Objective To determine if multi-detector CT (MDCT) characterization of plaque is correlatedwith the classification of acute coronary syndrome (ACS). Methods Altogether 1900patients were examined by MDCT from December 2007 to May 2009

of whom 95patients fulfilled the criteria of ACS. Those patients were divided into thediscrete plaque group ( n=61) anddiffuse plaque group ( n=34) based onthe findings in MDCT. The clinical diagnosis of ACS and CT results wereanalyzed

including segment stenosis score

segment involvement score

3-vesselplaque score

left main score

calcification score

and remodeling index. Theincidences of major adverse cardiac events in follow-up period were alsorecorded.ResultsThe patients of the diffuse plaque groupwere older than those of the discrete plaque group ( P＜0.0001). The diffuse plaque grouppresented more cases of hypertension

peripheral artery disease

diabetes

and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardialinfarction were found in discrete plaque group. The segment stenosis score ofthe discrete plaque group was lower than that of the diffuse plaque group(5.15±3.55 vs. 14.91±5.37

P＜0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of thediscrete plaque group was higher (1.12±0.16 vs.0.97±0.20

P＜0.05). Follow-up data showed that major adverse cardiac eventsoccurred more frequently in diffuse plaque group than in discrete group (29.41% vs. 11.48%

P=0.0288).Conclusions Characteristics of discrete and diffuseplaques may be significantly different among different classes of ACS. Thediffuse plaque may present higher risk

correlated to higher mortality. Thediagnosis of discrete and diffuse plaques by MDCT would provide a new insightinto the prognosis and treatment of ACS.