Abstract 1638: Association between Cardiovascular Risk Profiles and the Presence and Extent of Different Types of Coronary Atherosclerotic Plaque as Detected by Multidetector Computed Tomography
Objective: We systematically assessed the association between cardiovascular risk profiles and the presence and extent of coronary atherosclerotic plaque stratified by plaque composition
Methods: In this cross-sectional study, we included consecutive subjects who presented with acute chest pain in the emergency department but had no prior history of coronary artery disease (CAD) and did not develop acute coronary syndrome (ACS) during index hospitalization. All subjects underwent standard contrast-enhanced 64-slice coronary MDCT (0.6mm slice thickness, 120 kVp, 850 mAs). Two independent observers determined the presence of non-calcified coronary plaque (NCAP), mixed coronary plaque (MCAP) and calcified coronary plaque (CAP) in each coronary segment.
Results: Among 195 patients (91 women, mean age: 54.6±12.0 years) any plaque and exclusively NCAP were detected in 112 (57%) and 11 (10%), respectively. Subjects with exclusively NCAP had a higher prevalence of a family history (Fx) of CAD (45% vs. 18%, p=0.04), a higher body mass index (BMI) (35±6 vs. 29±5 kg/m2, p=0.002) but were of similar age ((50±6 vs. 49±9 years; p=0.83) as compared to subjects without any plaque but were younger than subjects with MCAP and CAP (p<0.0001). While the extent of NCAP decreased (<45 years: 1.08 vs. 45–52: 0.94 vs. 52– 62: 0.83 vs. >62: 0.41 segments of NCAP; p=0.06), the extent of MCAP and CAP increased with age (p=0.02 and p=0.13, respectively). In multivariate analysis, the extent of NCAP was significantly associated with HLP (OR: 1.46 per segment of NCAP, p=0.04) independent of the extent of MCAP and CAP.
Conclusions: The overall correlation of CAP to total plaque burden is robust since very few subjects have exclusively NCAP. The ratio of NCAP to CAP is not constant but changes with age. Only HLP was independently associated with the extent of NCAP. Large outcome studies will be necessary to determine whether the detection of NCAP provides incremental value over CAP and MCAP.