435-P: Novel Approach to the Detection and the Treatment of Vulnerable Coronary Plaques Using Color Mapped Coronary CT Angiography and Optimal Medical Therapy Including Anti-PCSK9 Antibody

Abstract

Background: Coronary CT angiography (CCTA) has been applied to detect vulnerable plaques having low attenuation of CT value and positive remodeling which have been associated with acute coronary syndrome. The present study was performed to establish a novel approach to qualitative and quantitative analysis of coronary plaque, especially early detection of high-risk plaque by visualizing intra-plaque localization of necrotic core and the evaluation of plaque stabilizing effect of optimal medical therapy (OMT) including anti-PCSK9 antibody. Methods: We developed color mapped CCTA. The vulnerable plaques are identified by red color (CT attenuation: 0-30) and yellow color (CT attenuation: 30-60). The effect of OMT including anti-PCSK9 antibody on the vulnerable plaques in diabetic patients was studied. Results: Color mapped CCTA clearly demonstrated the presence of necrotic core (red in yellow sign) in vulnerable plaque. After 12 months administration of anti-PCSK9 antibody, an improvement of vulnerable plaque e.g., disappearance of necrotic core in vulnerable plaque was observed. Conclusion: Color mapped CCTA provides a new insight into early detection of high-risk plaque by visualizing intra-plaque localization of necrotic core, also contributes to the evaluation of drugs which may improve vulnerable plaques. Disclosure A. Hirai: None. S. Kondo: None. T. Goto: None. K. Hirai: None. N. Kamiya: None. Y. Tanabe: None. I. Komesu: None. H. Moromizato: None. J. Nakazato: None. S. Ikejima: None. H. Sunagawa: None. T. Kido: None.