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

Area of Science:

• Cardiology
• Radiology
• Preventive Medicine

Background:

• Coronary artery disease (CAD) management requires accurate long-term risk stratification.
• Noncritical stenosis in CAD patients poses a challenge for prognostic assessment.
• Coronary computed tomography angiography (CTA) is increasingly used for CAD evaluation.

Purpose of the Study:

• To evaluate the long-term prognostic value of coronary CTA in patients with CAD and noncritical stenosis.
• To determine if coronary atherosclerotic plaque (CAP) morphology and extent predict cardiovascular (CV) and all-cause mortality.
• To identify imaging markers for risk stratification in CAD patients.

Main Methods:

• A cohort of 1138 patients with suspected CAD who underwent coronary CTA was analyzed.
• Coronary atherosclerotic plaque (CAP) was categorized (calcified, noncalcified, mixed) in 16 coronary segments.
• All-cause and CV mortality data were collected over a median follow-up of 141.5 months.

Main Results:

• Calcified CAP morphology was present in 14.5% and mixed CAP in 11% of patients.
• CV mortality occurred in 5% and all-cause mortality in 13.1% of patients.
• Multivariable analysis identified calcified CAP morphology and extent of diseased segments as significant predictors of mortality.

Conclusions:

• Calcified plaque morphology and a higher number of diseased segments on coronary CTA are significant predictors of long-term adverse CV outcomes.
• Coronary CTA findings can aid in stratifying risk and guiding aggressive preventive measures in CAD patients.
• These imaging markers may improve patient selection for closer monitoring and intervention.