The natural history of napkin-ring sign by coronary computed tomography angiography

Aleksandra Brutkiewicz; Mariusz Kruk; Marcin Demkow; Pal Maurovich-Horvat; Weronika Pleban; Anna Witowicz; Jerzy Pręgowski; Zofia Dzielinska; Witold Ruzyllo; Cezary Kępka

doi:10.5114/aic.2019.87886

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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Original paper

The natural history of napkin-ring sign by coronary computed tomography angiography

Aleksandra Brutkiewicz

¹

,

Mariusz Kruk

¹

,

Marcin Demkow

¹

,

Pal Maurovich-Horvat

²

,

Weronika Pleban

¹

,

Anna Witowicz

¹

,

Jerzy Pręgowski

¹

,

Zofia Dzielinska

¹

,

Witold Ruzyllo

¹

,

Cezary Kępka

¹

Coronary Artery and Structural Heart Diseases Department, Institute of Cardiology, Warsaw, Poland
Cardiovascular Imaging Research Group Heart and Vascular Center, Semmelweis University, Budapest, Hungary

Adv Interv Cardiol 2019; 15, 3 (57): 314–320

DOI: https://doi.org/10.5114/aic.2019.87886

Online publish date: 2019/09/18

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AMA

Brutkiewicz A, Kruk M, Demkow M, et al. The natural history of napkin-ring sign by coronary computed tomography angiography. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2019;15(3):314-320. doi:10.5114/aic.2019.87886.

APA

Brutkiewicz, A., Kruk, M., Demkow, M., Maurovich-Horvat, P., Pleban, W.,  & Witowicz, A. et al. (2019). The natural history of napkin-ring sign by coronary computed tomography angiography. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 15(3), 314-320. https://doi.org/10.5114/aic.2019.87886

Chicago

Brutkiewicz, Aleksandra, Mariusz Kruk, Marcin Demkow, Pal Maurovich-Horvat, Weronika Pleban, Anna Witowicz,  and Jerzy Pręgowski et al. 2019. "The natural history of napkin-ring sign by coronary computed tomography angiography". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 15 (3): 314-320. doi:10.5114/aic.2019.87886.

Harvard

Brutkiewicz, A., Kruk, M., Demkow, M., Maurovich-Horvat, P., Pleban, W., Witowicz, A., Pręgowski, J., Dzielinska, Z., Ruzyllo, W.,  and Kępka, C. (2019). The natural history of napkin-ring sign by coronary computed tomography angiography. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 15(3), pp.314-320. https://doi.org/10.5114/aic.2019.87886

MLA

Brutkiewicz, Aleksandra et al. "The natural history of napkin-ring sign by coronary computed tomography angiography." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 15, no. 3, 2019, pp. 314-320. doi:10.5114/aic.2019.87886.

Vancouver

Brutkiewicz A, Kruk M, Demkow M, Maurovich-Horvat P, Pleban W, Witowicz A et al. The natural history of napkin-ring sign by coronary computed tomography angiography. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2019;15(3):314-320. doi:10.5114/aic.2019.87886.

Introduction
Despite their significance, the prevalence and the incidence of vulnerable plaques in coronary arteries, as well as their natural history, remain poorly known.

Aim
To evaluate the prevalence, incidence and evolution of napkin-ring sign (NRS), and to establish factors associated with its presence, progression, or regression, in patients with suspected coronary artery disease (CAD).

Material and methods
The study is based on a single-center prospective registry. Eighty-nine patients with suspected CAD underwent two computed tomography angiography (CTA) examinations within an interval of at least 24 months. High-risk plaque was defined by the presence of a low-attenuation area adjacent to the coronary lumen, surrounded by a ring of higher attenuation – NRS.

Results
At the baseline 53 NRS were observed in 22 (25%) patients, 7 (8%) patients had single NRS and 15 (17%) had multiple NRS. After the follow-up period, there were 68 NRS in 32 patients. In 18 patients progression was observed with 23 additional NRS. Presence of single NRS and diabetes were independent predictors of NRS progression.

Conclusions
The number of NRS plaque tends to increase over time in patients with suspected CAD. The progression may be predicted by the presence of diabetes or single NRS.

keywords:

The natural history of napkin-ring sign by coronary computed tomography angiography

Aleksandra Brutkiewicz 1 , Mariusz Kruk 1 , Marcin Demkow 1 , Pal Maurovich-Horvat 2 , Weronika Pleban 1 , Anna Witowicz 1 , Jerzy Pręgowski 1 , Zofia Dzielinska 1 , Witold Ruzyllo 1 , Cezary Kępka 1

napkin-ring sign, vulnerable plaque, coronary computed tomography

Aleksandra Brutkiewicz

¹

,

Mariusz Kruk

¹

,

Marcin Demkow

¹

,

Pal Maurovich-Horvat

²

,

Weronika Pleban

¹

,

Anna Witowicz

¹

,

Jerzy Pręgowski

¹

,

Zofia Dzielinska

¹

,

Witold Ruzyllo

¹

,

Cezary Kępka

¹