The 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT) was held in July 2024 in Washington, DC. This conference was the largest international meeting showcasing the latest advances in the world of cardiovascular computed tomography (CCT). The meeting had a record high of 1,003 attendees from 39 countries who participated in 35 sessions, including 219 abstract posters and 57 educational exhibits. This expert analysis reviews the high points of the meeting.

Premeeting Hands-On/Interactive Workshops

The 2024 program featured a comprehensive lineup of structural computed tomography (CT) hands-on sessions, including preprocedural planning for all transcatheter valve interventions and left atrial appendage closure. It also offered a full-day interactive course covering all aspects of machine learning and artificial intelligence (AI) applied to cardiac imaging and, simultaneously, a full-day session on congenital heart disease imaging. The day wrapped up with the fully packed "Women in CT Happy Hour" to cultivate networking and mentorship among women involved in CCT.

Day 1

At the opening session, the editor-in-chief of the Journal of Cardiovascular Computed Tomography (JCCT), Dr. Armin Arbab-Zadeh, showed the top five CCT papers selected by the vote of the JCCT's associate editors. The Arthur S. Agatston Cardiovascular Disease Prevention Award was given to Dr. Renu Virmani for her career-long contributions to understanding the pathways of coronary atherosclerosis. The winning submission for the SCCT Clinical Trials and Registries Award (CTRA) was from Dr. Kenneth Chan, who presented his work entitled "Socioeconomic disparities and the prognostic value of coronary inflammatory risk from routine coronary CT angiography: the Oxford Risk Factors and Non-Invasive Imaging (ORFAN) study" (Figure 1, panel A).¹ Dr. Chan and colleagues studied a large CCT population with stable chest pain and analyzed pericoronary fat inflammation across the spectrum of socioeconomic status. They found that socioeconomic deprivation was associated with higher coronary inflammation and increased cardiac mortality.

This year's keynote lecturer was Dr. Leslee Shaw, who shared her thoughts about "Improving Global Public Health Through Cardiovascular CT." Dr. Shaw emphasized the central role of CCT as a potential tool to reduce the global burden of atherosclerosis by identifying and treating early coronary artery disease (Figure 1, panel B).² She also called for a worldwide collaboration to overcome common barriers and expand coronary computed tomography angiogram (CCTA) access, especially in developing countries.

The SCCT/Society for Cardiovascular Angiography and Interventions (SCAI) joint session included a key lecture on "Coronary CTA - How do I use to plan coronary interventions" by Dr. Carlos Collet, who also coauthored the SCCT expert consensus document on the topic.³

The highlight of the afternoon was the "Great Debates in Cardiac CT" session, which had distinguished speakers participating in head-to-head discussions on various clinical questions. One such question was, "Should coronary artery calcium be reported on noncardiac CTs?," with Dr. Michael Blaha arguing for and Dr. Marcio Bittencourt arguing against the position. Another clinical question was, "For patients with heart failure with reduced ejection fraction, does CCT provide more useful information than cardiac magnetic resonance?," with Dr. João Cavalcante arguing for and Dr. Chiara Bucciarelli-Ducci arguing against the position. This was a wonderful discussion in which both speakers agreed on the complementary role of both modalities in that scenario.

Day 2

On the second day, the Best Original Science session was held, including the Best Abstract Award, the Young Investigator Award (YIA), and the SCCT CTRA and YIA runner-up awards.

Best Abstract Award

This year, the Best Abstract Award was given to Dr. Seokhun Yang, who presented his work entitled "Coronary Ct Angiography-derived Precursors Of Acute Coronary Syndrome In Ischemia-causing Lesions" (Figure 1, panel C).⁴ The main clinical question was identifying CCT-derived predictors for future acute coronary syndrome (ACS) events among fractional flow reserve (FFR)–positive lesions. This was a substudy from the multicenter EMERALD II (Exploring the Mechanism of Plaque Rupture in Acute Coronary Syndrome Using Coronary CT Angiography and Computational Fluid Dynamics II) study involving 287 patients presenting with ACS after a CCTA. Dr. Yang and colleagues analyzed 1,527 lesions with FFR-CT ≤0.8 and found that an integrated AI-based approach can better identify high-risk lesions than can standard CCT characteristics.

Young Investigator Award

This year's YIA awardee was Dr. Brittany Weber, who presented her work entitled "The Frequency, Prevalence, And Outcomes Of Incidentally Detected Coronary Artery Calcium Using Artificial Intelligence Analysis Among Patients With Immune Mediated Inflammatory Diseases" (Figure 1, panel D).⁵ Dr. Weber and colleagues used a Food and Drug Administration (FDA)–approved AI solution for automated coronary artery calcification (CAC) quantification from non–electrocardiogram-gated chest CTs on 2,289 patients with autoimmune disorders and no previously known atherosclerotic cardiovascular disease. The overall prevalence of CAC score >0 was 53.4%, with 13% of patients having CAC score ≥300. At a median follow-up of 7.4 years, increasing CAC severity was associated with increased adjusted hazard ratio for all-cause mortality and major adverse cardiac events.

