit lesions. The findings support a potential role of CT imaging in recognition of rupture-prone coronary plaques.