640-CCTA Combined With Low Attenuation Plaque Volume(LAPV)to Predict Acute Coronary Syndrome

Objective:The characteristics of poor plaque as determined by coronary computed tomography angiography(CTA)are associated with major adverse cardiac events in the future.This study investigated the association between low-attenuation plaque volume(LAPV)quantified by coronary artery angiography(CCTA)and acute coronary syndrome(ACS)in 640-slice coronary angiography(CCTA),and further explored the predictive value and diagnostic efficacy of LAPV for ACS.Methods:A total of 35 patients with ACS who met the requirements were selected and matched with 35 patients with stable angina(SAP)(control group)by age,gender and risk factors.Coronary CTA data were analyzed using semi-automated software to quantify plaque characteristics across the coronary branch,including low attenuation plaque volume(<30HU,LAPV),low attenuation plaque volume(<60HU,LAPV),Non-calcified plaque volume(<150HU,NCPV),calcified plaque volume(CPV)and total plaque volume(TPV)and corresponding load,remodeling index(RI)and degree of stenosis(?50%,?70%).Results : Compared with the control group,LAPV(<30HU),LAPV<60HU)and corresponding load,NCPV,TPV and corresponding load,RI and stenosis degree(?70%)were significantly increased in ACS patients(P<0.035).The LAP load(<30HU),CPV and corresponding load,and degree of stenosis(?50%)did not differ between the two groups.Logistic analysis showed that LAPV(<30HU),LAPV(<60HU),NCPV,TPV,LAP load(<60HU),TP load and RI were independent of other risk factors in ACS development.while LAPV(<60HU)is more relevant for LAPV.LAPV(<30HU): The area under the ROC curve is 0.620,95% CI(0.512-0.728);when the plaque volume is ? 19.6 mm3,the sensitivity of the diagnostic ACS is 78.57%,and the specificity is 50.00%.LAPV(<60HU):The area under the ROC curve was 0.753,95% CI(0.661-0.845);when the plaque volume was ?36.4 mm3,the sensitivity of the diagnostic ACS was 83.33%,and the specificity was64.52%.The difference was statistically significant(P < 0.05).Conclusions:(1)In the overall plaque characteristics quantified by CCTA,total plaque volume,non-calcified plaque volume,low attenuation plaque volume and its corresponding load,PR are closely related to the occurrence of acute coronary syndrome.For low-attenuation plaque volume,low-attenuation plaque volume(<60 HU)is more correlated with ACS than low-attenuation plaque volume(<30 HU),further suggesting consistent with pathological plaque progression.(2)ROC curve analysis showed that LAPV(<60HU)highly indicated the possibility of ACS in the plaque volume ? 36.4mm3,and further provide predictive value and diagnostic efficacy for early prevention and diagnosis of ACS.(3)Low-attenuation plaque lold(<30HU),non-calcified plaque load,calcified plaque volume and corresponding load,coronary artery stenosis greater than or equal to 50% were not significantly associated with the occurrence of acute coronary syndrome.(4)Clinical coronary risk factors Gender,age and risk factors of cardiovascular disease were not significantly associated with acute coronary syndrome.