Calcified plaque morphology, density, and risk

In this issue of Atherosclerosis, Pugliese et al. investigated associations between stenosis severity, coronary calcium morphology, calcium density and specific coronary plaque ‘vulnerability’ features by computed tomography (CT) [ [1] Pugliese L. Spiritigliozzi L. Di Tosto F. Ricci F. Cavallo A.U. Di Donna C. De Stasio V. Presicce M. Benelli L. D'Errico F. Pasqualetto M. Floris R. Chiocchi M. Association of plaque calcification pattern and attenuation with instability features and coronary stenosis and calcification grade. Atherosclerosis. 2020; Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ]. One hundred symptomatic or asymptomatic patients, undergoing clinical coronary CT angiography (CCTA) and coronary artery calcium score (CACS) for evaluation of known or suspected coronary atherosclerosis and with at least one coronary stenosis, were included. The mean age was 67 years and 74% were male, 21% patients having diabetes, 59% hypertension, 78% CACS >100 and 15% CACS >1000 Agatston Units (AU). Both per-lesion and per-patient comparisons were made for CACS, stenosis severity, calcification pattern (spotty or large), calcification attenuation, and an instability score based on the number of high risk features (spotty calcification, positive remodeling, low-attenuation, and napkin ring sign; with scores ranging 0–3 and higher scores meaning higher instability). Association of plaque calcification pattern and attenuation with instability features and coronary stenosis and calcification gradeAtherosclerosisVol. 311PreviewCoronary computed tomography (CT) allows calculating coronary artery calcium score (CACS). However, other CT features might be more strongly related to plaque vulnerability and risk of future coronary events. This study investigated the association of plaque calcification pattern and attenuation with plaque instability features, coronary artery disease (CAD) grade and CACS. Full-Text PDF