Clinical Case N°1 : 

 

AI-assisted Coronary CT angiography might save lives : Acute myocardial infarction 48h after CCTA reported as normal.

A 50-year-old male underwent coronary CT angiography (CCTA) for atypical chest pain:

• Calcium scoring was 0.

• CCTA was initially read as normal. However, 48h after, the patient presented with acute myocardial infarction (MI). Urgent invasive coronary angiography revealed an obstructive thrombotic lesion of the mid LAD, successfully treated by stent.

 

Retrospective CT analysis revealed that the patient indeed had a 35% diameter stenosis (50% area stenosis), due to a large soft plaque of the mid LAD, with high positive remodeling (PR index = 2.5). A small diagonal branch occlusion was also detected.

 

CorEx Software was able to detect the LAD lesion in less than one minute, demonstrating the potential of AI to unveil non-obstructive, yet potentially deadly, soft plaques.

 

This case illustrates that:
MIs can often result from non-obstructive lesions (plaque rupture). A calcium score of 0 does not exclude possible obstructive coronary disease on CCTA. Non-obstructive lesions in CCTA are more difficult to detect than obstructive ones. CorEx may help in detecting not only obstructive lesions but also non-obstructive calcified lesions, with a point-of-care solution. CorEx might be helpful to prevent several events, including sudden cardiac death.