Beyond Coronary Stenosis: Coronary Computed Tomographic Angiography for the Assessment of Atherosclerotic Plaque Burden

Abstract

Coronary computed tomographic angiography (CCTA) is emerging as a key non-invasive method for assessing cardiovascular risk by measurement of coronary stenosis and coronary artery calcium (CAC). New advancements in CCTA technology have led to the ability to directly identify and quantify the so-called “vulnerable” plaques that have features of positive remodeling and low density components. In addition, CCTA presents a new opportunity for noninvasive measurement of total coronary plaque burden that has not previously been available. The use of CCTA needs also to be balanced by its risks and, in particular, the associated radiation exposure. We review current uses of CCTA, CCTA’s ability to measure plaque quantity and characteristics, and new developments in risk stratification and CCTA technology. CCTA represents a quickly developing field that will play a growing role in the non-invasive management of cardiovascular disease.

Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women

“…Among all individuals who are diagnosed with CAD, 30%-50% are considered to have low-to-moderate risk of clinically important CAD according to current risk stratification tools (2,3). In an effort to further reduce the burden of atherosclerotic cardiovascular disease, updated guidelines for cholesterol-lowering therapy focus on aggressive lipid modification strategies to reduce the incidence of cardiovascular effects in both primary and secondary prevention care (4).…”

The diagnosis of coronary plaque stability by multi-slice computed tomography coronary angiography

“…Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide despite some major pharmacologic and risk stratification advancement over the last two decades (1,2). In clinical practice, early detection of culprit plaque in advance with coronary computed tomographic angiography (CCTA), coronary angiography (CAG), or intravascular ultrasound (IVUS) may enable early intervention to prevent acute coronary syndrome (ACS) or other plaque-related diseases, decrease morbidity and mortality rates, and improve the quality of life for patients with CAD (3)(4)(5)(6)(7)(8).…”

A koronária-CT bevezetésének első tapasztalatai a Bajcsy-Zsilinszky Kórházban

“…A koronáriakalcifikáció mértékének meghatározá- A vizsgálat diagnosztikus teljesítménye alapján alkalmas kizárására, amely a mi eredményeinkben is megmutatkozik (magas negatív prediktív érték). A pozitív prediktív a kalcifikált plakkok esetében (10). Azonban a nonoba tulajdonság az egyéb, funkcionális noninvazív vizs-tív koronáriabetegség felismerése -a vizsgált betegek plakkot -segítséget nyújthat a kardiovaszkuláris eseméa SCOT-HEART-vizsgálat eredményei is.…”