Coronary Artery Vulnerable Plaque Detection And Characterization: What Do Cardiologists Need To Know?

Abstract

Acute coronary syndrome is often precipitated by a sudden thrombosis induced by the rupture or erosion of an
atherosclerotic plaque. In individuals with acute chest pain, culprit lesions' non-invasive detection has the ability
to improve non-invasive risk classification. Coronary computed tomography angiography [CCTA] detects
luminal stenosis and visualizes atheromatous mural changes [coronary plaques]. A higher risk of acute
cardiovascular events is seen in individuals having a large plaque volume, positive remodeling, napkin-ring
sign, spotty calcification, and low CT attenuation. Coronary CTA has shown to be a promising method for
determining coronary lesions' functional significance via the use of rest/dynamic myocardial CT perfusion
and/or CT-derived fractional flow reserve [FFR-CT]. Other invasive procedures as intravascular ultrasound and
optical coherence topography gain important insights but are limited to high-risk patients.