Clinical Research Papers:

Low- to high-density lipoprotein cholesterol ratio followed by coronary computed tomography angiography improves coronary plaque classification accuracy

Xiyang Hu _, Wei Zhang, Nairui Zhao, Rongcheng Zhao and Shuofeng Li

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Oncotarget. 2018; 9:7727-7738. https://doi.org/10.18632/oncotarget.23558

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Xiyang Hu1, Wei Zhang2, Nairui Zhao3, Rongcheng Zhao4 and Shuofeng Li1

1Department of Radiology, Cangzhou Central Hospital, Hebei, 061000, Cangzhou, China

2Department of Radiology, Cangzhou Hospital of Integrated Traditional and Western Medicine, Hebei, 061000, Cangzhou, China

3Department of Endocrinology, Cangzhou Central Hospital, Hebei, 061000, Cangzhou, China

4Department of Cardiology, Cangzhou Central Hospital, Hebei, 061000, Cangzhou, China

Correspondence to:

Xiyang Hu, email: [email protected]

Keywords: noncalcified plaque; mixed plaque; coronary computed tomography angiography; low- to high-density lipoprotein cholesterol ratio; intravascular ultrasound

Received: August 08, 2017     Accepted: November 16, 2017     Published: December 21, 2017


Coronary computed tomography angiography (CCTA) is a noninvasive test for detection and analysis of coronary plaques morphology and classification. The low- to high-density lipoprotein cholesterol (L/H) ratio is associated with plaques vulnerability. The study aims to investigate the diagnostic accuracy of CCTA and L/H ratio for plaques classification. We enrolled 212 patients with coronary artery single-vessel disease who performed preoperative CCTA and Intravascular ultrasound (IVUS)-guided invasive coronary angiography. Patients were assigned to the acute coronary syndrome (ACS) group (n = 129) and stable angina pectoris (SAP) group (n = 83). CCTA showed that patients with ACS had more soft plaque and less calcific plaque than those with SAP. The plaque volume and remodeling index measured by CCTA showed good correlation with those measured by IVUS. IVUS identified 91 soft, 58 mixed and 63 calcific plaques in this cohort. For diagnosis of noncalcified plaque (soft and mixed), CCTA had the sensitivity and specificity of 87.9% and 90.4%, respectively. While refer to the further diagnosis of mixed plaque from noncalcified plaque, the sensitivity and specificity was 88.4% and 88.8%, respectively. The L/H ratio was gradually decreased from soft plaque to calcific plaque. If the patients had both the two characteristics (L/H ≥ 2.55 and CCTA), the sensitivity, and specificity were improved in diagnosing noncalcified plaque or mixed plaque. In conclusion, a combined application of CCTA and L/H ratio improves the diagnostic accuracy for coronary noncalcified plaque or mixed plaque as compared to CCTA along.

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