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Beyond Coronary Stenosis: Coronary Computed Tomographic Angiography for the Assessment of Atherosclerotic Plaque Burden

Current Cardiovascular Imaging Reports volume 6, pages 89–101 (2013)Cite this article

Abstract

Coronary computed tomographic angiography (CCTA) is emerging as a key noninvasive method for assessing cardiovascular risk by measurement of coronary stenosis and coronary artery calcium (CAC). New advancements in CCTA technology have led to the ability to directly identify and quantify the so-called “vulnerable” plaques that have features of positive remodeling and low density components. In addition, CCTA presents a new opportunity for noninvasive measurement of total coronary plaque burden that has not previously been available. The use of CCTA needs also to be balanced by its risks; in particular, the associated radiation exposure. We review current uses of CCTA, CCTA’s ability to measure plaque quantity and characteristics, and new developments in risk stratification and CCTA technology. CCTA represents a quickly developing field that will play a growing role in the non-invasive management of cardiovascular disease.

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Acknowledgments

Funded by the National Institutes of Health (NIH) Intramural program.

This research was made possible through the National Institutes of Health (NIH) Medical Research Scholars Program, a public-private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer Inc, The Leona M. and Harry B. Helmsley Charitable Trust, and the Howard Hughes Medical Institute, as well as other private donors. For a complete list, please visit the Foundation website at http://www.fnih.org/work/programs-development/medical-research-scholars-program).

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  1. Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Building 10, Rm 1C355, Bethesda, MD, 20892-1182, USA

    Alan C. Kwan, Jose Vargas & David A. Bluemke

  2. Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue NA24, Cleveland, OH, 44195, USA

    George Cater

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  1. Alan C. Kwan
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Kwan, A.C., Cater, G., Vargas, J. et al. Beyond Coronary Stenosis: Coronary Computed Tomographic Angiography for the Assessment of Atherosclerotic Plaque Burden. Curr Cardiovasc Imaging Rep 6, 89–101 (2013). https://doi.org/10.1007/s12410-012-9183-z

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Keywords

  • Coronary computed tomographic angiography
  • CT
  • Atherosclerosis
  • Plaque
  • Non-calcified
  • Acute coronary syndrome
  • Vulnerable plaque
  • Spotty calcification
  • Coronary artery calcium
  • Reconstruction