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Review
. 2023 Apr;25(4):167-180.
doi: 10.1007/s11883-023-01088-0. Epub 2023 Feb 21.

Does Coronary Plaque Morphology Matter Beyond Plaque Burden?

Daniel Lorenzatti  1 , Pamela Piña  1   2 , Ibolya Csecs  1 , Aldo L Schenone  1 , Carlos A Gongora  1 , Mario J Garcia  1 , Michael J Blaha  3 , Matthew J Budoff  4 , Michelle C Williams  5   6 , Damini Dey  7 , Daniel S Berman  7 , Salim S Virani  8   9 , Leandro Slipczuk  10   11
Affiliations
Review

Does Coronary Plaque Morphology Matter Beyond Plaque Burden?

Daniel Lorenzatti et al. Curr Atheroscler Rep. 2023 Apr.

Abstract

Purpose of review: Imaging of adverse coronary plaque features by coronary computed tomography angiography (CCTA) has advanced greatly and at a fast pace. We aim to describe the evolution, present and future in plaque analysis, and its value in comparison to plaque burden.

Recent findings: Recently, it has been demonstrated that in addition to plaque burden, quantitative and qualitative assessment of coronary plaque by CCTA can improve the prediction of future major adverse cardiovascular events in diverse coronary artery disease scenarios. The detection of high-risk non-obstructive coronary plaque can lead to higher use of preventive medical therapies such as statins and aspirin, help identify culprit plaque, and differentiate between myocardial infarction types. Even more, over traditional plaque burden, plaque analysis including pericoronary inflammation can potentially be useful tools for tracking disease progression and response to medical therapy. The identification of the higher risk phenotypes with plaque burden, plaque characteristics, or ideally both can allow the allocation of targeted therapies and potentially monitor response. Further observational data are now required to investigate these key issues in diverse populations, followed by rigorous randomized controlled trials.

Keywords: CAC; Coronary artery disease; Plaque burden; Plaque morphology.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance
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