Chronic inflammatory mechanisms in the arterial wall lead to atherosclerosis, and include endothelial cell damage, inflammation, apoptosis, lipoprotein deposition, calcification and fibrosis. Cardiac computed tomography angiography (CCTA) has been shown to be a promising tool for non-invasive assessment of theses specific compositional and structural changes in coronary arteries. This review focuses on the technical background of CCTA-based quantitative plaque characterization. Furthermore, we discuss the available evidence for CCTA-based plaque characterization and the potential role of CCTA for risk stratification of patients with coronary artery disease.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Atherosclerotic plaque composition; Quantification analysis; Multi-slice cardiac computed tomography; Biomarkers Core tip: This review gives an overview of the current status of noninvasive assessment of coronary artery disease (CAD) and the ability of cardiac computed tomography angiography (CCTA) and cardiac biomarkers for the diagnostic classification and risk stratification of patients with suspected and known CAD. Since all techniques described herein are available in the clinical routine and are associated with an acceptable time spent the translation to the clinical realm appears promising. Focusing on CCTA-based quantitative plaque characterization we herein present the (1) available evidence; (2) comparison with other techniques of plaque characterization; and (3) the value of "bio-imaging" for the risk stratification of patients with CAD.Gitsioudis G, Katus HA, Korosoglou G. Assessment of coronary artery disease using coronary computed tomography angiography and biochemical markers.