Abstract 484: Correlation of Coronary Artery Wall Measurements on Dual-Source CTA With Framingham Risk Score
PURPOSE To investigate the association between cardiovascular risk factors as calculated by FRS and coronary artery mean wall thickness (MWT) on coronary CT Angiography (cCTA)
METHOD AND MATERIALS Framingham risk assessment was performed on 60 consecutive patients (38 male, 22 female, mean age 53.2±14.7 years) with suspected Coronary Heart Disease (CHD) who had undergone cCTA in our institution. They were divided into low and high-risk groups based on10yr risk % of developing hard (high risk≥5%, low risk<5%) and presence of individual risk determinants (i.e. age, systolic blood pressure (SBP), smoking, HDL and total cholesterol scores). The cCTA images were analyzed by plaque analysis software (SurePlaque, Vitrea). Coronary artery wall volume and length were measured for the LAD, RCA and LCX. MWT was calculated as the wall volume (mm3) per length of vessel measured. The total MWT per patient was calculated and compared between different risk groups. Multivariable linear regression, spearman’s correlation and ROC curve analysis were performed.
RESULTS Based on 10 years % risk, MWT for the high risk group was 8.7±1.9 mm2 vs 6.4±1.2 mm2 for low risk group. In univariate analysis, there was a significant difference in MWT values in hypertensive patients (untreated: SBP≥130 mmHg, treated: SBP≥120 mmHg) compared to normotensive patients (8.2±2.0 vs 6.5±1.2 mm2). The difference was also noticed between smokers and non-smokers (8.9±1.5 vs 7.0±1.8 mm2, all P<0.05). No significant difference was identified when patients were stratified based on age, HDL and total cholesterol. In regression analysis, age, HDL and smoker scores showed a trend towards significance (P = 0.21, 0.23, 0.24). There was a significant correlation between 10yr risk % and MWT (R = 0.65). MWT value of 7.65 mm2 had 80% sensitivity-92% specificity for identifying 10yr risk of more than 5%.
CONCLUSION Along with information on luminal narrowing, coronary artery wall thickness is provided with cCTA. This may become additional parameters for improved risk stratification of intermediate-risk patients. Coronary artery wall thickening is associated with clinical risk factors and may be used for further risk stratification as well as risk management in low and intermediate risk patients.