Plaque Assessment on Serial Coronary CTA
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.
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.
KeywordsAtherosclerosis 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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