Coronary Computed Tomographic Angiography With Fractional Flow Reserve in Patients With Type 2 Myocardial Infarction

被引：10

作者：

Mccarthy, Cian P. ^{[1
]}

Murphy, Sean P. ^{[1
]}

Amponsah, Daniel K. ^{[2
]}

Rambarat, Paula K. ^{[2
]}

Lin, Claire ^{[1
]}

Liu, Yuxi ^{[1
]}

Mohebi, Reza ^{[1
]}

Levin, Allison ^{[2
]}

Raghavan, Avanthi ^{[1
]}

Miksenas, Hannah

Rogers, Campbell ^{[3
]}

Wasfy, Jason H. ^{[1
]}

Blankstein, Ron

Ghoshhajra, Brian ^{[4
]}

Hedgire, Sandeep ^{[5
]}

Januzzi, James L. ^{[1
,6
,7
]}

机构：

[1] Massachusetts Gen Hosp, Dept Med, Div Cardiol, Boston, MA USA

[2] Massachusetts Gen Hosp, Dept Med, Boston, MA USA

[3] HeartFlow Inc, Mountain View, CA USA

[4] Brigham & Womens Hosp, Dept Med Cardiovasc Div & Radiol, Boston, MA USA

[5] Massachusetts Gen Hosp, Dept Radiol, Div Cardiovasc Imaging, Boston, MA USA

[6] Baim Inst Clin Res, Boston, MA USA

[7] Massachusetts Gen Hosp, 32 Fruit St,Yawkey 5B, Boston, MA 02114 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2023年 / 82卷 / 17期

关键词：

coronary computed tomography angiography; fractional flow reserve; type 2 myocardial infarction; AMERICAN-COLLEGE; OUTCOMES; DISEASE; ARTERY; CLASSIFICATION; RADIOLOGY; FEATURES; GENDER; CT;

D O I：

10.1016/j.jacc.2023.08.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Type 2 myocardial infarction (T2MI) related to a supply/demand imbalance of coronary blood flow is common and associated with poor prognosis. Coronary artery disease (CAD) may predispose some individuals to T2MI and contribute to its high rate of recurrent cardiovascular events. Little is known about the presence and extent of CAD in this population.OBJECTIVES The goal of this study was to evaluate the presence and characteristics of CAD among patients with T2MI.METHODS In this prospective study, consecutive eligible individuals with Fourth Universal Definition of Myocardial Infarction criteria for T2MI were enrolled. Participants underwent coronary computed tomography angiography (CTA), fractional flow reserve derived with coronary CTA (FFRCT), and plaque volume analyses.RESULTS Among 50 participants, 25 (50%) were female, and the mean age was 68.0 +/- 11.4 years. Atherosclerotic risk factors were common. Coronary CTA revealed coronary plaque in 46 participants (92%). A moderate or greater stenosis (>= 50%) was identified in 42% of participants, and obstructive disease (>= 50% left main stenosis or >= 70% stenosis in any other epicardial coronary artery) was present in 26%. Prevalence of obstructive CAD did not differ according to T2MI cause (P = 0.54). A hemodynamically significant focal stenosis identified by FFRCT was present in 13 participants (26%). Among participants with a stenosis >= 50% (n = 21), FFRCT excluded lesion-specific hemodynamically significant stenosis in 8 cases (38%).CONCLUSIONS Among individuals with adjudicated T2MI, CAD was prevalent, but the majority of patients had non-obstructive CAD. Mediators of ischemia are likely multifactorial in this population. (Defining the Prevalence and Char-acteristics of Coronary Artery Disease Among Patients with Type 2 Myocardial Infarction using CT-FFR [DEFINE TYPE 2 MI]; NCT04864119) (J Am Coll Cardiol 2023;82:1676-1687) (c) 2023 by the American College of Cardiology Foundation.

引用

页码：1676 / 1687

页数：12

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