CTA features of coronary plaques in evaluation on risk of in-stent restenosis / 中国医学影像技术

ABSTRACT

Objective To evaluate the risk of in-stent restenosis (ISR) after coronary artery stenting according to features of plaques on coronary artery CTA.Methods Totally 166 patients underwent coronary artery CTA before and 6-18 months after stent placement.Then the patients were divided into ISR group (n=16) and non-ISR group (n=150).The stenosis degree and plaque features were observed and compared between the two groups.Multivariate Logistic regression analysis was performed to evaluate ISR risk factors,and ROC curve was used to evaluate the diagnostic efficacy of plaques features in prejudgement of ISR.Results The lesion length,the ratio of noncalcified plaque,spotty calcium,positive remodeling and positive remodeling index in ISR group were higher than those in non-ISR group (all P ＜ 0.05).Multivariate Logistic regression analysis showed that noncalcified plaque (B=1.89,odd rate [OR] =6.63,P=0.01),spotty calcium (B=1.28,OR=3.59,P=0.01),positive remodeling (B=2.17,OR=8.71,P＜0.01) and lesion length (B=0.05,OR=1.05,P=0.04) were the risk factors of ISR.The area under the ROC curve (AUC) of lesion length and positive remodeling index for diagnosing ISR was 0.70 and 0.82 (both P＜ 0.01),respectively.The AUC of the combination of above plaque features for prejudgement of ISR was 0.87 (P＜0.01).Conclusion Lesion length,positive remodeling,noncalcified plaque and spotty calcium can be used to evaluate ISR after coronary artery stent placement.