Prognostic Value of Plaque Volume in Patients With First Diagnosis of Coronary Artery Disease: A Substudy of the PROMISE Randomized Clinical Trial
Authors' conclusion
In symptomatic patients without known CAD, coronary plaque volumes and burdens are low but are related to CAD risk factors and independently predictive of MACE.
Study context
- Population
- Symptomatic outpatients without known coronary artery disease (CAD) randomised to coronary computed tomographic angiography (CCTA)
- Participants
- 4,267 outpatients
- Comparison
- Quantitative CCTA plaque measures as predictors of MACE
- Primary endpoint
- MACE:
- Death
- Nonfatal MI
- Hospitalization for unstable angina
Methodological detailspost hoc analysis, multicentre (193 sites, North America), Trial conducted July 27, 2010, to October 31, 2014; data analyzed January 2021 to July 2024
- Post hoc analysis
- Multicentre (193 sites, North America)
- Trial conducted July 27, 2010, to October 31, 2014; data analyzed January 2021 to July 2024
Primary result
As reported in the abstract
MACE
Adjusted hazard ratio (95% CI)P value
TPBcontinuous; adjusted for clinical risk factors, statin use, qualitative CCTA findings
1.18(1.05–1.34)
P = 0.006NCPBcontinuous; adjusted for clinical risk factors, statin use, qualitative CCTA findings
1.20(1.05–1.37)
P = 0.007TPV ≥87 mm3optimal cutoff
2.07(1.24–3.49)
TPB ≥35%optimal cutoff
1.96(1.21–3.17)
NCPB ≥20%optimal cutoff
1.77(1.12–2.82)
Further findings
Total plaque volume (TPV)
- Median (IQR) TPV
- 39.8 mm3 (0-167) mm3
Characteristics by TPV ≥ median vs < median
- Mean (SD) age, years
- 62.1 [8.4] vs 58.7 [7.5]
- Male
- 1286/2133 [60.3%] vs 782/2134 [36.6%]
- Median (IQR) ASCVD risk score
- 14.4 [8.8-24.0] vs 7.9 [4.5-13.4]
- Total plaque burden (TPB) showed similar demographic associations
Original publication
Prognostic Value of Plaque Volume in Patients With First Diagnosis of Coronary Artery Disease: A Substudy of the PROMISE Randomized Clinical Trial. JAMA Cardiol. Published 1 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it