Open Access

Highly Inflamed Non-Calcified Coronary Plaques Sealed with Stents in Patients with Zero Calcium Score – a Case Series and Review of the Literature

Botond-Barna Mátyás
Botond-Barna Mátyás
, 
Renáta Gerculy
Renáta Gerculy
, 
Nóra Rat
Nóra Rat
, 
Emanuel Blîndu
Emanuel Blîndu
, 
Alexandra Gorea Stănescu
Alexandra Gorea Stănescu
, 
Aurelian Roșca
Aurelian Roșca
, 
Corneliu-Florin Buicu
Corneliu-Florin Buicu
, 
Imre Benedek
Imre Benedek
 and 
Theodora Benedek
Theodora Benedek
   | Dec 09, 2023
Journal of Cardiovascular Emergencies's Cover Image
About this article
Previous Article
Next Article
Cite
Article Category: Case Series
Published Online: Dec 09, 2023
Page range: 38 - 44
Received: Oct 21, 2023
Accepted: Nov 12, 2023
DOI: https://doi.org/10.2478/jce-2023-0016
Keywords
© 2024 Botond-Barna Mátyás et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

FIGURE 1.

In chronological order, the figure includes: (1) Case 1 CCTA scan demonstrating a severe proximal LAD stenosis caused by noncalcified plaque, with two high-risk plaque characteristics present: positive remodeling and low attenuation (on the left side, enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping result of the affected segment, showing an inhomogeneous mix of yellow, red, and blue colors, representing high vascular inflammation (within the orange frame); (3) Elective PCI procedure (enclosed by the green frame).
In chronological order, the figure includes: (1) Case 1 CCTA scan demonstrating a severe proximal LAD stenosis caused by noncalcified plaque, with two high-risk plaque characteristics present: positive remodeling and low attenuation (on the left side, enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping result of the affected segment, showing an inhomogeneous mix of yellow, red, and blue colors, representing high vascular inflammation (within the orange frame); (3) Elective PCI procedure (enclosed by the green frame).

FIGURE 2.

(1) Case 2 CCTA scan reveals a severe stenosis in the second segment of the LAD due to a non-calcified plaque, with the same two high-risk plaque characteristics present (enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping of the affected segment displays an uneven mix of yellow, red, and blue colors, indicating high vascular inflammation (within the orange frame); (3) Elective PCI procedure with good results (enclosed by the green frame).
(1) Case 2 CCTA scan reveals a severe stenosis in the second segment of the LAD due to a non-calcified plaque, with the same two high-risk plaque characteristics present (enclosed by the yellow frame, highlighted by green zones); (2) FAI mapping of the affected segment displays an uneven mix of yellow, red, and blue colors, indicating high vascular inflammation (within the orange frame); (3) Elective PCI procedure with good results (enclosed by the green frame).

FIGURE 3.

(1) Case 3 CCTA scan: Severe LAD stenosis due to non-calcified plaque (yellow frame, green zones); (2) FAI mapping: High vascular inflammation (orange frame); (3) Elective PCI procedure (green frame).
(1) Case 3 CCTA scan: Severe LAD stenosis due to non-calcified plaque (yellow frame, green zones); (2) FAI mapping: High vascular inflammation (orange frame); (3) Elective PCI procedure (green frame).

FIGURE 4.

PVAT examination findings: FAI score, adjusted relative risk for age and gender, and weighted FAI score of the most inflamed coronary artery
PVAT examination findings: FAI score, adjusted relative risk for age and gender, and weighted FAI score of the most inflamed coronary artery

Baseline, risk factors, laboratory and PVAT inflammation parameters for each case

Parameters Case 1 Case 2 Case 3
Age at time of scan (years) 33 59 43
BMI (kg/m2) 30.56 25.06 31.22
LVEF (%) 50 47 48
Risk factors
  Hypertension Yes Yes Yes
  Hypercholesterolemia Yes Yes Yes
  Diabetes No No No
  Smoking No No No
Laboratory parameters
  Creatinine (mg/dL) 1.13 0.91 0.87
  Total cholesterol (mg/dL) 211 260 172
  LDL cholesterol (mg/dL) 103 197 113
  Triglycerides (mg/dL) 106 105 107
PVAT inflammation parameters
  FAI (HU) −68.27 −66.44 −67.38
  FAI score 2.50 19.20 4.40
  FAI score percentile (%) 90th 96th 85th
Calcium score 0 0 0
CAD-RADS Score IV A IV A IV A
SYNTAX Score 8 5 5
PCI after CCTA Yes Yes Yes
Multi-vessel PCI No No No
eISSN:
2457-5518
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Emergency Medicine and Intensive-Care Medicine, Radiology, Internal Medicine, Cardiology
Journal RSS Feed