Multi-slice CT coronary angiography assessment of remodeling index in patients with low- to intermediate-risk stable angina

Shaimaa A Mostafa, Tarek Aboelazem, Osama Sanad, Haytham Abdelghafar, Ahmed Azam, Shaimaa A Mostafa, Tarek Aboelazem, Osama Sanad, Haytham Abdelghafar, Ahmed Azam

Abstract

Background: Early identification of vulnerable plaques by remodeling index prior to rupture and development of acute event is of considerable importance especially by a reliable non-invasive method as CT coronary angiography (CTA), so we aim to evaluate coronary artery remodeling index in patients with low- to intermediate-risk stable angina by CTA.

Results: This single-center, cross-sectional, observational study included 150 patients with stable angina with normal resting ECG, negative markers, normal systolic function by 2D echocardiography (EF > 50%), and without regional wall motion abnormality at rest who were referred to MSCT evaluation of the coronary artery tree; the mean age was 56.8 ± 6.4 years, 83.3% had one-vessel disease, and 16.7% had two-vessel diseases. The mean remodeling index (RI) was 1.04 ± 0.28, 38% had significant positive remodeling, LAD was the most affected vessel (55.3), and proximal lesions were predominant in 48.5%; there was a statistically significant positive correlation between RI and cholesterol, triglyceride, LDL, duration of DM, HBA1c, and plaque burden (P < 0.001) and a statistically significant negative correlation with HDL (P < 0.001). Predictors of higher RI were positive family history, diabetes mellitus, low HDL, HBA1c, and plaque burden% (P < 0.001). Patients with remodeling index > 1.1 were diabetic, hypertensive, smoker, with longer duration of diabetes mellitus, higher HBA1c, cholesterol, triglyceride, LDL, plaque burden, wall lumen ratio, stenosis area, and lower HDL.

Conclusion: CTA was able to detect the presence and extent of early, non-obstructive but significant coronary artery-positive remodeling in patients with low- to intermediate-risk stable angina patients.

Trial registration: NCT03963609 , 22 May 2019.

Keywords: CT coronary angiography; Remodeling index; Stable angina.

Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
MSCT angiography coronary of a male patient, a 42-year-old smoker, and complaining of chest pain: HbA1c was 11, cholesterol level was 249, TGS 250, HDL 35, and LDL 100. CT angiography shows the proximal LAD lesion with remodeling index 1.4%, plaque burden 77.2%, wall lumen ratio 338.4%, stenosis area 18%, stenosis diameter 21%, and stenosis length 12.4 mm

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