Long-Term Prognostic Value of Coronary Atherosclerotic Plaque Characteristics Assessed by Computerized Tomographic Angiography

Abstract

We aimed to present the long-term prognostic role of coronary computed tomography angiography (CTA) in a cohort of patients with coronary artery disease (CAD) and noncritical stenosis. A total of 1138 patients who underwent coronary CTA for suspected CAD were included in the study. For the categorization of the coronary atherosclerotic plaque (CAP), the coronary system was divided into 16 segments. For each segment, CAPs were categorized as calcified, noncalcified, and mixed. All-cause and cardiovascular (CV) mortality data were collected for prognostic evaluation. Coronary CTA analyses showed that 34.5% of patients had noncalcified CAP, 14.5% of patients had calcified CAP, and 11% of patients had mixed CAP. During a median of 141.5 months follow-up, CV and all-cause mortality was observed in 57 (5%) and 149 (13.1%) patients, respectively. In multivariable Cox regression analysis, calcified CAP morphology and the extent of involved segments were significant predictors of both CV and all-cause mortality. The presence of calcified CAP morphology and the higher number of diseased coronary segments via coronary CTA might help stratify patients at risk for adverse CV outcomes during long-term follow-up. Patients with these features at index coronary CTA may be evaluated more closely with aggressive preventive measures.

Gender-Dependent Comparison of Coronary Computed Tomography Angiographic Characteristics among Patients with Suspected Atherosclerosis: A Single-Center Experience

“…In the plaque subtype analysis, we found that the calcific plaque type was dominant. Ates et al 22 reported that calcific plaque rate was associated with major adverse cardiovascular events at the follow-up of 141.5 months. Recent studies showed that the presence of changes, such as plaque sensitivity, spot calcification, positive remodeling, and high attenuation revealed, was associated with accelerated atherosclerosis, and the authors emphasized the importance of close follow-up and effective treatment.…”

Artificial Intelligence—A Good Assistant to Multi-Modality Imaging in Managing Acute Coronary Syndrome

“…Atherosclerotic plaque features and stenosis can be evaluated qualitatively and quantitatively, providing comprehensive information to clinical practitioners, further enabling the prognostic prediction of ACS events (48)(49)(50).…”