| Objective:To investigate the reproducibility of a semi-automated software used for non-calcified plaque quantification by coronary CT angiography (CCTA).Methods:Totally 62 patients with non-calcified plaque detected by CCTA were enrolled in our study,49 men, ages 54.5 ± 10.2 years. Plaques detection and measurements were performed using the PlaqlD function of the attenuation-based semi-automated software (PlaqlD [CardlQXpressTM 2.0 Reveal, GE Medical Systems SCS, FRANCE]). Plaques were measured independently by two observers and one observer twice. Paired-Samples T test was used to compare intra-and inter-observer quantitative measurements. Pearson correlation analysis and Bland-Altman comparison were performed to test the congruency of intra-and inter-observer measurements.Results:Mean plaque volume determined by one observer twice was 78.1 ± 46.7 mm3,mean paired difference was 0.1±3.2 mm3,95% limits of agreement was (-6.2-6.4 mm3), correlation coefficient of intra-observer measurements was 0.998 (P ≤0.001). Mean plaque volume determined by two observer separately was 78.0 ± 47.2 mm3,mean paired difference was 0.9±4.8 mm3,95% limits of agreement was (-8.5—10.3 mm3), correlation coefficient of inter-observer measurements was 0.995 (P<0.001). Mean percent atheroma volume determined by one observer twice was 45.1 ± 12.1%, mean paired difference was-0.3±2.2%,95% limits of agreement was (-4.6—4.0%), correlation coefficient of intra-observer measurements was 0.984 (P＜ 0.001). Mean percent atheroma volume determined by two observer separately was 45.4 ± 12.1%, mean paired difference was-0.4± 2.3%,95% limits of agreement was (-4.9—4.1%), correlation coefficient of inter-observer measurements was 0.982 (P＜ 0.001).Conclusion:Our study demonstrated an excellent reproducibility of the measurement of this technique. CCTA might play an important role in serial studies to determine plaque progression or response to medical therapies.Objectives To evaluate effects of statin treatment on progression of mild non-calcified coronary plaque using serial coronary CT angiography (CCTA).Methods 206 consecutive patients with mild (< 50% luminal narrowing) non-calcified plaque on CCTA were enrolled in our study. Baseline and follow-up data were collected. Subjects were divided into three groups according to subsequent statin therapy:intensive statins (n= 55), defined as daily dose (receiving atorvastatin or rosuvastatin) lowers LDL-C on average by approximately≥50%;, moderate statins (n = 85), defined as daily dose (receiving any kind of the statins, including atorvastatin, rosuvastatin, simvastatin, fluvastatin) lowers LDL-C on average by approximately< 50%, and no statin (n= 66). Serial scans were performed after a median interval of 18 months (range 6 to 35 months). Low attenuation plaque (LAP) volume, total plaque volume, percent plaque volume were measured.Results LAP volume, total plaque volume and percent plaque volume showed significant regression among intensive statins compared to no statin group (annualized changes:-7.1 ± 13.1 VS.0.9 ±12.7 mm3, P<0.001;-16.4 ±35.0 VS.12.3 ±32.4 mm3, P< 0.001 and-6.2 ± 11.8 VS.3.5±12.1%, P<0.001, respectively). Progression of LAP volume, total plaque volume and percent plaque volume was retarded among moderate statins compared to no statin group (annualized changes:-2.8 ± 7.6 VS.0.9±12.7 mm3, P= 0.041;-0.1±25.6 VS.12.3±32.4 mm3, P= 0.014 and-1.8±11.2 VS.3.5±12.1%, P= 0.006, respectively). On multivariable model predicting change in total plaque volume, higher baseline LAP volume, moderate statin and intensive statin therapy were each independent predictors of plaque regression (standardized coefficients:baseline LAP volume-0.36, P< 0.001; moderate statin-0.21, P= 0.004; intensive statin-0.36, P< 0.001, respectively).Conclusions This study suggests that statin treatment can retard progression, and even induce regression of mild non-calcified coronary plaque, patients with greater baseline LAP volume are more likely to benefit from statin therapy.Objective To explore impact of coronary CT angiography findings on preventive medical treatment and control of coronary artery disease (CAD) risk factorsMethods Consecutive patients with atherosclerotic plaque detected by coronary CT angiography were enrolled in our study from September 2013 to December 2014, grouped as<50% stenosis and≥50% stenosis. Baseline and follow-up data were recorded. Comparative analysis was performed both between stenosis groups and pre-and post-CT angiography data. Multivariable logistic regression were preformed to investigate association between coronary CT angiography findings and subsequent medical therapies.Results Totally 160 patients were enrolled in our study,99 were<50% stenosis and 61 were≥50% stenosis. Significant reduction of total cholesterol(5.06±1.04 VS 4.54 ±1.09 mmol/L, P<0.001), low-density lipoprotein cholesterol (3.16±0.95 VS 2.60+ 0.88 mmol/L, P<0.001), and triglyceride [1.66 (1.14,2.28) VS 1.55(1.07,2.05) mmol/L, P=0.004] were observed Pre-versus post-CT angiography. Compared to patients with <50% stenosis, patients with≥50% stenosis demonstrated more significant reduction with regard to total cholesterol (-0.70±0.94 VS-0.42±0.96 mmol/L, P=0.035) and low-density lipoprotein cholesterol (-0.78±0.99 VS-0.43±0.79 mmol/L, P=0.016). After CT angiography, aspirin (13.8% VS 65.6%, P<0.001) and statin (20% VS 71.9%, P<0.001) use were significantly increased, blood pressure medication (53.1% VS 63.1%, P=0.07) use showed no statistical differences. Adjusted for baseline risk factors and pretest medications, CT angiography findings were independently associated with increased post-CT angiography use of aspirin [adjusted OR (95% CI): 3.58(1.61-7.99), P=0.002] and statin [adjusted OR (95% CI):15.01(4.40-51.22), P<0.001].Conclusion Coronary CT angiography findings demonstrated direct impact on subsequent medical therapies and control of CAD risk factors, and offered important guidance for prevention strategies of CAD.
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