Computed Tomographic Coronary Angiography–Derived Plaque Characteristics Predict Major Adverse Cardiovascular Events

Abstract

These data demonstrate that HRP is most likely an independent predictor of MACE, which supports the inclusion of HRP reporting in clinical practice. However, at this point, it remains unclear whether HRP reporting has clinical implications.

Coronary CT angiography derived plaque markers correlated with invasive instantaneous flow reserve for detecting hemodynamically significant coronary stenoses

“…Taking into account that LV, LL, VV, TPV, CPV and NCPV show the composition of plaques rather than their hemodynamic relevance the missing correlation to iFR® is as expected. Plaque composition is most likely an independent predictor of MACE as shown in a meta-analysis by Nerlekar et al [24]. Especially non-calcified plaque showed the strongest association in this study.…”

CT Myocardial Perfusion Imaging: A New Frontier in Cardiac Imaging

“…In fact, besides luminal area stenosis, other coronary plaque morphology and composition parameters may affect downstream myocardial perfusion. Accordingly, lesion-specific morphological features such as positive remodeling and noncalcified plaque volume have been associated with detrimental downstream hyperemic myocardial perfusion and FFR, independent of lesion severity, and are strong predictors of major cardiovascular events [ 112 – 114 ].…”

Coronary artery calcification: More than meets the eye

“…15 Conversely, spotty calcification on CT is associated with[ 2-fold increase risk in plaque rupture (HR 2.25; 95% CI 1.26-4.04; P = 0.006). 16 Similarly, analysis of plaque vulnerability by intravascular ultrasound has revealed that patients with stable angina have fewer and larger contiguous plaques compared to those who present with acute coronary syndrome, who have a greater number of small calcium deposits. 17 Taken together, these findings suggest that calcification may have a biphasic effect on plaque stability with early spotty deposition increasing plaque vulnerability and denser calcium deposition that group together into large areas stabilizing plaque ( Figure 1).…”