Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography

Mohammed Meah; Anda Bularga; Evangelos Tzolos; Andrew R Chapman; Marwa Daghem; John Hung; Justin  Chiong; Caelan Taggart; Ryan Wereski; Alasdair Gray; Marc R Dweck; Carl  Roobottom; Nick  Curzen; Attila  Kardos; Dirk  Felmeden; Nicholas L Mills; Piotr J Slomka; David E Newby; Damini Dey; Michelle C Williams

doi:10.1148/ryct.220081

Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography

Mohammed Meah, Anda Bularga, Evangelos Tzolos, Andrew R Chapman, Marwa Daghem, John Hung, Justin Chiong, Caelan Taggart, Ryan Wereski, Alasdair Gray, Marc R Dweck, Carl Roobottom, Nick Curzen, Attila Kardos, Dirk Felmeden, Nicholas L Mills, Piotr J Slomka, David E Newby, Damini Dey, Michelle C Williams

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

PURPOSE: To determine whether quantitative plaque characterization using CT coronary angiography (CTCA) can discriminate between type 1 and type 2 myocardial infarction.

METHODS: This was a secondary analysis of two prospective studies (ClinicalTrials.gov: NCT03338504 (2014-2019) and NCT02284191 (2018-2020)) that performed blinded quantitative plaque analysis on CTCA of participants with type 1 myocardial infarction, type 2 myocardial infarction, and chest pain without myocardial infarction. Logistic regression analyses were performed to identify predictors of type 1 myocardial infarction.

RESULTS: Overall, 155 participants (mean age, 64 ± [SD] 12 years; 114 men) and 36 participants (mean age, 67 ±12 years; 19 men) had type 1 and type 2 myocardial infarction respectively, and 136 (62 ± 12 years; 78 men) had chest pain without myocardial infarction. Participants with type 1 myocardial infarction had greater total (median, 44% [IQR, 35-50%] versus 35% [29-46%]), non-calcified (39% [31-46%] versus 34% [29-40%]) and low-attenuation (4.15% [1.88-5.79%] versus 1.64% [0.89-2.28%]) plaque burdens (p
CONCLUSION: Higher coronary low-attenuation plaque burden in patients with type I myocardial infarction may help distinguish these patients from those with type 2 myocardial infarction.

Original language	English
Journal	Radiology: Cardiothoracic Imaging
DOIs	https://doi.org/10.1148/ryct.220081
Publication status	Published - 27 Oct 2022

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High-Sensitivity Cardiac Troponin Beyond the Acute Coronary Syndrome
Mills, N., Anand, A., Chapman, A., Ferry, A., Newby, D., Strachan, F. & Tsanas, T.
UK-based charities
1/06/20 → 31/05/25
Project: Research
Redefining Unstable Angina with High-sensitivity Cardiac Troponin
Mills, N.
MRC
1/02/21 → 31/01/23
Project: Research
Effect of computed tomography coronary angiography on life-style and risk factor modification
Newby, D. & Williams, M.
UK-based charities
4/09/19 → 3/09/22
Project: Research

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Meah, M., Bularga, A., Tzolos, E., Chapman, A. R., Daghem, M., Hung, J., Chiong, J., Taggart, C., Wereski, R., Gray, A., Dweck, M. R., Roobottom, C., Curzen, N., Kardos, A., Felmeden, D., Mills, N. L., Slomka, P. J., Newby, D. E., Dey, D., & Williams, M. C. (2022). Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography. Radiology: Cardiothoracic Imaging. https://doi.org/10.1148/ryct.220081

@article{4c4c2f588ca24200a1c24085f38f2338,

title = "Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography",

abstract = "PURPOSE: To determine whether quantitative plaque characterization using CT coronary angiography (CTCA) can discriminate between type 1 and type 2 myocardial infarction. METHODS: This was a secondary analysis of two prospective studies (ClinicalTrials.gov: NCT03338504 (2014-2019) and NCT02284191 (2018-2020)) that performed blinded quantitative plaque analysis on CTCA of participants with type 1 myocardial infarction, type 2 myocardial infarction, and chest pain without myocardial infarction. Logistic regression analyses were performed to identify predictors of type 1 myocardial infarction. RESULTS: Overall, 155 participants (mean age, 64 ± [SD] 12 years; 114 men) and 36 participants (mean age, 67 ±12 years; 19 men) had type 1 and type 2 myocardial infarction respectively, and 136 (62 ± 12 years; 78 men) had chest pain without myocardial infarction. Participants with type 1 myocardial infarction had greater total (median, 44% [IQR, 35-50%] versus 35% [29-46%]), non-calcified (39% [31-46%] versus 34% [29-40%]) and low-attenuation (4.15% [1.88-5.79%] versus 1.64% [0.89-2.28%]) plaque burdens (pCONCLUSION: Higher coronary low-attenuation plaque burden in patients with type I myocardial infarction may help distinguish these patients from those with type 2 myocardial infarction. ",

