Key result
Nonobstructive CAD was the predominant contributor to total atherosclerotic plaque volume, with fibrous, fibrofatty, and necrotic core tissue volumes increasing with worsening clinical presentation.
Why the study?
The study examined obstructive and nonobstructive plaque volumes using quantitative computed tomography across populations with subclinical and clinically manifested CAD.
Do nonobstructive plaque characteristics assessed by QCT differ across subclinical and clinically manifested coronary artery disease?
Observational (n=855)
Do nonobstructive plaque characteristics assessed by QCT differ across subclinical and clinically manifested coronary artery disease?
Nonobstructive CAD is the predominant contributor to total atherosclerotic plaque volume, with high-risk plaque components (fibrous, fibrofatty, necrotic core) increasing with worsening clinical presentation.
Nonobstructive high-risk plaque volumes track with clinical severity; hypothesis-generating for QCT in CAD risk stratification.
BACKGROUND: We examined obstructive and nonobstructive plaque volumes in populations with subclinical and clinically manifested coronary artery disease (CAD) using quantitative computed tomography (QCT). METHODS: 855 participants with CAD (274 asymptomatic individuals, 254 acute chest pain patients without acute coronary syndrome (ACS), and 327 patients with ACS) underwent QCT of proximal coronary segments to assess participant-level plaque volumes of dense calcium, fibrous, fibrofatty, and necrotic core tissue. CONCLUSION: Nonobstructive CAD was the predominant contributor to total atherosclerotic plaque volume in both subclinical and clinically manifested CAD. Nonobstructive fibrous, fibrofatty and necrotic core tissue volumes increased with worsening clinical presentation, while nonobstructive dense calcium tissue volumes did not.
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Knegt et al. (2024) conducted an observational in Coronary artery disease (CAD) (n=855). Worsening clinical presentation of CAD vs. Asymptomatic CAD was evaluated on Participant-level plaque volumes of dense calcium, fibrous, fibrofatty, and necrotic core tissue (p=>0.3). Nonobstructive CAD was the predominant contributor to total atherosclerotic plaque volume, with fibrous, fibrofatty, and necrotic core tissue volumes increasing with worsening clinical presentation.
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