Abstract 10780: Plaque Disruption Identified by Coronary CTA in Acute Coronary Syndrome Versus Stable Clinical Presentations

Background: The ability of coronary CT angiography (CTA) to detect plaque disruption has been recently validated. This study was performed to delineate the frequency of CTA-identified disrupted plaques in acute coronary syndrome (ACS) versus stable patients. Methods: We identified those undergoing CTA followed by invasive coronary angiography (ICA) within 60 days. Quantitative 3-vessel CTA lesion analysis was performed on all plaques to assess total volume, low attenuation plaque volume (LAP, <50 HU), and remodeling index. Plaques were further assessed for CTA features of disruption, including ulceration and intra-plaque dye penetration (IDP). ICA was used to determine the culprit status of plaques analyzed by CTA. Patients undergoing CTA for evaluation of ACS were compared to stable patients for the frequency of plaque disruption by CTA. Results: In 145 patients (94 ACS; 51 stable), 679 plaques were analyzed by CTA. CTA identified features of disruption in 177 lesions (26 %), including ulceration in 86 (...