ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Coronary plaque burden and composition in an ESC guideline-selected outpatient CCTA cohort: age- and sex-specific percentile distributions.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
aimsCoronary computed tomography angiography (CCTA) as first-line diagnostic tool for suspected coronary artery disease (CAD) offers detailed assessment of coronary plaque, yet data on non-calcified components remain limited. This study aims to analyze total coronary plaque burden as well as non-calcified plaque characteristics in an ESC-guideline-selected cohort and to establish age- and sex-specific percentile distributions and benchmark values for quantitative plaque assessment.
methodsAll patients undergoing CCTA for a clinical indication at a German outpatient institution between July 2017 and June 2020 were included. Plaque analysis using validated semi-automated software was performed on all coronary arteries; plaque burden was measured with differentiation among total, calcified, non-calcified, and low-attenuation components.
resultsOf 5412 patients, coronary plaques were present in 67.1% of patients, with obstructive CAD in 29.3%. For example, the 50th, 75th, and 90th percentile values for total coronary plaque burden were 28.8 mm
conclusionsThis study provides novel insights into the prevalence and distribution of coronary plaque burden in a large outpatient cohort undergoing CCTA according to current ESC guideline recommendations. The presented age- and sex-specific percentile distributions provide benchmark values for quantitative plaque assessment in a real-world CCTA population and may facilitate standardized reporting and future outcome-based investigations of coronary plaque burden and composition.
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