Publication

Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography

Panayi, G., Wieringa, W. G., Alfredsson, J., Carlsson, J., Karlsson, J-E., Persson, A., Engvall, J., Pundziute, G. & Swahn, E., 3-May-2016, In : Bmc cardiovascular disorders. 16, 8 p., 78.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Panayi, G., Wieringa, W. G., Alfredsson, J., Carlsson, J., Karlsson, J-E., Persson, A., Engvall, J., Pundziute, G., & Swahn, E. (2016). Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography. Bmc cardiovascular disorders, 16, [78]. https://doi.org/10.1186/s12872-016-0254-y

Author

Panayi, Georgios ; Wieringa, Wouter G. ; Alfredsson, Joakim ; Carlsson, Jorg ; Karlsson, Jan-Erik ; Persson, Anders ; Engvall, Jan ; Pundziute, Gabija ; Swahn, Eva. / Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography. In: Bmc cardiovascular disorders. 2016 ; Vol. 16.

Harvard

Panayi, G, Wieringa, WG, Alfredsson, J, Carlsson, J, Karlsson, J-E, Persson, A, Engvall, J, Pundziute, G & Swahn, E 2016, 'Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography', Bmc cardiovascular disorders, vol. 16, 78. https://doi.org/10.1186/s12872-016-0254-y

Standard

Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography. / Panayi, Georgios; Wieringa, Wouter G.; Alfredsson, Joakim; Carlsson, Jorg; Karlsson, Jan-Erik; Persson, Anders; Engvall, Jan; Pundziute, Gabija; Swahn, Eva.

In: Bmc cardiovascular disorders, Vol. 16, 78, 03.05.2016.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Panayi G, Wieringa WG, Alfredsson J, Carlsson J, Karlsson J-E, Persson A et al. Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography. Bmc cardiovascular disorders. 2016 May 3;16. 78. https://doi.org/10.1186/s12872-016-0254-y


BibTeX

@article{1941f3666cbb4a8fa8814a43aa33981b,
title = "Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography",
abstract = "Background: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography (CTCA) and describe the clinical characteristics of this group of patients.Methods: This was a multicentre, prospective, descriptive study on CTCA evaluation in thirty patients fulfilling criteria for AMI and without visible coronary plaques on ICA. CTCA evaluation was performed head to head in consensus by two experienced observers blinded to baseline patient characteristics and ICA results. Analysis of plaque characteristics and plaque effect on the arterial lumen was performed. Coronary segments were visually scored for the presence of plaque. Seventeen segments were differentiated, according to a modified American Heart Association classification. Echocardiography performed according to routine during the initial hospitalisation was retrieved for analysis of wall motion abnormalities and left ventricular systolic function in most patients.Results: Twenty-five patients presented with non ST-elevation myocardial infarction (NSTEMI) and five with ST-elevation myocardial infarction (STEMI). Mean age was 60.2 years and 23/30 were women. The prevalence of risk factors of coronary artery disease (CAD) was low. In total, 452 coronary segments were analysed. Eighty percent (24/30) had completely normal coronary arteries and twenty percent (6/30) had coronary atherosclerosis on CTCA. In patients with atherosclerotic plaques, the median number of segments with plaque per patient was one. Echocardiography was normal in 4/22 patients based on normal global longitudinal strain (GLS) and normal wall motion score index (WMSI); 4/22 patients had normal GLS with pathological WMSI; 3/22 patients had pathological GLS and normal WMSI; 11/22 patients had pathological GLS and WMSI and among them we could identify 5 patients with a Takotsubo pattern on echo.Conclusions: Despite a diagnosis of AMI, 80 % of patients with normal ICA showed no coronary plaques on CTCA. The remaining 20 % had only minimal non-obstructive atherosclerosis. Patients fulfilling clinical criteria for AMI but with completely normal ICA need further evaluation, suggestively with magnetic resonance imaging (MRI).",
keywords = "Acute myocardial infarction, Normal coronary arteries, Computed tomography coronary angiography, MINCA, CARDIOVASCULAR MAGNETIC-RESONANCE, ARTERY-DISEASE, INTRAVASCULAR ULTRASOUND, INTRACORONARY ULTRASOUND, DIAGNOSTIC-ACCURACY, RISK STRATIFICATION, STENOSIS, ANGINA, WOMEN, QUANTIFICATION",
author = "Georgios Panayi and Wieringa, {Wouter G.} and Joakim Alfredsson and Jorg Carlsson and Jan-Erik Karlsson and Anders Persson and Jan Engvall and Gabija Pundziute and Eva Swahn",
year = "2016",
month = may,
day = "3",
doi = "10.1186/s12872-016-0254-y",
language = "English",
volume = "16",
journal = "Bmc cardiovascular disorders",
issn = "1471-2261",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography

AU - Panayi, Georgios

AU - Wieringa, Wouter G.

