MDCT detects cardiac risk profiles as it relates to coronary plaques

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Multidetector CT (MDCT) detected that the ratio of noncalcified coronary artery plaque (NCAP) to calcified coronary atherosclerotic plaque (CAP) is not constant but changes with age, and only hyperlipoproteinaemia (HLP) was independently associated with the extent of NCAP, according to a poster presentation at the American Heart Association scientific sessions held this week in Orlando, Fla.

Fabian Bamberg and colleagues conducted the study at Massachusetts General Hospital in Boston.

The researchers assessed the correlation between cardiovascular risk profiles and the presence and extent of coronary atherosclerotic plaque stratified by plaque composition.

In the cross-sectional study, they included consecutive subjects with acute chest pain in the emergency department, who had no prior history of coronary artery disease (CAD) and did not develop acute coronary syndrome during their hospital visit. All subjects underwent standard contrast-enhanced, 64-slice coronary MDCT (0.6mm slice thickness, 120 kVp). Two independent observers determined the presence of NCAP, mixed coronary plaque (MCAP) and CAP in each coronary segment.

Bamberg and his colleagues gathered information on 195 patients, consisting of 91 women and 104 men with a mean age of 54.6. Among these patients, plaque was detected in 112 patients (57 percent) and NCAP was detected in 11 patients (10 percent). The patients with NCAP had a higher prevalence of CAD in their family history and a higher body mass index. This group was similar in age compared to subjects without any plaque, but was younger than subjects with MCAP and CAP. While the extent of NCAP decreased, the extent of MCAP and CAP increased with age. In multivariate analysis, the extent of NCAP was significantly associated with HLP independent of the extent of MCAP and CAP.

The overall correlation of CAP to total plaque burden is robust since very few subjects have exclusively NCAP. The researchers determined that large outcome studies will be necessary to assess whether the detection of NCAP provides incremental value over CAP and MCAP.