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Prognostic Value of Serial Coronary CT Angiography in Atherosclerotic Plaque Modification: What Have We Learnt?

  • Cardiac Computed Tomography (A. Crean & G. Small,Section Editors)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of review

To provide an update and to outline the status of coronary computer tomography angiography (CCTA) in the evaluation of coronary plaques and discuss the relevance of serial CCTA in guiding cardiovascular risk stratification and anti-atherosclerotic medical therapy.

Recent findings

Coronary CTA is now the imaging modality of choice in monitoring changes in coronary plaque. It has been used in innumerable clinical trials which have demonstrated the benefits of several therapeutic agents and has excellent correlation with previously used invasive imaging modalities. It is safe, fast, less cumbersome, and a cost-effective testing method compared to other invasive imaging modalities for coronary plaque analysis.

Summary

The emergence of a noninvasive imaging modality such as CCTA now permits quantification not only of plaque burden but also allows for further distinction of plaque components and identification of vulnerable plaques. The application of these findings continues to extend the prospect of coronary CTA in evaluation and management of atherosclerotic coronary artery disease (CAD) in clinical practice. In the future, artificial intelligence and machine learning will play a significant role in plaque analysis allowing for high accuracy and reproducibility which will lead to a substantial increase in the utilization of coronary CTA.

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Abbreviations

TP :

Total plaque

NCP :

Non-calcified plaque

CP :

Calcified plaque

DCPV :

Dense calcified plaque

LAP :

Low-attenuation plaque

LRNC :

Lipid-rich necrotic core

PAV :

Percent atheroma volume

TAV :

Total atheroma volume

HRP :

High-risk plaque

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Funding

Matthew J Budoff receives research support from General Electric (GE) and funding support from the National Institutes of Health (NIH). Venkat S. Manubolu and Sion K. Roy declare that they have no financial interests to disclose.

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Authors and Affiliations

  1. Department of Cardiology, Lundquist Institute, 1124 W Carson Street, Torrance, CA, 90502, USA

    Venkat S. Manubolu, Sion K. Roy & Matthew J. Budoff

Authors
  1. Venkat S. Manubolu
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  3. Matthew J. Budoff
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Contributions

Dr. Matthew Budoff conceived of the article idea. All authors were involved in the literature search. The first draft of the manuscript was written by Venkat S. Manubolu, and all authors assisted with edits of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Matthew J. Budoff.

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Manubolu, V.S., Roy, S.K. & Budoff, M.J. Prognostic Value of Serial Coronary CT Angiography in Atherosclerotic Plaque Modification: What Have We Learnt?. Curr Cardiovasc Imaging Rep 15, 1–10 (2022). https://doi.org/10.1007/s12410-022-09564-y

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