Abstract 9599: Coronary Plaque Burden Assessed With Coronary Computed Tomography Angiography Predicts Future Coronary Events in Patients With Familial Hypercholesterolemia
Objectives: The aim of this study was to determine whether accumulation of coronary plaque burden assessed with coronary computed tomography angiography (CCTA) can predict future events in patients with familial hypercholesterolemia (FH).
Background: Although CCTA has demonstrated high diagnostic performance for detection and exclusion of obstructive coronary artery disease (CAD), the prognostic findings of CAD by CCTA have not, to date, been examined for the patients with FH which usually exhibit premature coronary atherosclerosis.
Methods: We evaluated a consecutive cohort of 102 heterozygous FH patients (male = 52, mean LDL-C = 277±58mg/dl) undergoing 64-detector row CCTA between 2008 and 2012 without known CAD, retrospectively. In those patients, we assessed coronary plaque burden assigning score (0 to 5) to each of 15 coronary artery segments according to the Society Cardiovascular Computed Tomography (SCCT) guideline. Those scores were summed and natural log-transformed. Time to major adverse cardiac events (MACE), including coronary revascularizations was estimated using multivariable Cox proportional hazards models.
Results: During the follow-up period (median 941 days), 21 MACE had occurred. Receiver-operating characteristic curve analyses identified the plaque burden score of 3.35 as the optimal cutoff for predicting prognosis, the sensitivity and specificity of which were 85.7% and 82.5%, respectively with an AUC of 0.90. Multivariate Cox regression analysis identified the presence of plaque score ≥ 3.35 as the significant independent predictor of MACE (HR = 3.65; 95%CI 1.32 to 25.84, p<0.05). When divided into 2 groups based on the plaque score cutoff, MACE was much higher in the group with plaque score ≥ 3.35.
Conclusions: Coronary plaque burden identified in a noninvasive, quantitative manner was significantly associated with future coronary events in patients with FH. These findings support the use of CCTA for risk assessment in FH.
Author Disclosures: H. Tada: None. M. Kawashiri: None. A. Hodatsu: None. C. Nakanishi: None. T. Konno: None. K. Sakata: None. T. Yoshimuta: None. K. Hayashi: None. A. Nohara: None. A. Inazu: None. H. Mabuchi: None. M. Yamagishi: None.
- © 2014 by American Heart Association, Inc.