Prediction of atherosclerotic disease progression using LDL transport modelling: a serial computed tomographic coronary angiographic study.
Eur Heart J Cardiovasc Imaging
; 18(1): 11-18, 2017 Jan.
Article
em En
| MEDLINE
| ID: mdl-26985077
ABSTRACT
AIM:
To investigate the efficacy of low-density lipoprotein (LDL) transport simulation in reconstructed arteries derived from computed tomography coronary angiography (CTCA) to predict coronary segments that are prone to progress. METHODS ANDRESULTS:
Thirty-two patients admitted with an acute coronary event who underwent 64-slice CTCA after percutaneous coronary intervention and at 3-year follow-up were included in the analysis. The CTCA data were used to reconstruct the coronary anatomy of the untreated vessels at baseline and follow-up, and LDL transport simulation was performed in the baseline models. The computed endothelial shear stress (ESS), LDL concentration, and CTCA-derived plaque characteristics were used to identify predictors of substantial disease progression (defined as an increase in the plaque burden at follow-up higher than two standard deviations of the intra-observer variability of the expert who performed the analysis). Fifty-eight vessels were analysed. High LDL concentration [odds ratio (OR) 2.16; 95% confidence interval (CI) 1.64-2.84; P = 0.0054], plaque burden (OR 1.40; 95% CI 1.13-1.72; P = 0.0017), and plaque area (OR 3.46; 95% CI 2.20-5.44; P≤ 0.0001) were independent predictors of a substantial disease progression at follow-up. The ESS appears as a predictor of disease progression in univariate analysis but was not an independent predictor when the LDL concentration was entered into the multivariate model. The accuracy of the model that included the LDL concentration was higher than the accuracy of the model that included the ESS (65.1 vs. 62.5%).CONCLUSIONS:
LDL transport modelling appears a better predictor of atherosclerotic disease progression than the ESS, and combined with the atheroma characteristics provided by CTCA is able to detect with a moderate accuracy segments that will exhibit a significant plaque burden increase at mid-term follow-up.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Simulação por Computador
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Doença da Artéria Coronariana
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Angioplastia Coronária com Balão
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Angiografia Coronária
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Angiografia por Tomografia Computadorizada
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Lipoproteínas LDL
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Heart J Cardiovasc Imaging
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Grécia