author = "Mohammed Meah and Anda Bularga and Evangelos Tzolos and Chapman, {Andrew R} and Marwa Daghem and John Hung and Justin Chiong and Caelan Taggart and Ryan Wereski and Alasdair Gray and Dweck, {Marc R} and Carl Roobottom and Nick Curzen and Attila Kardos and Dirk Felmeden and Mills, {Nicholas L} and Slomka, {Piotr J} and Newby, {David E} and Damini Dey and Williams, {Michelle C}",

note = "Funding Information: Disclosures of conflicts of interest: M.M. Author is a British Heart Foundation (BHF) clinical research fellow at the University of Edinburgh, a BHF grant (grant no. FS/19/46/34445) has supported author{\textquoteright}s work since November 2019. A.B. Support for the present manuscript from the BHF (grant no. FS/16/75/32533). E.T. No relevant relationships. A.R.C. No relevant relationships. M.D. No relevant relationships. J.D.H. No relevant relationships. J.C. No relevant relationships. C.T. No relevant relationships. R.W. Clinical training research fellowship from the Medical Research Council UK (no. MR/V007017/1). A.G. Participation on advisory board for Abbott for brain and cardiac biomarkers, fees paid to author{\textquoteright}s institution. M.R.D. No relevant relationships. C.R. No relevant relationships. N.C. Unrestricted research grants from Boston Scientific, Haemonetics, Beckmann Coulter, and HeartFlow; speakers fees from Abbott and Boston Scientific; travel sponsorship from Biosensors, Abbott, Edwards, and Medtronic. A.K. No relevant relationships. D.F. No relevant relationships. N.L.M. BHF grants (grant nos. CH/F/21/90010, RG/20/10/34966, and RE/18/5/34216) paid to author{\textquoteright}s institution; payment or honoraria for lectures from Abbott Diagnostics and Siemens Healthineers; payment for participation on advisory boards for LumiraDX, Roche Diagnostics, and Siemens Healthineers; receipt of reagent from Siemens Healthineers to support research. P.J.S. Grants from Siemens Medical Systems and National Institutes of Health, paid to author{\textquoteright}s institution; royalties or licenses from Cedars-Sinai Medical Systems, paid to author and author{\textquoteright}s institution; consulting fees from IBA; several patents planned and pending, not related to this field of work, via Cedars-Sinai; vice-president of Society of Nuclear Medicine. D.E.N. Supported by the BHF (grant nos. CH/09/002, RG/16/10/32375, and RE/18/5/34216) and is the recipient of a Well- come Trust Senior Investigator award (no. WT103782AIA); author is a co-applicant and co-author on the RAPID-CTA trial funded by the National Institute for Health (NIH) Research Health Technology Assessment Programme (no. 13/04/108) and the DEMAND-MI study funded by the BHF (FS/16/75/32533). D.D. NIH/National Heart, Lung, and Blood Institute grants (nos. 1R01HL148787-01A1 and 1R01HL151266); software royalties from Cedars-Sinai Medical Center, outside the current work. M.C.W. Supported by the BHF (grant no. FS/ICRF/20/26002); author has given talks for Canon Medical Systems and Siemens Healthineers; member of the board of directors of Society of Cardiovascular Computed Tomography; president-elect of the education committee of the British Society of Cardiovascular Imaging; president-elect of the European Society of Cardiovascular Radiology; Radiology: Cardiothoracic Imaging editorial board member. Funding Information: M.N.M. (no. FS/19/46/34445), E.T. (no. FS/CRTF/20/24086), A.R.C. (no. FS/16/75/32533), N.L.M. (nos. FS/16/14/32023, RG/20/10/34966, RE/18/5/34216), M.C.W. (nos. FS/ICRF/20/26002, FS/11/014, CH/09/002), and D.E.N. (nos. CH/09/002, RG/16/10/32375, RE/18/5/34216) are supported by the British Heart Foundation (BHF). A.B. and R.W. are supported by a clinical research training fellowship (nos. MR/V007254/1 and MR/V007017/1) from the Medical Research Council. D.D. is supported by National Institutes of Health/National Heart, Lung, and Blood Institute grants (nos. 1R01HL148787-01A1 and 1R01HL151266). The Edinburgh Clinical Research Facilities and Edinburgh Imaging facility are supported by the National Health Service Research Scotland through National Health Service Lothian Health Board. The RAPID-CTCA trial was funded by the National Institute for Health Research Health Technology Assessment Programme (no. 13/04/108). The DEMAND-MI study was funded by the BHF (no. FS/16/75/32533). A.R.C. receives additional support from the Academy of Medical Sciences (no. SGL021/1075). Publisher Copyright: {\textcopyright} RSNA, 2022.",

