CORONARY ATHEROSCLEROSIS SCORING BY THE LEIDEN CCTA RISK SCORE FOR PREDICTION OF MAJOR ADVERSE CARDIAC EVENTS: A PROPENSITY SCORE-BASED ANALYSIS OF DIABETIC AND NON-DIABETIC PATIENTS

Background: Risk scores derived from general populations of patients with chest pain often do not apply well to patients with diabetes mellitus (DM). To evaluate the performance of the Leiden coronary computed tomography angiography (CCTA) risk score—which incorporates many dimensions of coronary atherosclerosis—in diabetic and non-diabetic patients. Methods: 2,900 DM patients with suspected or known CAD underwent CCTA. In total, 732 diabetics were 1:1 propensity-matched with 732 non-diabetics by age, gender and cardiovascular risk factors. Leiden CCTA risk score (range 0-42) was compared between groups, along with per-patient and per-segment scores based on plaque composition, stenosis and location. Cox-regression analysis was used to assess the association between the Leiden CCTA risk score and the primary endpoint of all-cause death and non-fatal myocardial infarction. Results: In the study population (58 ± 12 years, 40% female), events occurred in 95 diabetics and 60 non-diabetics after median follow-up of 5.1 years. The Leiden CCTA risk score and per-patient weight scores were significantly higher in diabetic patients (all p<0.001). The Leiden CCTA risk score was independently predictive of the endpoint in DM and non-DM patients, especially when categorized (Figure 1, all p<0.05). Importantly, the interaction between DM and the score was non-significant (p>0.05). Conclusion The Leiden CCTA risk score applies well in both DM and non-DM patients, and may be useful for risk stratification.