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Short-Time Changes in Coronary Artery Plaques Assessed by Follow-Up Coronary CT Angiography-Characteristics and

Hanna Maria Görich1,2, Sebastian J Buss1, Mostafa Emami1

  • 1Radiology Center Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Heidelberg, Germany.

Frontiers in Cardiovascular Medicine
|August 26, 2021
PubMed

Insights

Short-term changes in coronary artery plaques are detectable with coronary CT angiography (CTA). These plaque changes in coronary artery disease (CAD) patients can lead to adjusted clinical management, optimizing individual therapy.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Coronary artery disease (CAD) exhibits a variable clinical progression.
  • Coronary CT angiography (CTA) enables comprehensive visualization of the coronary arteries and early detection of CAD.
  • Assessing short-term plaque evolution and its clinical implications using CTA is crucial for managing CAD.

Purpose of the Study:

  • To evaluate short-term changes in non-calcified and mixed coronary plaques using coronary CTA.
  • To determine the clinical impact of observed plaque changes in a real-world patient cohort.
  • To analyze plaque progression, stability, and regression in patients with chronic CAD.

Main Methods:

  • Retrospective analysis of 6,701 patients undergoing coronary CTA between November 2014 and July 2019.
  • Detailed analysis of non-calcified and mixed plaques in 1,211 coronary segments from 77 patients with chronic CAD.
  • Classification of plaque changes into stable, progressive, or regressive categories based on follow-up CTA.

Main Results:

  • Over a mean follow-up of 22.3 months, 58% of patients had stable plaques, 36% showed progression, and 7% exhibited regression.
  • Plaque regression was more common in females and observed only in patients with mild CAD or single-vessel disease.
  • Plaque progression was predominantly seen in male patients.
  • Follow-up CTA influenced patient management in 66% of cases.

Conclusions:

  • Coronary artery plaques can undergo significant changes within a relatively short timeframe.
  • Follow-up coronary CTA provides a non-invasive method to assess plaque development and guide individualized patient management.
  • The ability to monitor plaque changes allows for optimization of diagnostics and therapeutic strategies in CAD patients.

Keywords:
coronary CT angiographycoronary artery diseaecoronary artery plaquesdual-source CTfollow-up examinationsshort-time change detection

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