Mankind NIC Power Quiz

Name

CARDIAC CT ANGIOGRAPHY IMAGE OF MY PATIENT

Assessment of high-risk plaque features. (a) Low-attenuation plaque (white arrows); (b) Spotty calcifications (yellow arrow); (c) Positive remodeling (black arrows); (d) Napkin ring (white arrow). Type OK

CARDIAC CT ANGIOGRAPHY IMAGE OF MY PATIENT

Assessment of high-risk plaque features. "Type ok "

On Cardiac CT Angiography, which of the features is suggestive for vulnerable plaque?

• NAPKIN RING SIGN

• SPOTTY CALCIFICATION > 3MM

• PLAQUE ATTENUATION HOUNSFIELD UNITS > 80

• ALL OF THE ABOVE

Answer explanation

For plaque regression, what will be effective in the patient?

• EXERCISE

• COLCHICINE

• AGGRESSIVE LIPID LOWERING

• ALL OF THE ABOVE

Answer explanation

On OCT study during CAG, what will be the criteria for vulnerable plaque to predict future MI?

• thin fibrous cap <75 mm

• MLA <3.5 mm2

• large lipid arc >180°

• All of the above

Answer explanation

Multicenter prospective CLIMA study enrolling 1003 patients with CAD, the presence of OCT-defined vulnerable plaque (thin fibrous cap <75 mm, MLA <3.5 mm2, large lipid arc >180° and macrophages) increased the risk of cardiac death and target vessel myocardial infarction by seven times with the presence of a thin fibrous cap being the most important factor associated with clinical events in both women and men 

My patient with Anterior wall STEMI has lesions in non-infarct-related coronary arteries. Will aggressive lipid lowering stabilise those lesions in one year?

• Yes

• No

• No data available so far

• Requires minimum 3 years therapy

Answer explanation

IBIS-4 (Integrated Biomarker Imaging Study-4) study, 103 patients underwent IVUS and OCT of two non-infarct-related coronary arteries in the acute phase of STEMI.

At 13 months follow-up, the therapeutic regimen with high-dose rosuvastatin was demonstrated to promote plaque stabilization by increasing OCT-derived fibrous cap thickness by +24.4 μm (p = 0.008) and by reducing macrophage accumulation

My patient has focal FFR-Negative plaques that are angiographically >50% and have evidence of vulnerability on IVUS. Will a PCI revascularization be helpful along with aggressive lipid lowering

• No proven benefit beyond lipid lowering

• Yes

• Only Short -term benefits

• Not Sure

Answer explanation

Preventive Coronary Intervention on Stenosis With Functionally Insignificant Vulnerable Plaque - PREVENT

Park SJ, Ahn JM, Kang DY, et al., on behalf of the PREVENT Investigators. Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicenter, open-label, randomized controlled trial. Lancet April 2024

Results of this trial suggest that PCI of focal non-FFR-positive plaques that are angiographically >50% and have evidence of vulnerability on intravascular imaging (preventive PCI) along with OMT is superior to OMT for clinical outcomes at 2 years among patients with predominantly SIHD. The majority of this benefit was driven by a reduction in subsequent revascularization including ID-TLR. These benefits were sustained at 7 years of follow-up.

As per Victoria Initiate in established ASCVD patients what is the mean % LDL-C reduction with Inclisiran (CRENZLO) first with Usual care Strategy at day 330?

• 60% with Inclisiran (CRENZLO) first Vs 7% with usual care

• 40% with Inclisiran (CRENZLO) first Vs 10% with usual care

• 30% with Inclisiran (CRENZLO) first Vs 7% with usual care

• Not came across the Trial

Answer explanation

As per ORION 10 Study among patients with established ASCVD what is the reduction of LDL-C with Inclisiratn (CRENZLO) from baseline along with max. tolerated statin?

• 52%

• 50%

• 30%

• Not came across the Trial

Answer explanation