Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review

Coronary artery disease (CAD) is the most common cause of mortality among adults worldwide. In the prognostic risk stratification of these patients, crucial determinants are lumen stenosis, total volume and composition of the plaque. Considering that most of the myocardial infarctions are due to non...

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Main Authors: Gloria Santangelo, Elisa Gherbesi, Luca Donisi, Andrea Faggiano, Luca Bergamaschi, Carmine Pizzi, Stefano Carugo, Massimiliano Ruscica, Pompilio Faggiano
Format: Article
Language:English
Published: Termedia Publishing House 2024-06-01
Series:Archives of Medical Science
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Online Access:https://www.archivesofmedicalscience.com/Imaging-approaches-in-risk-stratification-of-patients-with-coronary-artery-disease,188808,0,2.html
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author Gloria Santangelo
Elisa Gherbesi
Luca Donisi
Andrea Faggiano
Luca Bergamaschi
Carmine Pizzi
Stefano Carugo
Massimiliano Ruscica
Pompilio Faggiano
author_facet Gloria Santangelo
Elisa Gherbesi
Luca Donisi
Andrea Faggiano
Luca Bergamaschi
Carmine Pizzi
Stefano Carugo
Massimiliano Ruscica
Pompilio Faggiano
author_sort Gloria Santangelo
collection DOAJ
description Coronary artery disease (CAD) is the most common cause of mortality among adults worldwide. In the prognostic risk stratification of these patients, crucial determinants are lumen stenosis, total volume and composition of the plaque. Considering that most of the myocardial infarctions are due to non-obstructive plaques or are associated with high-risk features, plaque composition can serve as an independent predictor of cardiac outcomes. Conversely, although there is a close relationship between ischemia and CAD severity, the assessment of the degree of ischemia, as a surrogate marker of the coronary plaque burden, remains a controversial issue. Thus, aim of this narrative review is to discuss the usefulness of the imaging methodologies to differentiate the ischemia vs the plaque burden in clinical practice. New diagnostic tools to evaluate the extent of the atheromatous coronary artery could help in tailoring a personalized therapeutic approach.
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record_format Article
series Archives of Medical Science
spelling doaj-art-518e968787b444069bae7cfda8ca6c3e2025-08-20T02:31:34ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512024-06-01211163110.5114/aoms/188808188808Imaging approaches in risk stratification of patients with coronary artery disease: a narrative reviewGloria Santangelo0Elisa Gherbesi1Luca Donisi2Andrea Faggiano3Luca Bergamaschi4Carmine Pizzi5Stefano Carugo6Massimiliano Ruscica7https://orcid.org/0000-0002-0195-7061Pompilio Faggiano8Department of Cardio-Thoracic-Vascular Diseases, IRCCS Foundation Ca’ Granda Hospital Maggiore Polyclinic, Milan, ItalyDepartment of Cardio-Thoracic-Vascular Diseases, IRCCS Foundation Ca’ Granda Hospital Maggiore Polyclinic, Milan, ItalyDepartment of Cardio-Thoracic-Vascular Diseases, IRCCS Foundation Ca’ Granda Hospital Maggiore Polyclinic, Milan, ItalyDepartment of Cardio-Thoracic-Vascular Diseases, IRCCS Foundation Ca’ Granda Hospital Maggiore Polyclinic, Milan, ItalyCardiology Unit, IRCCS University Hospital of Bologna, Bologna, ItalyCardiology Unit, IRCCS University Hospital of Bologna, Bologna, ItalyDepartment of Cardio-Thoracic-Vascular Diseases, IRCCS Foundation Ca’ Granda Hospital Maggiore Polyclinic, Milan, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyPoliambulance Foundation, Department of Cardiothoracic, Brescia, ItalyCoronary artery disease (CAD) is the most common cause of mortality among adults worldwide. In the prognostic risk stratification of these patients, crucial determinants are lumen stenosis, total volume and composition of the plaque. Considering that most of the myocardial infarctions are due to non-obstructive plaques or are associated with high-risk features, plaque composition can serve as an independent predictor of cardiac outcomes. Conversely, although there is a close relationship between ischemia and CAD severity, the assessment of the degree of ischemia, as a surrogate marker of the coronary plaque burden, remains a controversial issue. Thus, aim of this narrative review is to discuss the usefulness of the imaging methodologies to differentiate the ischemia vs the plaque burden in clinical practice. New diagnostic tools to evaluate the extent of the atheromatous coronary artery could help in tailoring a personalized therapeutic approach.https://www.archivesofmedicalscience.com/Imaging-approaches-in-risk-stratification-of-patients-with-coronary-artery-disease,188808,0,2.htmlcoronary artery diseaseatherosclerotic burdenplaquemyocardialischemiamultimodality imaging
spellingShingle Gloria Santangelo
Elisa Gherbesi
Luca Donisi
Andrea Faggiano
Luca Bergamaschi
Carmine Pizzi
Stefano Carugo
Massimiliano Ruscica
Pompilio Faggiano
Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review
Archives of Medical Science
coronary artery disease
atherosclerotic burden
plaque
myocardial
ischemia
multimodality imaging
title Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review
title_full Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review
title_fullStr Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review
title_full_unstemmed Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review
title_short Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review
title_sort imaging approaches in risk stratification of patients with coronary artery disease a narrative review
topic coronary artery disease
atherosclerotic burden
plaque
myocardial
ischemia
multimodality imaging
url https://www.archivesofmedicalscience.com/Imaging-approaches-in-risk-stratification-of-patients-with-coronary-artery-disease,188808,0,2.html
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