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Coronary computed tomography angiography (CCTA) can assess the degree and progression of coronary atherosclerosis and higher-risk plaque features, such as remodeling of the blood vessel wall, low attenuation lesions, and spotty calcification. In this analysis, 1005 patients (mean age, 60; 69% with atypical chest pain) from 7 countries were categorized as having low (<7.5%), intermediate (7.5%–20%), or high risk (>20%) based on their 10-year atherosclerotic cardiovascular disease (ASCVD) risk score (NEJM JW Dec 15 2013 and J Am Coll Cardiol 2014; 63:2935). These patients also underwent serial CCTA (mean time between scans, 3.3 years).
Progression in atherosclerosis volume was significantly greater in those with high ASCVD risk than those with…