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Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT
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Coronary artery disease reporting and data system (CAD-RADS), vascular inflammation and plaque vulnerability

Daisuke Kinoshita1, Keishi Suzuki1, Haruhito Yuki1

  • 1Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Journal of Cardiovascular Computed Tomography
|October 9, 2023
PubMed

Insights

Higher Coronary Artery Disease Reporting and Data System (CAD-RADS) scores correlate with increased vascular inflammation and plaque vulnerability. This finding enhances understanding of cardiovascular event prediction in coronary artery disease patients.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Vascular Biology

Background:

  • The Coronary Artery Disease Reporting and Data System (CAD-RADS) aids in predicting cardiovascular events.
  • Current understanding of CAD-RADS in relation to vascular inflammation and plaque vulnerability is limited.

Purpose of the Study:

  • To investigate the association between CAD-RADS scores and markers of vascular inflammation and plaque vulnerability.
  • To explore the role of pericoronary adipose tissue (PCAT) attenuation and plaque characteristics in predicting cardiovascular risk.

Main Methods:

  • Coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) data from 385 patients were analyzed.
  • CAD-RADS scores and PCAT attenuation were assessed for all coronary arteries.
  • Plaque vulnerability was evaluated using OCT in culprit vessels.

Main Results:

  • Patients with higher CAD-RADS scores (4b/5) exhibited significantly higher PCAT attenuation compared to those with lower scores (≤4a).
  • Increased prevalence of macrophages and a greater lipid index were observed in patients with higher CAD-RADS scores.
  • These associations were significant in chronic coronary syndrome but not in acute coronary syndromes.

Conclusions:

  • Higher CAD-RADS scores are linked to increased vascular inflammation and plaque vulnerability.
  • CAD-RADS may serve as a valuable tool for identifying high-risk patients with vulnerable coronary plaques.
Abstract

Keywords:
CAD-RADSOptical coherence tomographyPericoronary adipose tissuePlaque burdenVulnerable plaque

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