Author + information
- David A. Halon,
- Ronen Rubinshtein,
- Barak Zafrir,
- Mali Azencot,
- Moshe Y. Flugelman and
- Basil Lewis
Background: Although patient based risk factors for prediction of acute coronary syndromes (ACS) are well recognized, prospective identification of future culprit coronary plaques by non-invasive imaging is poorly documented.
Methods: We performed detailed analysis of coronary plaques by CT angiography (CTA) in 630 asymptomatic type 2 diabetics (age 63.5±5.3y, 50.5% women) with no known coronary artery disease (CAD) and followed them for 8.4±0.6 yr. In patients who later developed ACS and underwent invasive angiography (with no interim elective revascularization) culprit and non-culprit plaques were identified and correlated with their baseline CTA characteristics.
Results: ACS occurred in 14 patients (age 64.7±5.8y, 64% men) 4.3±2.5 (range 0.5-8.3) yrs after baseline CTA. On baseline CTA culprit plaques were larger, less dense and stenosis was greater (Table). Most (12, 86%) culprit plaques were <50% calcified vs 32 (38%) of non-culprit plaques (p=0.001). Combined C-statistic for culprit plaque (length, grade calcification and stenosis) = .774.
Conclusions: In asymptomatic diabetics, larger, less calcified plaque with prominent low density component and greater luminal stenosis on baseline CTA were more likely to become culprit plaques causing ACS several years later. Finding of high risk plaque characteristics on CTA in diabetics should trigger more intensive preventive treatment.
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: 1247-242
- 2017 American College of Cardiology Foundation