2414. Influence of Diabetes on Long-Term Outcome Using Coronary CT Angiography-Derived Plaque Information
Authors * Denotes Presenting Author
  1. Piotr Nikodem Rudzinski; Medical University of South Carolina; The Cardinal Stefan Wyszynski National Institute of Cardiology
  2. Verena Brandt *; Robert-Bosch-Krankenhaus
  3. Christian Tesche; Munich University Clinic, Ludwig-Maximilians University
  4. Moritz Baquet; Munich University Clinic, Ludwig-Maximilians University
  5. Maximilian Bauer; Munich University Clinic, Ludwig-Maximilians University
  6. U. Joseph Schoepf; Medical University of South Carolina
  7. Ulrich Ebersberger; Munich University Clinic, Ludwig-Maximilians University
To investigate the long-term prognostic value of coronary CT angiography (cCTA)-derived plaque information on major adverse cardiac events (MACE) in patients with and without diabetes mellitus.

Materials and Methods:
64 patients with diabetes (63.3±10.1 years, 66% male) and suspected coronary artery disease (CAD) who underwent cCTA were matched with 297 patients without diabetes according to age, sex, cardiovascular risk factors, statin and antithrombotic therapy. Major adverse cardiac events (MACE) were recorded. cCTA-derived risk scores and plaque measures were assessed. The discriminatory power to identify MACE were evaluated using multivariable regression analysis and the area under the receiver-operating characteristics curve (AUC).

After a median follow-up of 5.4 years, MACE occurred in 31 patients (8.6%). In patients with diabetes, cCTA risk scores and plaque measures were significantly higher compared to non-diabetic patients (all p<0.05). The following plaque measures were predictors of MACE in diabetic patients (odds ratio [OR]): segment stenosis score (OR 1.31, p=0.002), low-attenuation plaque (OR 5.89, p=0.023), and >=2 high-risk features (OR 6.32, p=0.017), and in non-diabetic patients: segment stenosis score (OR 2.08, p=0.004), and >=2 high-risk features (OR 5.14, p=0.024). Discriminatory power of CT scores and plaque measures in diabetic patients were significantly better than that of obstructive CAD and Framingham risk score (all p<0.05).

Diabetes is associated with a significantly higher degree of high-risk plaque features, which have independent predictive value for MACE. cCTA-derived plaque information portends improved risk stratification in diabetic patients beyond cCTA stenosis grading alone. CCTA-dervied plaque quantification and characterization may have utility to risk-stratify patients with and without diabetes mellitus for the prediction of future major adverse cardiac events.