274 Low attenuation non-calcified coronary plaques and positive remodeling index: markers of vulnerable coronary plaques in systemic lupus

Abstract

Background Positive remodeling index (RI) and presence of low attenuation noncalcified plaque (LANCP) are characteristic vessel changes in unstable coronary plaques. We sought to characterize LANCP and positive RI in patients with SLE. Methods A total of 72 patients who met the ACR or SLICC classification criteria for SLE had CT angiogram studies, 30 of which had follow up CT angiograms. A total of 100 healthy controls who had two CT angiograms were included in the study. Each noncalcified plaque (NCP) detected within the vessel wall was evaluated for minimum CT density and vascular remodeling index. A LANCP was defined as an NCP with a density Results Lupus patients had a significantly higher burden of LANCP compared to healthy controls in all age subgroups except in those >60 years of age. LANCP volume was associated with age (p Conclusions Lupus patients have a significantly higher burden of LANCP compared to healthy controls in all age subgroups except in those >60 years of age. The LANCP burden regresses more rapidly over time in lupus compared to controls. Surprisingly, the most significant LANCP plaque volume regression was seen in lupus patients who were never treated with statins, while the most significant progression was observed in those taking statins. Positive RI was ubiquitous, with no evidence of progression or differences compared to controls. These characteristic vessel changes may identify SLE patients at need for more frequent noninvasive cardiac monitoring. Funding Source(s): The Hopkins Lupus Cohort was funded by AR 69572.