SCCT CTRA and YIA Runner-Up Awards

Another SCCT award was given to Dr. Márton Kolossváry, who presented the study entitled "Pitavastatin Reduces Noncalcified Plaque Via Collagen Pathways Independently Of LDL-C In People With HIV" (Figure 1, panel E).⁶ In this subanalysis, Dr. Kolossváry and colleagues looked at the mechanistic pathways behind statin-driven atherosclerotic changes among individuals living with HIV using advanced coronary plaque quantification. They found that the expression of procollagen C-endopeptidase enhancer (PCOLCE; an enzyme involved in the maturation of collagen) was associated with a shift in plaque components toward plaque stabilization. Furthermore, they demonstrated that 84% of the total effect of statins on noncalcified plaque change was mediated through PCOLCE independently of LDL-C level reduction.

The runner-up YIA abstract entitled "Prognostic Implications Of Coronary Ct Angiography-derived Plaque And Hemodynamic Features On Acute Coronary Syndrome Across Varying Time Intervals: Emerald-II Study" was presented by Dr. Yang (Figure 1, panel F).⁷ Dr. Yang and colleagues analyzed 2,451 CCTA lesions from the EMERALD II study data with AI-enabled CCT quantitative coronary plaque and hemodynamic assessment to identify features that could predict short-term (<1 year) ACS versus longer-term (2-3 years) ACS. Interestingly, the AI-enabled model demonstrated an enhanced prediction for ACS culprit lesions compared with the standard CCTA analysis.

Afternoon Programming

In the afternoon, a key session took place on the role of CCT in clinical trials. Attendees heard about the challenges of establishing a CCTA core laboratory for trials from Dr. Borek Foldyna, who was involved in the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial analysis. The past SCCT president, Dr. Koen Nieman, provided glimpses into the future for the ongoing TRANSFORM (A Randomized Comparison of Stage-Based Care Versus Risk Factor-Based Care for Prevention of Cardiovascular Events) trial (Figure 1, panel B).

Day 3

The meeting was adjourned following the official handover of the presidency to Dr. Maros Ferencik, who now starts his 1-year term. Next year's SCCT meeting is scheduled to be held in Montreal, Canada on July 17-20, 2025.

Figure 1: Content Presented During the Best Original Science General Session at the 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT)

References

1. Chan K. Socioeconomic disparities and the prognostic value of coronary inflammatory risk from routine coronary CT angiography: the Oxford Risk Factors and Non-Invasive Imaging (ORFAN) study. Presented at the 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography, Washington, DC. July 19, 2024.
2. McDermott M, Meah M, Khaing P, et al. Rationale and design of SCOT-HEART 2 trial: CT angiography for the prevention of myocardial infarction. JACC Cardiovasc Imaging 2024;17:1101-12.
3. Andreini D, Collet C, Leipsic J, et al. Pre-procedural planning of coronary revascularization by cardiac computed tomography: an expert consensus document of the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr 2022;16:558-72.
4. Yang S, Lee K, Lee K, et al. Coronary Ct Angiography-derived Precursors Of Acute Coronary Syndrome In Ischemia-causing Lesions. Presented at the 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography, Washington, DC. July 20, 2024. Available at: https://www.journalofcardiovascularct.com/article/S1934-5925(24)00114-X/abstract. Accessed 10/17/2024.
5. Weber B, Biery D, Petranovic M, et al. The Frequency, Prevalence, And Outcomes Of Incidentally Detected Coronary Artery Calcium Using Artificial Intelligence Analysis Among Patients With Immune Mediated Inflammatory Diseases. Presented at the 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography, Washington, DC. July 20, 2024. Available at: https://www.journalofcardiovascularct.com/article/S1934-5925(24)00123-0/abstract. Accessed 10/17/2024.
6. Kolossváry M, Schnittman S, Zanni M, et al. Pitavastatin Reduces Noncalcified Plaque Via Collagen Pathways Independently Of Ldl In People With Hiv. Presented at the 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography, Washington, DC. July 20, 2024. Available at: https://www.journalofcardiovascularct.com/article/S1934-5925(24)00285-5/abstract. Accessed 10/17/2024.
7. Yang S, Lee K, Lee K, et al. Prognostic Implications Of Coronary Ct Angiography-derived Plaque And Hemodynamic Features On Acute Coronary Syndrome Across Varying Time Intervals: Emerald-II Study. Presented at the 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography (SCCT), Washington, DC. July 20, 2024.. Available at: https://www.journalofcardiovascularct.com/article/S1934-5925(24)00120-5/abstract. Accessed 10/17/2024.