Key PointsQuestionIs high-risk plaque, as detected by coronary computed tomographic angiography, associated with incident major adverse cardiovascular events? FindingsIn this substudy of the PROMISE trial, we evaluated the presence of high-risk plaque in 4415 patients. High-risk plaque was present in 676 patients (15%) and carried a 70% increased risk of major adverse cardiovascular events independent of cardiovascular risk factors and obstructive coronary artery disease; detection was most useful in younger patients, women, and those with nonobstructive coronary artery disease. MeaningThe findings suggest the potential significance of detecting high-risk plaques in patients with stable ischemic heart disease; however, the low absolute rates of major adverse cardiovascular events and low positive predictive value of high-risk plaque detection might limit its clinical applicability.
JAMA Cardiology – American Medical Association
Published: Feb 10, 2018
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