What Characteristics Define High-Risk Coronary Plaques?

A meta-analysis finds low overall prevalence of high-risk plaque features, among which thin cap fibroatheroma predicted the highest risk for future MACEs.

Identifying the imaging characteristics that define vulnerable or “high-risk” atherosclerotic plaques is an important objective of prevention. To that end, investigators performed a systematic review and meta-analysis of 31 studies (21 retrospective, 9 prospective) comprising 30,369 patients that examined the association of coronary atherosclerotic plaque characteristics (CPCs) with major adverse cardiovascular events (MACEs). CPCs evaluated were high plaque burden, low minimal lumen area, thin cap fibroatheroma (TCFA), high lipid core burden index, low-attenuation plaque, spotty calcification, napkin ring sign, and positive remodeling.

The median age of participants was 64 years, and 32% were women. Chronic coronary syndrome was the most co…

Reviewing Author

Karol E. Watson, MD, PhD, FACC

Disclosures

Consultant/Advisory BoardBoehringer Ingelheim; Amgen; Novartis; Lilly; Amarin

Speaker’s BureauBoehringer Ingelheim

Grant/Research SupportNIH

Editorial BoardsCirculation (Associate Editor)