ArticleJACC. Cardiovascular imaging2021
Risk Stratification With the Use of Coronary Computed Tomographic Angiography in Patients With Nonobstructive Coronary Artery Disease.
Article in JACC. Cardiovascular imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06520904 (Effect of PCSK9 Inhibitors on Coronary Atherosclerotic Plaques Derived From Optical Coherence Tomography in Patients With Premature Coronary Artery Disease), which is not on this map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of PCSK9 Inhibitors on Coronary Atherosclerotic Plaques Derived From Optical Coherence Tomography in Patients With Premature Coronary Artery Disease: a Randomized Controlled Trial
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effect of Intensive Lipid-Lowering Therapy on Coronary Plaque Stabilization Derived from Optical Coherence Tomography: a Meta-analysis and Meta-regression.Cardiovascular drugs and therapy · 2025 · on this mapPooled it
- Atherosclerosis quantification and cardiovascular risk: the ISCHEMIA trial.European heart journal · 2024Trial
- Multiparametric Coronary CT Angiography-Derived Imaging Biomarkers for Risk Stratification in Nonobstructive Coronary Artery Disease: Incremental Prognostic Value in Patients with Diabetes.Tomography (Ann Arbor, Mich.) · 2026Article
- A Pathophysiology-Oriented Imaging Phenotype Framework for Nonobstructive Coronary Artery Disease.Journal of cardiovascular development and disease · 2026Article
- Incremental prognostic value of pericoronary fat attenuation index in diabetic patients with non-obstructive coronary artery disease.BMC medical imaging · 2026Article
- Degree of hypertension and subclinical coronary atherosclerosis in asymptomatic individuals without cardiovascular disease.PloS one · 2026Article
- Association between serum uric acid and high-risk plaques assessed by coronary CT angiography.Open heart · 2025Article
- Longitudinal Effects of Lipid-Lowering Treatment on High-Risk Plaque Features and Pericoronary Adipose Tissue Attenuation Using Serial Coronary Computed Tomography.Diagnostics (Basel, Switzerland) · 2025Article
- Current Advancements in the Diagnosis and Management of Mild-to-moderate Coronary Stenosis.Reviews in cardiovascular medicine · 2025Review
- The role of chest pain symptoms in predicting coronary artery disease severity and MACE events in patients with zero CAC: a study from a large CCTA cohort.The international journal of cardiovascular imaging · 2025Article
- Development and validation of a novel nomogram to predict coronary artery calcification: a single center study.European journal of medical research · 2025Article
- Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study.Scientific reports · 2025Observational
- Composite cardiac computed tomography angiography score for improved risk assessment in chronic coronary syndromes.Scientific reports · 2025Article
- Whys and Wherefores of Coronary Arterial Positive Remodeling.Arteriosclerosis, thrombosis, and vascular biology · 2024Review
- Charting the Unseen: How Non-Invasive Imaging Could Redefine Cardiovascular Prevention.Journal of cardiovascular development and disease · 2024Review
- Computed Tomography Angiography Identified High-Risk Coronary Plaques: From Diagnosis to Prognosis and Future Management.Diagnostics (Basel, Switzerland) · 2024Review
- Global trans-lesional computed tomography-derived fractional flow reserve gradient is associated with clinical outcomes in diabetic patients with non-obstructive coronary artery disease.Cardiovascular diabetology · 2023Article
- Comparison of prognostic value between CAD-RADS 1.0 and CAD-RADS 2.0 evaluated by convolutional neural networks based CCTA.Heliyon · 2023Article
- What makes a plaque rupture? A simple answer seems too much to ask for.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Predicting High-Risk Plaques in Familial Hypercholesterolemia Using Clinical Variables and Coronary Artery Calcium.JACC. Advances · 2022Article
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13 authors.
Funding
Abstract
objectivesThe purpose of this study was to develop a risk prediction model for patients with nonobstructive CAD.
backgroundAmong stable chest pain patients, most cardiovascular (CV) events occur in those with nonobstructive coronary artery disease (CAD). Thus, developing tailored risk prediction approaches in this group of patients, including CV risk factors and CAD characteristics, is needed.
methodsIn PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) computed tomographic angiography patients, a core laboratory assessed prevalence of CAD (nonobstructive 1% to 49% left main or 1% to 69% stenosis any coronary artery), degree of stenosis (minimal: 1% to 29%; mild: 30% to 49%; or moderate: 50% to 69%), high-risk plaque (HRP) features (positive remodeling, low-attenuation plaque, and napkin-ring sign), segment involvement score (SIS), and coronary artery calcium (CAC). The primary end point was an adjudicated composite of unstable angina pectoris, nonfatal myocardial infarction, and death. Cox regression analysis determined independent predictors in nonobstructive CAD.
resultsOf 2,890 patients (age 61.7 years, 46% women) with any CAD, 90.4% (n = 2,614) had nonobstructive CAD (mean age 61.6 yrs, 46% women, atherosclerotic cardiovascular disease [ASCVD] risk 16.2%). Composite events were independently predicted by ASCVD risk (hazard ratio [HR]: 1.03; p = 0.001), degree of stenosis (30% to 69%; HR: 1.91; p = 0.011), and presence of ≥2 HRP features (HR: 2.40; p = 0.008). Addition of ≥2 HRP features to: 1) ASCVD and CAC; 2) ASCVD and SIS; or 3) ASCVD and degree of stenosis resulted in a statistically significant improvement in model fit (p = 0.0036; p = 0.0176; and p = 0.0318; respectively). Patients with ASCVD ≥7.5%, any HRP, and mild/moderate stenosis had significantly higher event rates than those who did not meet those criteria (3.0% vs. 6.2%; p = 0.007).
conclusionsAdvanced coronary plaque features have incremental value over total plaque burden for the discrimination of clinical events in low-risk stable chest pain patients with nonobstructive CAD. This may be a first step to improve prevention in this cohort with the highest absolute risk for CV events.
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