Atherosclerosis evaluation and cardiovascular risk estimation using coronary computed tomography angiography

Nick S. Nurmohamed, Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Alexander R. van Rosendael, Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Ibrahim Danad, Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Quyen Ngo-Metzger, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States.
Pam R. Taub, Section of Cardiology, Department of Medicine, University of California, San Diego, CA, United States.
Kausik K. Ray, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.
Gemma Figtree, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, Australia.
Marc P. Bonaca, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States.
Judith Hsia, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States.
Fatima Rodriguez, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.
Alexander T. Sandhu, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.
Koen Nieman, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.
James P. Earls, Cleerly, Inc., Denver, CO, United States.
Udo Hoffmann, Cleerly, Inc., Denver, CO, United States.
Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
James K. Min, Cleerly, Inc., Denver, CO, United States.
David J. Maron, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States.
Deepak L. Bhatt, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, Box 1030, New York, NY 10029, United States.

Document Type

Journal Article

Publication Date

5-27-2024

Journal

European heart journal

Volume

45

Issue

20

DOI

10.1093/eurheartj/ehae190

Keywords

Atherosclerotic cardiovascular disease; Coronary artery disease; Coronary computed tomography angiography; Major adverse cardiovascular events; Prevention

Abstract

Clinical risk scores based on traditional risk factors of atherosclerosis correlate imprecisely to an individual's complex pathophysiological predisposition to atherosclerosis and provide limited accuracy for predicting major adverse cardiovascular events (MACE). Over the past two decades, computed tomography scanners and techniques for coronary computed tomography angiography (CCTA) analysis have substantially improved, enabling more precise atherosclerotic plaque quantification and characterization. The accuracy of CCTA for quantifying stenosis and atherosclerosis has been validated in numerous multicentre studies and has shown consistent incremental prognostic value for MACE over the clinical risk spectrum in different populations. Serial CCTA studies have advanced our understanding of vascular biology and atherosclerotic disease progression. The direct disease visualization of CCTA has the potential to be used synergistically with indirect markers of risk to significantly improve prevention of MACE, pending large-scale randomized evaluation.

Department

Radiology

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