Abstract 2942: Clinical Outcome in Patients with NonCalcified Coronary Plaque Detected by Multi Slice Computed Tomography: Risk Factors, Stenosis and 34-month Clinical Outcome.
Background: Contrast enhanced Multislice Computed Tomography (MSCTA) can detect non-calcified plaque (NCP) in coronary arteries and associated coronary stenosis. However, the clinical impact of NCP is not well defined. This study examined the relationship of patient risk factors with NCP detected by MSCTA, and 34 month clinical follow-up.
Methods: From September 2003 to June 2004, 506 patients underwent contrast MSCTA using a 16-slice CTA. Non-Calcified plaque (NCP) was defined as intraluminal density with 25 ≤ HU ≤ 130. 124 patients (25%) had coronary artery calcium scores of zero and complete conventional risk factor profiles. Of these, 111 patients were followed clinically for a mean of 34 months.
Results: The CAC was zero in 124/506 (25%). Of these, 55/124 (44%) had no NCP, 63/124 (51%) had NCP but no significant stenosis, and 6/124 (5%) had NCP and stenosis by MSCTA. Patients in each group were similar in age, but differed significantly in their number of risk factors (Table 1⇓). Current or former smokers were more prevalent in the group with stenosis and NCP (83.3%) compared with the other two groups (41.3%, 16.4%), p=0.023. Cardiac events at mean 34 month follow-up: No Plaque: No events NCP but no stenosis: 2/54 (4%) with events (1 sudden cardiac death, 1 VT). NCP with significant stenosis: 2/ 5( 40%) pts had revascularization (1CABG, 1 PCI).
Patients with NCP identified with MSCT had significantly more risk factors, especially smoking.
NCP without calcium can result in a significant coronary stenosis
NCP detected by MSCT in pts with a CAC of 0 identified patients with late cardiac events.