Abstract 3089: Volumetric Analysis of Coronary Plaque Characterization in Patients with Metabolic Syndrome Using 64-slice Multi-Detector Computed Tomography (MDCT)
Background: Metabolic syndrome (MetS) is associated with adverse cardiovascular risk and mortality, where acute coronary syndrome (ACS) significantly impacts on mortality and morbidity. On the other hand, evidences have accumulated that the lipid-rich plaque may play a critical role in ACS. In this study, we thus assessed the impact of Mets on tissue characteristics of coronary plaques using MDCT.
Method: Among consecutive 94 patients with suspicious angina pectoris recruited to perform MDCT, we identified MetS by International Diabetes Federation definition. In MDCT analysis each plaque components and lumen were defined as follows;
Fibrous (60 –150HU)
Lumen (150 –500HU)
Then, volume of each plaque component in the predefined segment (10mm length) was calculated by use of commercially available software. Vessel volume, lumen volume, plaque volume (PV), the percentage of soft plaque volume (soft plaque volume / PV, %SPV) and the percentage of fibrous plaque volume were also calculated. We also arbitrarily defined the cutoff point for the lipid-rich plaque as 27.6% for %SPV and 61.1% for %FPV, which were the 75th percentile of %SPV and 25th percentile of %FPV.
Results: The prevalence of MetS was 41 patients (43.6%) among 94 patients. PV (p=0.0005) and soft plaque volume (p<0.0001) were significantly increased in MetS compared to non-MetS. Multivariate linear regression analysis after adjusting for confounding variables indicated that MetS is significantly correlated with an increase in %SPV (r=0.484, p=0.0001). Multivariate logistic regression analysis for lipid-rich plaque after adjusting for confounding variables indicated that MetS is significantly associated with lipid-rich plaque (OR 5.99, CI 1.94 –18.6, p=0.002).
Conclusions: MetS is significantly associated with lipid-rich plaque, suggesting the contribution to the increasing risk of plaque vulnerability.