High-Risk Coronary Plaques Complicated with Acute Coronary Syndrome in Young Patients

DOI: 10.1515/jim-2017-0050


Coronary computed tomography angiography (CCTA) has evolved notably over the last de-cade, gaining an increased amount of temporo-spatial resolution in combination with de-creased radiation exposure. The importance of CCTA is emerging especially in vulnerable and young patients who might not have developed a viable collateral vascular network to sustain the circulation to an infarction area during a major adverse coronary event. There are a few well-known markers by which a vulnerable plaque can be assessed and that can predict the subsequent events of sudden myocardial ischemia, such as an increased positive remodeling index (cut-off >1.4), low-attenuation plaque (cut-off <30 HU), plaque burden (cut-off >0.7), and napkin-ring sign (NRS). This manuscript presents a series of 3 clinical cases of young patients experiencing symptoms and signs of myocardial ischemia who underwent CCTA in order to assess the composition and functional characteristics of atherosclerotic plaques and their re-percussion in developing an acute coronary syndrome.

Keywords: vulnerable plaque, coronary computed tomography angiography, acute coronary

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