The Hemodynamic Impact of Unstable Coronary Plaques — Do We Have the Evidence?

Abstract

In the last years, estimation of the functional relevance of a coronary artery stenosis has raised an increased inter- However, the value of this interesting study is significantly altered by the low number of cases enrolled, being actually a pilot study. This could also represent an explanation for the lack of statistical significance in many of

Original Research. Transluminal Contrast Attenuation Gradient Is Associated with Coronary Plaque Vulnerability — a Computed Tomography Angiography-based Study

“…4 Invasive FFR represents today the gold standard for the assessment of hemodynamic significance of a coronary lesion, while noninvasive Determination of TAG by CCTA has been suggested in the last years as a faster and reliable alternative to both invasive and noninvasive FFR for assessing the functional significance of a coronary lesion, based on the concept that the more severe the luminal narrowing is, the higher drop in the contrast density along the coronary plaque will be recorded.…”

“…3 Despite the differences in the clinical presentation of these three forms, the common substrate that triggers the acute coronary event in all of them is represented by the presence of a vulnerable atheromatous plaque inside the coronary artery. 4 The concept of plaque vulnerability has been introduced in the literature in the last decades, describing an atheromatous coronary plaque which is exposed to a higher risk of rupture, leading to coronary occlusion and myocardial infarction. 5 Many studies tried to explain the complex process of plaque vulnerabilization and to characterize the features associated with coronary plaque vulnerability, in an attempt to identify imaging-derived biomarkers that could predict a future coronary event.…”