Key result
Total coronary atheroma burden quantified by computed tomography is a superior predictor of future cardiovascular events and disease progression compared to traditional risk factors or stenosis.
Why the study?
The high-risk plaque concept on CTA suffers from poor reproducibility and poor positive predictive power, prompting a review of total coronary atheroma burden as a predictor of coronary events.
Does the quantification of total coronary atheroma burden by CT improve the prediction of future cardiovascular events compared to assessing high-risk plaque or stenosis?
Does the quantification of total coronary atheroma burden by CT improve the prediction of future cardiovascular events compared to assessing high-risk plaque or stenosis?
Total coronary atheroma burden quantified by CT angiography is a superior predictor of future cardiovascular events compared to traditional stenosis severity or high-risk plaque features.
The extent of coronary artery disease has been shown to be an important indicator of prognosis. Cardiac computed tomography (CT) has the ability to measure plaque, with both coronary artery calcium scanning and CT angiography (CTA), to give a measure of total atheroma burden. Beyond assessing stenosis and atherosclerosis, CTA can assess high-risk plaque. These plaques are thought to be consistent with plaques that are vulnerable and more likely to rupture and cause acute coronary syndromes. However, the high-risk plaque concept suffers from poor reproducibility and poor positive predictive power. Total coronary atheroma burden has been shown to be a better predictor of coronary events than high-risk plaques or stenosis. This paper reviews the literature in this regard and demonstrates total coronary atheroma burden to be the best predictor of future cardiovascular disease. We searched MEDLINE, EMBASE and the Cochrane library database for studies assessing plaque burden and outcomes by CT. We used text words and related Medical Subject Headings (MeSH) for cardiac, calcification, plaque burden, CT, prognosis, mortality, event, death, survival and myocardial infarction.
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Foult et al. (2020) conducted a review in Coronary artery disease. Total coronary atheroma burden (TOCAB) quantification via CT vs. Traditional risk factors, calcium score, or significant stenosis was evaluated. Total coronary atheroma burden quantified by computed tomography is a superior predictor of future cardiovascular events and disease progression compared to traditional risk factors or stenosis.
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