Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
Department of Cardiology, Japanese Red Cross Okayama Hospital, Okayama, Japan.
Curr Cardiol Rep. 2019 Jun 21;21(8):72. doi: 10.1007/s11886-019-1170-4.
To summarize the current status of coronary computed tomography angiography (CTA) in the assessment of coronary plaques and discuss the ability of serial coronary CTA to quantitatively measure changes in the plaque burden in response to lipid-lowering therapy.
Recent advances in coronary CTA have allowed identification of high-risk coronary features in acute coronary syndrome and measurement of changes in the coronary plaque burden with good reproducibility. Statin therapy may delay plaque progression and change some plaque features. However, the clinical relevance of quantitative changes in coronary plaques and the optimal methods to reduce the plaque burden remain unclear. Despite guideline-directed lipid-lowering therapy, adverse events still occur in substantial numbers of patients receiving statins. Coronary CTA is noninvasive and has high diagnostic performance in patients with coronary artery disease, making change in the plaque burden an applicable biomarker for individualized assessment of future risk.
总结目前冠状动脉 CT 血管造影（CTA）在评估冠状动脉斑块方面的应用现状，并讨论系列冠状动脉 CTA 定量测量降脂治疗后斑块负荷变化的能力。
冠状动脉 CTA 的最新进展使人们能够识别急性冠脉综合征中的高危冠状动脉特征，并能够很好地重复测量冠状动脉斑块负荷的变化。他汀类药物治疗可能会延缓斑块进展并改变一些斑块特征。然而，冠状动脉斑块定量变化的临床意义以及降低斑块负荷的最佳方法尚不清楚。尽管进行了指南指导的降脂治疗，但仍有大量接受他汀类药物治疗的患者发生不良事件。冠状动脉 CTA 是一种非侵入性的检查方法，在冠心病患者中有较高的诊断性能，因此斑块负荷的变化是一种适用于评估未来风险的个体化生物标志物。
