Coronary risk factors and plaque morphology; semi-automated quantative coronary CTA analysis

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction With advances in coronary computed tomography angiography (CTA) technology dedicated semi-automated coronary plaque analysis software become researches field of interest. With detailed plaque analysis we can improve CTA diagnostic accuracy and prognostic value, this way improving chronic coronary syndrome (CCS) outcomes. Purpose The aim of this study was to evaluate well known modifiable coronary risk factors (arterial hypertension (AH), smoking, diabetes mellitus (DM), hypercholesterolemia, physical inactivity, obesity) and statin use in relation to more detailed plaque features. Methods 100 patients with stable angina and no previous history of CCS underwent CTA and were diagnosed with one or more intermediate stenosis (correspond to 50-69% stenosis). A total of 112 stenosis were analysed with post-processing semi-automated CTA dedicated software. This is a sub-study from a bigger trial, where intermediate lesions were analysed. Results Overall all lesions were analyzed as whole and at the vessel cross-section of maximum obstruction site. 45 different parameters were obtained. Analysis made at the level of whole lesion showed that smokers had lower plaque and dense calcium volumes (Table 1), statin users lower fibrous fatty and necrotic core volumes (Table 2). Obstruction area analysis showed significant larger vessel wall area and diameter in non-smokers group (Table 1), whereas statin users had smaller lumen area and diameter stenosis (Table 2). Patients with DM had bigger necrotic core volume with significant bigger fibrous fatty and necrotic core percentages (Table 3). AH, hypercholesterolemia, physical inactivity or obesity did not show any significant relation with plaque features (p≥0.05). Renal insufficiency was excluded as a risk factor as all patients referred to CTA had normal or slightly decreased renal function (GFR >60 ml/min.). Conclusion Our study shows that modifiable risk factors (smoking and DM) alongside with statin use are related to quantitative atherosclerotic plaque parameters. For risk factors modification impact on plaque characteristics studies should be done. Abstract Table 1; 2; 3.