High-risk plaque on coronary CTA linked to future MACE
Maros Ferencik, M.D., Ph.D., from Oregon Health and Science University in Portland, and colleagues conducted a prespecified nested observational cohort study to examine whether high-risk plaque detected by coronary CTA was correlated with incident MACE. All 4,415 stable symptomatic patients who received coronary CTA were followed for a median of 25 months.
Overall, the median atherosclerotic cardiovascular disease (ASCVD) risk score was 11 and the MACE rate was 3 percent. A total of 15.3 percent of patients had high-risk plaques, and 6.3 percent had significant stenosis (SS). The researchers found that the rate of MACE was higher with the presence of high-risk plaque (6.4 versus 2.4 percent; hazard ratio, 2.73). Even after adjustment for ASCVD risk score and SS, the correlation persisted (adjusted hazard ratio, 1.72). There was a continuous net reclassification improvement with the addition of high-risk plaque to the ASCVD risk score and SS assessment (0.34). Among patients with nonobstructive coronary artery disease, the presence of high-risk plaque increased MACE risk relative to patients without high-risk plaque (adjusted hazard ratio, 4.31 versus 2.64).
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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