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Highly Inflamed Non-Calcified Coronary Plaques Sealed with Stents in Patients with Zero Calcium Score – a Case Series and Review of the Literature Cover

Highly Inflamed Non-Calcified Coronary Plaques Sealed with Stents in Patients with Zero Calcium Score – a Case Series and Review of the Literature

Journal of Cardiovascular Emergencies
Volume 10 (2024): Issue 1 (March 2024)
By: Botond-Barna Mátyás,  Renáta Gerculy,  Nóra Rat,  Emanuel Blîndu,  Alexandra Gorea Stănescu,  Aurelian Roșca,  Corneliu-Florin Buicu,  Imre Benedek and  Theodora Benedek  
Open Access
|Dec 2023

Figures & Tables

FIGURE 1.

In chronological order, the figure includes: (1) Case 1 CCTA scan demonstrating a severe proximal LAD stenosis caused by noncalcified plaque, with two high-risk plaque characteristics present: positive remodeling and low attenuation (on the left side, enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping result of the affected segment, showing an inhomogeneous mix of yellow, red, and blue colors, representing high vascular inflammation (within the orange frame); (3) Elective PCI procedure (enclosed by the green frame).
In chronological order, the figure includes: (1) Case 1 CCTA scan demonstrating a severe proximal LAD stenosis caused by noncalcified plaque, with two high-risk plaque characteristics present: positive remodeling and low attenuation (on the left side, enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping result of the affected segment, showing an inhomogeneous mix of yellow, red, and blue colors, representing high vascular inflammation (within the orange frame); (3) Elective PCI procedure (enclosed by the green frame).

FIGURE 2.

(1) Case 2 CCTA scan reveals a severe stenosis in the second segment of the LAD due to a non-calcified plaque, with the same two high-risk plaque characteristics present (enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping of the affected segment displays an uneven mix of yellow, red, and blue colors, indicating high vascular inflammation (within the orange frame); (3) Elective PCI procedure with good results (enclosed by the green frame).
(1) Case 2 CCTA scan reveals a severe stenosis in the second segment of the LAD due to a non-calcified plaque, with the same two high-risk plaque characteristics present (enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping of the affected segment displays an uneven mix of yellow, red, and blue colors, indicating high vascular inflammation (within the orange frame); (3) Elective PCI procedure with good results (enclosed by the green frame).

FIGURE 3.

(1) Case 3 CCTA scan: Severe LAD stenosis due to non-calcified plaque (yellow frame, green zones); (2) FAI mapping: High vascular inflammation (orange frame); (3) Elective PCI procedure (green frame).
(1) Case 3 CCTA scan: Severe LAD stenosis due to non-calcified plaque (yellow frame, green zones); (2) FAI mapping: High vascular inflammation (orange frame); (3) Elective PCI procedure (green frame).

FIGURE 4.

PVAT examination findings: FAI score, adjusted relative risk for age and gender, and weighted FAI score of the most inflamed coronary artery
PVAT examination findings: FAI score, adjusted relative risk for age and gender, and weighted FAI score of the most inflamed coronary artery

Baseline, risk factors, laboratory and PVAT inflammation parameters for each case

ParametersCase 1Case 2Case 3
Age at time of scan (years)335943
BMI (kg/m2)30.5625.0631.22
LVEF (%)504748
Risk factors
  HypertensionYesYesYes
  HypercholesterolemiaYesYesYes
  DiabetesNoNoNo
  SmokingNoNoNo
Laboratory parameters
  Creatinine (mg/dL)1.130.910.87
  Total cholesterol (mg/dL)211260172
  LDL cholesterol (mg/dL)103197113
  Triglycerides (mg/dL)106105107
PVAT inflammation parameters
  FAI (HU)−68.27−66.44−67.38
  FAI score2.5019.204.40
  FAI score percentile (%)90th96th85th
Calcium score000
CAD-RADS ScoreIV AIV AIV A
SYNTAX Score855
PCI after CCTAYesYesYes
Multi-vessel PCINoNoNo
DOI: https://doi.org/10.2478/jce-2023-0016 | Journal eISSN: 2457-5518 | Journal ISSN: 2457-550X
Journal RSS Feed
Language: English
Page range: 38 - 44
Submitted on: Oct 21, 2023
|
Accepted on: Nov 12, 2023
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Published on: Dec 9, 2023
Published by: Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
non-calcified plaque,
calcium score,
coronary computed tomography angiography,
fat attenuation index,
coronary inflammation
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Cardiology,
Emergency medicine and intensive-care medicine,
Radiology

© 2023 Botond-Barna Mátyás, Renáta Gerculy, Nóra Rat, Emanuel Blîndu, Alexandra Gorea Stănescu, Aurelian Roșca, Corneliu-Florin Buicu, Imre Benedek, Theodora Benedek, published by Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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