Author + information
- Farangis Lavasania,b,
- Heidi Maya,b,
- Alan C. Kwana,b,
- George Catera,b,
- Boaz D. Rosena,b,
- David Bluemkea,b,
- Donald Lappea,b,
- Jeffrey Andersona,b,
- Kirk Knowltona,b,
- Joao Limaa,b and
- J. Muhlesteina,b
Background: CT coronary artery calcium scores (CAC) are predictive of future major adverse cardiovascular events (MACE). But it is proposed that non-calcified soft plaque may be more vulnerable, and actually increase risk. CT coronary angiography (CTCA), which requires contrast and higher doses of radiation, can quantitatively evaluate plaque composition. However whether CTCA is more accurate than standard CAC in predicting future cardiovascular risk remains to be determined.
Methods: A total of 224 asymptomatic diabetic patients (age = 61.8 years, males = 54%, mean duration of diabetes = 10.4 years) underwent coronary CTCA angiography. Quantitative compositional coronary plaque and CAC scores were measured using semi-automated software, and their relationship to future MACE (death, myocardial infarction and unstable angina) was determined by stratification into categories.
Results: Median follow-up was 6.6 years. Total MACE included 18(8.0%) patients. The median CAC for patients with and without MACE was 605 versus 50 respectively (P=0.008). Event rates and statistical significance for various CTCA and CAC results are shown in the table.
Conclusions: In asymptomatic diabetic patients undergoing CTCA, CAC score and calcified plaque burden were the plaque compositional variables most predictive of future MACE. Soft plaque compositional variables did not predict future risk. These findings provide further evidence of the relationship between coronary calcium and cardiovascular risk.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Prognostic Implications of CT Angiography
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1247-227
- 2017 American College of Cardiology Foundation