E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-062

Prognostic Implications of Non-Ischemic Lesions With High-Risk Plaque Features in Patients With Diabetes Mellitus

By Seokhun Yang, Doyeon Hwang, Eun-Seok Shin, Chang-Wook Nam, Joon-Hyung Doh, Jinlong Zhang, Jian'an Wang, Hitoshi Matsuo, Takashi Kubo, Tsunekazu Kakuta, Bon-Kwon Koo

Presenter

Seokhun Yang

Authors

Seokhun Yang1, Doyeon Hwang1, Eun-Seok Shin2, Chang-Wook Nam3, Joon-Hyung Doh4, Jinlong Zhang5, Jian'an Wang5, Hitoshi Matsuo6, Takashi Kubo7, Tsunekazu Kakuta8, Bon-Kwon Koo1

Affiliation

Seoul National University Hospital, Korea (Republic of)1, Ulsan University Hospital, Korea (Republic of)2, Keimyung University Dongsan Hospital, Korea (Republic of)3, Inje University Ilsan Paik Hospital, Korea (Republic of)4, The Second Affiliated Hospital Zhejiang University, China5, Gifu Heart Center, Japan6, Tokyo Medical University Hachioji Medical Center, Japan7, Tsuchiura Kyodo General Hospital, Japan8
View Study Report
TCTAP A-062
Imaging: Non-Invasive

Prognostic Implications of Non-Ischemic Lesions With High-Risk Plaque Features in Patients With Diabetes Mellitus

Seokhun Yang1, Doyeon Hwang1, Eun-Seok Shin2, Chang-Wook Nam3, Joon-Hyung Doh4, Jinlong Zhang5, Jian'an Wang5, Hitoshi Matsuo6, Takashi Kubo7, Tsunekazu Kakuta8, Bon-Kwon Koo1

Seoul National University Hospital, Korea (Republic of)1, Ulsan University Hospital, Korea (Republic of)2, Keimyung University Dongsan Hospital, Korea (Republic of)3, Inje University Ilsan Paik Hospital, Korea (Republic of)4, The Second Affiliated Hospital Zhejiang University, China5, Gifu Heart Center, Japan6, Tokyo Medical University Hachioji Medical Center, Japan7, Tsuchiura Kyodo General Hospital, Japan8

Background

While diabetes mellitus (DM) is a major prognostic factor in patients with coronary artery disease, the prognostic value of non-ischemic lesions with a vulnerable plaque in patients with DM needs more data.

Methods

In the international CCTA-FFR registry (NCT04037163) that enrolled patients who underwent coronary CT angiography (CCTA) and invasive fractional flow reserve (FFR), deferred vessels with FFR > 0.80 were included. An independent core laboratory analyzed CCTA data to obtain high-risk plaque features (i.e., plaque burden ≥ 70%, minimum lumen area < 4.0 mm2,low-attenuation plaque, and positive remodeling). The clinical endpoint was target vessel failure (a composite of cardiac death, myocardial infarction, or revascularization, TVF) at 5 years and adjudicated by an independent committee.

Results

Among a total of 517 deferred vessels with FFR > 0.80, 184 (35.6%) vessels had DM. The risk of TVF was higher in vessels with DM than those without DM (Hazard ratio [HR] 4.72, 95% confidence interval [CI] 1.88– 11.9, P < 0.001). In 184 vessels with DM, the prevalence of 0, 1, 2, and ≥ 3 high-risk plaque features was 19.0%, 35.3%, 28.3%, and 17.4%, respectively. Among them, the 5-year cumulative event of TVF was 8.7%, 9.3%, 10.7%, and 46.6% in those with 0, 1, 2, and ≥ 3 high-risk plaque features, respectively (Log-rank P <0.001). The presence of ≥ 3 high-risk plaque features was related to the increased risk of TVF in deferred vessels with DM (HR 7.31, 95% CI 2.59 – 20.6, P < 0.001).

Conclusion

The presence of multiple high-risk plaque features can predict an increased risk of future coronary events in non-ischemic lesions with DM. Therefore, plaque assessment can help better risk stratification in patients with DM.

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