The clinical value of quantitative analysis of CCTA plaques in evaluating high-risk plaques and their progression in el-derly patients with coronary heart disease

ZHOU Aiqi; WU Na; YANG Xuesong; LI Jianhua; YANG Liuqing

doi:10.20258/j.cnki.1006-9011.2025.01.010

Abstract：Objective To explore the role of quantitative analysis of coronary computed tomography angiography(CCTA)plaques in evaluating high-risk plaques and their progression in elderly patients with coronary heart disease.Methods A retro-spective analysis was conducted on the clinical data of 985 patients with coronary heart disease admitted to our hospital.All pa-tients had completed CCTA examination,and the detection of high-risk plaques was counted.According to whether high-risk plaques were found,they were divided into high-risk group and non-high risk group,and the quantitative analysis results of CCTA plaques were compared between the two groups.All patients were followed up for 1 year and divided into a progressive group and a non-progressive group based on whether their plaques had progressed.The quantitative analysis results of CCTA plaques were compared between the two groups.Results After CCTA examination,it was found that there were 352 patients in high-risk group and 633 patients in non-high risk group.The proportion of patients with calcified plaques detected in the high-risk group was higher than that in the non-high risk group(P<0.05).There was no statistically significant difference in param-eters,such as total plaque volume(TPV),total plaque volume burst(TPB),calcified plaque volume(CPV),and coronary ste-nosis rate between the two groups(P>0.05).The fibrotic plaque volume(FPV)of the high-risk group was higher than that of the non-high risk group(P<0.05).After CCTA examination,it was found that there were 184 patients in the progression group and 801 patients in the non-progression group.The proportion of patients with calcified plaques detected in the progression group was higher than that in the non-progression group(P<0.05).There was no statistically significant difference in CPV between the two groups(P>0.05).The parameters of TPV,TPB,FPV,and coronary stenosis rate in the high-risk group were higher than those in the non high-risk group(P<0.05).The sensitivity of quantitative analysis of CCTA plaques for predicting the progression of high-risk plaques was 88.59%(163/184),the specificity was 96.75%(775/801),the accuracy was 95.23%(938/985),and the Youden index was 0.853.Conclusion The quantitative analysis of CCTA plaques can assist in the clinical identification of high-risk plaques,and has good evaluation value for plaque progression.It can be used for the determination of plaque properties and disease assessment in patients with coronary heart disease.