التفاصيل البيبلوغرافية
| العنوان: |
Obilježja vulnerabilnog plaka na višeslojnoj kompjutoriziranoj tomografiji koronarnih arterija. (Bosnian) |
| Alternate Title: |
Vulnerable Plaque Characteristics at Coronary Computed Tomography Angiography. (English) |
| المؤلفون: |
Medaković, Petar, Jukić, Mladen, Biloglav, Zrinka |
| المصدر: |
Cardiologia Croatica; Jan/Feb2023, Vol. 18 Issue 1/2, p7-21, 15p |
| مصطلحات موضوعية: |
CORONARY artery disease, ACUTE coronary syndrome, CORONARY disease, PROGNOSIS, DIAGNOSIS, ATHEROSCLEROTIC plaque |
| مصطلحات جغرافية: |
CROATIA |
| الشركة/الكيان: |
EUROPEAN Union, EUROPEAN Society of Cardiology |
| Abstract (English): |
According to morbidity and mortality indicators, cardiovascular diseases are the leading public health issue in the Republic of Croatia and the European Union. Although mortality rates from ischemic disease have been reduced, Croatia is still categorized among countries with high cardiovascular risk. The guidelines of the European Society of Cardiology from 2020 for acute coronary syndrome (ACS) in patients with low to intermediate risk of coronary atherosclerotic heart disease (CHD) recommend coronary computed tomography angiography (CCTA) as an alternative to invasive coronarography. In most patients with suspicion of CHD, CCTA leads to the diagnosis of non-obstructive diseases, which causes the majority of ACS cases. Multi-slice Computed Tomography scanners of the newest generation employ low doses of radiation and low contrast volume to reliably show the characteristics of vulnerable plaque: (i) positive remodeling, (ii) low attenuation plaque, (iii) spotty calcification, and the (iv) napkin-ring sign. Due to positive remodeling, these plaques are often non-obstructive, and according to the CAD-RADS 2.0 guidelines from 2022 all their characteristics should be specifically emphasized in CCTA findings. Based on the assessment of the prognostic value of vulnerable plaque characteristics for adverse cardiac events, CCTA has been shown to be equally valid as other invasive diagnostic methods. Additionally, it was shown to be useful in indicating the optimal medication therapy and monitoring its effects. The results of large international randomized trials indicate the direction of the treatment approach for vulnerable plaque. [ABSTRACT FROM AUTHOR] |
| Abstract (Croatian): |
Kardiovaskularne su bolesti, prema pokazateljima morbiditeta i mortaliteta, vodeći javnozdravstveni problem u Republici Hrvatskoj i Europskoj uniji. Premda stope smrtnosti od ishemijske bolesti srca padaju, Hrvatska se još uvijek ubraja u države visokog kardiovaskularnog rizika. Smjernice Europskoga kardiološkog društva iz 2020. godine za akutni koronarni sindrom (AKS) u bolesnika s niskim do srednjim rizikom od koronarne aterosklerotske bolesti srca (KBS) preporučuju MSCT koronarografiju kao alternativu invazivnoj koronarografiji. U većine bolesnika sa sumnjom na KBS nakon MSCT koronarografije postavi se dijagnoza neopstruktivne bolesti koja uzrokuje većinu slučajeva AKS-a. MSCT uređaji najnovije generacije uz nisku dozu zračenja i mali volumen kontrasta pouzdano prikazuju obilježja vulnerabilnog plaka: (i) pozitivno remodeliranje, (ii) plak niske atenuacije, (iii) točkastu kalcifikaciju i (iv) znak prstena za salvete. Ti su plakovi zbog pozitivnog remodeliranja često neopstruktivni, a prema smjernicama CAD-RADS 2.0 iz 2022. godine, sva njihova obilježja potrebno je na MSCT nalazima posebno naglasiti. Pri procjeni prognostičke vrijednosti obilježja vulnerabilnog plaka za neželjene kardijalne događaje MSCT se pokazao podjednako valjan kao i druge invazivne dijagnostičke metode. Isto tako, kod vulnerabilnih plakova pokazao se korisnim pri indiciranju optimalne medikamentne terapije kao i u praćenju njezina učinka. Rezultati velikih međunarodnih randomiziranih istraživanja upućuju na smjer terapijskog pristupa vulnerabilnom plaku. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
