Non-obstructive low attenuation coronary plaque predicts three-year acute coronary syndrome events in patients with hypertension: Multidetector computed tomographic study

• Published in: Journal of cardiology Vol. 59; no. 2; pp. 167 - 175
• Main Authors: Nakanishi, Koki, MD, Fukuda, Shota, MD, Shimada, Kenei, MD, FJCC, Ehara, Shoichi, MD, Inanami, Hitoshi, MD, Matsumoto, Kenji, MD, Taguchi, Haruyuki, MD, Muro, Takashi, MD, FJCC, Yoshikawa, Junichi, MD FJCC, Yoshiyama, Minoru, MD, FJCC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2012
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Aged; Cardiovascular; Computed tomography; Coronary artery disease; Female; Follow-Up Studies; Humans; Hypertension; Hypertension - complications; Male; Multidetector Computed Tomography - methods; Plaque, Atherosclerotic - diagnostic imaging; Hypertension; Computed tomography; Coronary artery disease
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2011.11.010

Summary Background Arterial hypertension is an established risk factor for acute coronary syndrome (ACS). Multidetector computed tomography (MDCT) is an accurate and less invasive technique for assessment of the degree of coronary artery luminal narrowing and characterization of coronary atherosclerosis. We therefore aimed to investigate the predictive power of MDCT for future ACS events and compared with traditional parameters in patients with hypertension. Methods One hundred and thirty-four patients (93 men, mean age 70 ± 11 years) with hypertension underwent MDCT for evaluation of coronary artery disease. MDCT analysis focused on the presence of plaques, the degree of stenosis, and the plaque characteristics. Traditional parameters included Framingham risk score, carotid intima-media thickness, and left ventricular mass index. Results During a mean follow-up of 39 ± 10 months, ACS events occurred in 10 patients, including myocardial infarction ( n = 3) and unstable angina ( n = 7). Multivariate analysis identified total number of low attenuation plaques as an independent predictor of ACS events ( p < 0.001). Conclusion We demonstrated that non-obstructive low attenuation coronary plaques on MDCT predicted more accurately future ACS events in patients with hypertension than traditional parameters.