Key result
CCTA combined with FAI analysis identified highly inflamed, non-calcified, high-risk coronary plaques in three patients with a zero calcium score, leading to successful stenting.
Case Report (n=3)
No
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CCTA with FAI analysis can identify highly inflamed, high-risk non-calcified plaques in patients with a zero calcium score, guiding immediate intervention.
The modern management of coronary artery disease (CAD) uses coronary computed tomography angiography (CCTA) to enhance plaque evaluation and cardiovascular risk assessment. CCTA identifies high-risk plaques, and the latest CT technologies based on calculation of fat attenuation index (FAI) allow assessment of inflammation at the level of the target coronary artery. We present a series of case studies with chest pain and positive CCTA, in whom a significant stenosis was detected in the left anterior descendent coronary artery, and the existence of high-risk, inflamed plaques was documented even in the context of a zero calcium score. A severe narrowing of the left anterior descending artery, exhibiting the pattern of high-risk anatomy, was associated with a very high inflammation depicted by FAI analysis in all three cases, an association that may be extremely dangerous. In this case series, CCTA examination led to immediate stenting of the obstructive stenosis, sealing the dangerous plaque.
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Matyas et al. (2023) conducted a case report in Coronary artery disease with zero calcium score (n=3). CCTA with FAI analysis and stenting was evaluated on Identification of high-risk inflamed plaques and procedural success. CCTA combined with FAI analysis identified highly inflamed, non-calcified, high-risk coronary plaques in three patients with a zero calcium score, leading to successful stenting.
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