Preventative Imaging with Coronary Computed Tomography Angiography

Curr Cardiol Rep. 2023 Nov;25(11):1623-1632. doi: 10.1007/s11886-023-01982-8. Epub 2023 Oct 28.

Abstract

Purpose of review: Coronary computed tomography angiography (CCTA) is the diagnostic modality of choice for patients with stable chest pain. In this review, we scrutinize the evidence on the use of CCTA for the screening of asymptomatic patients.

Recent findings: Clinical evidence suggests that CCTA imaging enhances cardiovascular risk stratification and prompts the timely initiation of preventive treatment leading to reduced risk of major adverse coronary events. Visualization of coronary plaques by CCTA also helps patients to comply with preventive medications. The presence of non-obstructive plaques and total plaque burden are prognostic for cardiovascular events. High-risk plaque features and pericoronary fat attenuation index, enrich the prognostic output of CCTA on top of anatomical information by capturing information on plaque vulnerability and coronary inflammatory burden. Timely detection of atherosclerotic disease or coronary inflammation by CCTA can assist in the deployment of targeted preventive strategies and novel therapeutics to prevent cardiovascular disease.

Keywords: Cardiovascular prevention; Cardiovascular risk stratification; Coronary computed tomography angiography; Fat attenuation index; High-risk plaque features.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Computed Tomography Angiography / methods
  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Vessels
  • Heart
  • Humans
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Predictive Value of Tests
  • Tomography, X-Ray Computed / methods