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We determined the number of vulnerable plaque characteristics (VPC) with 1) attenuation <30HU, 2) positive remodeling, and 3) focal calcification that are required in a single non-calcified plaque (NCP) on CT to result in high risk of causing major adverse cardiac events (MACE).
A total of 304 subjects with suspected coronary artery disease (172 male; 65±12 yrs) and normal myocardium underwent CT (Light speed Ultra 16,GE Healthcare) from 2003 to 2004.
The 304 subjects were classified into 2 groups: 1) 278 who did not have an NCP with any VPCs or had an NCP with one VPC, and 2) 26 with an NCP with 2-3 VPCs. Significant differences between the groups were observed for the occurrence of MACE in Kaplan Meier analysis (KMA) (P=0.032). Cox proportional hazard model (CPHM) revealed that the presence of 2-3 VPCs in an NCP was a great predictor of the occurrence of MACE (hazard ratio 13.7, P<0.001). We also classified the subjects into 2 other groups as follows: 1) 299 who did not have an NCP with any VPCs or had an NCP with 1-2 VPCs, and 2) 5 with an NCP with 3 VPCs. Significant differences between groups were observed for the occurrence of MACE in KMA (P<0.001). CPHM revealed that the presence of 3 VPC in an NCP was a great predictor of the occurrence of MACE (hazard ratio 85.0, P<0.001).
The coexistence of 2-3 VPCs in an NCP on CT was a critical factor for the prediction of MACE in subjects. Therefore, the presence of 2-3 VPCs in an NCP on CT indicates the need for careful follow up with control of risk factors.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: What's New with Risk Stratification in SIHD: Biomarkers, Genes and ECG
Abstract Category: 10. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1154-67
- 2013 American College of Cardiology Foundation