Related Experiment Video

Updated: Feb 27, 2026

Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
13:07

Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression

Published on: January 15, 2022

4.6K

AI-enabled Quantitative High-Risk Plaque Attributes for Predicting Coronary Events in Nonculprit Vessels

Qian Chen1, Xiaofei Gao2, Ling Lin2

  • 1Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Radiology. Cardiothoracic Imaging
|February 26, 2026
PubMed

Insights

Artificial intelligence (AI) analysis of coronary CT angiography (CCTA) identifies high-risk features in nonculprit vessels. These AI-derived features predict major adverse cardiac events (MACE) after percutaneous coronary intervention.

Area of Science:

  • Cardiovascular Imaging and Intervention
  • Artificial Intelligence in Medicine
  • Radiology and Cardiac Diagnostics

Background:

  • Percutaneous coronary intervention (PCI) aims to revascularize culprit lesions.
  • Nonculprit coronary artery disease significantly impacts long-term outcomes post-PCI.
  • Accurate risk stratification of nonculprit vessels is crucial for personalized patient management.

Purpose of the Study:

  • To evaluate the prognostic capability of artificial intelligence (AI)-derived high-risk features from coronary CT angiography (CCTA).
  • To assess these features in nonculprit vessels among patients who have undergone PCI.
  • To determine if AI-derived features offer incremental value beyond traditional risk factors.

Main Methods:

  • Retrospective analysis of 1495 patients undergoing CCTA and subsequent PCI.
  • AI algorithms assessed high-risk CCTA features: significant stenosis, high-risk plaque, high plaque volume, low CT-FFR, and high pericoronary adipose tissue attenuation.
  • Multivariable Cox regression analyzed the association between high-risk features and nonculprit vessel-related major adverse cardiac events (MACE) over a median follow-up of 3.3 years.

Main Results:

  • A total of 2014 nonculprit vessels were analyzed; 5.0% experienced MACE.
  • Vessel-specific CT-FFR (aHR=0.14, P=.02) and necrotic core volume (aHR=1.30, P=.01) were independent predictors of MACE.
  • AI-derived features demonstrated incremental prognostic value when added to clinical risk factors (AUC increased from 0.60 to 0.67, P<.001).

Conclusions:

  • AI-derived high-risk features from CCTA provide significant independent prognostic information for nonculprit vessels.
  • These features enhance risk prediction for major adverse cardiac events in patients post-PCI.
  • AI analysis of CCTA represents a promising tool for improving risk stratification in coronary artery disease.

Keywords:
Computed Tomographic AngiographyHigh-Risk PlaquePercutaneous Coronary Intervention

More Related Videos

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

16.2K
A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

735

Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
595
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
1.3K
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
770
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
334
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
810
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
629