Identifying patients who are at risk for a future myocardial infarction, is still one of the biggest challenges in cardiology. In this study the investigators will investigate culprit lesion in patients with NSTEMI and the ability of cardiac CT with dual energy computed tomography (DECT) scanning to describe and identify plaques that may be vulnerable. The investigators will also describe changes in characteristic in both stable and unstable plaques during 1 year follow up of NSTEMI and a matching group of stable angina pectoris (SAP) patients.
Patients with verified NSTEMI undergo contrast-enhanced coronary DECT before conventional coronary angiography (CAG), and DECT characteristics of the culprit lesion will be determined. All Non-culprit lesions will be observed during 2 month and 1 year follow up characteristics and changes in plaque composition, volume and core content will be assessed. Patients with SAP undergo a baseline DECT similar to NSTEMI group. Because the expected change in coronary plaques in SAP group is minimal, there is no need for follow up at 2 month.
Study Type
OBSERVATIONAL
Enrollment
135
Cardiac CT before the CAG, and follow up after 2 month and 12 month
Department of Medical Research, OUH, Svendborg
Svendborg, Denmark
RECRUITINGDescription and characteristics of culprit lesion by DECT. (z-value)
measure the z-value for the culprit lesion, by marking the culprit lesion with a region of interest (ROI) and the DECT will calculate the mean z-value by mg/mm\^3 in the marked ROI
Time frame: 72 hours
Describe if the culprit lesion contains 1: soft 2: mixed or 3: calcified tissue
Visually description if the culprit lesion contain 1: soft tissue (dark area in the scan) 3: calc (white area) or 2: mixed (combined dark and white areas)
Time frame: 72 hours
Measure the volume of the culprit lesion
CT software will be automatically able to measure the volume (mm3) og culprit lesion
Time frame: 72 hours
Measure the remodeling index of culprit lesion
CT software will be automatically able to measure the remodeling index in culprit lesion (mm)
Time frame: 72 hours
Determine the mean Z value for non-culprit plaques containing 1: soft tissue
measure the z-value for the culprit lesion, by marking the lesion with a ROI and the DECT will calculate the mean z-value in the marked ROI
Time frame: 72 hours
Determine the mean Z value for non-culprit plaques containing 1: soft tissue
measure the z-value for the culprit lesion, by marking the lesion with a ROI and the DECT will calculate the mean z-value mg/mm\^3 in the marked ROI
Time frame: 2 month
Determine the mean Z value for non-culprit plaques containing 1: soft tissue
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measure the z-value for the culprit lesion, by marking the lesion with a ROI and the DECT will calculate the mean z-value mg/mm\^3 in the marked ROI
Time frame: 1 year
Determine the mean Z value for non-culprit plaques containing 2: mixed tissue
z-value mg/mm\^3
Time frame: 72 hours
Determine the mean Z value for non-culprit plaques containing 2: mixed tissue
z-value mg/mm\^3
Time frame: 2 month
Determine the mean Z value for non-culprit plaques containing 2: mixed tissue
z-value mg/mm\^3
Time frame: 1 year
Determine the mean Z value for non-culprit plaques containing 3: calcified tissue
z-value mg/mm\^3
Time frame: 72 hours
Determine the mean Z value for non-culprit plaques containing 3: calcified tissue
z-value mg/mm\^3
Time frame: 2 month
Determine the mean Z value for non-culprit plaques containing 3: calcified tissue
z-value mg/mm\^3
Time frame: 1 year
changes in non-culprit plaques during 1 year in comparison til patients with stable angina pectoris
z-value z-value mg/mm\^3
Time frame: 1 year
z value in myocardium related to culprit vessel compared to z-value in myocardium corresponded to non-culprit vessel
z-value z-value mg/mm\^3
Time frame: 72 hours