冠状动脉ct血管成像评估易损斑块的临床应用研究

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Patients undergoing coronary CT angiography (CCTA) evaluated for vulnerable coronary plaques (n=690). Intervention: Vulnerable coronary plaque detected by coronary CTA with double-blind reading and AI assistance vs. No vulnerable coronary plaque detected on coronary CTA. Primary outcome: Composite cardiovascular events (myocardial infarction, unstable angina, coronary revascularization, cardiovascular death) at 3 years (RR 2.94, 95% CI 1.76-4.92, p=<0.001).

Q: What does this research mean for the field?

Coronary CTA-based detection of vulnerable plaques combined with AI-assisted risk stratification predicts 3-year composite cardiovascular events with high diagnostic accuracy (AUC = 0.88) and excellent inter-reader reliability. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

婷 王

doi:10.37155/2661-4766-0807-11

January 1, 2026临床医学前沿Open Access

冠状动脉ct血管成像评估易损斑块的临床应用研究

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Why the study?

This study aimed to evaluate the clinical predictive value of coronary CTA in identifying vulnerable plaques and to establish an imaging risk stratification system that provides a reproducible assessment model for early cardiovascular event screening in primary care.

Does vulnerable plaque detection via AI-assisted double-blind coronary CT angiography predict the 3-year composite cardiovascular endpoint in patients undergoing coronary CT angiography?

Key Points

Investigate the clinical predictive value of coronary CTA in identifying vulnerable plaques and construct an imaging-based risk stratification system for early cardiovascular event screening.
Prospectively enrolled 690 patients undergoing coronary CTA, categorizing them into a vulnerable plaque group (n=300) and a control group without vulnerable plaques (n=390).
Applied double-blind review by three radiologists combined with artificial intelligence software to assess plaque features, following participants for 3 years to track composite cardiovascular endpoints.
Cardiovascular events occurred in 15.0% (45/300) of the vulnerable plaque group versus 5.1% (20/390) of the control group (RR 2.94, 95% CI 1.76-4.92, P < 0.001).
Vulnerable plaque features showed strong independent associations with events, including low-density lipid core (OR 8.52, 95% CI 5.63-12.89, P < 0.001), positive remodeling index > 1.1 (OR 10.25, 95% CI 6.78-15.49, P < 0.001), and fibrous cap thickness < 0.5 mm (OR 12.34, 95% CI 8.12-18.76, P < 0.001).
The risk stratification model achieved an AUC of 0.88, with overall inter-observer agreement demonstrating Kappa = 0.87 (95% CI 0.83-0.91) and ICC = 0.89 (95% CI 0.84-0.93, P < 0.001).

Study Design

Type

Cohort (n=690)

Blinding

Double-blind image reading and blinded endpoint adjudication

Multicenter

No

Structured PICO

Does vulnerable plaque detection via AI-assisted double-blind coronary CT angiography predict the 3-year composite cardiovascular endpoint in patients undergoing coronary CT angiography?

P

Population

690 adults undergoing coronary CTA at a single center in China (mean age 55.2 years, 37.4% female, age range 18-85), stratified into vulnerable plaque detected (n=300) and undetected (n=390) groups and followed for 3 years.

E

Exposure

Coronary CT angiography (CCTA) using Revolution CT ES multislice spiral CT with double-blind reading by 3 experienced radiologists combined with Shukun coronary AI software to identify and quantify vulnerable plaque features (low-attenuation lipid core <30 HU, positive remodeling index >1.1, fibrous cap thickness <0.5 mm); non-interventional study with no changes to baseline medical therapy.

C

Comparator

Control group without vulnerable plaque signs on CCTA (n=390), undergoing the same scanning, post-processing, AI-assisted double-blind reading, and follow-up protocols, stratified and randomly matched by age, sex, and cardiovascular risk factors, maintaining original medical therapy.

O

Outcome

Composite cardiovascular endpoint (myocardial infarction, unstable angina, coronary revascularization, cardiovascular death) over 3 years of follow-up, adjudicated by a blinded independent endpoint committee.composite

Main Result

Relative Risk: 2.94 (95% CI 1.76–4.92)

Absolute Event Rate: 15% vs 5.1%

p-value: p=<0.001

Coronary CTA combined with AI-assisted double-blind reading reliably identifies vulnerable plaques (Kappa > 0.85) and strongly predicts 3-year cardiovascular events (RR 2.94, model AUC 0.88), offering a reproducible risk stratification tool for primary care screening.

Limitations

Single-center cohort study
Lack of direct head-to-head comparison between AI and manual reading
Lack of systematic radiation dose monitoring
No direct head-to-head comparison between AI and manual reading alone

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Implication

AI-assisted CTA detection of vulnerable plaques was associated with higher events; leaves open whether it improves risk stratification beyond standard models.

Abstract

王婷（平罗县人民医院）目的：探究冠脉CTA识别易损斑块的临床预测价值、构建影像风险分层体系，为基层心血管事件早筛提供可复制评估模式。方法：前瞻性纳入690名冠脉CTA受检者，采用双盲阅片结合AI识别斑块影像特征，并分为易损斑块检出和未检出两组进行3年随访，以复合心血管终点分析影像特征与事件的关系。结果：易损斑块组3年心血管事件更高并呈剂量－反应关系；风险分层模型AUC = 0.88，判效均衡，阅片者Kappa > 0.85，重复性好。结论：冠脉CTA 能够识别易损斑块，影像参数与心血管风险相关，AI加上双盲阅片可以用于基层标准化筛查，有助于实现冠心病早期精准管理。目的：探究冠脉CTA识别易损斑块的临床预测价值、构建影像风险分层体系，为基层心血管事件早筛提供可复制评估模式。方法：前瞻性纳入690名冠脉CTA受检者，采用双盲阅片结合AI识别斑块影像特征，并分为易损斑块检出和未检出两组进行3年随访，以复合心血管终点分析影像特征与事件的关系。结果：易损斑块组3年心血管事件更高并呈剂量－反应关系；风险分层模型AUC = 0.88，判效均衡，阅片者Kappa > 0.85，重复性好。结论：冠脉CTA 能够识别易损斑块，影像参数与心血管风险相关，AI加上双盲阅片可以用于基层标准化筛查，有助于实现冠心病早期精准管理。

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Cite This Study

婷王 (2026) conducted a cohort in Patients undergoing coronary CT angiography (CCTA) evaluated for vulnerable coronary plaques (n=690). Vulnerable coronary plaque detected by coronary CTA with double-blind reading and AI assistance vs. No vulnerable coronary plaque detected on coronary CTA was evaluated on Composite cardiovascular events (myocardial infarction, unstable angina, coronary revascularization, cardiovascular death) at 3 years (RR 2.94, 95% CI 1.76-4.92, p=<0.001).

synapsesocial.com/papers/6af46d8f7bb3da179b85012a https://doi.org/10.37155/2661-4766-0807-11

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冠状动脉ct血管成像评估易损斑块的临床应用研究

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

冠状动脉ct血管成像评估易损斑块的临床应用研究

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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