Quantitative baseline CT plaque characterization of unrevascularized non-culprit intermediate coronary stenosis predicts lesion volume progression and long-term prognosis: A serial CT follow-up study.

AIMS: To investigate the quantitative baseline CT plaque characterization of unrevascularized non-culprit intermediate coronary stenosis and its association with lesion volume progression and long-term prognosis.

METHODS: Patients with baseline coronary CT angiography (CCTA) and invasive coronary angiography (ICA) and at least one unrevascularized non-culprit intermediate coronary stenosis were prospectively enrolled for this study. All patients were followed up by a second CCTA at 1-year to 1.5-year interval. High-risk plaque features as well as other quantitative plaque measurements were recorded.

RESULTS: 140 patients with 165 unrevascularized non-culprit intermediate lesions were selected. Lesion volume progression was identified in 18 lesions (10.9%, 18/165) at follow-up CCTA and 15 patients experienced major adverse cardiac events (MACE) during a mean follow-up period of 51.5 months. Low attenuation plaque (LAP) was more frequently present in the lesion-progression subgroup and MACE subgroup (lesion-progression VS. non-lesion progression: 55.6% VS. 8.8% and MACE VS. MACE free: 40% VS. 12.8%, both p < 0.05), while other parameters showed no significant differences. Based on stepwise multivariable logistic regression analysis, LAP was an independent predictor (OR = 16.74, 95%CI = 5.02 to 55.84, p < 0.001) for lesion volume progression and MACE (OR = 4.25, 95%CI = 1.03 to 17.53, p = 0.046).

CONCLUSIONS: The presence of LAP of unrevascularized non-culprit intermediate stenosis is associated with lesion volume progression and an independent predictor for MACE occurrence.