Regression of coronary plaque after coronary artery bypass graft

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Sudden chest pain in a 62-year-old woman indicated potential coronary artery disease.
• Severe stenosis of the left main coronary trunk artery (LMT) was suspected.
• Plaque characteristics are crucial for assessing cardiovascular risk.

Purpose of the Study:

• To evaluate the effectiveness of lipid-lowering therapy on coronary plaque stabilization.
• To assess the utility of 64-multidetector row computed tomography (MDCT) in diagnosing and monitoring coronary artery disease.
• To analyze changes in plaque density and stenosis severity over time.

Main Methods:

• A 62-year-old female patient presenting with chest pain underwent 64-MDCT and coronary angiography (CAG).
• Initial assessment revealed severe LMT stenosis with soft plaque (32.4 HU).
• Treatment included statin therapy and coronary artery bypass graft (CABG). Follow-up assessments were performed after three years.

Main Results:

• Initial 64-MDCT showed severe LMT stenosis with soft plaque.
• After three years of statin therapy and CABG, follow-up 64-MDCT indicated mild stenosis and plaque regression (73.1 HU, intermediate plaque).
• CAG revealed degradation of CABG flow and mild LMT stenosis.

Conclusions:

• Lipid-lowering therapy with statins may contribute to the stabilization of soft coronary plaque.
• Non-invasive 64-MDCT is a valuable tool for diagnosing coronary artery disease.
• MDCT aids in evaluating coronary plaque size and properties, facilitating treatment monitoring.