Jihoon Bae, Presenter: Nothing to Disclose

Yeo Goon Kim MD, Abstract Co-Author: Nothing to Disclose

Jeong A Kim MD, Abstract Co-Author: Nothing to Disclose

Sang Il Choi MD, Abstract Co-Author: Nothing to Disclose

Eun Ju Chun, Abstract Co-Author: Nothing to Disclose

To compare the prognostic value of coronary CT angiography (CCTA) compared to coronary artery calcium scoring (CACS) and carotid intimomedial thickeness (CIMT) or plaque on carotid doppler for risk stratification of cardiovascular disease (CVD) in asymptomatic adults.

From ESCORT cohort of 5,142 asymptomatic adults,1,577 adults (1121 male, mean age 55.9±8.5 years) who underwent carotid Doppler, CACS and CCTA were assessed for CVD (cardiac death, nonfatal myocardial infarction, unstable angina, stroke and coronary late revascularization). CIMT > 10mm or plaque at common carotid or internal carotid artery were indicated for positive carotid Doppler. CCTA images were analyzed as the plaque type (noncalcified, mixed, calcified and high-risk plaque) and the degree of stenosis with per-patient (0, 1-49%, 50-69%, > 70%), per-vessel (0 to 3 vessels) and per-segment (segment stenosis score [SSS]). The prediction power for CVD at each modalities were compared using area under the receiver-operating characteristic curve(AUC).

During of 75 ±11 months of follow-up, CHD occurred in 52 subjects (3.3%). By univariate analysis, all stenosis degree with per-patient (hazard radio [HR], 4.37; 95% confidence interval [CI], 3.43 to 5.56), per-vessel (HR, 4.55; 95% CI, 3.52 to 5.87) and per-segment (HR, 1.42; 95% CI, 1.34 to 1.49) were associated with increased risk of CVD. Plaque type also associated with CVD, mixed or calcified plaque (HR, 15.6; 95% CI, 5.4 to 44.9), NCP (HR, 31.1; 95% CI, 10.2 to 94.4) and high risk plaque (HR, 61.5, 95% CI, 18.9 to 193.2) show incrementally increased risk (all p < 0.05). Beyond FRS (AUC 0.68), additional CIMT (0.67) did not increase the prediction for CVD. However, additional CACS (0.71) and CCTA (0.77) improved prediction for CVD.

For risk stratification of CVD in asymptomatic adults, CCTA shows incremental prognostic value over additional CAC or CIMT with FRS.

CCTA might have a potential as non-invasive imaging tool for risk stratification of cardiovascular disease in asymptomatic adults.

Bae, J, Kim, Y, Kim, J, Choi, S, Chun, E, Comparison of Multi-modality Imaging for Risk Stratification of Cardiovascular Events in Asymptomatic Adults.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045758.html