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  • Plaque composition in...

Plaque composition in CT coronary angiography may distinguish type 1 MI from type 2 MI

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-11-04T12:15:07+05:30  |  Updated On 4 Nov 2022 4:21 PM IST
Plaque composition in CT coronary angiography may distinguish type 1 MI from type 2 MI
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A new study found that a higher low-attenuation coronary plaque burden distinguishes type 1 myocardial infarction from patients with type 2 myocardial infarction. The study results were published in the journal Radiology: Cardiothoracic Imaging.

Myocardial infarction (MI) is diagnosed when there is an evident acute myocardial injury in the setting of myocardial ischemia. Distinguishing type 1 and 2 MI is a common clinical conundrum that is difficult to resolve. Hence researchers conducted a secondary analysis of two studies to determine if quantitative plaque characterization can discriminate between type 1 and type 2 myocardial infarction by using CT coronary angiography (CTCA). A secondary analysis of two prospective studies that performed blinded quantitative plaque analysis on findings from CTCA in participants with type 1 myocardial infarction, type 2 myocardial infarction, and chest pain without myocardial infarction was done. Logistic regression analyses were performed to identify predictors of type 1 myocardial infarction.

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Results

  • 155 participants with a mean age of 64 years had type 1 MI and 36 participants with a mean age, of 67 years who had type 2 myocardial infarction, and 136 participants with a mean age of 62 years who had chest pain without myocardial infarction participated in the study.
  • There were greater total, noncalcified, and low-attenuation plaque burdens (P < .05 for all) in participants with type 1 myocardial infarction than those with type 2.
  • When compared with those with chest pain without myocardial infarction, participants with type 2 myocardial infarction had similar low-attenuation plaque burden to (P = .4).
  • Low-attenuation plaque was an independent predictor of type 1 myocardial infarction, with better discrimination than noncalcified plaque burden and maximal area of coronary stenosis.
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Takeaway message:

  • CT coronary angiography can quantify important differences in the plaque composition of patients with type 1 and type 2 myocardial infarction.
  • Low-attenuation plaque burden provided strong discrimination between type 1 and type 2 myocardial infarction, independent of the severity of coronary stenosis or clinical characteristics.
  • Quantitative plaque analysis may help differentiate between patients with type 1 and type 2 myocardial infarction.

Further reading: Meah MN, Bularga A, Tzolos E, et al. Distinguishing Type 1 from Type 2 Myocardial Infarction by Using CT Coronary Angiography. Radiology: Cardiothoracic Imaging. 2022;4(5). doi:10.1148/ryct.220081

myocardial infarctionCT coronary angiographytype 1 myocardial infarctiontype 2 myocardial infarctionLow-attenuation plaquechest pain
Source : Radiology: Cardiothoracic Imaging
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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