Plaque Assessment on Serial Coronary CTA

  • Guilherme Monteiro
  • Roberto C. Cury
  • Marcio S. BittencourtEmail author
Cardiac Computed Tomography (B Chow and G Small, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cardiac Computed Tomography


Purpose of Review

This review addresses the role of serial coronary computed tomography angiography (CTA) on the evaluation of atherosclerosis progression, risk stratification, and targeting individual pharmacotherapy.

Recent Findings

The presence, extent, and severity of coronary artery disease (CAD) detected by coronary CTA are associated with an adverse prognosis. Similarly, the presence of high-risk plaque features such as positive remodeling, low-attenuation plaque, spotty calcifications, and napkin-ring sign are associated with major adverse cardiac events. More recently, examinations using serial coronary CTA have also shown that these static CTA plaque features are associated with a more rapid progression of atherosclerosis on follow-up imaging and may identify a subset of patients at increased risk for plaque rupture. While the impact of serial CTA findings on management and hard outcomes remains a topic of ongoing investigation, available data supports the ability of statin therapy to reduce CTA-identified plaque burden and modify plaque composition.


Coronary CTA identifies various plaque features associated with an increased risk of plaque progression and adverse cardiac events. Available data support the use of CTA to individualize statin therapy and utilize serial CTA imaging to study the impact of pharmacotherapy on plaque burden and outcomes.


Atherosclerosis Atherosclerotic plaque Plaque progression Coronary artery disease Coronary computed tomography angiography 


Compliance with Ethical Standards

Conflict of Interest

Guilherme Monteiro, Roberto C. Cury, and Marcio S. Bittencourt declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Guilherme Monteiro
    • 1
  • Roberto C. Cury
    • 2
  • Marcio S. Bittencourt
    • 2
    • 3
    • 4
    Email author
  1. 1.Imagem Cardíaca da Clínica Imagem - FlorianópolisSão PauloBrazil
  2. 2.Delboni - DASASão PauloBrazil
  3. 3.Hospital Israelita Albert EinsteinSão PauloBrazil
  4. 4.Center for Clinical and Epidemiological ResearchUniversity Hospital, University of Sao PaulSao PauloBrazil

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