year = "2022",

month = oct,

day = "27",

doi = "10.1148/ryct.220081",

language = "English",

journal = "Radiology: Cardiothoracic Imaging",

issn = "2638-6135",

publisher = "Radiological Society of North America Inc.",

}

Meah, M, Bularga, A, Tzolos, E, Chapman, AR, Daghem, M, Hung, J, Chiong, J, Taggart, C, Wereski, R , Gray, A , Dweck, MR, Roobottom, C, Curzen, N, Kardos, A, Felmeden, D, Mills, NL, Slomka, PJ, Newby, DE, Dey, D & Williams, MC 2022, 'Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography', Radiology: Cardiothoracic Imaging. https://doi.org/10.1148/ryct.220081

TY - JOUR

T1 - Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography

AU - Meah, Mohammed

AU - Bularga, Anda

AU - Tzolos, Evangelos

AU - Chapman, Andrew R

AU - Daghem, Marwa

AU - Hung, John

AU - Chiong, Justin

AU - Taggart, Caelan

AU - Wereski, Ryan

AU - Gray, Alasdair

AU - Dweck, Marc R

AU - Roobottom, Carl

AU - Curzen, Nick

AU - Kardos, Attila

AU - Felmeden, Dirk

AU - Mills, Nicholas L

AU - Slomka, Piotr J

AU - Newby, David E

AU - Dey, Damini

AU - Williams, Michelle C

N1 - Funding Information: Disclosures of conflicts of interest: M.M. Author is a British Heart Foundation (BHF) clinical research fellow at the University of Edinburgh, a BHF grant (grant no. FS/19/46/34445) has supported author’s work since November 2019. A.B. Support for the present manuscript from the BHF (grant no. FS/16/75/32533). E.T. No relevant relationships. A.R.C. No relevant relationships. M.D. No relevant relationships. J.D.H. No relevant relationships. J.C. No relevant relationships. C.T. No relevant relationships. R.W. Clinical training research fellowship from the Medical Research Council UK (no. MR/V007017/1). A.G. Participation on advisory board for Abbott for brain and cardiac biomarkers, fees paid to author’s institution. M.R.D. No relevant relationships. C.R. No relevant relationships. N.C. Unrestricted research grants from Boston Scientific, Haemonetics, Beckmann Coulter, and HeartFlow; speakers fees from Abbott and Boston Scientific; travel sponsorship from Biosensors, Abbott, Edwards, and Medtronic. A.K. No relevant relationships. D.F. No relevant relationships. N.L.M. BHF grants (grant nos. CH/F/21/90010, RG/20/10/34966, and RE/18/5/34216) paid to author’s institution; payment or honoraria for lectures from Abbott Diagnostics and Siemens Healthineers; payment for participation on advisory boards for LumiraDX, Roche Diagnostics, and Siemens Healthineers; receipt of reagent from Siemens Healthineers to support research. P.J.S. Grants from Siemens Medical Systems and National Institutes of Health, paid to author’s institution; royalties or licenses from Cedars-Sinai Medical Systems, paid to author and author’s institution; consulting fees from IBA; several patents planned and pending, not related to this field of work, via Cedars-Sinai; vice-president of Society of Nuclear Medicine. D.E.N. Supported by the BHF (grant nos. CH/09/002, RG/16/10/32375, and RE/18/5/34216) and is the recipient of a Well- come Trust Senior Investigator award (no. WT103782AIA); author is a co-applicant and co-author on the RAPID-CTA trial funded by the National Institute for Health (NIH) Research Health Technology Assessment Programme (no. 13/04/108) and the DEMAND-MI study funded by the BHF (FS/16/75/32533). D.D. NIH/National Heart, Lung, and Blood Institute grants (nos. 1R01HL148787-01A1 and 1R01HL151266); software royalties from Cedars-Sinai Medical Center, outside the current work. M.C.W. Supported by the BHF (grant no. FS/ICRF/20/26002); author has given talks for Canon Medical Systems and Siemens Healthineers; member of the board of directors of Society of Cardiovascular Computed Tomography; president-elect of the education committee of the British Society of Cardiovascular Imaging; president-elect of the European Society of Cardiovascular Radiology; Radiology: Cardiothoracic Imaging editorial board member. Funding Information: M.N.M. (no. FS/19/46/34445), E.T. (no. FS/CRTF/20/24086), A.R.C. (no. FS/16/75/32533), N.L.M. (nos. FS/16/14/32023, RG/20/10/34966, RE/18/5/34216), M.C.W. (nos. FS/ICRF/20/26002, FS/11/014, CH/09/002), and D.E.N. (nos. CH/09/002, RG/16/10/32375, RE/18/5/34216) are supported by the British Heart Foundation (BHF). A.B. and R.W. are supported by a clinical research training fellowship (nos. MR/V007254/1 and MR/V007017/1) from the Medical Research Council. D.D. is supported by National Institutes of Health/National Heart, Lung, and Blood Institute grants (nos. 1R01HL148787-01A1 and 1R01HL151266). The Edinburgh Clinical Research Facilities and Edinburgh Imaging facility are supported by the National Health Service Research Scotland through National Health Service Lothian Health Board. The RAPID-CTCA trial was funded by the National Institute for Health Research Health Technology Assessment Programme (no. 13/04/108). The DEMAND-MI study was funded by the BHF (no. FS/16/75/32533). A.R.C. receives additional support from the Academy of Medical Sciences (no. SGL021/1075). Publisher Copyright: © RSNA, 2022.

