Evaluation of coronary atherosclerotic plaques

In many patients, unheralded myocardial infarction associated with a mortality of approximately 20% is the first manifestation of coronary artery disease. Approximately 40% of the population is considered to have a moderate midterm risk of 10% to 20%. Any of the stratification schemes suffers from a lack of accuracy to correctly determine the risk, and uncertainty exists regarding how to treat individuals who have been identified to be at intermediate risk. Other tools providing information about the necessity to reassure or to treat these patients are warranted. Currently, the assessment of the atherosclerotic plaque burden by CT may be able provide valid information for this cohort. This article discusses the potential value and limitations of cardiac CT for evaluating coronary atherosclerotic plaque.