FIGURE 1.
CCTA reveals severe stenosis in the proximal LAD (white arrows), caused by a mixed plaque, which showed clear signs of vulnerability: positive remodeling, low-attenuation plaque, and the napkin-ring sign.
FIGURE 2.
ECG indicating ST-segment elevation in V1–V5
FIGURE 3.
ICA of the target lesion before and after stenting. A. coronary angiography revealing a critical, elongated stenosis in segments I–II of the LAD, characterized by an unstable plaque and overlapping thrombotic material. B,C. Angiographic outcomes after revascularization and stenting of the LAD and IB, showing TIMI 3 flow.
TABLE 1.
Baseline, risk factors, laboratory and PVAT inflammation parameters for each case. Increased values are marked with bold.
| Parameters | Normal values | Patient's values |
|---|---|---|
| White blood cells (× 109/L) | 4.5–11 | 30.48 |
| Platelets (× 109/L) | 150–400 | 486 |
| Hemoglobin (g/dL) | 13.8–17.2 | 15.9 |
| Hematocrit (%) | 41–50 | 47.2 |
| Creatinine (mg/dL) | 0.74–1.35 | 1.29 |
| Urea (mg/dL) | 6–24 | 43.80 |
| Glucose (mg/dL) | < 99 | 201 |
| K+ (mmol/L) | 3.6–5.2 | 6.60 |
| Na+ (mmol/L) | 135–145 | 140 |
| CK (U/L) | 55–170 | 813 |
| Total cholesterol (mg/dL) | < 200 | 209.3 |
| HDL cholesterol (mg/dL) | > 60 | 58.2 |
| LDL cholesterol (mg/dL) | < 100 | 129.7 |
| Triglycerides (mg/dL) | < 150 | 97.5 |
| Uric acid (mg/dL) | 3.5–7.2 | 6.8 |
| AST (GOT) (U/L) | 8–33 | 468 |
| ALT (GPT) (U/L) | 4–36 | 208 |
| aPTT (s) | 21–35 | 117.2 |
| CK-MB (ng/mL) | 5–25 | 125.7 |
| hs-cTnI (μg/L) | < 14 | 4.710 |
[i] CK, creatine phosphokinase; AST, aspartate aminotransferase; ALT, alanine amino-transferase; aPTT, activated partial thromboplastin time; CK-MB, creatine kinase myocardial brain; hs-cTnI, serum high-sensitivity troponin-I
FIGURE 4.
Analysis of coronary inflammation and calculation of fat attenuation index (FAI) at the level of the culprit lesion. Calculated FAI score was 6.0, which falls in the 91st percentile for coronary inflammation, ranking almost the highest among individuals of the same age and gender.
FIGURE 5.
Syngo.via Frontier® analysis of the mixed plaque at the proximal LAD