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• W3111272473 abstract "In this issue of the journal, Pérez de Isla and colleagues [ [1] Perez de Isla L. Alonso R. Gomez J. Muniz-Grijalvo O. Diaz-Diaz J. Zambon D. et al. Coronary plaque burden, plaque characterization and their prognostic implications in familial hypercholesterolemia. A computed tomographic angiography study. Atherosclerosis. 2020; (in press) Abstract Full Text Full Text PDF Scopus (2) Google Scholar ] report on 259 asymptomatic patients with genetically diagnosed familial hypercholesterolemia (FH) submitted to coronary computed tomography angiography (CCTA). They performed a quantitative assessment of coronary plaque burden and composition in all patients and followed them for an average of 3.9 years after the initial scan. The results should be considered in the context of the current cardiovascular risk assessment approaches. Despite advances in the diagnostic work-up and both pharmacologic and invasive treatment of coronary artery disease (CAD), acute coronary syndromes (ACS), sudden death and progressive heart failure are still the leading causes of morbidity and mortality in the Western world [ [2] Virani S.S. Alonso A. Benjamin E.J. Bittencourt M.S. Callaway C.W. Carson A.P. et al. Heart disease and stroke statistics-2020 update: a report from the American heart association. Circulation. 2020; 141 (03): e139-596 Crossref PubMed Scopus (2600) Google Scholar ]. Cardiac computed tomography angiography (CCTA) is a unique diagnostic tool that provides non-invasive visualization of moving coronary arteries with isotropic submillimeter spatial and high temporal resolution. In contrast to all other non-invasive diagnostic techniques, CCTA provides not only an opportunity to diagnose obstructive CAD but also a direct assessment of the atherosclerotic plaque burden and plaque composition that can be differentiated into calcified and non-calcified or low-attenuation non-obstructive plaques. Low attenuation plaques, along with other high-risk features, such as spotty calcification, positive remodeling, or the napkin-ring sign [ [3] Puchner S.B. Mayrhofer T. Park J. Lu M.T. Liu T. Maurovich-Horvat P. et al. Differences in the association of total versus local coronary artery calcium with acute coronary syndrome and culprit lesions in patients with acute chest pain: the coronary calcium paradox. Atherosclerosis. 2018; 274: 251-257 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar ], have the potential to improve patients’ risk stratification independent of stenosis severity [ [4] Chang H.-J. Lin F.Y. Lee S.-E. Andreini D. Bax J. Cademartiri F. et al. Coronary atherosclerotic precursors of acute coronary syndromes. J. Am. Coll. Cardiol. 2018; 71 (05): 2511-2522 Crossref PubMed Scopus (174) Google Scholar ]. In a recent publication, low-attenuation plaque burden was associated with a 5-fold higher risk for subsequent ACS, clearly surpassing the prognostic value of stenosis severity [ [5] Williams Michelle C. Jacek Kwiecinski Mhairi Doris Priscilla McElhinney D'Souza Michelle S. Sebastien Cadet et al. Low-attenuation noncalcified plaque on coronary computed tomography angiography predicts myocardial infarction. Circulation. 2020; 141 (May 5): 1452-1462 Crossref PubMed Scopus (106) Google Scholar ]. Coronary plaque burden, plaque characterization and their prognostic implications in familial hypercholesterolemia: A computed tomographic angiography studyAtherosclerosisVol. 317PreviewHeterozygous familial hypercholesterolemia (FH) is associated with premature atherosclerotic cardiovascular disease. Semi-automated plaque characterization (SAPC) by coronary computed tomographic angiography (CTA) provides information regarding coronary plaque burden and plaque characterization. Our aim was to quantify and characterize the coronary plaque burden of patients with FH using SAPC analysis and to identify which factors are related to plaque burden and plaque characteristics. A second aim was to analyse the prognostic implications of these parameters. Full-Text PDF" @default.
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• W3111272473 title "Coronary computed tomography angiography in asymptomatic patients: Still a taboo or precision medicine?" @default.
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• W3111272473 doi "https://doi.org/10.1016/j.atherosclerosis.2020.12.001" @default.
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