Abstract 14747: Hyperintense Coronary Plaque Detected by Noncontrast T1-Weighted Magnetic Resonance Imaging Predicts Coronary Events in Patients with Coronary Artery Disease
Background: The presence of a coronary hyperintense plaque (HIP) on non-contrast T1-weighted (T1W) cardiac magnetic resonance is associated with positive coronary artery remodeling, low plaque density on computed tomography, and plaque attenuation on intracoronary ultrasound. It is unclear whether HIP may be a potential marker for plaque vulnerability and clinical outcome.
Hypothesis: We hypothesized that the presence of HIP predicts future coronary events in patients with coronary artery disease (CAD).
Methods: A total of 356 patients presenting for coronary artery disease screening were prospectively examined by 1.5-T MR system (Intera, Philips Medical Systems). All patients were categorized into four groups based on the presence or absence of HIP and CAD, i.e., CAD(+)/HIP(+), CAD(+)/HIP(−), CAD(−)/HIP(+), and CAD(−)/HIP(−). Patients were followed for 3 years or until the occurrence of coronary events. A signal intensity ratio of the coronary plaque to cardiac muscle (PMR) > 1.0 was defined as HIP.
Results: Of the 47 patients with CAD(+)/HIP(+), 10 (21.2%) developed a coronary event, compared with 4 (2.4%) of 162 CAD(+)/HIP(−) patients. None of the 147 HIP(−)/CAD(−) patients had coronary events. The presence of HIP was significantly associated with cardiac events compared to the absence of HIP groups (log-rank p<0.0001). Multivariate Cox regression analysis identified the presence of HIP as an independent predictor of cardiac events (odds ratio: 1.4, 95% confidence interval: 1.01–1.99, p=0.041).
Conclusions: The presence of HIP detected by non-contrast T1W imaging may be a potential method for identifying vulnerable coronary lesions.
- © 2010 by American Heart Association, Inc.