Multislice computed tomography in the evaluation of coronary atherosclerosis dynamics: data three-year observation in patients with myocardial infarction-segment elevation ST and stenting of coronary arteries

Main Article Content

L. M. Babii
V. O. Shumakov
O. P. Pogurelska
A. Yu. Rybak
I. E. Malynovska
Yu. O. Khomenko
N. M. Tereshchenko
O. V. Voloshina
L. F. Kisilevich


The aim – to use multislice computed tomography (MSCT)-coronary angiography data to determine the presence of atherosclerotic process progression in coronary vessels in the dynamics of the three-year follow-up period in patients after STEMI and coronary artery stenting.
Materials and methods. 66 MSCT-coronary angiography studies were performed in 19 men after primary myocardial infarction with ST-segment elevation (STEMI) and coronary artery stenting. All patients were male, ranging in age from 38 to 66 years, with a mean (Me 55.6; (Q1–Q3 (49–64)) years, and 18 of 19 (94.0 %) patients developed Q-MI. 1 patient (6 %) had non-Q-MI. A month after acute MI, patients underwent MSCT of the heart with coronary vascular contrast. Re-examination was performed one, two and three years after the development of STEMI. According to the results of MSCT coronary angiography determined the functional status of stents, as well as the presence or exclusion of signs of restenosis (about 50 % or more) or thrombosis 100 % – occlusion) in the stent coronary artery and in non-infarction-causing arteries. With the progression of atherosclerotic plaque, an increase in atherosclerotic plaque of more than 20 % was taken into account compared to the previous study.
Results and discussion. By the end of the first year after MI in 11 of 19 (57.9 %) patients according to MSCT-coronary angiography, no progression of atherosclerotic lesions of the coronary arteries was observed. 1 patient (5.6 %) had stent restenosis, which was confirmed by CAG data. Progression of atherosclerotic lesions was observed in 7 patients (36.8 %), 3 of them (16.6 %) in the stent artery, and in 4 patients in the non-infarction-causing artery. In the second year after myocardial infarction, compared with the annual examination, in 6 of 14 (42.9 %) no progression of atherosclerosis was observed, and in 7 of 14 (50 %) progression of atherosclerotic lesions not in the stent artery, and only in 1 of 14 – progression of atherosclerosis in the stent artery. In the third year after the development of MI, 10 of 14 (71.4 %) had no progression of atherosclerosis, and 4 patients showed progression in both IOA and other arteries.
Conclusions. MSCT coronary angiography is an informative method in assessing the functional status of stents and determining the progression of coronary atherosclerosis in the infarct-causing artery and other coronary arteries in patients after MI and coronary artery stenting in the dynamics of three-year follow-up. The lack of progression of atherosclerosis was accompanied by slightly lower levels of low-density lipoprotein cholesterol, compared with patients with progression of atherosclerosis.

Article Details


myocardial infarction, coronary artery stenting, multislice computed tomography, progression of coronary atherosclerosis


Ел Манаа Х.Э., Щекочихин Д.Ю., Шабанова М.С. и др. Возможности мультиспиральной компьютерной томографии в оценке атеросклеротического поражения коронарных артерий // Кардиология.– 2019.– № 59 (2).– С. 24–31. doi:

Коваленко В.М., Дорогой А.П. Серцево-судинні хвороби: медично-соціальне значення та стратегія розвитку кардіології в Україні // Укр. кардіол. журн.– 2016.– Додаток 3.– С. 5–15.

Коваленко В.М., Федьків С.В. Застосування мультиспіральної комп’ютерної томографії в діагностиці ішемічної хвороби серця // Укр. кардіол. журн.– 2007.– № 1.– С. 70–80.

Терновой С.К., Насникова И.Ю., Морозов С.П. Мультиспиральная компьютерная томография коронарных артерий.– М.: Реал Тайм, 2009.– 56 с.

Терновой С.К., Синицын В.Е., Гагарина Н.В. Неинвазивная диагностика атеросклероза и кальциноза коронарных артерій.– М.: Атмосфера, 2003.– 141 с.

Федьків С.В., Коваленко В.М., Дикан І.М. та ін. Мультиспіральна комп’ютерна томографія: перспективи застосування в сучасній клінічній практиці для діагностики серцево-судинних захворювань // Променева діагностика, променева терапія.– 2008.– № 1.– С. 5–13.

Boogers M.J., Broersen A., van Velzen J.E. Automated quantification of coronary plaque with computed tomography: comparison with intravascular ultrasound using a dedicated registration algorithm for fusion-based quantification // Eur. Heart J.– 2012.– Vol. 33 (8).– P. 1007–1016. doi:

Borja I., Stefan J., Stefan A. et al. Borja Ibanez 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) // Eur. Heart J.– 2018.– Vol. 39, Issue 2.– P. 119–177. doi:

Budoff M.J., Achenbach S., Blumenthal R.S. et al. Assessment of coronary artery disease by cardiac computed tomography, a scientific statement from the Ameri­­can Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology // Circulation.– 2006.– Vol. 114.– P. 1761–1791. doi:

Cho I., Al’Aref S.J., Berger A. et al. Prognostic value of coronary computed tomographic angiography findings in asymptomatic individuals: a 6-year follow-up from the prospective multicentre international CONFIRM study // Eur. Heart J.– 2018.– Vol. 39 (11).– P. 934–941. doi:

Dewey M., Teige F., Schnapauff D. et al. Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging // Ann. Intern. Med.– 2006.– Vol. 145.– P. 407–415. doi:

