Abstract 15685: Quantitative CTA Analysis of Coronary Plaque Progression in SMARTool Clinical Study: The Association Between Baseline Clinical Parameters and Plaque Progression.

Introduction: The SMARTool clinical study (Horizon 2020) aims to develop an integrated artery- and patient-specific comprehensive predictive model of plaque progression using serial coronary CT angiography (CTA). Although semi-automated techniques for quantitative assessment of coronary plaques are highly reproducible, only few studies have investigated the use of these techniques to assess plaque progression. Hypothesis: We assessed the hypothesis that baseline clinical parameters are associated with plaque progression using serial coronary CTA. Methods: Patients were prospectively included to undergo serial coronary CTA. Quantitative assessment of all coronary plaques was performed using a dedicated software package (QAngio CT RE, Medis, Leiden, The Netherlands). Plaque progression was defined by an increase in plaque volume above the median. A binomial logistic regression was performed, including the baseline clinical parameters, low-density lipoprotein (LDL) and statin use at follow-up as independent variables and the annual change in plaque volume (also classified according to the tissue components) as dependent variable. Results: In total, 590 coronary segments from 212 patients were quantitatively assessed with a mean interscan period of 6.2 ± 1.4 years. The median annual change in overall plaque volume was 2.33 (interquartile range (IQR) 0.36-6.46) mm3. In multivariable analysis, only hypertension was independently associated with an annual change in overall plaque volume (odds ratio (OR) 1.64, 95% confidence interval (CI) 1.17-2.31; P = 0.004). Although statin use at follow-up was not associated with an annual change in overall plaque volume (OR 1.02, 95% CI 0.71-1.46; P = 0.93), an independent association with dense calcium volume change was found (OR 1.88, 95% CI 1.22-2.89; P = 0.004). Conclusions: Hypertension was the only clinical parameter associated with overall plaque progression, assessed by quantitative CTA analysis. Although statin use did not show any effect on overall plaque progression, its use was associated with a significant increase in dense calcium volume, thereby potentially reducing coronary plaque vulnerability. [ABSTRACT FROM AUTHOR]