High-Risk Plaques on Coronary Computed Tomography Angiography

JACC Cardiovasc ImagingPublished 13 Sep 2023

Observational imaging study
Computed tomography angiography (CTA) vs optical coherence tomography (OCT) correlation
follow-up up to 3 years

Authors' conclusion

All 4 HRP features on CTA were associated with features of vulnerability on OCT.

Study context

Population: Patients who underwent both CTA and OCT before coronary intervention1,075 lesions analysed
Participants: 448 patients

Exposure: High-risk plaque (HRP) features on CTA vs plaque characteristics on OCT
Outcome: Correlation of HRP features on CTA with plaque characteristics on OCT

As reported in the abstract

HRP features on CTA vs OCT vulnerability features

All 4 HRP features associated with thin-cap fibroatheroma
Positive remodeling (PR) associated with all OCT features of plaque vulnerability
Low-attenuation plaque (LAP) associated with lipid-rich plaque, macrophage and cholesterol crystals
Napkin-ring sign (NRS) associated with cholesterol crystals
Spotty calcification (SC) associated with microvessels

Observational data: associations, not effects.

Composite of target vessel nontarget lesion revascularization and cardiac death (cumulative incidence) · up to 3 years

P = 0.010

HRP4.7%

Without HRP0.5%

High-Risk Plaques on Coronary Computed Tomography Angiography. JACC Cardiovasc Imaging. Published 13 September 2023. doi:10.1016/j.jcmg.2023.08.005

Summarised from the published abstract; every number is checked against it