Key result
CCTA-defined mixed or noncalcified plaque predicts vasospastic angina with ~75% probability.
Why the study?
Vasospastic angina is associated with myocardial bridge and pericoronary adipose tissue inflammation, but clinical and CCTA features predicting vasospastic angina in patients with angina and nonobstructive coronary arteries remained to be investigated.
Does CCTA assessment predict vasospastic angina in patients with angina and nonobstructive coronary arteries?
Observational
Does CCTA assessment predict vasospastic angina in patients with angina and nonobstructive coronary arteries?
Noninvasive comprehensive assessment with CCTA can help identify patients with angina and nonobstructive coronary arteries who are at high risk for vasospastic angina.
CCTA plaque features may aid VSA probability estimation in nonobstructive angina; leaves open prospective validation before clinical adoption.
BACKGROUND: Recent studies have shown that vasospastic angina (VSA) is associated with myocardial bridge (MB) and pericoronary adipose tissue inflammation. We aimed to investigate the clinical and coronary computed tomography angiographic (CCTA) features that could predict VSA in patients with angina and nonobstructive coronary arteries. METHODS: ) from the vessel wall. Coronary plaques were qualitatively classified as noncalcified or calcified plaques in each vessel. In addition, MB was evaluated in the left anterior descending artery. RESULTS: (≥-72.6 Hounsfield unit, median), and CCTA-defined mixed or noncalcified plaque in the coronary tree predicted VSA with a 75.0% probability, while the absence of all 3 factors precluded VSA with 95.6% probability. CONCLUSIONS: For patients with angina and nonobstructive coronary arteries, a prespasm provocation test using a noninvasive comprehensive assessment with CCTA may help identify those at high risk for VSA.
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Mineo et al. (2025) conducted an observational in Angina and nonobstructive coronary arteries. Coronary computed tomography angiography (CCTA) was evaluated on Prediction of vasospastic angina. CCTA-defined features including mixed or noncalcified plaque predicted vasospastic angina with a 75.0% probability, while the absence of all 3 factors precluded it with 95.6% probability.
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