PY - 2022/10/27

Y1 - 2022/10/27

N2 - PURPOSE: To determine whether quantitative plaque characterization using CT coronary angiography (CTCA) can discriminate between type 1 and type 2 myocardial infarction. METHODS: This was a secondary analysis of two prospective studies (ClinicalTrials.gov: NCT03338504 (2014-2019) and NCT02284191 (2018-2020)) that performed blinded quantitative plaque analysis on CTCA of participants with type 1 myocardial infarction, type 2 myocardial infarction, and chest pain without myocardial infarction. Logistic regression analyses were performed to identify predictors of type 1 myocardial infarction. RESULTS: Overall, 155 participants (mean age, 64 ± [SD] 12 years; 114 men) and 36 participants (mean age, 67 ±12 years; 19 men) had type 1 and type 2 myocardial infarction respectively, and 136 (62 ± 12 years; 78 men) had chest pain without myocardial infarction. Participants with type 1 myocardial infarction had greater total (median, 44% [IQR, 35-50%] versus 35% [29-46%]), non-calcified (39% [31-46%] versus 34% [29-40%]) and low-attenuation (4.15% [1.88-5.79%] versus 1.64% [0.89-2.28%]) plaque burdens (pCONCLUSION: Higher coronary low-attenuation plaque burden in patients with type I myocardial infarction may help distinguish these patients from those with type 2 myocardial infarction.

AB - PURPOSE: To determine whether quantitative plaque characterization using CT coronary angiography (CTCA) can discriminate between type 1 and type 2 myocardial infarction. METHODS: This was a secondary analysis of two prospective studies (ClinicalTrials.gov: NCT03338504 (2014-2019) and NCT02284191 (2018-2020)) that performed blinded quantitative plaque analysis on CTCA of participants with type 1 myocardial infarction, type 2 myocardial infarction, and chest pain without myocardial infarction. Logistic regression analyses were performed to identify predictors of type 1 myocardial infarction. RESULTS: Overall, 155 participants (mean age, 64 ± [SD] 12 years; 114 men) and 36 participants (mean age, 67 ±12 years; 19 men) had type 1 and type 2 myocardial infarction respectively, and 136 (62 ± 12 years; 78 men) had chest pain without myocardial infarction. Participants with type 1 myocardial infarction had greater total (median, 44% [IQR, 35-50%] versus 35% [29-46%]), non-calcified (39% [31-46%] versus 34% [29-40%]) and low-attenuation (4.15% [1.88-5.79%] versus 1.64% [0.89-2.28%]) plaque burdens (pCONCLUSION: Higher coronary low-attenuation plaque burden in patients with type I myocardial infarction may help distinguish these patients from those with type 2 myocardial infarction.

U2 - 10.1148/ryct.220081

DO - 10.1148/ryct.220081

M3 - Article

SN - 2638-6135

JO - Radiology: Cardiothoracic Imaging

JF - Radiology: Cardiothoracic Imaging

ER -

Distinguishing Type 1 from Type 2 Myocardial Infarction Using CT Coronary Angiography

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Projects

High-Sensitivity Cardiac Troponin Beyond the Acute Coronary Syndrome

Redefining Unstable Angina with High-sensitivity Cardiac Troponin

Effect of computed tomography coronary angiography on life-style and risk factor modification

Cite this