AU - Alfredsson, Joakim

AU - Carlsson, Jorg

AU - Karlsson, Jan-Erik

AU - Persson, Anders

AU - Engvall, Jan

AU - Pundziute, Gabija

AU - Swahn, Eva

PY - 2016/5/3

Y1 - 2016/5/3

N2 - Background: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography (CTCA) and describe the clinical characteristics of this group of patients.Methods: This was a multicentre, prospective, descriptive study on CTCA evaluation in thirty patients fulfilling criteria for AMI and without visible coronary plaques on ICA. CTCA evaluation was performed head to head in consensus by two experienced observers blinded to baseline patient characteristics and ICA results. Analysis of plaque characteristics and plaque effect on the arterial lumen was performed. Coronary segments were visually scored for the presence of plaque. Seventeen segments were differentiated, according to a modified American Heart Association classification. Echocardiography performed according to routine during the initial hospitalisation was retrieved for analysis of wall motion abnormalities and left ventricular systolic function in most patients.Results: Twenty-five patients presented with non ST-elevation myocardial infarction (NSTEMI) and five with ST-elevation myocardial infarction (STEMI). Mean age was 60.2 years and 23/30 were women. The prevalence of risk factors of coronary artery disease (CAD) was low. In total, 452 coronary segments were analysed. Eighty percent (24/30) had completely normal coronary arteries and twenty percent (6/30) had coronary atherosclerosis on CTCA. In patients with atherosclerotic plaques, the median number of segments with plaque per patient was one. Echocardiography was normal in 4/22 patients based on normal global longitudinal strain (GLS) and normal wall motion score index (WMSI); 4/22 patients had normal GLS with pathological WMSI; 3/22 patients had pathological GLS and normal WMSI; 11/22 patients had pathological GLS and WMSI and among them we could identify 5 patients with a Takotsubo pattern on echo.Conclusions: Despite a diagnosis of AMI, 80 % of patients with normal ICA showed no coronary plaques on CTCA. The remaining 20 % had only minimal non-obstructive atherosclerosis. Patients fulfilling clinical criteria for AMI but with completely normal ICA need further evaluation, suggestively with magnetic resonance imaging (MRI).

AB - Background: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography (CTCA) and describe the clinical characteristics of this group of patients.Methods: This was a multicentre, prospective, descriptive study on CTCA evaluation in thirty patients fulfilling criteria for AMI and without visible coronary plaques on ICA. CTCA evaluation was performed head to head in consensus by two experienced observers blinded to baseline patient characteristics and ICA results. Analysis of plaque characteristics and plaque effect on the arterial lumen was performed. Coronary segments were visually scored for the presence of plaque. Seventeen segments were differentiated, according to a modified American Heart Association classification. Echocardiography performed according to routine during the initial hospitalisation was retrieved for analysis of wall motion abnormalities and left ventricular systolic function in most patients.Results: Twenty-five patients presented with non ST-elevation myocardial infarction (NSTEMI) and five with ST-elevation myocardial infarction (STEMI). Mean age was 60.2 years and 23/30 were women. The prevalence of risk factors of coronary artery disease (CAD) was low. In total, 452 coronary segments were analysed. Eighty percent (24/30) had completely normal coronary arteries and twenty percent (6/30) had coronary atherosclerosis on CTCA. In patients with atherosclerotic plaques, the median number of segments with plaque per patient was one. Echocardiography was normal in 4/22 patients based on normal global longitudinal strain (GLS) and normal wall motion score index (WMSI); 4/22 patients had normal GLS with pathological WMSI; 3/22 patients had pathological GLS and normal WMSI; 11/22 patients had pathological GLS and WMSI and among them we could identify 5 patients with a Takotsubo pattern on echo.Conclusions: Despite a diagnosis of AMI, 80 % of patients with normal ICA showed no coronary plaques on CTCA. The remaining 20 % had only minimal non-obstructive atherosclerosis. Patients fulfilling clinical criteria for AMI but with completely normal ICA need further evaluation, suggestively with magnetic resonance imaging (MRI).

KW - Acute myocardial infarction

KW - Normal coronary arteries

KW - Computed tomography coronary angiography

KW - MINCA

KW - CARDIOVASCULAR MAGNETIC-RESONANCE

KW - ARTERY-DISEASE

KW - INTRAVASCULAR ULTRASOUND

KW - INTRACORONARY ULTRASOUND

KW - DIAGNOSTIC-ACCURACY

KW - RISK STRATIFICATION

KW - STENOSIS

KW - ANGINA

KW - WOMEN

KW - QUANTIFICATION

U2 - 10.1186/s12872-016-0254-y

DO - 10.1186/s12872-016-0254-y

M3 - Article

VL - 16

JO - Bmc cardiovascular disorders

JF - Bmc cardiovascular disorders

SN - 1471-2261

M1 - 78

ER -

ID: 40910025