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Coronary atherosclerosis evaluation by intracoronary optical coherence tomography and 320-row coronary computed tomography: correlation and concordance of the findings of both methods


Atherosclerotic disease is responsible for almost 50% of all annual deaths and is also a major cause of comorbidities. While atherosclerosis is, by itself, a benign disease, it often leads to complications such as acute thrombosis. This usually occurs due to the rupture or erosion of an atherosclerotic plaque and evolves into an acute ischemic event. Until now, the identification of patients at high risk of an acute ischemic event mainly relied on the analysis of risk scores. Although these risk scores correctly estimate cardiovascular risk of middle-aged men, they are not as accurate in older patients, and especially in the younger ones. Ischemic noninvasive tests are performed to refine this type of evaluation in high-risk individuals, in order to provide information about potential coronary stenosis. However, these tests at most identify severe obstructive plaques, i.e. the ones that limit coronary flow reserve. As most coronary events are caused by a ruptured non-critical plaque and because this plaque type is much more common than the ones that limit blood flow, the predictive value of noninvasive tests for an acute coronary event is particularly low. During the last decade, development of new tools to identify vulnerable atherosclerotic plaques increased the predictive and diagnostic accuracy. This study will compare the findings of 320-row detector computed coronary tomography, a noninvasive test performed to assess coronary artery plaques, with the findings of optical coherence tomography, the gold standard invasive test for the diagnosis of vulnerable plaque. At the end of this study, we expect to get a better understanding of the morphological features of atherosclerotic plaques in both imaging modalities, which will translate in better diagnosis and treatment to patients with atherosclerotic diseases. (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
YBARRA, LUIZ F.; SZARF, GILBERTO; ISHIKAWA, WALTHER; CHAMIE, DANIEL; CAIXETA, ADRIANO; PURI, RISHI; PERIN, MARCO A. Diagnostic Accuracy of 320-Row Computed Tomography for Characterizing Coronary Atherosclerotic Plaques: Comparison with Intravascular Optical Coherence Tomography. CARDIOVASCULAR REVASCULARIZATION MEDICINE, v. 21, n. 5, p. 640-646, MAY 2020. Web of Science Citations: 0.

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