Background: Positively remodeled coronary artery lesions, despite causing non-significant arterial
stenosis, have been implicated in adverse cardiovascular events. This study aims to identify the
morphological characteristics of positively remodeled coronary lesions detected by multi-slice
computed tomography (MSCT) coronary angiography and evaluate their predictive value for
cardiovascular events over a 90-day follow-up.
Methods: This prospective cohort study included 50 patients undergoing MSCT coronary angiography
at the National Heart Institute. Patients with a single-vessel disease exhibiting positive arterial
remodeling with non-significant stenosis were selected. Clinical assessments, including demographic
data, cardiovascular risk factors, and MSCT findings, were collected. Follow-up was conducted at 90
days to record adverse cardiovascular events
Results: Among the 50 patients, 20 (40%) developed cardiovascular events within 90 days. Significant
predictors of future events included dyslipidemia (p = 0.012), diabetes mellitus (p = 0.001), LDL levels
(p< 0.001), total cholesterol (p = 0.004), HDL levels (p = 0.048), and the remodeling index (p< 0.001).
CT measurements revealed that higher wall/lumen area percentage (p< 0.001), plaque burden
percentage (p< 0.001), and high-attenuation plaque area (p< 0.001) were significant predictors.
Wall/lumen area percentage and plaque burden percentage showed the highest predictive performance,
with 100% sensitivity and specificity.
Conclusions: Positively remodeled coronary lesions, particularly those with higher wall/lumen area
and plaque burden, are strong predictors of future cardiovascular events. Comprehensive analysis of
plaque characteristics and arterial measurements can enhance risk stratification, aiding in the
prevention and management of cardiovascular disease |
