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Related Concept Videos

Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

Imaging Studies for Cardiovascular System II:Types of Echocardiography

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Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
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Distinguishing Type 1 from Type 2 Myocardial Infarction by Using CT Coronary Angiography.

Mohammed N Meah1, Anda Bularga1, Evangelos Tzolos1

  • 1British Heart Foundation Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland (M.N.M., A.B., E.T., A.R.C., M.D., J.D.H., J.C., C.T., R.W., A.G., M.R.D., N.L.M., D.E.N., M.C.W.); Usher Institute, University of Edinburgh, Edinburgh, Scotland (A.G., N.L.M.); University Hospital Plymouth, Plymouth, England (C.R.); Faculty of Medicine, University of Southampton, Southampton, England (N.C.); University Hospital Southampton, Southampton, England (N.C.); Department of Cardiology, Milton Keynes University Hospital, School of Sciences and Medicine, University of Buckingham, Buckingham, England (A.K.); Torbay and South Devon NHS Foundation Trust, Torquay, England (D.F.); Departments of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, Calif (P.J.S., D.D.); and Edinburgh Imaging, Queen's Medical Research Institute University of Edinburgh, Edinburgh, Scotland (D.E.N., M.C.W.).

Radiology. Cardiothoracic Imaging
|November 7, 2022
PubMed
Summary
This summary is machine-generated.

Quantitative CT coronary angiography (CTCA) plaque analysis can differentiate between type 1 and type 2 myocardial infarction. Higher low-attenuation plaque burden is a key indicator for type 1 myocardial infarction.

Keywords:
CT AngiographyIschemia/InfarctionQuantitative CT

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Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Distinguishing between type 1 myocardial infarction (MI) and type 2 MI is crucial for appropriate treatment.
  • CT coronary angiography (CTCA) offers detailed visualization of coronary plaque characteristics.

Purpose of the Study:

  • To evaluate the capability of quantitative plaque characterization using CTCA to differentiate between type 1 MI and type 2 MI.
  • To identify specific plaque features that predict type 1 MI.

Main Methods:

  • Secondary analysis of two prospective studies (NCT03338504, NCT02284191) involving participants with type 1 MI, type 2 MI, and chest pain without MI.
  • Blinded quantitative plaque analysis of CTCA findings using logistic regression to identify predictors of type 1 MI.

Main Results:

  • Participants with type 1 MI exhibited significantly greater total, noncalcified, and low-attenuation plaque burdens compared to those with type 2 MI (P < .05 for all).
  • Low-attenuation plaque burden was an independent predictor of type 1 MI (aOR, 3.44; P < .001), demonstrating superior discrimination compared to noncalcified plaque and maximal stenosis (C-statistics 0.75 vs 0.62 and 0.61).
  • Type 2 MI patients showed similar low-attenuation plaque burden to those without MI (P = .4).

Conclusions:

  • Elevated low-attenuation coronary plaque burden identified via CTCA can aid in distinguishing type 1 MI from type 2 MI.
  • Quantitative CTCA plaque analysis provides valuable insights into the underlying pathophysiology of different MI types.