Emerging Role of Coronary Computed Tomography Angiography in Lipid-Lowering Therapy: a Bridge to Image-Guided Personalized Medicine

Toru Miyoshi, Kazuhiro Osawa, Keishi Ichikawa, Kazuki Suruga, Takashi Miki, Masashi Yoshida, Koji Nakagawa, Hironobu Toda, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Itoh

Research output: Contribution to journalReview article

Abstract

Purpose of Review: 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 Findings: 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. Summary: 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.

Original languageEnglish
Article number72
JournalCurrent Cardiology Reports
Volume21
Issue number8
DOIs
Publication statusPublished - Aug 1 2019

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Precision Medicine
Lipids
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Therapeutics
Acute Coronary Syndrome
Coronary Artery Disease
Biomarkers
Guidelines
Computed Tomography Angiography

Keywords

  • Atherosclerosis
  • Coronary artery disease
  • Coronary computed tomography angiography
  • Lipid
  • Plaque
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Emerging Role of Coronary Computed Tomography Angiography in Lipid-Lowering Therapy: a Bridge to Image-Guided Personalized Medicine",
abstract = "Purpose of Review: 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 Findings: 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. Summary: 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.",
keywords = "Atherosclerosis, Coronary artery disease, Coronary computed tomography angiography, Lipid, Plaque, Statin",
author = "Toru Miyoshi and Kazuhiro Osawa and Keishi Ichikawa and Kazuki Suruga and Takashi Miki and Masashi Yoshida and Koji Nakagawa and Hironobu Toda and Kazufumi Nakamura and Hiroshi Morita and Hiroshi Itoh",
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T2 - a Bridge to Image-Guided Personalized Medicine

AU - Miyoshi, Toru

AU - Osawa, Kazuhiro

AU - Ichikawa, Keishi

AU - Suruga, Kazuki

AU - Miki, Takashi

AU - Yoshida, Masashi

AU - Nakagawa, Koji

AU - Toda, Hironobu

AU - Nakamura, Kazufumi

AU - Morita, Hiroshi

AU - Itoh, Hiroshi

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose of Review: 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 Findings: 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. Summary: 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.

AB - Purpose of Review: 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 Findings: 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. Summary: 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.

KW - Atherosclerosis

KW - Coronary artery disease

KW - Coronary computed tomography angiography

KW - Lipid

KW - Plaque

KW - Statin

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