Predictive value of the coronary artery calcium score and advanced plaque characteristics: Post hoc analysis of the PREDICT registry

It is still unclear whether coronary plaque characteristics assessed in coronary computed tomography angiography (CCTA) in association with the coronary artery calcium score (CACS) have predictive value for coronary events. To clarify this hypothesis, we studied 2083 suspected coronary artery disease patients in this PREDICT post hoc analysis. High-risk plaque was independently predictive in the lower CACS classes (<100) but it was not independent in the high CACS class (≥100). This study shows that assessment of adverse features by coronary plaque imaging independently predicts coronary events in patients with suspected CAD and a low CACS. Our findings suggest that the clinical value of high-risk plaques to CACS and stenosis assessment appears marginal.Image 1