Calcified Plaque Component as a Negative Predictive Marker for Coronary Plaque Progression

Abstract

Background and purpose: Coronary calcification is an important predictor of coronary artery disease and cardiovascular event, although calcified coronary plaque itself cause less plaque rupture or thrombosis, compared with non-calcified or mixed plaque. Development and regression of atherosclerotic plaque and formation of coronary calcification can be observed with Multi-detector computed tomography.

Methods: Seventy patients who had undergone coronary CT scan at least 2 times were retrospectively reviewed. Two scan were performed with interval of at least 10 months. All of these patients had more than one intermediate coronary lesion on initial scan. Volume and characteristics of coronary plaque were quantitatively assessed using semi-automated software. The plaques were classified to one of three categories

non-calcified, calcified, and mixed plaques. Calcified plaque was excluded from the study.

Results: Seventy patients were included in the analysis and no patients experienced acute coronary syndrome or sudden cardiac death during follow up period. Mean duration between two scan was 10.3 ± 60.6 months. Total plaque volume was not significantly changed during follow-up period

initial volume of plaque was 366.1 ± 145.8 mm3 and follow up volume of plaque was 366.2 ± 161.2 mm3 with annualized absolute volume change of -3.81mm3 and annualized percent change of –0.5%. Initial low calcified plaque volume was associated with acceleration of plaque progression. Statin didnt affect plaque progression or regression in this study.

Conclusion: We retrospectively observed progression of coronary atherosclerotic plaque with multi-detector coronary CT. Initial smaller volume of calcified plaque component was associated with plaque progression.