Coronary disease & ACSCohort study
Lesion-Level Association Between Artificial Intelligence–Derived Coronary Calcium Volume and Plaque Vulnerability
- prospective, observational PECTUS-obs study
Authors' conclusion
Most severely calcified nonculprit lesions demonstrate a significantly lower prevalence of plaque vulnerability features as compared to less calcified, more lipid-rich lesions, which may contribute to the lower lesion-level acute event rate observed in heavily calcified lesions.
Study context
- Population
- Patients with myocardial infarction who underwent intracoronary optical coherence tomography (OCT) imaging of all fractional flow reserve-negative nonculprit lesionslesions from 414 patients
- Participants
- 488 patients
- Exposure
- Plaque vulnerability features across quartiles (Q1-Q4) of total calcium volume indexed for lesion length
Main finding
As reported in the abstract
Calcium plaques identified
Lesions with calcium plaques
470 (96.3%)
Observational data: associations, not effects.
Further findings
Median, mm3/mm
| Outcome | Q1 | Q2 | Q3 | Q4 |
|---|---|---|---|---|
| Lesion-level median indexed total calcium volume | 0.004 (IQR 0.001–0.011) | Not reported in the abstract | Not reported in the abstract | 0.83 (IQR 0.63–1.18) |
Lipid-rich plaques, macrophage accumulation, microvessels
- The lower quartiles demonstrated the highest prevalence
Thin-cap fibroatheroma and layered plaques
- Accumulated predominantly in the middle quartiles (Q2-Q3)
Cholesterol crystals
- No significant differences between quartiles
Mean number of plaque vulnerability features
- Q1-Q3 lesions demonstrated a greater mean number of plaque vulnerability features than Q4 lesions
- P < 0.001 for all
Original publication
Lesion-Level Association Between Artificial Intelligence–Derived Coronary Calcium Volume and Plaque Vulnerability. JACC Adv. Published 28 July 2026. doi:10.1016/j.jacadv.2026.103077
Summarised from the published abstract; every number is checked against it