scholarly journals Atherosclerotic Plaque in Patients with Zero Calcium Score at Coronary Computed Tomography Angiography

2018 ◽  
Author(s):  
Fabíola Santos Gabriel ◽  
Luiz Flávio Galvão Gonçalves ◽  
Enaldo Vieira de Melo ◽  
Antônio Carlos Sobral Sousa ◽  
Ibraim Masciarelli Francisco Pinto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Atherosclerotic Plaque ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Calcium Score ◽  
Coronary Computed Tomography ◽  
Zero Calcium Score

scholarly journals Clinical Relevance of Coronary Computed Tomography Angiography Beyond Coronary Artery Stenosis

2021 ◽  
Author(s):  
Mohammed Nooruddin Meah ◽  
Michelle C. Williams
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
High Risk ◽  
Atherosclerotic Plaque ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Calcium Score ◽  
Coronary Plaque ◽  
Coronary Computed Tomography ◽  
Low Attenuation Plaque

Background The capabilities of coronary computed tomography angiography (CCTA) have advanced significantly in the past decade. Its capacity to detect stenotic coronary arteries safely and consistently has led to a marked decline in invasive diagnostic angiography. However, CCTA can do much more than identify coronary artery stenoses. Method This review discusses applications of CCTA beyond coronary stenosis assessment, focusing in particular on the visual and quantitative analysis of atherosclerotic plaque. Results Established signs of visually assessed high-risk plaque on CT include positive remodeling, low-attenuation plaque, spotty calcification, and the napkin-ring sign, which correlate with the histological thin-cap fibroatheroma. Recently, quantification of plaque subtypes has further improved the assessment of coronary plaque on CT. Quantitatively assessed low-attenuation plaque, which correlates with the necrotic core of the thin-cap fibroatheroma, has demonstrated superiority over stenosis severity and coronary calcium score in predicting subsequent myocardial infarction. Current research aims to use radiomic and machine learning methods to further improve our understanding of high-risk atherosclerotic plaque subtypes identified on CCTA. Conclusion Despite rapid technological advances in the field of coronary computed tomography angiography, there remains a significant lag in routine clinical practice where use is often limited to lumenography. We summarize some of the most promising techniques that significantly improve the diagnostic and prognostic potential of CCTA. Key Points:  Citation Format

scholarly journals Changes in Atherosclerotic Plaque Composition with Anti-Lipid Therapy as Detected by Coronary Computed Tomography Angiography

2021 ◽  
Author(s):  
Drew Thomas ◽  
Darma Marcelin ◽  
Shone Almeida
Keyword(s):  
Computed Tomography ◽  
Cardiovascular Disease ◽  
Atherosclerotic Plaque ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Plaque Composition ◽  
Cardiac Events ◽  
Mortality And Morbidity ◽  
Lipid Management ◽  
Coronary Computed Tomography

Lipid management remains the mainstay of cardiovascular disease prevention. Drugs that target cholesterol reduction, such as HMG-CoA reductase inhibitors (statins) and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, have shown significant mortality and morbidity benefit. Predominantly targeting low-density lipoprotein (LDL). These drugs have been indicated to reduce lipid composition and plaque proliferation. Total plaque burden and composition can now be assessed with noninvasive advanced cardiac imaging modalities. This chapter will address the components of atherosclerotic plaque as identified with coronary computed tomography angiography (CCTA) and review in detail the changes in plaque characteristics that may be responsible for reduction in cardiac events. These changes in plaque composition may help guide future management of cardiovascular disease, serving as an imaging biomarker for better risk stratification. Readers will gain a deeper understanding of plaque morphology with direct clinical applicability as well as an understanding of how noninvasive imaging can be utilized to assess plaque composition.

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