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The Quantification of Total Coronary Atheroma Burden – A Major Step Forward

Published Online: December 23rd 2020 Heart International. 2020;14(2):Online ahead of journal publication
Authors: Jean-Marc Foult, Shruthi Pranesh, Matthew J Budoff
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Article Information

The extent of coronary artery disease has actually been shown to be an important indicator of prognosis. Cardiac CT has the ability to measure plaque, with both coronary artery calcium (CAC) scanning and computed tomographic angiography (CTA) to measure total atheroma burden. Beyond assessing stenosis and atherosclerosis, CT angiography can assess the high-risk plaque. These plaques are thought to be consistent with plaques that are vulnerable, more likely to rupture and cause acute coronary syndromes. However, the high-risk plaque concept suffers from poor reproducibility and poor positive predictive power. Total coronary artery burden has been shown to be a better predictor of coronary events than high risk plaques or stenosis. This paper reviews the literature in this regard and demonstrates total coronary atheroma burden to be the best predictor of future cardiovascular disease.


Coronary atherosclerosis, CT angiography, plaque, outcomes, coronary artery disease, CT angiography


**This manuscript has been accepted for publication, but may be subject to minor changes during the production process.**

Article Information:

Jean-Marc Foult, Shruthi Pranesh, Matthew J. Budoff have no financial or non-financial relationships or activities to declare in relation to this article.

Compliance With Ethics

All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions. Informed consent was received from the patient involved in this case study.

Review Process

Double-blind peer review


All named authors meet the criteria of the International Committee of Medical Journal Editors for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval for the version to be published.


Matthew Budoff MD 1124 W Carson Street, Torrance CA 90502 USA E: mbudoff@lundquist.org


No funding was received in the publication of this article.

Open Access

This article is freely accessible at touchCARDIO.com © Touch Medical Media 2020



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