Serial Coronary CTA for Monitoring Response to Lipid-Lowering Therapy: A Narrative Review.

IF 5.2 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Atherosclerosis Reports Pub Date : 2025-10-06 DOI:10.1007/s11883-025-01354-3

Malek Nayfeh, Maria Alwan, Mouaz H Al-Mallah, Mahmoud Al Rifai

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引用次数: 0

Abstract

Purpose of the review: This review summarizes current evidence on the use of serial coronary computed tomography angiography (CCTA) to monitor the effects of lipid-lowering therapies (LLTs)-including statins, PCSK9 inhibitors, and icosapent ethyl-on coronary plaque regression.

Recent findings: Serial CCTA enables detailed anatomic assessment of plaque characteristics including luminal stenosis, total plaque volume, calcified plaque, non-calcified plaque, and high-risk plaque features. Functional imaging with Fractional Flow Reserve from Computed Tomography and inflammatory assessment via perivascular fat attenuation index and pericoronary adipose tissue improve disease characterization. Together, these complementary tools provide a comprehensive evaluation of both the structural and biological aspects of coronary atherosclerosis, enhancing risk stratification and monitoring of therapeutic response to LLT. Serial CCTA is a valuable noninvasive tool for monitoring the effects of LLTs on coronary plaque progression aiding in risk stratification. However, wider clinical adoption is limited by cost, radiation exposure, contrast-related risks, and technical challenges in some patient populations.

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连续冠状动脉CTA监测对降脂治疗的反应：叙述性回顾。

本综述的目的：本综述总结了目前使用连续冠状动脉计算机断层扫描血管造影（CCTA）监测降脂疗法（LLTs）的证据，包括他汀类药物、PCSK9抑制剂和二羟戊二烯对冠状动脉斑块消退的影响。近期发现：连续CCTA可以对斑块特征进行详细的解剖评估，包括管腔狭窄、斑块总体积、钙化斑块、非钙化斑块和高危斑块特征。计算机断层扫描分数血流储备的功能成像和血管周围脂肪衰减指数和冠状动脉周围脂肪组织的炎症评估改善了疾病的特征。总之，这些互补的工具提供了冠状动脉粥样硬化的结构和生物学方面的全面评估，加强了风险分层和对LLT治疗反应的监测。连续CCTA是一种有价值的无创工具，用于监测llt对冠状动脉斑块进展的影响，有助于风险分层。然而，在一些患者群体中，更广泛的临床应用受到成本、辐射暴露、对比剂相关风险和技术挑战的限制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.