High-risk plaque in patients with near normal coronary angiograms

Area of Science:

• Cardiology
• Radiology

Background:

• Cardiac computed tomography angiography (CCTA) is increasingly used in emergency settings for chest pain evaluation.
• CCTA can identify coronary plaques with high-risk features, even when significant stenosis is absent.

Observation:

• Anecdotal evidence suggests a link between high-risk coronary plaques and future acute coronary syndrome (ACS).
• This case highlights a patient with such plaques, underscoring the clinical observation.

Findings:

• The presence of non-obstructive, high-risk coronary plaques is associated with an elevated risk of ACS.
• This subgroup of patients presents a diagnostic and therapeutic challenge.

Implications:

• High-dose statin therapy is a potential treatment, with percutaneous coronary intervention reserved for flow-limiting lesions.
• Prospective trials are needed to establish optimal management strategies and confirm outcomes for patients with high-risk plaques.