The use of coronary computed tomography angiography (CCTA) to predict coronary artery plaque, with a focus on new,...

Area of Science:

• Cardiovascular Imaging
• Radiomics
• Biomarkers

Background:

• Coronary artery disease (CAD) is a leading cause of mortality worldwide.
• Early detection of vulnerable plaques is crucial for preventing adverse cardiovascular events.
• Novel imaging biomarkers are needed to improve risk stratification in patients with CAD.

Purpose of the Study:

• To develop and validate a predictive model using the fat attenuation index (FAI) derived from coronary computed tomography angiography (CCTA).
• To assess the FAI's ability to predict the formation of new, high-risk, and obstructive coronary plaques.
• To evaluate the incremental value of FAI compared to conventional cardiovascular risk factors.

Main Methods:

• Retrospective study including 160 patients for model development and 60 for external validation.
• Patients underwent at least two CCTA scans within 5 years, with initial scans showing normal coronary arteries.
• Quantitative FAI evaluation was performed on the three major coronary arteries using initial CCTA data.

Main Results:

• Newly formed plaques were identified in 60 out of 160 patients.
• FAI demonstrated significant predictive value for new plaques (AUC 0.723), high-risk plaques (AUC 0.822), and obstructive plaques (AUC 0.823).
• FAI showed incremental predictive value over conventional risk factors for all plaque types (P < 0.001).

Conclusions:

• The fat attenuation index (FAI) is a valuable imaging biomarker for predicting coronary plaque formation.
• FAI effectively identifies high-risk and obstructive plaques, aiding in cardiovascular risk assessment.
• Combining FAI with traditional risk factors enhances the prediction of coronary plaque development.