Enfermedades cardiovasculares y diagnóstico

A Novel Coronary CT Angiography Score for Patients of ACS

Abstract

Lu Gan, Li Yang

Background: Coronary atherosclerosis is one of the most significant diseases in recent years. CCTA can provide a non-invasive quantitative assessment of coronary atherosclerotic plaque.

Objectives: To describe a novel score with CCTA in assessment of coronary atherosclerotic plaque characteristics in patients with acute coronary syndrome (ACS).

Methods: We retrospectively analyzed 213 patients from Jun 2012 to Jun 2014. All patients were classified into four groups: healthy individuals as a control group, unstable angina group (UA), non-ST-segment elevation myocardial infarction group (NSTEMI) and ST-segment elevation myocardial infarction group (STEMI). Segment involvement score (SIS), segment stenosis score (SSS) and a novel CCTA score (CCTAs) were calculated, respectively. All evaluation indicators were analyzed with SPSS 20.0 software. All images were analyzed by two experienced radiologists, they had no knowledge of clinical or angiographic results.

Results: 1. Significant differences were found among all groups of age (P=0.007), SBP (P=0.013), and males (P=0.047). 2. Significant differences in SIS, SSS, CCTAs were found between the UA, NSTEMI and STEMI groups (P=0.00) 3. SBP and CCTAs were found to be independent risk factors of UA (OR=1.042, P=0.008; OR=1.211, P=0.000, respectively). CCTAs were independent risk factors of MI (OR=1.77, P=0.000). 4. With healthy group as control, for group UA, AUC of CCTAs was 0.741. For group MI, AUC of CCTAs was 0.955. The efficiency of simultaneously identifying cases (i.e., SBP and CCTAs) in group UA was 0.850.

Conclusion: CCTAs are more robust than SIS, SSS scores for the diagnoses of patients with ACS.