Heart, Vessels and Transplantation · Published 2026-05-13 · DOI 10.24969/hvt.2026.650
Saeda Mohamed Abd Elwahab, Ashraf Alamir Abdelfattah, Wafaa Ahmed Abdelwahab, Ghada Mohamed Abd ElRazik, Ahmed G. Bakry
Objective: Coronary plaque morphology is a key determinant of atherosclerotic risk. While stenosis severity remains central to diagnosis, plaque composition and its interplay with clinical risk factors may provide complementary insights for patient stratification. This study aimed to evaluate the association between coronary plaque characteristics, traditional cardiovascular risk factors, and stenosis severity in patients undergoing multidetector computed tomography coronary imaging (MDCT). Methods: In this cross-sectional study, 51 patients with suspected coronary artery disease (CAD) underwent MDCT at Qena University (SVU) Hospitals, followed by conventional coronary angiography (CCA). Plaques were categorized as calcified, non-calcified, or mixed. Clinical data included age, sex, diabetes, hypertension, smoking, and dyslipidemia were recorded. Stenosis severity was graded according to the CAD–Reporting and Data System (CAD-RADS). Associations were analyzed using Chi-square tests, correlation, and multivariable logistic regression. Results: Non-calcified plaques were most prevalent (56.3%), followed by mixed plaques (25%) and calcified plaques (18.8%). Diabetes and smoking correlated with the presence of non-calcified and mixed plaques (p<0.05), while calcified plaques predominated in hypertensive and older patients. In regression analysis, diabetes (OR 2.85, 95% CI 1.1–7.2) and smoking (OR 2.40, 95% CI 1.0–6.1) independently were associated with high-risk plaque phenotypes. MDCT showed excellent diagnostic performance for detection of significant CAD using CCA as gold standard with accuracy of 78.4% , sensitivity - 74.3%, specificity - 87.5%, positive predictive values - 92.9 %, and negative predictive value -60.9 %. Conclusion MDCT revealed relationships between risk factors and plaque morphology. Diabetes and smoking were linked to vulnerable plaque types, while age and hypertension were associated with calcified lesions. Integrating plaque composition into CT-based evaluation may improve risk stratification beyond stenosis grading.
Abstract from DOAJ. Public domain (CC0 1.0).
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Elwahab, S., Abdelfattah, A., Abdelwahab, W., et al. (2026). Coronary plaque characteristics on CT Angiography: Associations with risk factors and stenosis burden. Heart, Vessels and Transplantation. https://doi.org/10.24969/hvt.2026.650