Related Experiment Video
Updated: Jun 25, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary computed tomography angiography-derived total coronary plaque burden associated with subsequent
Jinxing Liu1, Naqiang Lv1, Jiangshui Wang2
1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Insights
Coronary computed tomography angiography (CCTA) before percutaneous coronary intervention (PCI) can predict future cardiovascular events. Specific plaque burden variables identified by CCTA are independently associated with major adverse cardiovascular events (MACEs) post-PCI.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Coronary artery disease (CAD) management often involves percutaneous coronary intervention (PCI).
- Assessing residual cardiovascular risk after PCI is crucial for patient outcomes.
- Coronary computed tomography angiography (CCTA) provides detailed visualization of coronary plaque.
Purpose of the Study:
- To evaluate the association between coronary plaque burden variables from pre-PCI CCTA and major adverse cardiovascular events (MACEs) occurring after PCI.
- To determine if CCTA-derived plaque characteristics can predict post-PCI MACEs.
Main Methods:
- Retrospective analysis of 230 patients who underwent CCTA before their first PCI.
- Quantification of coronary plaque burden variables including total plaque volume, percent atheroma volume, and volumes/fractions of low-attenuation, fibrous, and calcified plaque.
- Assessment of MACEs (all-cause death, myocardial infarction, stroke, revascularization) over a median follow-up of 4.8 years.
Main Results:
- Higher total plaque volume, total percent atheroma volume, and volumes of low-attenuation and fibrous plaque were independently associated with increased MACEs.
- Hazard ratios for the highest tertile of these variables ranged from 2.06 to 3.04 compared to the lowest tertile.
- Neither total calcified plaque volume nor its fraction independently predicted MACEs.
Conclusions:
- Pre-PCI CCTA-derived coronary plaque burden, specifically total plaque volume, percent atheroma volume, and volumes of low-attenuation and fibrous plaque, are significant predictors of post-PCI MACEs.
- CCTA before PCI offers valuable insights into residual cardiovascular risk, aiding in patient management and potentially reducing future adverse events.
Objective:
To investigate the association of coronary plaque burden variables derived from coronary computed tomography angiography (CCTA) before patients underwent their first percutaneous coronary intervention (PCI) procedure and major adverse cardiovascular events (MACEs) after PCI.
Methods:
Patients who underwent CCTA before their first PCI were included retrospectively. A radiologist and a cardiologist analyzed CCTA images on a dedicated workstation. The coronary plaque burden variables included total plaque volume, total percent atheroma volume, volumes and fractions of total low-attenuation plaque, total fibrous plaque, and total calcified plaque. The primary outcomes were MACEs, a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and unscheduled coronary revascularization.
Results:
A total of 230 patients were included in the final analysis. During a median follow-up of 4.8 years, 67 MACEs occurred. Total plaque volume, total percent atheroma volume, volumes of total low-attenuation plaque and total fibrous plaque but not their fractions were independent predictors for MACEs. Compared with the first tertiles, the hazard ratio of the third tertile of total plaque volume, total percent atheroma volume, total low-attenuation plaque volume, and total fibrous plaque volume were 2.06 (95% CI: 1.03-4.15), 2.15 (95% CI: 1.02-4.51), 3.04 (95% CI: 1.45-6.36), and 2.23 (95% CI: 1.11-4.46), respectively. Neither total calcified plaque volume nor fraction was associated with MACEs independently.
Conclusion:
Selected pre-PCI CCTA-derived variables, including total percent atheroma volume, volumes of total plaque, total low-attenuation plaque and total fibrous plaque, were significantly associated with MACEs after PCI, suggesting that CCTA before PCI reveals the residual risk after revascularization.
Clinical Relevance Statement:
The coronary plaque burden variables derived from coronary computed tomography angiography before percutaneous coronary intervention are independently associated with major adverse cardiovascular events, which could be instrumental in optimizing patient management.
Key Points:
Coronary plaque burden is associated with cardiovascular events in patients with coronary artery disease. Selected total plaque burden variables derived from coronary computed tomography angiography before percutaneous coronary intervention were associated with poor prognosis. Routine coronary computed tomography angiography before percutaneous coronary intervention might be helpful in reducing future risks.
More Related Videos
13:07Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