Díaz-Antón B., Solís J. et al. Diagnostic and prognostic value of coronary computed tomography angiography in patients with severe calcification // J. Cardiovasc. Transl. Res.– 2020. doi:

Eren E., Yilmaz N., Aydin O. Functionally defective high-density lipoprotein and paraoxonase: a couple for endothelial dysfunction in atherosclerosis // Cholesterol.– 2013.– Article ID 792090, 10 p. doi:

Gao D., Ning N., Guo Y. et al. Computed tomography for detecting coronary artery plaques: a metaanalysis // Atherosclerosis.– 2011.– Vol. 219.– P. 603–609. doi:

Haage J.R., Lanzieri C.F. CT and MR Imaging of the Whole Body.– 4-th ed.– Phyladelphia. Morby, 2002.– 1820 p. doi:

Heseltine T., Murray S.W., Ruzsics B. et al. Latest Advances in Cardiac CT // Eur. Cardiol.– 2020.– Vol. 26.– P. 1–7. doi:

Hou Z.H., Lu B., Li Z.N. et al. Quantification of atherosclerotic plaque volume in coronary arteries by computed tomographic angiography in subjects with and without diabetes // Chin. Med. J. (Engl).– 2020.– 6. doi:

Hulten E.A., Carbonaro S., Petrillo S.P. et al. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis // J. Am. Coll. Cardiol.– 2011.– Vol. 57 (10).– P. 1237–1247. doi:

Jason M., Tarkin M.R., Dweck N.R. et al. Imaging Atherosclerosis // Circulation Research. Originally published.– 2016.– Vol. 118.– P. 750–769. doi:

Jernberg T. Swedeheart Annual Report 2015 // Karolinska University Hospital, Huddinge, 14186 Stockholm; 2016.

Kajinami K., Seki H., Takekoshi N. et al. Coronary calcification and coronary atherosclerosis: site by site comparative morphologic study of electron beam computed tomography and coronary angiography // Am. Coll. Cardiol.– 1997.– Vol. 29.– № 7.– P. 1549–1556. doi:

Leber A., Knez A., Becker A. et al. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound // J. Am. Coll. Cardiol.– 2004.– Vol. 43.– P. 1241–1247. doi:

Lehman S.J., Schlett C.L., Bamberg F. et al. Assessment of coronary plaque progression in coronary CT angiography using a semi-quantitative score // JACC Cardiovasc. Imaging.– 2009.– Vol. 2 (11).– P. 1262–1270. doi:

Neiman A., Vasimahmed L., Omar K. et al. Coronary CT Angiography StatPearls // Treasure Island (FL): StatPearls Publishing; 2020-2019 Aug 29.

Pundziute G., Schuijf J.D. Evaluation of plaque characteristics in acute coronary syndromes: non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis // Eur. Heart J.– 2008.– Vol. 29 (19).– P. 2373–2381. doi:

Ramjattan N., Lala V., Kousa O. et al. Coronary CT Angiography // Treasure Island (FL): StatPearls Publishing, 2020.– 29 р.

Rensing B., Vos J., Smits P. et al. Coronary restenosis elimination with a sirolimus eluting stent // Eur. Heart J.– 2001.– Vol. 22.– P. 2125–2130. doi:

Sandfort V., Lima J.A.C., Bluemke D.A. Noninvasive imaging of atherosclerotic plaque progression: status of coronary CT angiography // Circ. Cardiovasc. Imaging.– 2015.– Vol. 8 (7). doi:

Smit J.M., van Rosendael A.R., Mahdiui M. et al. Impact of clinical characteristics and statins on coronary plaque progression by serial computed tomography angiography // Circ. Cardiovasc. Imaging.– 2020.– Vol. 13 (3).– Р.009750. doi:

Tomizawa N., Yamamoto K., Inoh S. et al. High-risk Plaque and Calcification Detected by Coronary CT angiography to predict future cardiovascular events after percutaneous coronary intervention // Acad. Radiol.– 2018.– Vol. 25 (4).– P. 486–493. doi:

Townsend N., Wilson L., Bhatnagar P. et al. Cardiovascular disease in Europe: epidemiological update 2016 // Eur. Heart J.– 2016.– Vol. 37 (42).– С. 3232–3245. doi:

Widimsky P., Wijns W., Fajadet J. et al. European Association for Percutaneous Cardiovascular Interventions. Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries // Eur. Heart J.– 2010.– Vol. 31 (8).– Р. 943–957. doi:

Xiaohua Yin, Rong Xu, Yingchun Wang et al. Implication of coronary CT angiography combined with four-dimensional speckle tracking echocardiography for predicting major adverse cardiac events // Intern. J. Cardiovasc. Imaging.– 2018.– Vol. 34.– Р. 1287–1293. doi:

Xu Y., Mintz G.S., Tam A. et al. Prevalence, distribution, predictors, and outcomes of patients with calcified nodules in native coronary arteries: a 3-vessel intravascular ultrasound analysis from Providing Regional Observations to Study Predictors of Events in the Coronary Tree (PROSPECT) // Circulation.– 2012.– Vol. 126.– P. 537–545. doi:

Yin P., Dou G., Yang X.J. et al. Noninvasive Quantitative Plaque Analysis Identifies Hemodynamically Significant Coronary Arteries Disease // Thorac. Imaging.– 2020.– Vol. 12. doi:

Yu M., Lu Z., Li W. et al. Coronary plaque characteristics on baseline CT predict the need for late revascularization in symptomatic patients after percutaneous intervention // Eur. Radiol.– 2018.– Vol. 28 (8).– Р. 3441–3453. doi:

Most read articles by the same author(s)

1 2 > >>