Prognostic Value of Plaque Volume in Patients With First Diagnosis of Coronary Artery Disease

Does quantitative plaque assessment improve prognostication of major adverse cardiovascular events (MACE) in patients with unknown history of coronary artery disease?In this substudy of the randomized clinical trial PROMISE, among 4267 symptomatic patients, higher total plaque volume (≥87 mm), total plaque burden (≥35%), and noncalcified plaque burden (≥20%) were associated with an increased risk of MACE, independent of atherosclerotic cardiovascular disease risk, statin use, 50% or more stenosis, coronary artery calcium score, and high-risk plaque.Quantitative plaque measures on coronary computed tomographic angiography (CCTA) improve risk prediction for MACE and may enhance early cardiovascular risk assessment beyond clinical risk and routinely assessed CCTA metrics.

Corresponding Author: Borek Foldyna, MD, PhD, Cardiovascular Imaging Research Center, Massachusetts General Hospital, 165 Cambridge St, Ste 400, Boston, MA 02114 (bfoldyna@mgh.harvard.edu).

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