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  • Panayi, GeorgiosLinköpings universitet,Institutionen för medicin och hälsa,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US (author)

Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • 2016-05-03
  • Springer Science and Business Media LLC,2016
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:lnu-54669
  • https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-54669URI
  • https://doi.org/10.1186/s12872-016-0254-yDOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-129496URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Swedish Heart and Lung Foundation [20120449]; Region of Ostergotland [437491]; European Union FP 7 [223615]; Medical Research Council of Southeast Sweden [157921]
  • Background: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography (CTCA) and describe the clinical characteristics of this group of patients. Methods: This was a multicentre, prospective, descriptive study on CTCA evaluation in thirty patients fulfilling criteria for AMI and without visible coronary plaques on ICA. CTCA evaluation was performed head to head in consensus by two experienced observers blinded to baseline patient characteristics and ICA results. Analysis of plaque characteristics and plaque effect on the arterial lumen was performed. Coronary segments were visually scored for the presence of plaque. Seventeen segments were differentiated, according to a modified American Heart Association classification. Echocardiography performed according to routine during the initial hospitalisation was retrieved for analysis of wall motion abnormalities and left ventricular systolic function in most patients. Results: Twenty-five patients presented with non ST-elevation myocardial infarction (NSTEMI) and five with ST-elevation myocardial infarction (STEMI). Mean age was 60.2 years and 23/30 were women. The prevalence of risk factors of coronary artery disease (CAD) was low. In total, 452 coronary segments were analysed. Eighty percent (24/30) had completely normal coronary arteries and twenty percent (6/30) had coronary atherosclerosis on CTCA. In patients with atherosclerotic plaques, the median number of segments with plaque per patient was one. Echocardiography was normal in 4/22 patients based on normal global longitudinal strain (GLS) and normal wall motion score index (WMSI); 4/22 patients had normal GLS with pathological WMSI; 3/22 patients had pathological GLS and normal WMSI; 11/22 patients had pathological GLS and WMSI and among them we could identify 5 patients with a Takotsubo pattern on echo. Conclusions: Despite a diagnosis of AMI, 80 % of patients with normal ICA showed no coronary plaques on CTCA. The remaining 20 % had only minimal non-obstructive atherosclerosis. Patients fulfilling clinical criteria for AMI but with completely normal ICA need further evaluation, suggestively with magnetic resonance imaging (MRI).

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  • Wieringa, Wouter G.Univ Groningen, Netherlands,University of Groningen, Netherlands (author)
  • Alfredsson, JoakimLinköpings universitet,Medicinska fakulteten,Avdelningen för kardiovaskulär medicin,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)joaal38 (author)
  • Carlsson, JörgLinnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Kalmar County Hospital, Sweden; Linnaeus University, Sweden(Swepub:lnu)jocaaa (author)
  • Karlsson, Jan-ErikLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,County Hospital Ryhov, Sweden(Swepub:liu)janka97 (author)
  • Persson, AndersLinköpings universitet,Avdelningen för radiologiska vetenskaper,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)andpe75 (author)
  • Engvall, JanLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Fysiologiska kliniken US(Swepub:liu)janen74 (author)
  • Pundziute, GabijaUniv Groningen, Netherlands,University of Groningen, Netherlands (author)
  • Swahn, EvaLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)evasw45 (author)
  • Linköpings universitetInstitutionen för medicin och hälsa (creator_code:org_t)

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  • In:BMC Cardiovascular Disorders: Springer Science and Business Media LLC161471-22611471-2261

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